I didn’t want to return to the hospital. However, I did and I am better for it.
Monday and Tuesday were quite the struggles: an attempt to regain my footing and my mojo after a week of no patient contact. I felt slow and unwieldy in both my interviews and my presentations. Eventually, I returned to my typical form.
Toward the back half of this week, I noticed something new. I am not sure if it was the time off the floors, which provided enough of a deload from the stimulus so I could return better and stronger. Maybe it is just that I am three months into residency and I am getting into a groove and more confident in my own abilities.
Whatever the case, I found myself taking the time to be the physician and psychiatrist I want to be.
It is easy to wrap up an interview when you finish the consult question and the patient becomes “gretzy“. It is easy to chalk it up to factors outside your control, that you are not the primary team, just the consultant.
It is much harder to take the time to ask personal questions that won’t necessarily change the diagnosis or medical management. To pursue avenues of conversation that are out of curiosity for the human sibling sitting sick in the bed before you.
I determined that a patient lacked medical decision-making capacity, meaning the primary team would decide for them. After a prolonged silence, I asked them their past and how they became the way they are. It took more time, a precious resource. However, I felt like I was practicing medicine in a way that medical school Eugene would approve. In a way that future Eugene will appreciate.
During residency, it is easy to grind and do simply what is demanded of you because that can be an already insurmountable task. It is hard to be curious, to ask questions beyond the history of present illness, to engage a scared and ailing human.
Sometimes, it feels like I spend the entire day shrugging off attempts to pull me underwater. I can place no fault on the drowning person, that is what we all do when we feel the panic rise: we pull them under. Perhaps my time in the hospital as a psychiatrist will always feel this way. But, I can at least look at them with compassion and sorrow, instead of cold self-preservation.
I hope I can keep this sentiment going. Maybe I will. Maybe it will return in waves until it is a steady part of my practice. Only more time will tell.
Relationally, I feel well. Close with my nuclear family, and we have a gathering in NYC coming up. Close with Mackenzi, my mother-in-law, and my baby. We are establishing a sustainable orbit, with many more course-corrections to come. I look forward to the challenge!
Emotionally, I feel better today. The seven days on after eight days off really took it out of me: weekend call is why I’m writing this on Monday instead of Sunday. But, I spent this morning refilling the battery and I had a wonderful afternoon with the baby. Things are good.
Physically, a bit tight and not very well moved. I should perform more maintenance and keep my body moving more. Vacation was excellent, a great change of pace. But now, I need to return to the steady rhythm of movement throughout the week.
Spiritually, I am returning. Slowly. I am not where I want to be. But with the death of summer and the falling leaves, I feel renewed and more like myself. Maybe I’m finally adapting to the stressors in my life and now I can look around me and rejoice.
- Relational – 4/5
- Emotional – 4/5
- Physical – 2/5
- Spiritual –3/5
- Total – 13/20
- 3wk running total – 40/60
Long Form Sundays
- On a week off
- On high volume and low processing
- On necessary brevity (or the beginning of Consult Liaison Psych)
On Death Podcast
- With Michael Douglas – 20191010
- With Rashad Malik Davis – 20180329
- With Camille Culbreath – 20190914