Posts Tagged ‘psychiatry’

Sometimes I wonder how my work in psych is affecting my future work as a physician. One might say that I could simply look at psychiatrists that have been practicing for a couple of years to see how they change, but my role in their care is very different from that of a physician.

I’m the one they curse at when dinner is late. I’m the one holding their hand while a new IV is put in. I’m the one that makes them remove their own clothing and put on a hospital gown when they are admitted. I’m the one who sees the faces of their family members as they enter the locked unit. I’m the one who gets hit. I hear their insistence that they’ve learned their lesson. And I hear the same plea on their next admission.

So yes, my perspective has changed.

One of the best things that has changed about it is the realization that I can’t change people. I can facilitate and support that change, create a good environment within the hospital to further help that change, but ultimately the patient is the only one who can make that change. And my powers are even more limited than that–once they leave the controlled climate of an inpatient unit, I can’t promise that their home environment will be conducive to the change.

I am not one of the bright-eyed students who crumbles at the first “failure.”

But I also see the darker side of people. I am not the innocent person who takes anyone’s words at face value. I listen carefully, I read body language, and I fact check to see if the patient is being truthful before I trust what they tell me. I’m not sure if this is a bad thing or just neutral. On one hand I don’t automatically trust patients, but on the other hand I don’t label it as a lie until I’ve checked into it further.

What else?

I shrink away from a raised hand. I get really nervous when a patient stands in a doorway and I have no way out. I don’t take insults and curses personally. I can calmly listen to a manic rant that rips at my character and continue on with life. I have become a decent mediator. I am unfazed at any display of anger or intimidation. I can stand my ground.

I have great sympathy for the families who are torn by their loved one’s illness. I have sympathy for the patients who don’t get better. Sympathy for the ones who can’t seem to cope with life in non-destructive ways.

And I take great joy in watching someone leave as a different person and hoping (for their health) that we don’t meet again.

I think this experience is good. I will have a different perspective than most physicians. I will know that what they tell me in the 10 min I see them on rounds is not the whole story, I will have an appreciation for the people who spend every hour working with them.

I will realize that sometimes I will fail, but I will take even more joy in the success of a patient because of it.

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