April 2007
Psychiatry
I never thought psychiatry would interest me until we began our psychiatry lectures and practical sessions as part of the second-year POM course.
We had our last psychiatry session today, and I have to say it has been an eye-opening experience. Each Tuesday afternoon for the last few months I have been trekking down to the Palo Alto VA hospital. The preceptors there have been terrific--they are really engaging.
Today I saw patient who committed suicide by eating a box of rat poison. As you medical types may know, rat poison is essentially coumadin. After downing the poison with a cup of coffee, the patient looked down and read that it would take at least four days to kill the mice, and he being much larger than a mouse, he figured it would take over a week. A few days later, he was shaving and ended up bleeding uncontrollably, at which point he went to the ER of the VA hospital. He ended up becoming unconscious and spent several days in the ICU while the doctors scrambled to figure out the coagulopathy he had. Eventually, he told the doctors of his suicide attempt and was transferred to psych ward.
Speaking to him, it really hit home how much psychiatric and emotion health plays into our overall health. Because of my interest in surgery, I have tended to view disease as physical and biomedical manifestations. But listening to his story (the loss of a loved one and subsequently all his life savings and his home), reminded me of the truly human aspect of medicine--not just pathology, physiology, pharmacology, but the quotidian fortunes and misfortunes of life.
I have to admit before I started this psychiatry block, I approached psychiatric illness with more than a little bit of skepticism. Having no real frame of reference, I wondered why these patients couldn't just tell themselves to get better. But after seeing patients with schizophrenia, delusional disorder, PTSD, and major depression, I realized that they are truly suffering and sick--that psychiatric illnesses are just as debilitating as medical and surgical ones and as worthy of all of our attention. Seeing the effects of the numerous antipsychotics and antidepressants have been eye-opening as well--we really can make these patients better.
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