Archive for October 2011
Today we had “Professor’s Rounds,” where one of us picks a patient and presents the case to the group and an Attending doctor. Then we bring the patient in and watch the Attending interview the patient.
Today, prompted by the chosen patient’s lack of “insight” (ie, the patient believed he/she was absolutely fine and not ill in any way), our Attending shared a quick, amusing story with us.
He once had five patients who all believed they were Jesus Christ, so he decided to see if meeting each other might help them gain some insight. A couple of them got angry, “How dare these people think they’re me?!” Others who were quiet during the meeting later approached him, and commented on how sad and obviously crazy these other people were, thinking that they were also Jesus.
It’s quite fascinating what we can become convinced of, isn’t it? The psychiatric cases are the most dramatic and oftentimes entertaining stories to share, but it happens to the conventionally sane appearing too (anti-vaccinationists come to mind).
Last week I came home to find a small gathering of deliciously crunchy leaves by the stairs. Some trees are changing colors, and across the street from my building, one tree is already bare.
I can’t deny that it’s Fall already. That I’m 17.5 weeks through third year. That 2012 is fast approaching, I’m 25 years old, and I’m 19 months away from my MD degree.
Today Fall showed its unpleasant side. I had a cold and rainy bike ride to work, and all day a headache pulsed in the background. When I got home, I crawled into my bed immediately after my shower, and I guess I fell asleep because two hours later I woke up to my phone ringing and I know I wasn’t reading that whole time. I’m out of painkillers, somehow, but I dragged myself out of bed for a bit, and finally took proper advantage of having a gas stove. I made myself s’mores! (a s’more?)
And now, for once, I’m heading to bed at the proper time to ensure I might actually get a full night’s rest and wake up before my alarm.
Someone just tweeted this really beautiful article from the New York Times, called “Notes From a Dragon Mom.” It’s a very sad yet somehow uplifting piece written by a mother who has known from birth that her child is not going to live very long. And it reminded me of a conversation I had with a patient while I was on neurology.
I was seeing the patient in the emergency department, and while waiting for my Resident to come and officially do the consult, she was talking to me on and off, in a bit of a daze, about her family. Mostly I remember her because I felt so helpless to help her – there was nothing we could do but wait – yet she quite desperately wanted someone to fix her. She didn’t quite know what was happening and she kept forgetting where she was, but through it all she knew that she wasn’t well.
I also remember her because of how she talked of one of her children, who I gather only lived till her late teens or early twenties. She didn’t talk with sadness, but almost with joy. She was so happy to remember her daughter, to remember how bright and beautiful and determined of a person she was, despite her condition. She felt blessed that her daughter had been a part of her life, even though it’d only been for a fraction of the time that you want your children to be around.
As part of my psychiatry rotation, I’ll be spending a total of six afternoons in the child clinic. It has made my days long (~11 hours) since clinic runs late, but it has been a very interesting experience. I’ve seen quite the range of the autistic & aspergers spectrum, from non-verbal teenagers who spend most of the interview curled up with their mothers to highly functioning teenagers dealing with having just started college. And you see quite the range of parents. Some are handling it with more grace and good nature than others, but all are handling it. They might not have to watch their children die, but they’re faced with the knowledge that when they die, who’s going to continue to take care of their child?
I don’t find death in and of itself tragic until I’m faced with the thought of those left behind; that’s when my emotionality kicks in. I watched a patient in our geriatric ward code a few days ago. She had choked, and it took a while before they got her breathing again (she’s okay now, by the way). I felt some shock and worry and sadness in the beginning, when there were some other patients and nurses around reacting emotionally to the situation, but once they were gently escorted away, I was watching with mostly a professional detachment and curiosity.
Maybe this is why I like to hear people’s stories. I prefer to see them as people, as individuals with friends and families, with triumphs and hardships, and getting a better, bigger picture is how I do that.
Have I mentioned yet that I’m really enjoying Psychiatry? It’s definitely high on my list right now.
Meet Mehmet. He lives on my bed and was a gift from my boyfriend Ahmet three months before we started dating. Should I ever end up staying the night in a hospital, or several nights, Mehmet will not be joining me.
Intern: “What’s the teddy bear sign?”
Attending: *turns to me* Would you bring a teddy bear with you if you were in the hospital?
Me: Probably not.
But to be honest, the reasons I wouldn’t are 1) because a stuffed animal I am attached to enough to want it in a stressful situation is probably one I don’t want to subject to the hospital environment and 2) I know about the teddy bear sign, and don’t want my doctors and nurses to assume I’m crazy.
Obviously, if you’re under the age of 13, no one is going to think you’re crazy for having a teddy bear with you, but by the time you hit 18? Your staff are going to be wary of you and on the lookout for psychiatric conditions.
Sunday was my birthday, and now I’m 25 years old. I should be getting my driver’s license in a few weeks, and I’ll still be younger than my mother was when she got hers. =D
Seeing as my Neurology Shelf exam is tomorrow, I didn’t do much to celebrate. I had a delicious brunch with my friends, hung out at one of their apartments briefly, then came home to try to study (sigh. Medical school).
One of the things I will always remember about my birthday this year is how on Monday, my aphasic stroke patient was able to sing Happy Birthday to me, even though he probably couldn’t have generated those words to just say them. There’s some touchingly amusing about your patient, his family, and your team singing happy birthday to you as part of a teaching moment.
On to the presents! My parents were going to get me an ipad for my birthday, but I’m still laptopless after kneeling on my netbook a few months ago and breaking the screen… So I’ll be picking out an inexpensive new computer instead, I think. To get a new netbook or something slightly larger though? Decisions, decisions.
They’re hard to see at this picture size, but I got some lovely new earrings from my friend Feiya for my birthday! Earrings, like socks, are not something I can ever have too many of.
And I got a beautiful new orchid from my friend Hao. It’s a different species from my others, and hopefully I can keep this one alive and thriving too!
Last but not least, Amrita made me a lemon poppyseed cake, at my request, as my birthday cake. It was delicious and I still have some leftovers. Cake for breakfast! (photo stolen from her website) Lemon poppyseed cake is very near and dear to my heart. It’s not the sort of cake that you put icing on, which is just fine with me. It’s soft, moist, bursting with lemon flavor and crunchy poppy seed goodness. I still remember the first time I had it. I think it was one of the first time’s I’d had something with lemon flavor that wasn’t sour, and it took me a while to identify what the flavor was (I was pretty young).