Med Students Anonymous

2.5 days left till my psych rotation (and 3rd year!) is over! It can't come soon enough...I think I'm about to become a basket case...most likely I'm experiencing Generalized Anxiety Disorder or Psychosis NOS. Just kidding...I think. It's definitely time for a vacation. A road trip to Yellowstone is exactly what I need right now.

Still, I've enjoyed psych (though I won't miss having to use a key to get through every single door...the joys of a locked ward). It has unquestionably produced some of the best stories of the year and I've seen people come in completely unhinged and pull it together over night with the help of some meds (or maybe they're just sobering up). I also got to see Electroconvulsive Therapy which was nothing like One Flew Over the Cuckoo's Nest since the patients were anesthetized and none were as energetic as Jack Nicholson to begin with. There have been a few patients who are severely over medicated but that's way more reversible than a lobotomy.

Substance abuse has been a major issue with a lot of the patients and from the way they talk it seems like you can find heroin on every street corner. Procuring drugs is definitely outside my skill set but I don't think it would be professional for me to ask them for details. As part of the rotation we had to attend both an AA Meeting (yes they really did say the serenity prayer and recite the 12 steps...plus I got to say "Hi, my name is Lianna and I'm a medical student"). People's willingness to discuss their problems openly was incredibly impressive and I can definitely understand how hearing stories from people who are going through the same thing can be really beneficial. Having some goody two shoes doctor tell you to quit smoking crack probably doesn't cut it. Unfortunately only 30% of people maintain sobriety through AA, but it's still better than 5% of people who try to quit drinking by themselves. Bad news. I think med students could benefit from frequent meetings to share our horror stories and stresses. I can't believe the school year is almost over. In less than a year I'll be a doctor!

It's All In Your Head Part 2

Stomping out mental illness has been quite the trip. The past week on the psych ward has been a lot more work than I imagined, but at least it's engaging and I actually feel like I'm part of the team. The patients keep things interesting...the guy who collects dead squirrels (and carries their rotting corpses around with him) because he thinks they're talking to him), the guy who thinks he's Satan, the lady who stabbed herself with a kitchen knife when her boyfriend said he was leaving her (she was actually the normal one of the bunch). I actually enjoy talking to them, trying to figure out how they ended up in this position, trying to get them back on track.

Of course that raises the question of what is crazy anyway. I mean, in some of the patients you instantly know they're out of whack, but in the majority they actually seem pretty normal until you ask them if they've heard any voices recently. I got to go to court to watch a commitment hearing and our patient really came across as totally sane on the stand, it was only testimony from her mom about her hoarding tendencies that got her committed. Then there's the idealistic kid who recently dropped out of college, smokes pot, and thinks that there's a government conspiracy supporting the corn industry resulting in high fructose corn syrup in all of our food products. Not wanting to participate in a dysfunctional society is not necessarily crazy. Plus, most of his views are pretty much identical to those of some of my friends. Go figure.

I've always been leery of psych meds...but they definitely get results. If you've got mild depression a little psychotherapy might go a long way, but for bipolar mania or schizophrenia it's hard to argue that just talking about it will make everything better. Still just talking about things can be incredibly beneficial and perhaps it doesn't happen enough. What about Mind Over Meds?