Doctor Psychobabble

“Walk into splintered sunlight
Inch your way through dead dreams
to another land
Maybe you’re tired and broken
Your tongue is twisted
with words half spoken
and thoughts unclear
What do you want me to do
to do for you to see you through
A box of rain will ease the pain
and love will see you through”

- Lyrics from “Box of Rain” by The Grateful Dead

I just got home from a 16-hour day at the hospital. Adolescent boys galore.

Highlights from the day:

1. I made the decision to stay on the adolescent boys unit for another month. More on that to come soon. But the staff on my unit did seem pleased.

2. A nurse on another unit saying to me, “are you an emergency psychiatrist?” based solely on her impression of me from minimal interaction (and no emergency). That’s cool.

3. Getting accosted by a crowd of Hasidic Jews with sticks. (Lulavs are cool!)

4. Letting a kid beat me in spades as a form of therapy (no, but seriously, I could have won!)

5. Walking home in the rain. Not because I have to. Because I want to.

6. Egg and cheese with tomato on whole wheat toast sandwiches from cart guys who say to me, “hey doc, the usual?”

7. A wonderfully sweet mentally retarded (intellectually challenged) patient identifying me as “the nicest nurse.”

8. Diagnosing cellulitis.

9. Fist bumping.

10. Words half spoken.

Photo: Taken on my walk home from the hospital in the rain.

Part of My “Yo Brooklyn, Fuhgeddaboudit” Photo Series

“The definition of insanity is doing the same thing over and over and expecting different results.”

- Benjamin Franklin

I just arrived home from another marathon day at the hospital on the inpatient adolescent boys psychiatric unit. I have every reason not to be typing right now, yet the comfort and release I attain from blogging is not rivaled by much else, so here we are.

I did not eat today, save for a banana stuffed into my face for “breakfast.” There simply was no time for it. Every moment of my day is occupied by my patients.

I was originally supposed to switch to the inpatient adolescent girls unit next month. However, as there will be no resident to replace me next month on the boys unit, and because the boys unit has been entirely busier than the girls, I received a request to stick it out and continue on the boys unit next month.

I have a million reasons not to do so. The paramount one being that I currently have no life outside of the hospital and I potentially would have one if I transferred to the girls unit.

However, I feel somewhat compelled to continue caring for my “boys.” In addition, I am familiar/get along with all of the staff on this unit. I am so tired that learning a brand new routine and set of staff seems like a huge task at this point.

I would have opportunities to work with girls in the future, if I so desired. (This is me convincing myself.)

Anyway, I will make the official decision by Friday. We shall see how it works out…

I have not eaten real food in over 24 hours, and I can’t begin to describe my hunger right now, so it’s time to Grubhub some sushi and wash the sweat from my fatigued body.

I hope you enjoy the photos with this post, all taken on my walk to the hospital yesterday. My obsession with “trash” aka discarded items continues….

Part of My “Trash Talkin” Photo Series

“They usually call death row the Last Mile, but we called ours the Green Mile, because the floor was the color of faded limes. We had the electric chair then. Old Sparky, we called it. I’ve lived a lot of years, Ellie, but 1935 takes the prize. That was the year I had the worst urinary infection of my life. That was also the year of John Coffey and the two dead girls.”

- Quote by Paul Edgecomb, from “The Green Mile”

I am tired. In lieu of words, please enjoy this photo taken on my walk to the hospital today and the accompanying quote.

Part of My “Trash Talkin” Photo Series

• Suicide Draws Attention to Gay Bullying – NYTimes.com
• How One Small Group Sets Doctors' Pay – NYTimes.com
• Optimism, but Not Too Much, Can Be Good For You – NYTimes.com
• You're Only as Old as You Run – NYTimes.com
• American Goat Cheese: From Hippie Chick To Hip And Chic : The Salt : NPR
• Therapists Are ‘Seeing’ Patients Online – NYTimes.com

Please check out my latest post on “The Ink Blot” at Medscape/WebMD to read my poem about working on the adolescent boys psychiatry unit. (Ok, so maybe I cheated and recycled and modified the poem I wrote last Friday.)

Click Here to View the Original Post on Medscape

Years ago, I lost one of my best friends to suicide. Since then, I have been an avid supporter of the American Foundation for Suicide Prevention. I will be walking to support the foundation next month. Please see the details below for more information.

I will be joining with thousands of people nationwide to walk in AFSP’s New York City Walk to benefit the American Foundation for Suicide Prevention. I would appreciate any support that you give me for this worthwhile cause.

Donating online is safe and easy! To make an online donation please go here, and click the “Support This Participant” button on the page.

“Insanity is relative. It depends on who has who locked in what cage.”

- Ray Bradbury

“If we weren’t all crazy, we would go insane.”

- Jimmy Buffett

I just got home from a 13-hour day at the hospital. Words truly fall dreadfully short in their capacity to describe my day today, and how I feel right now.

However, I am oddly compelled to express my thoughts. So I shall attempt to do so in a quasi-poem format:

“13 Hours”

Thirteen hours of madness
Fluctuating sadness
Antipsychotics lubricate
Food deprivation permeates
Murder, abuse and horror
Latex gloves are no barrier
We say irritability
You claim normalcy
Marijuana and sharpie fumes
Fear trapped inside unlocked rooms
Warm food from uncles in paper bags
Scribbles on prescription pads
Soft restraints
Physical complaints
Feces in bags thrown at us
Examine this mental status
Aggression flowers
In 13 hours

I need food, STAT. My job inspires me in strange ways…

“Strange days have found us
And through their strange hours
We linger alone
Bodies confused
Memories misused
As we run from the day
To a strange night of stone”

- Lyrics to “Strange Days” by the Doors

It’s 9:00 p.m. I just got home from a very looooooong day at the hospital.

As I was leaving the unit (adolescent boys inpatient psychiatry), I had a sort of mind-bending experience. I was chatting with some of the boys and discussing the latest in iPhone technology, and it suddenly occurred to me how very strange my job is.

I have put in very long hours at the hospital for the past few weeks. I arrive on the unit around 7:00 a.m. and rarely leave before 9:00 p.m. I take no breaks. I rarely eat, save for a protein bar or “egg and cheese with tomato on a roll” from the cart man outside the hospital shoved into my face while writing orders. I basically live and breathe teenage boys with A LOT of emotional turmoil, behavioral disturbances, social problems, etc., etc.

It’s a crazy, strange, mixed-up world.

From the moment I arrive on the unit to the moment I leave, I’m so busy putting out fires that I rarely have time to breathe. Or think.

And now that I’m home, I’m too tired to think. Or write.

Bodies confused.

Memories misused.

This is my brain retiring. G’night world!

Quote: Dedicated to Jon!
Photos: Taken on my walk home from the hospital yesterday. 1) “The Doors.” 2) “Flatbush Corp.”

Part of My “Trash Talkin” Photo Series

Part of My “Yo Fuhgeddaboudit” Photo Series

“You told me, “I’ve seen it all before
I’ve been there, I’ve seen my hopes and dreams
A-lying on the ground
I’ve seen the sky just begin to fall”
He said, “All things pass into the night”
And I said, “Oh no sir, I must say you’re wrong
I must disagree, oh no sir, I must say you’re wrong
Won’t you listen to me?”

Goodbye horses, I’m flying over you
Goodbye horses, I’m flying over you”

- Lyrics to “Goodbye Horses” by Q Lazzarus

It’s 8:00 p.m. I just got home from a 12+ hour at the hospital. I am tired. Yes, I am.

Over the weekend, what started as a mild sore throat evolved into a rip-roaring cold, with lots of accompanying nasal congestion and a cough.

Over the weekend and throughout my day today I have had cold-induced dissociative experiences. I have seen time lapsed versions of reality, and I have had out of body experiences.

I had every intention of sucking it up and going for a run today after work (studies show that unless you are very ill, mild to moderate exercise is actually beneficial), but by the time I got home just now, all motivation to run had been removed from my body.

My work on the inpatient adolescent boys psychiatry unit continues to be challenging.

Thought for the day: when it comes to treating kids in psychiatry, treating the family is usually just as (if not more) important, and is frequently entirely more challenging.

Part of My “Trash Talkin” Photo Series

• “Have You Seen a Therapist Yourself?” | Psychology Today
• Sharing the Stresses of Being a Doctor – NYTimes.com
• Laughter Produces Endorphins, Study Finds – NYTimes.com