Feelings on psychiatry..

Today I have been interviewing my first psychiatric patient. I was quite nervous, actually, as psychiatry is a little different in its routine and type of patient than internal medicine. It’s more sensitive. It’s especially hard when patients are stuck in their beliefs and loose sight of reality, whereas others know they have a mental disorder and why they are hospitalized. Last week, we saw a man who thought he chose to be forcefully detained in his religious megalomania. He looked healthy, but his manner and content of thought were quite ‘deviant’. By using the word ‘deviant’, I feel it’s very hard to chose the right words as to not offend people, but my experience within psychiatry is still too limited to be able to use the appropriate jargon.

Anyway, conducting the case history with my patient went quite well: I was able to structure the conversation, ease him to talk to me (he was nervous too), and to get somewhat of a differential diagnosis in my head. Although I did miss some things, I did well for the first time, yay!

Every time I come into contact with psychiatry, the field mesmerizes me. Mental health is a sensitive topic for one, and there are many grey areas in ‘disease’, but mental processes in the brain are fascinating and you come across so many different people as your patients. But when I see a patient who’s clearly diagnostically delusioned, I do feel sorry for them. There are medicines and therapies, but nothing works a 100% and most drugs have serious side-effects. It would kill me if I wasn’t in the right mind, although I might not be aware of that (and maybe that’s even worse..).Ā I don’t know how I feel about that feeling, I’m quite stuck in my thoughts on this matter; is it okay for doctors to feel sorry for their patients?

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7 comments

  1. I think it is very important that you feel sorry for your patients. You shouldn’t show this, but keep in mind they are only human, just like you. Human beings with a life, family, friends, ideas,… They are more than their condition, and even though it is sometimes favorable to neglect this, I believe a doctor should treat the patient, not “just” the condition.
    And congratulations on your first psych interview! I know from my own experiences it’s quite a stressful thing to be in such a situation, so if you managed to calm him, you did very well šŸ™‚

    1. Thanks for your comment! It’s indeed the fact that they are only human and that so little can be done about their conditions, and thus their lives.. Of course the pathology fascinates me, but I don’t know if I could deal with lives and relationships being crushed because the mind’s not working the way they want to.
      Are you a psychologist/psychiatrist yourself? Do you have any more tips, or topics for me to think about?

      1. Well, I’m not a psychiatrist, I’m a psychiatric patient šŸ™‚
        But you know, they say the worst lunatics make the best therapists, so I guess you could draw a parallel…
        As for tips and topics… I can only rely on my own experiences from the other side of the interrogation table… In my idea it is very important when interviewing a psychiatric patient to have an idea of what the problem is in the first place. By example, when someone is psychotic and believes he’s being followed and mocked all the time, you should be very careful with your facial expressions.
        There is only so much someone can take. That is -I believe- also the reason why physical contact is forbidden on the ward. Realizing the humanity of your patients and feeling sorry for them is something else than trying to carry their sorrow in their place. It would crush you.

      2. Well, it’s actually way more useful for me to learn from patients than from ‘specialists’:) so thanks for your input! I’m really a people’s person; of course interested in the pathology but always seeing the person and their lives and how that disease is influencing it.. Should not take it home with me but sometimes some stories just stick around in your head…

      3. I understand what you mean… it’s bizarre how one situation doesn’t seem to touch you at all while another one feels like a hit in the face.
        But psychiatry needs people like that. People-people. And kindness. Lots of kindness.
        I’m glad to be of help šŸ™‚

      4. Thanks šŸ™‚
        Do you write a lot on your blog? Will def keep following you šŸ™‚

      5. Every day… It is kind of my way to relax…
        and thanks!

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