Mental State

I’m halfway through my psych rotation and thoroughly enjoying it, far more than I’d expected I would.

My rotations worked out in such a way that my specialties have been sort of smooshed together at the end of fifth year. And because I also chose to do general medical type things for both of my electives, this means I’ve spent the better part of the last year and a half in general medicine, which is the subject of my delighted and unconditional love; and general surgery, with whom my relationship is best described as one of mutual and mostly happy tolerance. It’s strange, then, this close to The End, to find myself so very much out of what has become my comfort zone.

In my first week, I was coming home every night slightly bug-eyed at some of the things that I’d heard. I have one particular patient who is very pleasant and very happy to chat to me and has excellent insight into his condition, but is also quite floridly psychotic – which simply means, more or less, that he knows that he’s psychotic. Now, the cognitive dissonance that such a concept creates in me is headache-inducing, at best, so one can only imagine how difficult it must be for him. He’s unusual. My patients more commonly run the spectrum from the ones with fairly stable chronic disease who are being seen by outpatient psychiatrists to the ones who have no insight at all and scream at us on ward rounds and kick me out of the room.

It’s a truly fascinating speciality.

I think my fascination with it may say more about me as a nosy person than it does about it as a subject.


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