For the past few weeks, life has kept happening.
As I overcame one obstacle and began to process the lessons from it, another would show itself. The death of a new, old friend followed by a family trip to the city with a bridal shower followed by the need to update the registration on my vehicle followed by a weekend of camping with my partner heading to one place and myself learning to hunt in another. Superimposed upon all of this, of course, the rigors and emotional demands of medical school with my first week of inpatient psychiatry beginning this past Monday.
As a result of this headlong battle, I’ve placed my projects like these reflections and my interview series on the backburner. I’ve continued to put out the necessary materials so that I fulfill the obligation to myself, but the past few weeks of writing has been a struggle. How can I accurately reflect on the challenges in my life? Do I highlight one and leave the others on the table? Do I briefly cover all of them but ignore the impact each has on my psyche and my future? Or, do I defend and juke to simply stay on my feet?
That seems to be my tact, for the moment. I haven’t spent much time in front of the keyboard. I want to remedy this. A twenty-minute session can lead to five hundred words without a problem, and I can devote that time well before my Sunday posts. Today, Sunday, I have decided to write constantly for about 20min and immediately post whatever comes out. Perhaps, I’ve avoided reflection because I know much will come out. Rather than accept the deluge of words and ideas and feelings, I bottle them up. This blockage might underlie other struggles, and so addressing this may help. Maybe not.
Already, I feel a bit better. A lovely expression of skill, allowing my fingers glide across the keyboard. I can write the words out about as fast as I can think them, which prevents too much thinking and promotes simply doing. Except, when I think of a better way to express myself, then the backspace key becomes my closest and green-tongued confidant. Sometimes, I just need to write and I need to edit less.
So, in the spirit of less editing, I will express.
Inpatient Psychiatry has been both a struggle and an opportunity. I see the ways in which my current suite of interviewing and counseling skills are woefully inadequate for this patient population. Someone who has so much anxiety that they attempted suicide via 90 benzo pills will hardly be assured by verbal reminders that you shouldn’t worry. A manic patient with anxiety will hang on my words and any idea that I express to them will roll around and pick up speed until they are flung back at me with impressive force.
Many of my preconceived notions about the limitations of the modern practice of psychiatry are rooted in deep, cultural issues that cannot be tackled by a single white coat and prescription pad. A suicidal patient needs so much more than we can provide them after discharge from the inpatient setting. So many of them need to change the people they live with, the persons that are close to them, and the families that brought them into the world. For the patient suffering the long-term effects of a demanding and sometimes abusive parent relationship, how can we stabilize them?
The limitations of this medicine stare at me and when I try to stare back, I flinch. I want to practice a new type of psychiatry when I finish my residency, but how could this even address these deeper problems? Am I arrogant enough to think that my new thing can solve all the old problems? I hope not.
For now, I just want to learn. I want to stay a student. I think this is the root of my issues, at least today. I need to remember that my role for these few years is to learn. Absorb like a sponge the problems and the woes so that when it is my time to act, I can act without hesitation. I should not spread myself thin trying to act now.
Take care of myself and my partner. Listen to my peers when they need a hand. Care for patients, but realize that I am not the caregiver. The burden is not yet on my shoulders. I should enjoy this brief time before I accept that weight. The time will come. Hurrying can only ensure that I enjoy neither the present or the future.
The twenty minutes are up.
Long Form Sundays
- On family reunions (or the transition to fall)
- On holes of the heart (or ode to a garbage cat)
- On taking aim (or the beginning of Neuro/Psych)