Emergency psychiatry
I decided to do this elective in order to rule psychiatry in or out, and because i love the emergency department in any case. I thought that it would be busy and challenging, and not too many hours of sitting around a hospital doing nothing but being bitter about missing the rest of my life.
This month well exceeded my expectations, and i'll give another list of points i came out of it with.
Families were really key in this department, something i've never really seen done quite the same way. Doctors are notoriously bad at predicting who is going to kill themselves. I don't know if families are much better, but it's comforting to everyone to share the risk of sending someone home and/or keeping them in hospital. We are all fallible, and working together can hardly make that worse. It was downright pleasant to be part of a team that thinks that way.
Power -- that a non-negotiated/non-consensual power imbalance doesn't really serve anyone. I'm going to get my french up to good enough to read the whole book that my supervisor wrote on the topic eventually. But from working there i finally got how relationships where people are stuck in roles that slot one person into being the protector or predator and the other person the one who is protected or aggressed are so very damaging. And how stuckedness in those unhelpful and inflexible roles are different from relationships where people are aware of their own autonomy and vulnerability, and choose to enter into relationships where power is not equal in order to heal or grow. -- It's another delightful paradox where unequal power distribution in a relationship is something can be both damaging and growth stunting and/or a place for real connection and healing.
Gay. What's with that? Patients, doctors whatever, i don't really get it. I'm sure somebody somewhere has written a paper on it which i haven't bothered to look up. Why is ER psych such a queer place?
I have way more of a "feel" for what borderline PD is now. And how borderline-y impulsivity is different from ADHD impulsivity. And the little gem about teddy bears. (Tho not all of those with teddies are BPD, most borderlines have teddies). I think that's one of the more useful tidbits i could never have picked up from a book.
And psych doesn't really smell that bad. There is no "peeling back someone's oozing folds in the middle of the night". It's a different kind of intimacy with strangers that is much less physical. The physician doesn't have gizmos or gadgets, and only her/his personality to work with. And being the tool exposes me and my own flaws far more than interactions that are mediated by my stethoscope.
predictably, no quick answers. gah. I'm sure it will all come clear after a few months of communing with CaRMS. . .
This month well exceeded my expectations, and i'll give another list of points i came out of it with.
Families were really key in this department, something i've never really seen done quite the same way. Doctors are notoriously bad at predicting who is going to kill themselves. I don't know if families are much better, but it's comforting to everyone to share the risk of sending someone home and/or keeping them in hospital. We are all fallible, and working together can hardly make that worse. It was downright pleasant to be part of a team that thinks that way.
Power -- that a non-negotiated/non-consensual power imbalance doesn't really serve anyone. I'm going to get my french up to good enough to read the whole book that my supervisor wrote on the topic eventually. But from working there i finally got how relationships where people are stuck in roles that slot one person into being the protector or predator and the other person the one who is protected or aggressed are so very damaging. And how stuckedness in those unhelpful and inflexible roles are different from relationships where people are aware of their own autonomy and vulnerability, and choose to enter into relationships where power is not equal in order to heal or grow. -- It's another delightful paradox where unequal power distribution in a relationship is something can be both damaging and growth stunting and/or a place for real connection and healing.
Gay. What's with that? Patients, doctors whatever, i don't really get it. I'm sure somebody somewhere has written a paper on it which i haven't bothered to look up. Why is ER psych such a queer place?
I have way more of a "feel" for what borderline PD is now. And how borderline-y impulsivity is different from ADHD impulsivity. And the little gem about teddy bears. (Tho not all of those with teddies are BPD, most borderlines have teddies). I think that's one of the more useful tidbits i could never have picked up from a book.
And psych doesn't really smell that bad. There is no "peeling back someone's oozing folds in the middle of the night". It's a different kind of intimacy with strangers that is much less physical. The physician doesn't have gizmos or gadgets, and only her/his personality to work with. And being the tool exposes me and my own flaws far more than interactions that are mediated by my stethoscope.
predictably, no quick answers. gah. I'm sure it will all come clear after a few months of communing with CaRMS. . .
Labels: medskool
posted by lothyn at 24.8.07
0 Comments:
Post a Comment
<< Home