Doctor Psychobabble

“I just realized that I’m cognitively promiscuous.”

- Dr. Psychobabble

Life has been busy but incredibly awesome as of late. Yesterday, I went to see Phantom of the Opera on Broadway with my fellow “psychos.” I realized that I’m not a huge fan of the Phantom, per se, but I am a huge fan of Broadway shows, especially when the tickets are complimentary.

Today was the first day of a new rotation for me. I am still rotating in consultation liaison psychiatry, but I’m at a different hospital, so it’s added a new perspective and spice. I was then on call at another hospital and just arrived home a few minutes ago.

I had a ridiculously silly consult tonight, and would kill to provide the details, but the damn HIPAA prevents me from doing so. What I can say is that it involved a Ouija board and a misunderstanding. I have the funnest job in the entire universe. Seriously. And you could never make up the things I see. They are simply larger than life.

Time to order some sushi and chow down. I realized today that I am not alone in my sushi addiction, and that makes me happy. It’s good to not be alone.

Here is a random list of stuff “learned” today:

1. Trash makes me happy.

2. Cognitive promiscuity makes me happy.

3. I have the best job there is.

4. Just because a hospitalist thinks a patient has decision making capacity doesn’t make it so.

5. I’m not half bad at reading brain MRIs.

6. When the nurses don’t know me at a hospital, they are at first confused as to why some crazy looking chick is walking around asking questions and talking to patients, but they then become excited to know that I’m a doctor and psychiatrist-in-training.

7. I “get” non-verbal communication on a profoundly deep level.

8. Having an easily accessible fridge at work is a good thing.

9. Haldol is a darn amazing medication.

10. Mostly, people just want someone to talk to.

11. I don’t even want to attempt to imagine life without dogs.

Photo: Taken in Times Square last night after enjoying the Phantom.

“No man is so foolish but he may sometimes give another good counsel, and no man so wise that he may not easily err if he takes no other counsel than his own. He that is taught only by himself has a fool for a master.”

- Hunter S. Thompson

Today was rejuvenating. November is officially my dedicated “research month.” What exactly does that mean? Good question. Well, my residency program is actually super cool in that it provides a dedicated month during your PGY-2 year where you pretty much spend the entire month doing research. It’s actually even cooler than it sounds. You get to work with a mentor (mine happens to be awesome) on a research project, which may or may not eventually result in a poster presentation or paper. However, the real “meat” is that although you may not discover the cure to all cancer during your one dedicated month, you end up dabbling in enough research and learning enough to ignite a passion or develop a plan to continue working on research if you so desire. It’s actually a pretty awesome idea, which has served to inspire many residents before me. In addition to working on research this month, I am responsible for supporting our department’s weekly Grand Rounds, and I will be on call every Sunday night. Not a bad deal, at all.

In fact, the only side effect of research month is that there are many days where I don’t actually have to leave my apartment if I don’t want to. I can work on a lot of the research from the comfort of my own home and in my jammies. This is totally awesome, however I realized today that this has an unintended side effect. If I’m not forced to get up at the break of dawn, shower, get dressed, and leave my apartment, it turns out that I don’t. I may get a lot of things accomplished, but I also miss out on “world exploration.” This occurred to me today during my walk to the hospital. I realized that I was quite rejuvenated and excited about walking to work, experiencing the world, and having the opportunity to take photos (see above).

So, today was a great day. Every Thursday, us residents have a dedicated day for didactics. In addition to experiencing some much needed human contact, I learned some cool stuff as well. For example:

1. High Expressed Emotion (EE) can involve emotional over-involvement by family members who blame themselves for a family member’s mental illness, and this can have a negative effect on the patient.

2. Treatment fidelity has to do with how accurately or faithfully a program (or intervention) is reproduced from a manual, protocol or model.

3. Antisocial Personality Disorder is considered the “grandfather” of personality disorders in that it was the first personality disorder to be identified in the DSM.

I’ve been attempting to save moulah and cook dinner for the past week. But tonight is time for celebration and hence time to order sushi (I’m very good at rationalizing). So, this is me signing off. Time to take counsel from the uncooked fishies…

Part of My “Yo Brooklyn, Fuhgeddaboudit” Photo Series

“Night time is really the best time to work. All the ideas are there to be yours because everyone else is asleep.”

- Catherine O’Hara

It’s 9 a.m. I am finally home, post-call. 25.5 hours worked. About 3 crappy hours slept. Brain only minimally functional.

Ramblings of Stuff Learned:

1) I love working nights. There’s something magical about working while most of the world (in my time zone) sleeps.

2) I absolutely abhor the appearance of crocs. But I’m not gonna lie, they are awesome for overnight calls.

3) The nursing drive-bys (hey, this patient vomited…what’s your name doc?) suck. No, not all nurses do this. And yes, I totally understand why they do it. But it still can suck for the docs.

4) Getting paged for absolutely mundane, non-emergent (hey doc, this patient’s tylenol PRN expired…no, they don’t need any tylenol right now, but can you renew it?) issues at 3 a.m. sucks.

5) Always assume that the call room will be 20 degrees colder than you think, and bring extra blankets in advance to compensate.

6) Having the ability/knowledge to work up a complicated medical scenario is awesome. But not being able to figure out how to work the call room bed is not.

7) Not eating for 18 hours sucks. But being so busy that you don’t even notice your hunger makes it better.

8 ) Always, ALWAYS make sure you prepare before your shift. I usually do. But last night as soon as I walked in the door, I had 8 million things to do and consults waiting. I didn’t have time to stuff my pockets with goodies like chapstick and cash. That was not cool.

9) Patients who need their blood drawn at 4 a.m. and happen to have awesome veins should get awards.

10) If I had to do it all over again, I would. The good and the bad.

Time to shower/eat/figure out where my brain is/sleep.

Good night/morning, world!

Photos: All taken on my shift tonight. 1) The sign outside my call room. 2) 2 am shot taken outside on my way to the bodega. 3) My feets.

Please check out my latest post on “The Ink Blot” at Medscape/WebMD to read about my lessons learned from Hurricane Irene.

Click Here to View the Original Post on Medscape

“Put your heart, mind, intellect and soul even to your smallest acts. This is the secret of success.”

- Swami Sivananda

Today was an absolutely awesome day. I started work at 8:00 a.m. this morning and am just now getting home at 11:00 p.m. I learned a lot today. I did a lot today. I am incredibly hungry but wanted to bust out a few thoughts before chow down. Random stuff learned/done/observed today:

1. It is VERY difficult to not be happy while listening to Bill Withers “Ain’t no Sunshine” and walking to work at the same time.

2. While I sometimes feel like I know nothing as a PGY-2 resident, it turns out that I actually know a helluvalot.

3. My community is my extended family.

4. Having the time to read brings me much pleasure.

5. Cyproheptadine is an amazing drug.

6. Working makes me happy.

7. My job as a consultation-liason psychiatrist is frequently giving what I call “luvins” to the patients. Sometimes a consult from an ER doc that “the patient wants to sign out AMA!” simply means that the patient needs someone to vent to, and someone who will actually listen.

8. Happiness for me means sweating, bleeding, and facing my fears (see title of this post).

9. What most people consider “bizarre” may be fairly commonplace for me.

10. I may have a leftover addiction.

Time to eat!

Photos: 1) My doggies in what I refer to as the “drunk tank.” I went for a run in the POURING rain yesterday and my doggies were soaked. They benefit from “wetness” isolation precautions. 2) My doggy Molly this morning. I found her in my bathtub. I have absolutely no idea why she was there.

Part of My “Doggy Doos” Photo Collection

Please check out my latest post on “The Ink Blot” at Medscape/WebMD to read my survival guide for interns.

Click Here to View the Original Post on Medscape

Just got home from a 14-hour day on call at the hospital. It’s Saturday night. I have to go in to work again tomorrow at 7 a.m. Am waaaaaaaaaaaay too tired to write anything exciting.

One thing I found interesting from today is sign out. As I was on call, the day folks all signed out to me and then tonight, I signed out everything to the night float team. I am reminded of the game “telephone” where one person says something to another person and then they say that to the next person, and so on….and by the end of the line the original blurb is incomprehensibly changed.

Same thing can happen with sign outs.

Lesson learned from today. Making your patients laugh is one of the most important therapies that exist. Seriously.

It’s leftover sushi time. Buenas noches!!!

Photo: Taken on my walk to the hospital today.

Part of My “Trash Talkin” Photo Series

“Many is a word that only leaves you guessin’,
Guessin’ ’bout a thing you really ought to know.
You really ought to know.
I really ought to know.”

- Led Zeppelin, “Over the Hills and Far Away”

Just got home from being on call all day long in medicine. Saw a lot. Did a lot. Some stuff learned/observed:

1. It’s somewhat ironic that I still have a bad cough and keep admitting patients with HIV, rule out tuberculosis.

2. Sometimes being a good doctor means recognizing important signs/symptoms. Sometimes it means coming up with a good treatment plan. Sometimes it means stealing sandwiches from the refrigerator for them.

3. A good medical student is an intern’s best friend.

4. Sometimes humor is seriously the best medicine.

5. Antimicrobacterial hand gel really hurts when you have a papercut on your hand.

6. Never believe everything a patient says. Never dismiss anything a patient says.

7. Caffeine is an intern’s best friend.

8. Psychiatric patients are the best, I don’t care what other docs say.

9. When in a pinch, a latex glove on a stethoscope can be a good idea.

10. Patients appreciate when you check in on them more than you need to.

11. Vaseline shouldn’t be so difficult to obtain in a hospital.

It’s dinner, shower, and sleep time!

Photos: Taken on my walk to the hospital today. Discarded sofas make me happy.

Part of My “Trash Talkin” Photo Series

I just got home from a 15-hour on-call day at the hospital. I’m tired and hungry but wired and inspired.

Rather than attempt to say something deep, smart, profound or witty, I will share a few random “stuff learned” from my long day.

1. I really do enjoy working. It fills me with a sense of purpose.

2. You can be the best nurse/doctor/etc. at putting in an NG tube, but if you lack the finesse to get the patient to agree to the procedure, you’re not really all that good at it.

3. I’m fairly good at guesstimating a patient’s weight.

4. Dick head doctors are real dick heads.

5. I will continually have to justify turning down a ride home from my colleagues. They just can’t comprehend why I would ever prefer to walk instead.

6. I like showing up early.

7. I may never be a master at starting IV lines, and I am okay with that.

8. Telling a patient they have cancer or that their foot must be amputated is not fun, but makes me a better/stronger person.

9. I don’t want to die in a hospital.

10. I love my job.

I have to wake up in 6 hours to be at the hospital again tomorrow. Time to eat and shower. Good night world!

Photos: 1) Taken from the window of the hospital. 2) Taken on my walk home tonight.

Part of My “Yo Brooklyn, Fuhgeddaboudit” Photo Series

Please check out my latest post on “The Ink Blot” at Medscape/WebMD to read my thoughts on asking patients questions.

Click Here to View the Original Post on Medscape