Day 2

I started my Psych rotation two days ago and began seeing patients yesterday. It was a painful start, especially since I felt so uncomfortable in my skin that I made myself look and feel even more incompetent than I was (if that is possible). Today, fortunately, things went a lot more smoothly, largely due to some tips from a very generous MSIV on my team and my intern's continuing patience and attentiveness. Of course, first impressions go far, so now I'll probably need to dye my hair and start a whole new look to convince my attending that I am, indeed, capable of doing a bit more than just tying my shoelaces.

My first four weeks will be spent doing Psych consult, which I think I will really enjoy. We pick up patients anywhere in the hospital, when their primary care team feels that they might need a second opinion about their mental status or psychiatric treatment. We might evaluate an older man admitted for infection and sudden onset of confusion, and try to weed out how much of his changing behaviro is caused by dementia, delirium and/or deptression. The trauma unit might ask as to help manage the medication for a schizophrenic patient who hurt himself in an unsuccessful suicide attempt or a person with a narcissistic personality whose behavior is making treatment difficult. Every day and every patient is very different from the last, and all have interesting stories.

I'm currently following two patients, who are about as opposite from each other as can be, though both have a primary diagnosis of depression and have recently suffered a loss. One old and one young; at different, but very crucial, times of their lives. I wish I could write more, but I don't think I could do say enough about their stories without revealing too much identifying information...and one never knows how far that can go on the internet.

Anyway, I'm grateful to be starting with Psych. It is probably the most nurturing rotation one could begin third year with. Now if I could just stop looking like I have no idea what I'm doing.