Doctor Psychobabble

• Physician's memoir relates tales of madness in psychiatric emergency room
  (tags: interesting)
• Approach May Matter In Advice On Weight – NYTimes.com
  (tags: interesting)
• The Book Bench: On Dressing Up Your Pets : The New Yorker
  (tags: interesting)
• Nuedexta Approved to Control Pseudobulbar Affect – NYTimes.com
  (tags: interesting)
• Keep Your Fingers Crossed: Can 'Magical Thinking' Actually Work? : The Two-Way : NPR
  (tags: interesting)
• Brain Molecule May Offer Key to Erasing Fearful Memories : Shots – Health News Blog : NPR
  (tags: interesting)

Well, it’s official. I am a senior citizen. It’s October 30th (not technically Halloween but close enough for celebrations). I had the day off today, and I have the day off tomorrow. This is my “golden weekend” for the month of October. I could totally go out tonight dressed up in an awesome costume and party it up all night long without having to wake up early tomorrow. But I just don’t feel like it. Staying home, catching up on emails, and cooking dinner sounds more appealing to me. And Halloween has always been my very favorite holiday. I live for dressing up in costumes (although I also enjoy doing so on many other days in the year).

But this Halloween will be spent at home with my partner named Micah, my brown dog named Molly, and my black and white dog (who has a raging ear infection) named Scope. Cheers!

Photo: Halloween 2003. I’m dressed as Laura Croft and my friend Toshiki is dressed as a pimp. I totally forced him to wear my clothes and flaunted him around all night. T’was his first Halloween in the US of A. Tosh, if you are reading this from Japan, know that I miss you!

Today’s Tally:

Miles walked: 7
Hours spent on subway: 2
Meals eaten: 1.5
Patient’s rounded on: 12
Approximate blood glucose level right now: 25
Photos taken with iPhone: 3
Number of times I had a patient scream at me: 13
Consult patients seen: 1
Number of people encountered with dreadlocks: 42
Total hours spent commuting and working: 17
Number of hours until I have to wake up tomorrow: 5
Dogs to greet me with licks upon arrival home: 2

Living the life of a psychiatry resident: priceless

Part of My “Trash Talkin” Photo Series

“Don’t worry about a thing,
‘Cause every little thing gonna be all right.
Singin’: “Don’t worry about a thing,
‘Cause every little thing gonna be all right!”

- Bob Marley, lyrics from the song, “Three Little Birds”

Today, as I travelled on the Brooklyn A Train to my hospital destination in the dark hours of the morning, I saw a familiar sight. There was a guy, with his long white coat wrapped around his arm, and stethoscope hung purposefully on top. He looked like he was on a mission. Yet, I sensed that something was amiss. I noted the long length of his white coat and determined that he must be a resident, yet something about his demeanor screamed “med student!” Perhaps it was the way he clutched his stethoscope as a child might clutch their teddy bear. I knew something didn’t add up.

The man rode all the way to the last stop on the train with me. He off-boarded the train and made his way through the turnstiles, just a few steps behind me. And then I realized that I continued to hear the sound of his feet hitting the sidewalk behind me as I made my way to the hospital. But I walk fast. Very fast. Yet he pressed on. I could see him in the periphery of my vision.

Finally we arrived at a traffic light, and then he said, “hey, I know you, you are Kendra, I read your blog!” It turns out that this nice man was a medical student at my former medical school. And he even recognized me from my previous website. To make a long story short, I found out that he was starting his very. first. day. as a clinical medical student in ob/gyn, at the same hospital at which I was rotating.

Once I realized that he was a med student, and not a resident, it all kind of made sense. And then I was magically transported back to my first day of surgery. Yes, I’d had a psych rotation prior, but that didn’t really count, especially since I already knew quite a bit about psychiatry. My first day of surgery was actually a night call. It was one of the most memorable nights of my life. Memorable in a bad way. I was lost, confused, floundering. I experienced my first sleepless night in a hospital. I had no idea how to figure out which medications a patient was receiving. The IV lines weaving in and out and around my patients were like an impossible jigsaw puzzle. People screamed things at me. I only knew how to perform a 45-minute physical exam. Not a 2-minute real life exam. I cried in the stairwell at one point and contemplated going home and throwing away my dreams and aspirations of becoming a doctor.

And then I looked into the wide eyes of this freshly minted, virgin clinical medical student and saw myself, 2 years ago. And I realized how far I’ve come in such little time. And I also realized that he was on the brink of what would grow into an immensely challenging, yet rewarding journey. He was standing at the precipice. The same one, which I had teetered on so precariously not so long ago.

And he was wearing the wrong coat.

I realize now that I should have alerted him to this. But I was just so caught up in the moment that it slipped my mind.

So, dear, wonderful med student who I met today. If you read this, I apologize for not brining this to your attention in a kind and understanding way. Hopefully, someone else will do so in a friendly manner.

And although I know that my words can only do so much to soothe your incredibly stressed out and overwhelmed nerves right now.

I just wanna say.

That everything’s gonna be alright.

Photos: On my walk to and from the subway on my journey to and from the hospital.

Part of My “Yo Brooklyn, Fuhgeddaboudit” Photo Series

“The Roots of Violence: Wealth without work, Pleasure without conscience, Knowledge without character, Commerce without morality, Science without humanity, Worship without sacrifice, Politics without principles.”

- Mahatma Ghandhi

I just got home from a long “call” in the CPEP (psych ER). It’s Sunday night. I REALLY miss weekends. I haven’t had a full weekend off in a while, and I really miss having one day a week where I can relax. When you only have one day off a week, it tends to be spent catching up on errands and not actually relaxing. At least that’s how it works for me.

I saw a bunch of patients today. As we were giving our sign-outs tonight to the oncoming shift, I realized the intensity of loss and sadness, which is just an ordinary day in the CPEP. Floridly psychotic patients, a patient whose mother had given up on her and dumped her in the ER, patients with chronic, unremitting substance abuse, a first psychotic break which might just ruin a young man’s opportunities at having a productive life, a child who was born as a “crack baby” and had their life made difficult from birth, an elderly male with such severe tardive dyskinesia that he didn’t want to live anymore, a severely demented man who thought I was his dead wife.

Just another day in the CPEP.

And try as I might, it’s very challenging to see this kind of sadness on a daily basis and not be affected. To not take my work home with me is an impossible task.

But it’s late on a Sunday night and I have to arise early in the morning. And I am grateful for all that I have learned. And all that my patients have taught me. Good night, world!

Photos: From my walk to and from the subway stop on my way to the hospital last week.

Part of My “Yo Brooklyn, Fuhgeddaboudit” Photo Series

• In Tarloff Trial, Both Sides Agree – Lock Him Up – NYTimes.com
  (tags: interesting)
• When Isolation Hampers More Than Bacteria — Doctor and Patient – NYTimes.com
  (tags: interesting)
• Dollars For Docs: Drug Co. Flattery Wins Docs, Influences Prescriptions : NPR
  (tags: interesting)

Please check out my latest post on “The Ink Blot” at Medscape/WebMD to find out my experience in answering this question!

Click Here to View the Original Post on Medscape

This is just too cool for skool.

I have brought back my “2010 Video a Day Project.” Yes, I missed some days here and there. And I decided to turn it into “any kind of 3 second daily pause,” including photos as well. I am trying to upload it somewhere besides Youtube, but I am having some technical difficulties. So enjoy this for the time being!

Today was a great learning experience and very fascinating. I REALLY wish that I did not have to wake up in 6 hours (and I haven’t yet eaten or showered) because I would love nothing more than to share a detailed story of my day and all that I learned.

So, instead, I will give the very brief version. I woke up early and went to my inpatient psychiatric rotation, which involves a 2 hour commute. I did my normal work and then I had to leave at 2:30 p.m. to head back to my residency hospital to do a Consultation Liaison call. Consultation Liaison Psychiatry is really about the intersection of medicine and psychiatry. Basically, we respond to anyone who calls for a “psych consult” in the hospital.

I saw 2 patients, and also worked on an admission. It was interesting because one of my patients was NOT severely mentally ill. She was actually a good historian. I could talk to her and she did not spout nonsensical sentences at me. She was an elderly female with severe acrophobia (fear of heights). Basically the consult was about evaluating her to see if she needed psychiatric medications, etc. Turns out she just needed some psychoeducation and a benzo PRN. I would explain what all of this means, but I haven’t eaten in over 10 hours and I desperately need some sleep.

I do promise to write up the case, however. It was that life-altering. I heart CL psych!

Photo: My “brief” experience on a NYC bus. I still stand by my assertion that I can always get where I need to be in less time than a bus can take me there. Case and point, I walked 2.3 miles to the hospital today for call instead of riding the bus again!