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..). 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?