Today was my last day with my psych attending. Next week he's attending the APA conference. Something strange happened today. I left the ED to go to his office to have him sign off my "passport" (a list of things I am supposed to have done during my psych rotation) and get final feedback from him (so that my eval is not a total surprise). Well, it went fine. He stressed two points: (1) beware of the unconscious and (2) when making decisions affecting a patient, ask yourself "if this patient were my brother or mother or father or daughter, would I make the same decision?" If the answer is yes, you most likely made the right decision, if not, re-evaluate yourself and your plan. After I shook his hand and he parted with his final advice to me as I carry on in the rest of third year, I felt I needed a minute so I went to the ladies room. And that's when the strange thing happened. A few tears fell. I had a little bit of the feeling I have when I meet a priest or an ascetic or sometimes a child that really touches my spirit. I realized that perhaps at that moment, "the spirit stirred within me" because my attending was a different kind of person, a kind of person who often makes you critically examine yourself and puts you in uncomfortable positions. But he is incredibly deep and empathetic. He was absolutely fascinating to watch in his zone, i.e. the role of the psychoanalyst.
Many people (students and residents) can't stand him. He is almost the antithesis of efficiency, he is old-school and he is not easy to please nor to understand. I had many times when I was annoyed and frustrated with him too, but I every day I learned something I couldn't learn from a book from him. He taught me things about myself that I now how to face. How do I deal with my emotions? Where and how do I adopt a "theory of mind" so that I don't get burnt out from medicine or take what patients say to me too personally?
I don't know how to finish this blog properly because my internal conversation is not finished. What does God want me to do now?
Friday, May 21, 2010
Friday, May 7, 2010
The Unconscious and our Spirituality
Since my attending is fascinated with the "unconscious" mind, we spend a lot of time talking about the subject and today we discussed something that really clicked with me. We talked about patients that we hate and what to do with them. The bottom line is that you need to REALIZE and KNOW that you have certain feelings toward people or things. If you are consciously aware of your feelings towards a patient for example then you can CONSCIOUSLY control how you behave towards them. For example, if I know that Mr. Star Trek really annoys me with his manic behaviors and that I hate him for that, I can better moderate my own reactions to him and know how to interact with him in the correct way. If instead I don't acknowledge that I actually cannot stand the man, I don't have control over my actions with him (because unconscious thoughts are by definition uncontrollable) and may do something inappropriate.
The same with sin. If I know my weak spots and what tempts me, I can exercise better self-control. If I don't ever put in time to think about my sinfulness or lusts or desires, I will never be able to control myself because I haven't implanted the idea in my head that I NEED to...and that is dangerous.
The same with sin. If I know my weak spots and what tempts me, I can exercise better self-control. If I don't ever put in time to think about my sinfulness or lusts or desires, I will never be able to control myself because I haven't implanted the idea in my head that I NEED to...and that is dangerous.
War is Hell
This quote was said first by William Sherman (Union general in the Civil War) and again by my attending today after we met Edgar Allen Poe, our patient today who is suffering from terrible PTSD after returning from Iraq a couple years ago. I'm conservative but I believe war is hell. The world is not our home. How could we regard the world our home when it is such a dark place? We live in the world but the world is not our home.
Today Edgar Allen Poe cried in front of us as he remembered the day he lost two friends with him while they were driving in a HumVee. "Why not me?" "Why didn't I die?" His thoughts went back and forth saying how he thought about this a lot and talking about how much he missed his daughter and wife. Tears continued to stream much like they had been flowing yesterday while talking to his wife. "I just have so much on my mind...that's why I just end up doping myself so that I can block these thoughts," he was referring to his opiate use.
The psych unit is a sad place for so many reasons. War is hell. You don't just go serve your duty abroad for one year and come back. You come back different and for some people, they suffer for the rest of their life. I see a little of the hell they experienced in the eyes of our warriors. While we live so comfortably, our warriors bear the sacrifice of mental and physical suffering.
Today Edgar Allen Poe cried in front of us as he remembered the day he lost two friends with him while they were driving in a HumVee. "Why not me?" "Why didn't I die?" His thoughts went back and forth saying how he thought about this a lot and talking about how much he missed his daughter and wife. Tears continued to stream much like they had been flowing yesterday while talking to his wife. "I just have so much on my mind...that's why I just end up doping myself so that I can block these thoughts," he was referring to his opiate use.
The psych unit is a sad place for so many reasons. War is hell. You don't just go serve your duty abroad for one year and come back. You come back different and for some people, they suffer for the rest of their life. I see a little of the hell they experienced in the eyes of our warriors. While we live so comfortably, our warriors bear the sacrifice of mental and physical suffering.
Tuesday, May 4, 2010
First Day on the Psych Ward
So it's been a long time since I last blogged and I blame that on Boards. I don't have much to say about the boards process except that my most recent memory before boards was palm sunday apparently and that my life after that is a big blank because things that will remain unspoken happened in the time between then and my vacation to the uk/egypt.
Anyways, on to important matters--like our subconscious. My attending, an eclectic psychiatrist, asked me on the first day of my first rotation as a 3rd year med student if I believed I had a subconscious. Actually, I had no idea what one was--I thought maybe it's kind of like Freud's superego if that was really Freud and if the term really is superego. You see--a student studying for Boards learns to recognize words, associations and patterns. Deep psychological theory is not on the Exam. But anyways, I answered in the affirmative because it seemed like the right answer and feared he would ask me to defend my answer. He didn't and just responded, "Good."
This article talks about a few studies done to understand the role of the subconscious and going by my first day with psych patients today, I do believe I gave the right answer. The subconscious uses subliminal messages in the environment to guide our minds to think in a certain way. Today, I was walking from a lecture to the acute care psych ward I work at. I have a two really "scary" patients. They are criminals. They beat their wives. They are addicted to the strongest of drugs. They rob drug dealers (and all that comes with that task). They're on probation in multiple areas. Additionally, they are covered in tattoos, have needle marks up their arms bilaterally and are branded. I'm the type of person that walks into CVS and makes sure I look everyone up and down as they pass me to make sure they are not "suspicious" looking or get enough information about them so that if something were to happen, I'd have something to offer the cops. I am also super anxious when I'm around people that don't fit my well-kempt, polite and high-class standards. But today, this was different. I felt fine, even safe, being in a room with these people. Maybe it was because I was wearing a white coat and they were wearing hospital uniforms. Maybe it was because they were the ones who were a bit scared. I went to two patients to get them to do a mental exercise for me and they were relieved when I told them they were done after a couple minutes (all they had to do was draw a clockface with the time I told them)---they thought it was some "trick" on them or something that would "catch" them and require them to face consequences. Maybe it was because on paper, people that look really terrible, are simply very broken people. And when you realize that you don't have to be afraid. I guess what I'm trying to say is that I really love my patients. My first patients on my first day as a third year have already proved to be great teachers.
Anyways, on to important matters--like our subconscious. My attending, an eclectic psychiatrist, asked me on the first day of my first rotation as a 3rd year med student if I believed I had a subconscious. Actually, I had no idea what one was--I thought maybe it's kind of like Freud's superego if that was really Freud and if the term really is superego. You see--a student studying for Boards learns to recognize words, associations and patterns. Deep psychological theory is not on the Exam. But anyways, I answered in the affirmative because it seemed like the right answer and feared he would ask me to defend my answer. He didn't and just responded, "Good."
This article talks about a few studies done to understand the role of the subconscious and going by my first day with psych patients today, I do believe I gave the right answer. The subconscious uses subliminal messages in the environment to guide our minds to think in a certain way. Today, I was walking from a lecture to the acute care psych ward I work at. I have a two really "scary" patients. They are criminals. They beat their wives. They are addicted to the strongest of drugs. They rob drug dealers (and all that comes with that task). They're on probation in multiple areas. Additionally, they are covered in tattoos, have needle marks up their arms bilaterally and are branded. I'm the type of person that walks into CVS and makes sure I look everyone up and down as they pass me to make sure they are not "suspicious" looking or get enough information about them so that if something were to happen, I'd have something to offer the cops. I am also super anxious when I'm around people that don't fit my well-kempt, polite and high-class standards. But today, this was different. I felt fine, even safe, being in a room with these people. Maybe it was because I was wearing a white coat and they were wearing hospital uniforms. Maybe it was because they were the ones who were a bit scared. I went to two patients to get them to do a mental exercise for me and they were relieved when I told them they were done after a couple minutes (all they had to do was draw a clockface with the time I told them)---they thought it was some "trick" on them or something that would "catch" them and require them to face consequences. Maybe it was because on paper, people that look really terrible, are simply very broken people. And when you realize that you don't have to be afraid. I guess what I'm trying to say is that I really love my patients. My first patients on my first day as a third year have already proved to be great teachers.
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