ndab Ah Yes, Medical School: Go Crazy? Don't Mind If I Do!

Monday, May 22, 2006

Go Crazy? Don't Mind If I Do!

They say that it is impossible to leave a patient encounter without some part of that patient rubbing off on you. After one week in a schizophrenia ward, I say they are a bunch of assholes. Let me explain.

I started working on this ward last Tuesday, choosing it based on its strong reputation of being a great place to learn, to work with interesting people, and to consistently stroll in at 9:00 AM and get out at 1:00 PM every day. Amid a sea of psychotics, I was quickly assigned to two patients, one a manic depressive on a downer so low that he may actually be more depressed than me at a hot shiksa convention (otherwise known as EVERYWHERE…gah!), and another with dementia manifesting as psychotic behavior. Swell.

Observing the proceedings of schizophrenics, I quickly started collecting some of the interesting things that occurred. Some like to punch themselves in the leg. Some are convinced of massive government conspiracies. Some have a penchant for flattery, perppering conversations with remarks about my greatness as a doctor and horrifically flammable farts. Meanwhile, some like to get caught masturbating all around the ward, rubbing their privates in every which way for any passers-by. Lovely.

As each day in this ward has gone by, as I have been surrounded by more and more people with all sorts of delusions about wire-tapping, government agents, being followed, talking angels, leprechauns (OK, OK, that’s not all true…you can’t be a paranoid schizophrenic about government wire-tapping when, in reality, you are actually being wire-tapped), I am noticing a change in my own perception, one not obvious to me until my stroll to the gym this afternoon (“gym” being my code word for “the hospital that I never left during the entire day until 5:00 PM”, of course). Yikes.

Walking down the street, I brushed by a gentleman standing by a pole. I thought nothing of it at first, but soon I found myself thinking about how odd it was that he was wearing a formal suit with dark sunglasses during an otherwise dreary, cloudy day. I kept walking, but when I turned to look behind me he was following me from behind. Weird. I kept walking, faster now, but he was still behind me, keeping pace. Shit.

I made it to the center part of campus where there was a big crowd, and I ran into someone from my class. We chatted for a moment before we went our separate ways, but I couldn’t help but notice that not only was that Sunglasses Guy still behind me, but also there were a few random people nearby giving me funny looks. The kind of funny looks you give someone when they are talking to themselves. The kind of funny looks I give to the transients at Starbucks I see talking to themselves on a regular basis. Then I started wondering whether that classmate didn’t even exist, that I was going nuts, that I was losing my mind just like John Nash did, sans the mathematical genius or ability to score a hot chick who, by virtue of having dark hair, was also obviously smart.

I’m sure there’s a good lesson to take from this. Some would probably throw around ideas of transference and counter-transference or different fancy shmancy big psychiatric words. Others might tell me about my engrams and how I too could be a certifiably insane movie star. I don’t really know. However, I do know that I have another four weeks to go on my psychiatry rotation, and I’m more than a little worried that I’m going to have to check myself in before it’s all said and done.

But, if nothing else, there is one lasting lesson to remember: when they say that part of a patient rubs off on you, at least make sure they don’t mean that literally, because they could be referring to the dude who masturbates in public and it’d be a shame to stain your otherwise impeccably clean white coat.

P.S. Extra points for anyone who can name the person I am quoting in the title and the context in which this person makes this statement. And by extra points I mean a seat next to me and my Queen Amidala doll (Best. Gag Hanukah Gift. Ever.) at the Dorkiest People Alive convention.


Blogger -M- said...

HOMER SIMPSON IN THE EPISODE WHERE THE SIMPSONS HAVE TO TAKE CARE OF BURNS' CASTLE WHILE HIM AND SMITHERS GO AWAY!! ( spoof of the shining) im PRETTY sure that's it... * ponders * homer then goes psycho and tries to kill his family.. lol....

" no beer and tv make homer go..."

7:31 PM  
Blogger Ally said...

Damn, someone got the simpsons reference before I... doh.

One another note, and I am not typically one to correct blogs, but I can't help myself. As a "fake" psychologist one cannot be both schizophrenic and bipolar. Quite litterally impossible... Its one of those things that gets to you after a while. Not ever nutter out there is schizophrenic. Nor does it reference one's inability to make up their mind.

Otherwise, huge fan of the blog! You enterain me as I attempt to avoid writing my dissertation... Thanks.

8:28 PM  
Blogger Gregory House, PA-C said...

damn damn damn. i knew that too. do i get points for knowing it was a simpsons treehouse of horror special?

9:18 PM  
Blogger Admin said...

For the sake of clarity, the ward that I work on takes other psych patients besides schizo's...although I'm not gonna pretend like I knew that you can't be schizo and bipolar at the same time bc I haven't cracked open a book since this rotation started. I should add that I will be able to prescribe drugs in t-minus 1 year.

10:19 PM  
Blogger The Angry Frenchie said...

-Homer: No beer and no TV make Homer go something something...
-Marge: Go Crazy?
-Homer: Don't mind if I do!

Are there any psych patients that actually eat their own feces, like the nanny in South Park who had to put up with Cartman?

10:35 PM  
Blogger Cheeler said...

Ha ha! Hilarious.

Where do you attend medical school anyway? Just curious -- I'd like to know if I've interviewed there this past year.


11:17 PM  
Blogger Rachel said...

Well let's just hope you won't be treating any psych patients in t-1 year. Unless of course you step up to the plate here - and I think you will. It was the sleeper hit of my clinical education. I was shocked at how much I enjoyed working in a similiar setting - a lock-down unit for young patients with psychosis. It certainly can make you question your own psych status sometimes though.

Also, I think you technically can be schizophrenic and bipolar at the same time - I think that would be called schizoaffective disorder. No not YOU Fake Doctor, but why don't you crack open a book and get back to us with the answer.

4:42 AM  
Anonymous Anonymous said...

You wore your white coat on psych oy vey!

8:47 AM  
Anonymous Anonymous said...

Oy gevalt, how could I not know it was the Simpsons!

11:03 AM  
Blogger Paige Jennifer said...

When I candy striped back in the day (ah, memories of the paper thin, cotton, red-n-white jumper come rushing back), I used to sidestep the psych ward like the plague (Dam, Tzefardea, Kinim, Psych Ward, Arov). Freaked me out to no end. Does that make me a bad person? And no, I'm not really looking for an answer to that question.

1:47 PM  
Blogger Margie the Pickle Princess said...

I knew the quote too! Can I have a cookie? Gold star?

A friend of mine just started a nursing rotation at a hospital for the criminally insane. Yikes! Who's she have to piss off to score that gig I wonder?

3:28 PM  
Anonymous Anonymous said...

I had a patient on the psych ward who was thought that Marky Mark was going to impregnate him at night.

4:45 PM  
Blogger K said...

In response to the question about feces eating; yes. My folks are psychiatric nurses, had one of em at their hospital (well, he didn't actually ingest it, just held it in his mouth).

Pretty gross.

6:27 PM  
Blogger Twanna A. Hines | FUNKYBROWNCHICK.com said...

Okay, am I the *ONLY* person in the universe who doesn't like The Simpsons????

5:16 AM  
Anonymous Anonymous said...

I've got one at work who'll rip his hand open to eat the blood... or throw it at you... depends on the mood.

5:31 AM  
Anonymous Anonymous said...

i almost burst my firmly cewed food after i read your post..

anyway, if you have the time to open the DSM-IV-TR (the bibble to all clinician psychologist). schizoaffective and schizophenia is a different dissorder with almost simillar symptoms (maybe 'cause both are psychotic dissorder).

a schizophrenic can't be bipolar in the same time. like ally said, it's gets to you after a while (if u'r a bipolar. at least that what i learned in this past 3 years..

look forward for your next post! (^^)*

8:08 AM  
Anonymous Anonymous said...

Hey I belive all those in the wards know too much and or not really mad ! Now, am I mad ?

8:26 PM  
Blogger MedStudentGod (MSG) said...

Personally I think that most Psychiatrists are already crazy and that is the reason they gravitated towards the field. Plus they take themselves far too seriously - as if they control the world with their minds or something :)

Step 1 then clinics...CAN'T WAIT!!!

9:40 PM  
Anonymous Anonymous said...

I have to say I'm more than a little disturbed at the attitudes here about people with psychiatric disorders. These people have a disease; they can't help it. Are you also afraid that working with oncology patients will make you catch cancer? Or working in OB will make you pregnant?

Not trying to break up the party or anything. I'm just dismayed at the way people with mental illness continue to be stigmatized in the 21st century - and by medical people who ought to know better.

In any case, good luck with the psychiatric rotation. I'm sure it'll be challenging.

2:51 PM  
Anonymous Anonymous said...

No TV and no beer make Homer something, something...

9:20 PM  
Anonymous Anonymous said...

Go crazy? Don't mind if I do!

10:37 PM  
Anonymous Anonymous said...

Mmm, something....

3:44 PM  
Blogger genderist said...

As long as we're giving out extra credit, one extra point will be awarded for all future Simpsons references.

9:47 PM  
Blogger ACG said...

damn.. I knew it, but I just found your blog.
that's gotta count for something.

8:51 AM  
Blogger DrG said...

Linked to you in case your interested.

10:05 AM  
Blogger Dave said...

Can you pleaaase do a post to acing Step 1 of the boards like you did for the MCAT? I'm taking it on Saturday.

4:44 PM  
Anonymous Anonymous said...

I asked a psych pt in the ER this weekend if she had ever seen virgina wolfe.and she ..........."yes, and i'm like her"..... i was like holy crap. she is alert and oriented. haha

8:42 PM  
Anonymous Anonymous said...

i keep thinking her name is Queen Amygdala.... oh god i have been studying again!

10:51 PM  
Anonymous Anonymous said...

the field of psychiatry and mental health in general seems to generate a fair amount of ambivalence and insecurity in many of us. most people are curious about the human mind, but that curiousity is usually usurped by the avoidance of emotionally charged material, fears of our own neurosis unleashed, merging with the psychotic patient, etc.

on another note, i see the thread on the schizophrenia/bipolar deal. inevitably, the internists who did exams on the psych unit not infrequently put bipolar AND schizophrenia in their H&P's, which is entirely wrong.

still, those in the field know it can be difficult to distinguish the two. some docs lean heavily toward bipolar and the mood disorders and can make a case that nearly all schizophrenics are bipolar. it's a trend, just like everyone 50 years ago with a government conspiracy was always a paranoid schizophrenic.

truth is, in some cases it is hard to distinguish. and the schizoaffective diagnosis seems overused and not clear to me in a fair amount of the cases it's used in. the crux in modern psychiatry of course is primary mood disorder vs. primary thought disorder.

i find the whole field perpetually intriguing, even years after discovering my initial awe.

similarly, i find your blog the same.

take care.

6:25 AM  
Anonymous Anonymous said...

as far as the patients being ass holes - that may be true in some cases - they're really not THAT much different than you or i.

6:32 AM  
Anonymous Anonymous said...

I really enjoy reading your blog, it's hilarious! I have sent the link to friends of mine in med-school, pre-med and "normal" people alike have all responded that they love it's humor and honesty. Random question not having ANYTHING whatsoever to do with you post: how do you feel about the D.O. degree and osteopathic schools in general? I'm applying to schools right now, and I've been getting nervous and decided that I should apply to DO's in additional to the 18 MD schools I'm applying to. Sorry I know this isn't relevant, and you probably don't have time to answer such pesky questions. Just though I'd give it a try since it sounds like you've definitely got a good head on your shoulders and can give respectable advice.

10:18 AM  
Anonymous Anonymous said...

why did you write "hell no: psychiatry"

11:58 AM  
Anonymous Anonymous said...

Listen up!

Schizophrenia and Bipolar disorder (manic depression)= manic depressive psychosis!

schizophrenics are more likely to suffer hallcinations and engage in pointless repetitive behaviour.
manic depressive psychosis most likely to be overeactive, destructive and changeable (Frith & Johnstone, 2003)

Psychoanalyst, Swansea, U.K.

3:44 PM  
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