Saturday, July 30, 2005

Indentured Servitude

Also known as, Residency.

Today is my first 24-hour call for psychiatry. And my first weekend call. It's been interesting. I have certainly been learning a lot: we've covered some consult patients (tell other services about their crazy patients), we sent someone to our other psych hospital (tell the patient that she's crazy)--against her will (take away the rights of the crazy person)--and we've answered some calls about outpatients (help soothe crazy people). Meanwhile I have been hanging out with the nurses (we are all crazy people here).

It's been interesting, although I have really started to hate the sound of my pager.

I have spent the last month on our geriatric psych unit, which is actually the only psych floor in the main hospital. It's a unique kind of set-up, different from Vermont: the elderly and medically complicated patients stay here, and any other kind of patient (children, adolescents, and medically stable adults) go to the off-site psych hospital. We rotate there second year of residency. It's almost like we do most of the "medically complicated" stuff our first year: our geri floor, medicine (or pediatrics) floors, and the ED. After that we get to start forgetting everything we know about medicine: antibiotics, chest X-rays, anticoagulation, IV fluid rates, etc. It's kind of sad, in a way, although we start learning more and more specific psych information. I guess we can't know EVERYTHING--it's why we specialize, right? A pulmonologist probably forgets what he knows about renal, too. But it's still kind of weird, and sad. Chris definitely wants me to hang on to my medicine knowledge, and while I am using it, I know I will. And when I am not using it? Well, there's always my palm pilot. And the internet, of course.

So, it's been going okay. I am starting to get to know everyone. I like most of my fellow interns. There is one psych intern whom I do NOT like. I'm working on that and trying to be gracious and understanding and etc, etc, etc, but when my friends who are interns on OTHER services say, "We can't believe how you have to put up with this person," well, then it's harder. One thing that made me upset, though: when she first had her name badge made, she didn't put her last name on it. I have seen nurses do this sometimes on psych, especially if they are rotating in from other services. It's like there is this idea that in some way, putting your last name on your badge makes you vulnerable: that somehow, a "crazy" person (and crazy = bad, of course) will find your last name out and then, like, STALK you. Why is this a problem to me? Well, first of all, there is that stigma thing. As a "mental health professional," I am deeply interested in decreasing the suffering of my patients. This includes the societal and psychic suffering that comes from being judged because of one's illness. And second? For right now, most of my patients are so out-of-their-mind demented that they can't even remember my FIRST NAME, much LESS be interested in my last name. One of my patients has given up and just calls me "Red."

Plus, it's cool to be introduced as "Dr. Brownlowe."

So, life is going pretty well right now, and I am working hard and learning a lot and doing well. Chris and one of the new interns, Amam, have been hanging out today and brought me dinner: Afghan food! No, not made of a blanket, but actually Afghani food. It was tasty and rice-y. It was also nice to not have to eat a hamburger for dinner.

Next month (as in, on Monday) I start on pediatrics. More fun stories from the OTHER end of life. So you'll hear from me then. I promise.

Sunday, July 03, 2005