Doctor Psychobabble

So, I am dreadfully tired right now. I did have an awesome day at the hospital, and I learned so very much. But I finally heard back from a friend today, who I hadn’t heard from in a very long time. I wasn’t sure why she had not been responding to me for so very long. It turns out that she had felt neglected that I hadn’t been in contact with her, and had not been able to spend time with her during my week off from med school rotations back in April. It turns out that the reason that I had not been able to see her was because that was the week that I was terribly sick AND moving into my new apartment. In fact, that whole week was a blur because of cold medications. And it was followed by six weeks of LONG hours in pediatrics.

My point is that med school/residency/being a doctor can suck for some reasons. The biggest one that I can think of right now is that we never really know our schedules. Even when we think we do, they can change at the drop of a hat. We might have to stay late unexpectedly, or be called in to take care of things. And this can be very hard for our friends and family (and particularly our non-medical friends and family) to understand. To them, it feels like neglect. And I totally understand that.

I’m sort of ranting right now in a very fatigued state. But the point is that I feel much regret that I hurt my friend. But I feel even more regret to lose one of the best friends that I’ve ever had.

What is it about medical school and residency that prevents one from eating? Please excuse my incoherence at the moment. Except for a Cliff bar (yay, that I had one), I have not eaten all day long. Today was tiring. I’m starving. Literally almost toppling over. I am about to make some dinner, move the car, walk the dogs, feed the dogs, etc. etc. I had an awesome day. But I am so tired. And so. friggin. hungry!

Photo: Taken on my delirious walk home from the hospital.

Please check out my latest post on “The Ink Blot” at Medscape/WebMD. I ramble a lot about how much I enjoy what I do to make money in life!

Click Here to View the Original Post on Medscape

I just got home from a 15-hour day, including call in the psych ER. I’m way too tired and hungry to write much. But the gist of the evening was that I evaluated an adolescent in the ER. It took us 6 hours to do the eval and eventually discharge the patient. I have only worked with adults in psych for my entire career and throughout med school. I learned tonight that I have a lot to learn about child/adolescent psych! Family dynamics are complicated. Family therapy is challenging. I feel drained from dealing with all that is adolescent defiance and rebellion (more on that soon!). But yes, I did learn, and that is a good thing! Time to eat and wash the grunge from my body!

Part of My “Trash Talkin” Photo Series

• Vital Signs – Patterns – A Thin White Line Among Doctors? – NYTimes.com
  (tags: interesting)
• A Record Number of Drugs Are Being Tested to Treat Mental Illness – Prescriptions Blog – NYTimes.com
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• Doctor and Patient – Letting Patients Read Their Doctors’ Notes – NYTimes.com
  (tags: interesting)
• Why Do We Like What We Like? : NPR
  (tags: interesting)

I have about 8 billion things that I could talk about right now. But (as always, lately) I’m completely fatigued. I had high points today, I had low points. But the 1-cent story? I love my job. I love psychiatry. I love being challenged on a daily, hourly, minutely, secondly basis (excuse my poetic license). I’m sure this is because of a combination of factors, but I know that one of the prominent ones is because I tend to enjoy life, in general, and because I’m one lucky gal, who is incredibly blessed to be able live out her dreams. I am so very content. I promise to write more stimulating stuff, soon. In the meantime, please enjoy this photo of the “bubble man stand” a few yards from my apartment. Unfortunately, my iPhone failed to capture the bubbles, which continually flow into the air surrounding the stand. Also, my sushi order was just now delivered to my front door. It’s chow time! I heart NYC!

Part of My “Yo Brooklyn, Fuhgeddaboudit” Photo Series

Please check out my latest post on “The Ink Blot” at Medscape/WebMD. I’m posting this right now in an extremely fatigued state. I have no promises with regards to comprehension!

Click Here to View the Original Post on Medscape

It’s 11:00 p.m. I just got home from “short call” at the psych ER. I spent 15 hours total at the hospital today. I’m pooped, but the espresso I drank a few hours ago is still flowing through my veins (perhaps that was a bad idea). I have so many thoughts brewing in my head right now. I learned so much today. Here are a few things off the top of my head:

1. Nurses can be mistrustful and doubtful of your ability to make decisions as a doctor, especially as an intern (but rightfully so!). I have to get used to this.

2. I have yet to get “used” to admitting patients involuntarily, especially when I know how much it can upset them.

3. It’s amazing what people will tell you, once you introduce yourself as “Dr. so and so.”

4. Psychiatry is the coolest field in the universe.

5. Defensive medicine sucks sometimes, but it is a necessary evil in today’s world of malpractice.

6. I shouldn’t drink a double espresso within 5 hours of having to go to sleep.

I have to get up in about 6 hours. I should really be sleeping right now. But it’s time to walk the doggies, and shower, and attempt to cleanse the caffeine and excitement from my body. Nitey, world!

Photo: Scopers post-drinking from the “human” water fountain at the park.

Today was my first call in the CPEP (Comprehensive Psychiatric Emergency Program). I left this morning at 7:15 a.m., and I just now got home, and it’s close to 10:00 p.m. I’m pooped to the max, but incredibly exhilarated by my first “call” in a psychiatric emergency room as a doctor. I learned so much today and had so many interesting experiences, but let me list just a few:

1. I learned again that my experience as a psych tech is oh so valuable. We had several “codes” called. I interacted with several aggressive, hostile, angry and threatening patients. Yet I managed to stay calm, and not be hurt. (And I think that my years of experience helps me with my countertransference…more on that soon.)

2. I “committed” my first patient. Well, to be specific, I admitted my patient to the hospital involuntarily (against their will). Of course, my attending also signed the paper, but I completed it and was the physician in charge of the case.

3. I am starting to remember what working long hours in psychiatry (and specifically, emergency psychiatry) can do to you. It’s very difficult to not be affected by the work that you do. And sometimes you start to feel a little crazy yourself. It’s challenging to explain, but it does something to your psyche to work with acutely psychotic patients for long periods of time.

4. I learned that as a psychiatric intern, my opinion matters, but it’s not the final word. I evaluated a patient and deemed them okay for discharge. But my attending (who has MUCH more experience than I) decided that my patient needed to be admitted. So we did so.

5. The ethical/legal/moral decisions, issues, and questions in psychiatry are endless and always at the forefront. I encountered approximately 8 billion of them today. It is very tricky work, indeed.

It’s now time for me to relax and perhaps have a bubble bath. I definitely think I earned it.

Photo: Part of My “Trash Talkin” Photo Series

Today was a long, but wonderful day. If you’ve been keeping up with my posts, you might be ever so slightly annoyed by my continual love of my psychiatry residency. But I really just can’t help it. It’s soooooo very, very awesome. I love what I do. I love taking care of my patients. I love all of the great didactics and learning experiences. I love being a doctor. So far, I have only made one small mistake involving drawing labs on a patient that weren’t 100% necessary. But I’m sure that I will have many more mistakes to come. And I’m learning how to accept this. I also now have a medical student that I’m responsible for. I thought this would be scary, but it turns out that I love to teach! I even have a new title: “Clinical Assistant Professor.” How cool is that? I like working hard. I don’t mind working long hours, when I feel like I’m making a difference. And the best part? I GET PAID to do this! That’s really the icing on the cake at this point.

Tomorrow, I go in for my first 12 hour call in the CPEP (Comprehensive Psychiatric Emergency Program), which is basically a psychiatric ER. I will have many more calls to come. I love my job. I love residency. It’s actually a little crazy, because I thought that at this point in my training, I’d be overwhelmed and tired. But it turns out that I’m just happy and content and tired. So far, at least. We shall see how it progresses. But for the time being, I’m happy to work hard for my money. And truly love what I’m doing!

Photo: At the laundromat!