Going Mental

Last week was the first week of mental health rotation. The mental health inpatient unit has fourteen beds and they've been full most of the time. Mental health service has come a long way since the days of Bedlam. The big institutions are all gone; no one gets committed anymore. What's left now are acute services and patients are discharged to the community. And then there are the rules. All the rules and regulations that ensure the proper treatment of patients while they are at their most vulnerable directly translates into mounds of paperwork. I know paperwork is an unavoidable part of medicine, but mental health definitely takes the cake in this aspect. The doctors are constantly writing in patients' charts and filling out forms.

I sat in on patient interviews all week. Listening to their stories and hallucinations, hearing them describe the way they perceived the world around them, I felt like a voyeur peering through a keyhole into their psyche. This catatonic patient who worried about every minute details of daily living, that floridly psychotic one having a complete breakdown, this one with delusions of grandeur who absolutely believed in his story, that schizophrenic one who was constantly arguing with the voices in her head - it was like watching a drama, a comedy, a tragedy, and a film noir all rolled into one. From day one, the med school has been teaching us to empathize with patients, to understand where they are coming from. But it looks like psychiatry wound have to take exception to that rule. The hardest part of psychiatry is probably learning to not empathize so much that we start to identify with the patient - in order to maintain insight into the patient's problems, but more importantly, for our own sanity.

It's going to be an interesting rotation.

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Tonight's dinner: chicken cacciatore on cous cous with silverbeet.