Saturday, November 17, 2012

Cat's 3rd Year Med Student Checklist


*      Head out the door, on time, wearing neatly pressed dress clothes, white coat with at least 3 pens in the pocket, and name badge. 

*      Arrive early, approximately 10 minutes prior to the office physician, and several hours before the rounding physician at the hospital

*      Anticipate at least one of the physician/nurse/tech/janitor’s movements or needs

*      Ask intelligent question
-Well, at least it sounded intelligent in my head before it came out of my mouth.

*      Appear busy

*      Actually be busy
-Hopefully.

*      Balance staying out of the way, being helpful, and learning something
-Probably not.

*      Review relevant apps, websites, lectures, and texts
-Is there a way to half check this?

*      Remember to drink at least 1/3 of the water you just told a patient that they should be drinking

*      File away useful information in an orderly fashion somewhere in my cortex

*      Overcome the fear of doing something wrong

*      Make a connection between something learned in the classroom and a patient symptom

*      Become slightly closer to comfortable with a doctor or a floor or a specialty before being whisked away for the next month long whirlwind. 

*      Stand in awe of merely being near a patient
-Check, check, and double check.

Thursday, November 15, 2012

Psychiatric Reflections


If
by Rudyard Kipling

"If you can keep your head when all about you
Are losing theirs and blaming it on you;
If you can trust yourself when all men doubt you,
But make allowance for their doubting too:
If you can wait and not be tired by waiting,
Or, being lied about, don't deal in lies,
Or being hated don't give way to hating,
And yet don't look too good, nor talk too wise;

If you can dream-and not make dreams your master;
If you can think-and not make thoughts your aim,
If you can meet with Triumph and Disaster
And treat those two impostors just the same:.
If you can bear to hear the truth you've spoken
Twisted by knaves to make a trap for fools,
Or watch the things you gave your life to, broken,
And stoop and build'em up with worn-out tools;

If you can make one heap of all your winnings
And risk it on one turn of pitch-and-toss,
And lose, and start again at your beginnings,
And never breathe a word about your loss:
If you can force your heart and nerve and sinew
To serve your turn long after they are gone,
And so hold on when there is nothing in you
Except the Will which says to them: 'Hold on!'

If you can talk with crowds and keep your virtue,
Or walk with Kings-nor lose the common touch,
If neither foes nor loving friends can hurt you,
If all men count with you, but none too much:
If you can fill the unforgiving minute
With sixty seconds' worth of distance run,
Yours is the Earth and everything that's in it,
And-which is more- you'll be a Man, my son!"
---------------
I have read this poem many times.  I even had a version of it on the bathroom wall of my old apartment.  However, it takes new meaning when discussed in a therapy session with patients in the psychiatric wing of a hospital. 
---------------
"If you can keep your head when all about you
Are losing theirs and blaming it on you;
If you can trust yourself when all men doubt you,
But make allowance for their doubting too..."


She suffers from paranoid delusions- believing that many people are after her and trying to kill her.  The medical staffs’ calm demeanor is frustrating to her.  She cannot understand why we are merely adjusting her medications and not bringing in the FBI.  She peers across the table at me with skepticism, her eyes a startling blue under her matted blonde bangs. 
"Wow!  That color blue really suits you!”
I want to say.  But she might take it the wrong way.  No one wants to be told that the blue paper scrubs suit them.  Besides, this is supposed to be a therapy session.

---------------

He is nervous, very nervous, and that is why he is here.  They tell him that he will have to have a surgery for an incidental finding discovered on a randomly ordered test.  Because the surgery will involve running a catheter into the blood vessels of his brain, he is worried about the surgery’s side effects. 
“What if I end up, you know… more mentally handicapped then I am?”

To that, Kipling says,

"If you can force your heart and nerve and sinew
To serve your turn long after they are gone,
And so hold on when there is nothing in you
Except the Will which says to them: 'Hold on!'"


---------------
One patient voiced her sorrow that many people dismiss her as worthless as soon as they find out that she has a mental illness.  They don’t think that she can dream.  They don’t even think that she can think.  Another patient comforts her:

“You have enough to worry about without people hanging around who treat you like that.  Good riddance.  We only need the people who will help us get better.”
"If you can wait and not be tired by waiting,
Or, being lied about, don't deal in lies,
Or being hated don't give way to hating,
And yet don't look too good, nor talk too wise..."
---------------

"If you can make one heap of all your winnings
And risk it on one turn of pitch-and-toss,
And lose, and start again at your beginnings,
And never breathe a word about your loss."
She sat next to me silently throughout most of the therapy session.  The therapist only seemed to call on her when she didn’t have a well formulated answer.  However, there was one important question that she did answer on the worksheet:

“When was there a time that you started over?”

Her quiet, yet determined answer?

“Right now”

 

 

 

 

Humbling


Getting married is the single most humbling thing I have ever done. 

It is humbling that someone as wonderful as my husband wants to spend the rest of his life with me.  It is humbling that my mom and husband spent much time and energy to ensure that we would have a beautiful wedding while I studied for boards.  It is humbling that so many of my talented friends and family donated their time, abilities, and money to help my wedding dreams become reality.  It is humbling to have been able to wear the gown of my mother, the shoes of my great-great grandmother, the hoopskirt of my grandmother, and the necklace of my mother in law.  It is humbling that so many people who have played a role in my life and the life of my parents came to witness as we pledged our live to each other.  It is humbling to receive so many gifts to help us as we begin our lives together.

I am blessed.