Sunday, March 15, 2009

Psych, and changes

It's been a long time since writing.
The psych rotation has been brutal. Aside from driving to Palo Alto 3-4 times per week, it's just taxing.
We're in an acute inpatient locked ward from 7:30-12, with discussion afterwards from 12-1.
I carry the key for the three students who are on the floor.
It's tough. I almost just wrote "it's insane" but I felt if I wrote that, it's not for the reasons a reader might think they are. It's the entire situation. We were lucky enough to be plopped right into the center of Veteran's care at the VA, so not only were we dealing with psych, we were dealing with psych in a military model.
For one, the psychiatrists and the psychologists were absolutely amazing - incredibly compassionate and intelligent.
The patients were really interesting. I saw people with PTSD, schizophrenia, borderline, schizoaffective, major depressive, generalized anxiety, conversion disorder, etc. Everything under the sun. Everything. There was a patient who had a cure for everything you could imagine, who was incredibly intelligent. There were patients with criminal histories, who were amazingly sweet to us but when we read about what they had done, our hearts stopped and we wondered how they could have performed the atrocities they did.
Intense doesn't even begin to cover it.
Aside from the stress of driving so much, the psychological stress of being in this environment was definitely tangible.
Bearing witness- we were constantly bearing witness to other people's pain, whether that was wondering if the devil was putting voices in their heads, wondering if their families loved them, wondering why they had been hurt.
I met one patient who I just connected with right off the bat. He hadn't eaten in a while, and was there voluntarily, depressed. He told me I could never understand.
I just listened, and tried to help as much as possible by just being present and just being kind. Three days later, he started eating.
Two weeks later, he told me he loved me, and it caught me totally off guard. I had no idea what to say back- how do you explain that you have care and compassion for someone without saying that you love them "in that way"?
How do you do that?
I said, "Thank you. I wish the best for you."
And I felt like an asshole. But I was still present for that patient in his moment, and I felt like that was the best I could do at that time.
There is so much I'm not writing.
That's what strikes me about MEPN. I am pretty conscious of HIPAA, so I try not to write too much about patients or I change things about patients I interact with- or I just don't write about it.
There is so much you will see that you won't write about.
So much.
Psych has been an amazing experience.