I'm crazy, not stupid
One of the things that I had to get used to in psych was not carrying my stethoscope. I don't even bother to do a physical exam most days - actually one of my friends on psych consults told me they are told specifically not to touch the patient.
So not shockingly, when one of my schizophrenic patients was complaining of belly pain, I never did a physical exam. I asked all the proper questions but did not touch the patient. My resident ordered some tests, and not too shockingly, she may have had mild pancreatitis.
Which leads me to the point of my post. I got to go prepare her and talk to her about the Xrays and CT she was going to get which involved a trip to radiology. We discussed the machines and how she would have to hold still. Then I said it.
"Are the voices okay with you having these tests?"
She looked at me like I was crazy. And honestly, was I just appealing to auditory hallucinations that I
know don't exist?
Worse, she laughed and patted me on the head, telling me that it would be fine.
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In mostly unrelated news, I got the stuffing beat out of me in judo today, which proves I am both crazy and stupid.
Silently mad
One of my co-workers on psychiatry and I had a nice talk today. Even more hilarious was my joke about my possibly having ADHD. My co-worker responded with 'I had you pegged in the first five minutes. Even when you couldn't talk, you were still interrupting.'
It was said because I had laryngitis for the first week of my psych rotation and had to 'write' to talk. Do you have any idea how rough it is to not speak for a week, especially when your main job is talking to your patients? While I am now a killer charades player, there isn't an easy why to pantomime 'are you having auditory hallucinations?'
Kudos to my partner Brandon for patiently trying to translate my impatient scribblings on my trusty silence notepad. Who knew doctors and doctors-to-be had terrible handwriting?
Psych is one of those things that is both exciting and disappointing at the same time. It's cool in some ways because your job is to communicate with your patients and try to understand how and what they are thinking. However, during inpatient psych, you also don't feel like you are being a doctor - I'm not even carrying my stethoscope. Physical exam equipment in nonexistent. Heck, I even snuck down to the ER to get a measuring tape. (It's not stealing; it's a redistribution of the hospital resources)
That doesn't even start on the patients. In theory, about 1 in 3 patients have a mental illness, which means that psychiatric disorders are massively under diagnosed. By the time you end up on the psych floor of the hospital, you have be be practically uncontrollably mentally ill. We're talking psychotic, my TV is monitoring my movements, psychotic. There isn't alot counseling and therapy can do for people who are sure the government is putting thoughts in their heads. Your best bet is to medicate them out of their psychotic break and hope that the types of therapy you teach them prevents them from doing this again.
However, the social problems of this all still prevails. For example, what can you expect from a schizophrenic that has never held down a job because the illness disrupts basic functioning? Or that poor manic patient who spent her lifesavings and then some during her last manic episode where she also got fired from her job? A lucky few of the seriously mentally ill will get rehabilitated and rejoin society. The rest of them will be back here on my floor again in a week, a month, a year.
Non resolution
Everyone asks you what your New Year's resolutions are. I've decided that to combat the boring 'lose weight' and so forth ones people make all the time. Instead I am going to list 5 things from the past year that I REFUSE to change.
Allie's 2007 non-resolutions
1. Watching as much medical TV as possible: It's an excellent way to fake study. Really.
Seriously. Also allows you to pick out all the medical inaccuracies - especially on nip/tuck.
2. Keeping my friends in the loop: 2006 was the year my friends came up big and I'm blessed to have them in my life. I've seen Sarah and Rori more often in the past 12 months than I did in the previous 2 years, and my set of Columbus friends have come up big for me.
3. Working out all the time: exercise is one of the best ways to keep life balanced and survive med 3. It's also more awesome when you are strong enough to pin someone at judo. Maybe I'll win that intramural weight lifting contest yet.
4. Decorating my apartment is totally worth it: Some of the best things I did was make my apartment my own. This is the first year I decorated for Christmas, and I'm making decision based on what kind of life I want next year. The value of black out curtains cannot be under-estimated.
5. Making up for unhealthy weeks on the weekend: I was pretty surprise to find out that I could make up most of my nutrients if I ate salads and meals on the weekends and lived on garnola bars during the week. Pretty soon I'll market it my new diet and make enough money to pay off my debt.
Ta-da. That's the way the year ends. Keep on rolling.
