Psychiatry

I finished my 6-week psychiatry rotation with a passion for it that I never quite tapped into when I was studying it in undergrad. It was such a unique and interesting experience overall. I spent 2 weeks in the inpatient crisis unit, 2 weeks in psychosocial rehabilitation, 1 week in child psychiatry, and 1 week in adult psychiatry.

I have now seen the depths of mental illness that many people don't get the chance to see. This was most prominent in the inpatient crisis stabilization unit. You can imagine it as an emergency room for psychiatric issues. Schizophrenia is a common one that I saw. The great thing about my position as a student is that I had the opportunity to sit with patients (for 2 hours if necessary) to explore their minds - hallucinations and delusions and all. Some have insight into the fact that the voices are not real. Some do not. And they can experience this nightmare every minute of the day and then even worse when they lay down to sleep. It is often chronic and debilitating.

I had the change to talk to patients who were depressed or using drugs and alcohol who couldn't seem to fight their way back to the people they used to be.

I saw so many people admitted involuntarily who were angry and confused. Sometimes it was the family members who brought them and sometimes it was the police.



Psychosocial rehabilitation was a program we worked in that focused on integrating into society, social skills, coping strategies, and managing personal finances. We were able to get to know patients in a less formal setting. These patients had their symptoms under control enough to come to this day program and go home at night where they lived independently, with others, or in group homes. We did classroom discussions, exercise, and we went to the mall. The patients were surprisingly open about their experiences which broadened my understanding of living with a psychiatric disorder.

As interesting as the crisis unit and psychosocial rehab were, I think my favourite setting was outpatient. I was working with a child psychiatrist so we did 3 full assessments in the morning and follow up appointments after that. The assessments go through a patient's full history of present illness plus medical, psychiatric, surgical, and family history. The doctor made notes about the patients appearance, motor activity, eye contact, mood, speech, thought process, and more.


I love how psychology and communication skills factor into all patient interactions. It is amazing how much you communicate with the people around you without saying a word. Your body language, the way you dress, the way you walk, and the way you look at someone are all messages that you are giving about yourself. Sometimes people don't realize how much of themselves they are revealing.


On the other hand, two things I disliked about psychiatry were that family doctors were called in to do medical evals and that it was not hands-on. Also the fact that the psychiatry field is primarily medication management whereas the psychologists/therapists do more of the psychotherapy. I am trying to weigh these things against how much I love the work.

I have been asking all the psychiatrists when they realized that they knew they wanted to do psychiatry and if they are happy with where they are at. Almost every time they say that they didn't plan on psychiatry until they experienced it and that they are satisfied with their choice. 

I was given the opportunity to work with each of the 3 residents in adult psychiatry. I also sat in with a psychiatrist that was retired from the military hospital who treated Vietnam war veterans with PTSD. Lots of chances to see different approaches and styles. 

Psychiatry has taught me tolerance, empathy, and the ability to be less judgemental and I think that is a gift in its own right. I will be honest in saying that some of my own views were challenged and that is never an easy truth to swallow. It has been a great experience - one that I will take with me for a long time.

Oh god.

The fact that I was able to write this without trying has got to be some sort of indication that psychiatry is a good fit for me.

You might be looking at a future psychiatrist. 

Well, damn.