I was nervous going in. I really wanted to like it, to validate that this was what I was meant to do. I didn't want to have a panic attack, thinking all my future plans would be unraveling if I decided this wasn't what I wanted to. I had 1 month of inpatient and 1 month of outpatient to get a good idea of the field.
I started on inpatient at the county treatment center. Brutal honesty here: I was so so anxious that first week there. It's a locked unit and I was nervous for so many reasons. 1) Most of the patients are psychotic. 2) I didn't want to drop my key at any point and have it picked up by someone else. 3) I didn't want to get hurt - we actually had to take a mini self-defense class the day before we started just in case. And they gave us lanyards that break apart if someone tries to choke you. All of this was making for a very jumpy T. Which wasn't a feeling I was liking. It was definitely a difficult environment and so unlike my previous rotations. People don't just get better over the course of a few days in the hospital. Some patients had been there for months or even years! The hero complex in me wanted to fix everyone quickly, but that would not apply here. However, I slowly adapted to my surroundings and everyday became easier and easier. There were some moments that were certainly scary - such as when a patient got attacked by another patient right in front of me, or when a patient I didn't know kept approaching me and I yelled for staff because I wasn't sure what they wanted, or when a patient I had been taking care of suddenly yelled that he didn't want to see me again and refused to talk to me anymore. It was quite an experience, and I'm grateful that I did it, but I wasn't sure if this was something I wanted to do for the rest of my life.
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| Lunch at the treatment center! I got a meal card and everything. Only $2 for this whole thing. |
But before I started on my outpatient month, med school friend F and I attended a Psychiatry conference in SoCal. It was a really great weekend and I learned a lot, especially about delirium tremens and new treatment strategies for that. The place wasn't too shabby, either. What do you think?
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| Eggs benedict aka my favorite breakfast ever. |
I told myself I wouldn't make any decisions until my outpatient month was over. But looking back, I think I enjoyed inpatient more than outpatient. In general, I think I thrive much more in the inpatient setting. I like the structure, and the acuity of the patients. Something was missing for me in outpatient psychiatry. I think I wanted to have the role of the psychologist or case worker rather than the psychiatrist in that setting.
In my heart, I knew that the decision had already been made for me. I didn't think this was the right career path for me. I didn't love even though I really really really wanted to. I felt guilty for so many reasons. I had told people this was what I was going to do. I had been the president of the Psychiatry club at school! I had mentors who had taken the time to talk to me, guide me, give me advice over the last 2+ years. I felt like I would be letting them down, that they would somehow be disappointed with me for diverging from this path. I also wasn't sure whether I liked Pediatrics so much because it was right after Surgery or whether I truly truly liked it. I was so concerned I even scheduled a meeting with one of our deans who also dispenses career advice. I think I just needed someone to hear out my thoughts even though I knew what I wanted. It was nice that he validated my concerns and offered his thoughts that I was making the right decision, especially given that I was still thinking about Peds months after that rotation had ended. That felt nice to hear and eased my worries a bit.
So that's that. Sorry Psychiatry. I really really wanted to like you. I leave you with this: one interesting assignment we had for the rotation was to attend a local AA or NA meeting and then write a reflection about it. Here are a few excerpts from my piece:
My first thought while perusing the Internet, looking for a meeting to attend, was: Wow! I had no idea there were so many meetings that occur on a weekly basis just here. There were so many to choose from, I figured they would be small, intimate sessions – perhaps 15 or 20 people at a time. My second surprise was when I walked into one and there were at least 50, if not more, people there. There were professionally-dressed people, people who brought along their kids or spouses, people who had never attended a meeting before, and people who had been attending for longer than I’ve been alive. Some had been sober for years, others for days. Some had relapsed. It’s humbling to think that there are so many people who struggle with this and we would not even know it when passing them by on the street or working by them side-by-side. It was immediately clear to me that this was a safe place for them to come to, not only to maintain their sobriety, but also be able to check-in about things and gain and give support to others who have walked a similar path.
....
Many of the attendees who spoke and shared their experiences relayed
that they do not think it is possible to overcome this addiction without a
sponsor, and that sponsor is preferably someone who is in recovery themselves.
I completely understood this statement and it resonated with me for many
reasons, not least of all because of being in medical student. Most of the
time, I find it difficult to share some of my experiences and feelings
regarding school with friends or family who are not in the healthcare field. Somewhere
along the line, things get “lost in translation.” While it’s helpful and
wonderful to have supportive people around, it’s truly significant when that
person can also serve as a “mentor” figure, one who has already gone through
similar experiences and can provide advice, share coping strategies, and offer
encouragement.
