I am having problems finding the motivation to write blogs. When I get home from work, I want to lay down and go to sleep (waking up at 4:45am is killing me, even though I am off of work earlier).
Yesterday, I had one of those experiences that sort of make doing what I do (and what I'm probably going to do, in one form or another, for the rest of my life) worth doing.
What's interesting is that this all coincided with me fully realizing and verbalizing earlier yesterday morning how I really do not like psychiatry all that much. I mean, this is what I deal with a large portion of the days, most days of the week: drug seeking, drug addiction, and drug detox. After a while, this really wears on a person and really can jade you. A large portion of patients coming to see you are simply hoping that they can fool you into believing that they need to be prescribed a controlled substance (and this isn't just in psychiatry, it's in all medicine). And then it is easy to assume that whoever is coming to see you is very possibly not coming because they have a problem (aside from addiction), but because they just want to get high... or make some money selling whatever drug it is they're looking for. This is a disservice to everyone really; the doctor because he/she is wasting his/her time on a patient who doesn't need help when they could be treating someone who does; other patients because they have to wait and sometimes aren't able to be seen promptly because available slots are filled with drug seekers; plus there are many other things I'd rather not get into right now...
My main point at this time is that when I am able to see a patient that genuinely needs help for an illness, it is refreshing and rewarding.
This lady comes into the office for an initial psychiatric visit. She's about 30 years old, pleasant, animated, and she seems very excitable. Within a few minutes of talking to her, I learn that she has bipolar disorder, rheumatoid arthritis, and some other less notable problems. She came to the office because she was on lithium, a mood stablizing drug for bipolar, which interacts with many of the medications used for the treatment of her arthritis. And when I say interacts, I mean that it can cause lithium, a highly toxic drug, to reach high, more toxic levels that can kill people. This poor lady learned this the hard way when she was put on an anti-inflammatory for arthritis, which caused her a couple weeks in the hospital due to the reaction. So she basically wanted to be taken off lithium and put on another drug so she could be treated for her arthritis.
Anyway, to continue with the story, my job during this rotation is to take detailed histories of patients so that the doctor can better treat their condition with a better understanding of what's going on in a person's life. So I just start asking her the questions. I quickly learn that she's had a hard life (not that lots of people don't), and she, more than anything, just wants to talk to someone about it and have her pain validated.
To begin, when she was six years old, she watched her father get shot in the head by her own grandfather. She told me how she laid down on the kitchen floor next to his body after witnessing the tragedy. Her father was only 26 years old. After the death of her father, her mother became physically violent with her and her sister, beating them with various objects, sticking their hands in metal fans (she showed me her scars). When she was 8 years old, her Uncle began sexually molesting her, which he did until she was 12 years old. She stopped the molestation herself by stabbing her Uncle. He went to jail for 2 years and has been out ever since. Just 3 years ago, she watched her sister's trailor go up in flames. No one knew that her sister was still inside. Her sister was only 20 years old. Since then she has taken custody of her nephew, who she considers her child.
While she was telling me her story, she went from laughing, to tears, then back to laughter. She told me how her children are all star athletes, how she has been married to her husband since she was 16 and they still have a wonderful marriage. After all that has happened to her, she still always tried to look towards the happiness in her life. She was strong, but she knew she needed someone's help.
She is one of the most incredible people I have met in my year of working at all these various clinics and hospitals. I felt like we had formed a bond in a matter of an hour, that I will never be able to forget. When she was finally able to go in to see the doctor, she made sure that I came in there with her. She had told me that just being able to talk to me about it was worth the trip.
It was a connection. Something that was able to make all the nonsense that I deal with all day worth it. It sounds corny, but its times like these that make every doubt about when I will be doing for the rest of my life go away.
There is a 99% chance that I will never see her again. But I will never forget her, and I know that I will always wonder hows she doing and whether she got the help that she needed. And honestly, it just makes me feel like maybe I made a difference in her life, and that she won't forget me either.
And now that I finished my mushy outpouring of emotion and sentiment. I find that I'm feeling quite taxed, and perhaps second guessing my publishing of this entry. But I will anyway, I spent too much time writing it to let it go to waste.
Cheers.
Tuesday, March 30, 2010
Friday, March 12, 2010
The Proof is in the Pudding
We all can breathe a great sigh of relief. My Family Medicine test has been effectively passed. Not only that... but I incredibly almost got a 'B' on it (and I still might if the extra points go through). So while it may seem to some that a 'C' isn't so great of an accomplishment, I am infinitely proud of myself. These tests are hard, and it basically comes down to the fact that I passed (with seven points to spare), and more importantly, I don't have to retake it.
More good news of the week? My Pediatrics test, which I originally failed by 2 questions (I had a 68%) has gotten 3 points added to it, which pushes me into passing. Here is another testament to the difficulty of these tests... my 68% was indeed the highest grade on this particular test at this particular time. So... could that insinuate that the test is flawed? I will not comment, while I am still in the position to feel the wrath of the powers that be.
Anyway, now that I have tried to convince you guys that I have an intellectual deficit...
Psychiatry!
My first day was yesterday. The psych unit at the hospital has 60 beds. There are three units: A Unit, B Unit, and the Adolescent Unit (one of the units is designated for "old people," but I have forgotten which one). When I go in there, I get lost. It's like a huge circle of interconnecting hallways, offices, patient rooms. Not only that, almost every step you take, you hit a locked door that you need a special key for, which I don't have (a fact that will resurface later). I become completely disoriented, so I hope I will never be left alone in there. It is a maze.
SO. Yesterday was my first day. Patient rounds start at 7:00am with my doctor. It is at this time that all the patients are in various steps of rousing from sleep. Some are walking the halls in their open hospital robes, some are fully dressed and conversing with nurses at the nurses station. Others are still in bed. However, as I walk in, some of the most lively patients are already in their lobby/activity room. And as I stand at the nurses station, eerie piano music floats out of the lobby. The notes are slow, out of tune, and remind you of some sort of horror movie. The music weaves in with the low murmur of voices and tv/radios from the lobby. If I hadn't been among a group of people, I may had become frightened and not completely sure that I wasn't in some slasher flick. It was odd.
Moving on, most of the patients here aren't "psychotic," although some are. This one particular lady in a wheelchair was wheeling around telling us how God said she didn't need medicine and that the nurses were all demons, sent from the devil himself. "Praise Jesus, I'm healed!" she would say to the doctor as he tried to tell her that she needed her medications. Somehow, I he had convinced her to take her medicine by telling her that he was sent from God to make her better with his medicines. She was fairly cooperative after that.
Many of the patients there were admitted for drug problems, suicide attempts, and stuff of that nature. Most of them are frequent fliers... they are discharged and then are back before a month has passed. At this point, there really is not any immensely interesting patient case worth writing about, but there is something funny that happened to me today.
There is this unit called the ER 3, which really is a just a holding unit for psychiatric patients before they are admitted or discharged. Well, I had just been let off work and the doctor had told me to go back to the hospital and talk to the nurses in the holding unit about this new patient that was supposed to be coming in today. Of course, I went down there and entered the keycode and the keypad to get into this unit (if you haven't noticed, people don't like psych patients escaping, so everything is always locked). When you go into the room, you enter the lobby area with about four chairs, a tv, and a security guard. The guard wasn't there. I walked down the hall to the nurses station, and there was no one there either. I looked around and there weren't any patients, so I decide I should probably just leave then since I don't know when anybody is coming back. I walk back down the hall to the lobby and look for the keypad to get back out of the holding cell.
I see no keypad. But I see that characteristic keyhole on the wall that every door in the psych unit has.
I just try opening the door.
Like I suspected, it was locked.
I go back down the hall because I had seen another exit door. It is also locked.
I stand there and think. I return to the nurses station and look for a key. Of course, there is none. It would be irresponsible to leave a key out (and too convenient for me).
So. I stand there. I pace the hall. I keep turning the doorknobs, knowing it is still locked... will ALWAYS be locked. Really, my only option is to sit and hope someone comes back.
I wait by the nurses station for about 10-15 minutes, when I hear the door open down by the lobby. I book it down there to see who's going to rescue me. It is the security guard.
"I'm trapped. I've been locked in here on accident," I say to him, and further explaining how I came to be here. He only looks at me, obviously not in a very good mood.
"You've been locked in here?" he finally says.
"Yes. I thought there was a keypad over here, but there quite obviously is not." I reiterate. It is at this point I realize why he doesn't seem very over zealous to help me out. I mean, how does he know that I'm not a patient who enacted this elaborate plan to escape? He doesn't.
Finally, after scrutinizing me for a little while, he says, "You're lucky that I think I've seen you around here before..."
I am relieved. And I am freed.
I have a feeling this will be an interesting month.
More good news of the week? My Pediatrics test, which I originally failed by 2 questions (I had a 68%) has gotten 3 points added to it, which pushes me into passing. Here is another testament to the difficulty of these tests... my 68% was indeed the highest grade on this particular test at this particular time. So... could that insinuate that the test is flawed? I will not comment, while I am still in the position to feel the wrath of the powers that be.
Anyway, now that I have tried to convince you guys that I have an intellectual deficit...
Psychiatry!
My first day was yesterday. The psych unit at the hospital has 60 beds. There are three units: A Unit, B Unit, and the Adolescent Unit (one of the units is designated for "old people," but I have forgotten which one). When I go in there, I get lost. It's like a huge circle of interconnecting hallways, offices, patient rooms. Not only that, almost every step you take, you hit a locked door that you need a special key for, which I don't have (a fact that will resurface later). I become completely disoriented, so I hope I will never be left alone in there. It is a maze.
SO. Yesterday was my first day. Patient rounds start at 7:00am with my doctor. It is at this time that all the patients are in various steps of rousing from sleep. Some are walking the halls in their open hospital robes, some are fully dressed and conversing with nurses at the nurses station. Others are still in bed. However, as I walk in, some of the most lively patients are already in their lobby/activity room. And as I stand at the nurses station, eerie piano music floats out of the lobby. The notes are slow, out of tune, and remind you of some sort of horror movie. The music weaves in with the low murmur of voices and tv/radios from the lobby. If I hadn't been among a group of people, I may had become frightened and not completely sure that I wasn't in some slasher flick. It was odd.
Moving on, most of the patients here aren't "psychotic," although some are. This one particular lady in a wheelchair was wheeling around telling us how God said she didn't need medicine and that the nurses were all demons, sent from the devil himself. "Praise Jesus, I'm healed!" she would say to the doctor as he tried to tell her that she needed her medications. Somehow, I he had convinced her to take her medicine by telling her that he was sent from God to make her better with his medicines. She was fairly cooperative after that.
Many of the patients there were admitted for drug problems, suicide attempts, and stuff of that nature. Most of them are frequent fliers... they are discharged and then are back before a month has passed. At this point, there really is not any immensely interesting patient case worth writing about, but there is something funny that happened to me today.
There is this unit called the ER 3, which really is a just a holding unit for psychiatric patients before they are admitted or discharged. Well, I had just been let off work and the doctor had told me to go back to the hospital and talk to the nurses in the holding unit about this new patient that was supposed to be coming in today. Of course, I went down there and entered the keycode and the keypad to get into this unit (if you haven't noticed, people don't like psych patients escaping, so everything is always locked). When you go into the room, you enter the lobby area with about four chairs, a tv, and a security guard. The guard wasn't there. I walked down the hall to the nurses station, and there was no one there either. I looked around and there weren't any patients, so I decide I should probably just leave then since I don't know when anybody is coming back. I walk back down the hall to the lobby and look for the keypad to get back out of the holding cell.
I see no keypad. But I see that characteristic keyhole on the wall that every door in the psych unit has.
I just try opening the door.
Like I suspected, it was locked.
I go back down the hall because I had seen another exit door. It is also locked.
I stand there and think. I return to the nurses station and look for a key. Of course, there is none. It would be irresponsible to leave a key out (and too convenient for me).
So. I stand there. I pace the hall. I keep turning the doorknobs, knowing it is still locked... will ALWAYS be locked. Really, my only option is to sit and hope someone comes back.
I wait by the nurses station for about 10-15 minutes, when I hear the door open down by the lobby. I book it down there to see who's going to rescue me. It is the security guard.
"I'm trapped. I've been locked in here on accident," I say to him, and further explaining how I came to be here. He only looks at me, obviously not in a very good mood.
"You've been locked in here?" he finally says.
"Yes. I thought there was a keypad over here, but there quite obviously is not." I reiterate. It is at this point I realize why he doesn't seem very over zealous to help me out. I mean, how does he know that I'm not a patient who enacted this elaborate plan to escape? He doesn't.
Finally, after scrutinizing me for a little while, he says, "You're lucky that I think I've seen you around here before..."
I am relieved. And I am freed.
I have a feeling this will be an interesting month.
Wednesday, March 10, 2010
New Beginnings...
I have decided to start a blog. The timing interestingly enough corresponds with the beginning of a new rotation for me... Psychiatry. Hopefully, I will have stories that will be interesting enough to share with the rest of humanity.
I have encountered many... unique people in the journey through school so far. Are all of them blog-worthy? Probably not. But they may be blogged anyway, if there is nothing more spellbinding to write.
At this moment, I can think of several things I could continue on with. However, I have a test tomorrow at noon, which (believe it or not) I haven't spent the proper amount of time studying for. While I will not be able to make up for all my lost time in 12 hours, I could begin making amends tonight to the Family Medicine EOR Exam god (who goes by the name of Michael) by trying to freshen up on coronary artery disease with a sprinkle of male erectile dysfunction (a topic I randomly opened my book up to just now).
Well, since I've refreshed my Facebook about twelve times in the past 1 minute, I feel it's time for me to move on and take care of the duties that await me. I have no other excuses.
Good night, and good luck.
I have encountered many... unique people in the journey through school so far. Are all of them blog-worthy? Probably not. But they may be blogged anyway, if there is nothing more spellbinding to write.
At this moment, I can think of several things I could continue on with. However, I have a test tomorrow at noon, which (believe it or not) I haven't spent the proper amount of time studying for. While I will not be able to make up for all my lost time in 12 hours, I could begin making amends tonight to the Family Medicine EOR Exam god (who goes by the name of Michael) by trying to freshen up on coronary artery disease with a sprinkle of male erectile dysfunction (a topic I randomly opened my book up to just now).
Well, since I've refreshed my Facebook about twelve times in the past 1 minute, I feel it's time for me to move on and take care of the duties that await me. I have no other excuses.
Good night, and good luck.
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