If my calling had been psychiatry I would be in poor shape. Not that I don't enjoy the interactions with patients, its purely because I don't understand it. I just don't get it. When I see patients on a daily basis, what's the actual goal of my conversations with them? You can't just ask concrete things like, how's your pain, are you peeing, and how's breast feeding going. Instead you explore their delusions of grandeur or paranoia, you dive into the depths of their feelings of worthlessness depression and terrifying anxiety to see how the neurotransmitters in their brain are being affected by the cocktail of blockers or stimulators that you have them taking. You go up gradually on the anti-psychotics, play around with their sleep medication until they come back in touch with reality as we know it. Of course, those with more training in psychotherapy give cognitive behaviour homework to those with depressive and anxiety disorders, and together we work through coping strategies. But if you're frankly psychotic, if you think you're the queen of England, there is no logical reasoning that can make you believe otherwise. So we tinker with the neurons in their brain.
There are times when I'm intrigued by perceptions of reality and get caught up in the stories. I want to probe into their theories of spirituality and understand their relationships with God. But then I realize they are God and we're not actually talking about the same thing. As a medical student I remember walking through the unit and there was a patient lying on the ping pong table proclaiming that they were the Messiah. Another patient came up to her and said, "are you really God?" To which God responded indignantly, "yes, of course I am!" The reply came with a snort, "well do I ever have a bone to pick with you!"
Last week it was 'Welfare Wednesday' which meant being on call Sunday was incredibly busy. As it was explained to me, you get your check Wednesday, go buy your drug of choice, alcohol, crystal meth, crack, whatever, have your binge which can last two or three days and by the weekend you're in withdrawal and come to hospital with you heart about to stop or thinking Hell's Angels are hunting you down. Now some crazy people can be hilarious, bursting into song and quite comfortable in their role as the queen and its fun to joke about, but when Hell's Angels want you dead the fear is palpable. You see terror in their eyes and you can nearly smell their angst. Then its not funny at all, its terrifying, and all you want to do is convince then that they're safe . . . which you can't do, so you play with their neurons again.
So I am left fascinated by the mind and unable to understand its complexities. Entertained at times and heartbroken the next minute. It seems a lot of time is spent convincing people to take medications that they desperately need with the rest spent convincing people NOT to take drugs that alter their mental state. My mind is hopelessly concrete, and although I am intrigued by the minds of others, my skills lay in more surgical things . . . and catching babies on the happiness ward of course.
2 comments:
When I was in my first year of grad school I was wrestling with whether I wanted to become a a specialist in the Renaissance era or a specialist in the Romantic era. A professor and potential thesis supervisor said to be me it's worthwhile to figure out what area I was more energized by. He explained it is like rubbing sandpaper across the grain of wood. Rub it the right way and you get a smooth, polished piece of art. Rub it the wrong way and you damage the natural beauty.
Somebody's got to catch those babies.
Post a Comment