Monday, October 01, 2007

Return to Psychiatry

If I thought ENT was a step back in time, psychiatry is worse. Don't get me wrong, I loved psychiatry as a med student, but here I'm not even supposed to talk to the patients. My whole experience is to "shadow" a psychiatrist, basically pretending I am a hole in the wall. So clinic was pretty boring this morning, with the only bright spot occurring when I stood behind the front desk looking out. On the back of the desk is a row of photos of people who have made credible death threats against staff in this psychiatry group, along with a short description of last known whereabouts and any other useful bits of information. One guy had the terse line "an FBI investigation is ongoing" beneath his description.

Next month, when I return to the wards, I don't think I'll complain too much about COPD exacerbation patients. At least none of them have ever tried to kill me.

This is a pretty informal rotation, so I ditched the clinic in the afternoon. I joined up with the Consult-Liaison team instead, and had a much better time. C/L psych is something I could enjoy, plus the specialists in it seem to be the sarcastic, screwball humor, polymath types that I enjoy so much in any specialty. We didn't have too many patients, so the attending launched into an impromptu discussion of paraphilias, which is apparently his research interest. Think Doctor George Huang from Law and Order: SVU, only an older white guy and you've got a pretty good idea what this doctor is like. Both entertaining and informative.

He reminded me, at first, why I thought psych was so cool, but after a while he began to remind me why I couldn't end up doing it. Psychiatry can be pretty creepy, and while some of the discussion was interesting, after a while, frank discussion of deviancy gets old, and then painful to discuss. I have been relieved before when a lecturer (usually a pulmonologist) ended a talk, but the end here was a very different sort of relief. That's more of an "awakening from sleep" relief. This was more a "coming out of a haunted house" relief. We'll see tomorrow what a full day in the haunted house is like.

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