Going into my psychiatry rotation, I wasn’t sure if I was going to like it or not. There was a time in my life where I really thought I wanted to be a psychiatrist, but I have since decided that it probably isn’t for me. Although, after 2 weeks of inpatient psych, I am loving it!
Day one on the ward was a little scary. As I sat in the office in the middle of the ward, one patient waited outside staring at me with a big grin on his face, while another old man with a scary scowl had one big eye open and it was directed right at me. I kept a wide berth between myself and the patients in the hallway. I wasn’t sure if someone was going to attack me or not.
It took a few days for me to get used to psych, but I really fell in love with the patients on the ward. Sure they are all crazy, but at the end of the day they are still patients, and I love spending time with them.
In psychiatry I’ve encountered patients from all ends of the spectrum – schizophrenia, PTSD, depression, anxiety, alcohol and drug abuse, Bipolar Disorder, personality disorders, previous sexual abuse, gender dysphoria, you name it!
My favorite patients are the old men with schizophrenia. They follow me around the halls mumbling nonsense. Sometimes they stop to salute a passerby or to take a drink of water from the air. It really is comical, and you can’t help but laugh and fall in love with them.
My least favorite patients are the ones with personality disorders, such as antisocial or borderline. Antisocial patients can be really, really mean. For instance one of our Antisocial patients was the most unpleasant man I have ever met. Nothing made him happy. He was so ungrateful to everybody he met. Just sitting in the same room with him put me on edge. I never saw him smile. Everything he said was a complaint. I have never been so excited to discharge a patient! Borderline patients are very emotional. They tend to make up stories and have a lot of instability in relationships. I don’t have the patience to sit and listen to them! If it weren’t for these two types of patients, I really think I could do psychiatry.
I now start two weeks of outpatient psych. I don’t think I will like it as much. As I’ve said before, I enjoy inpatient medicine where I can see the same patients every day and really get to know them. But I am looking forward to this experience. I am sure I will see a different side of psychiatry, so that will be interesting.
This rotation really makes me wish I could live several lives. In one I would be a hospitalist, in another a psychiatrist, and in the others I could do all of the other fields of medicine that I will encounter in the next two years. I just love medicine, and there really hasn’t been a specialty I’ve tried yet that I haven’t loved. I wish I could do it all, which probably means Internal Medicine is a good fit for me. I keep reminding myself that there are “Crazies” everywhere, so I’m sure I will still get to work with psychiatric patients as a hospitalist.
*I just wanted to add a few more thoughts after getting some feedback from readers who have struggled with mental illness. I really didn’t mean to offend anyone with this post. Although I find some of my patients “comical,” they still struggle with mental illness, and I didn’t mean to say I was laughing at them. Mental illness really isn’t a laughing matter. Many of our patients had crippling PTSD and almost all of them were homeless, and there really is nothing funny about that.
I started my psychiatry rotation being scared of the patients, but by the end of it I realized that they were just people who were sick like everybody else. I didn’t have to be afraid. In fact all of the psychiatrists I have spoken with said they have never been attacked by a patient. I learned that I didn’t have to be afraid of them; I had to approach them like I approach all of my patients – with love and with empathy.
One thing I did experience during my rotation was how much discrimination psychiatric patients face even within the medical community. We had a patient who was undergoing chemo, and we couldn’t place him into a certain facility strictly because he was a “psych patient,” even though his schizophrenia was well managed, he had no delusions or hallucinations, and he was the sweetest man to everyone he met.
Again, I apologize if I offended anybody!
Psychiatry is one of my favorites, but I really only started enjoying it during my sixth year rotation, so it can take a while. I really struggle with antisocial and borderline personality types too – they make me feel very miserable and angry and I struggle to deal with it appropriately. I suppose it’s one of those things that takes practicing!
Maybe you need to watch a little Dream Team again to help you make up your mind. Who knew that a Chloupek classic might point you in a career direction.
Don’t worry, I already did.