ndab Ah Yes, Medical School: Serenity Now

Thursday, June 08, 2006

Serenity Now

Something remarkable has happened. Actually, I am writing this right after it happened. Let me explain. It's 2:00 PM, and I'm sitting at a computer in the schizophrenia ward of the local VA. I have had little sleep. I'm beaten down from almost one full year of all this. The 4:00 AM alarm clocks. The driving. The pain, humiliation, and frustration of being the most clueless person around all the time. The patient's and their issues (and their non-issues that they think are issues because someone or something told them that they have issues that are not real issues). The futility. The guilt. Frustrations. Anger. Grief.

It really weighs on you, and I think "it" is mostly fatigue. But I'm pretty sure that everyone, at some point, experiences what just happened to me. Like I said, I am sitting at a computer, having finished my work two hours ago but still waiting for the resident to read my notes so that I can go home. I am sitting at a computer, having just noticed that same resident emerge from her office with a brand new hair style, a hair style she no doubt spent the last half hour sculpting and molding to perfection, knowing full well that there were two glorious notes written by none other than me waiting for her approval, just sitting idly in her VA inbox, waiting to be free. And I think of all the notes I've written, all that paper. All those labs. The progress notes. The transfer notes. Accept notes. Discharge notes. Procedure notes.

Like I said, I am sitting at a computer, passing the time away, when I look up and see a patient pacing back and forth, a schizophrenic patient smacking his lips because the medications made him do so. A schizophrenic patient so undeniably focused on this task of walking back and forth, up and down the halls for reasons obvious only to himself and the voices in his head, that his dedication would be unmatched throughout the world. He sees and hears nothing else in the world. He just keeps walking back and forth, smacking his lips. Nothing else matters.

It was right about at that moment that I started laughing hysterically.

I laughed for about five minutes straight. Watching this guy do his crazy thing. Waiting for my resident to acknowledge my existence. Wearing every ounce of a year's worth of fatigue on my shoulders.

Maybe it's not so bad after all.


Anonymous Anonymous said...

That's the spirit. If you don't laugh you might cry and laughing is always better than crying.

2:46 PM  
Anonymous Anonymous said...

She was fixing her hair for you

3:46 PM  
Blogger Darwin said...

I do feel your pain, sometimes laughing is the only thing that keeps you sane, even hysterical laughter.

Just hang in there, it'll be over soon. I finished my degree last week and it feels unreal to think I never have to worry about another lecture or exam or whatever for the rest of my life! It's worth the wait.

3:49 PM  
Blogger The Angry Frenchie said...

Try not to go too crazy.

6:33 PM  
Anonymous Anonymous said...

He was smacking his lips for you

7:20 PM  
Blogger GB, RN said...

Dear Lord...he's snapped.

7:58 PM  
Blogger genderist said...

Just keep jumping through those hoops... you'll make it...

8:39 PM  
Blogger Gregory House, PA-C said...

Insanity later? No, I think insanity has already set in.

9:19 PM  
Blogger sadielady said...

that is awesome. i would give anything to have witnessed that scene. excellent post.

9:32 PM  
Blogger Audi said...

I totally understand laughing at schizophrenic people My mother is a schizophrenic and at times you just have to look at what they are doing, like playing with there donkey ears and tail, and laugh. Keep laughing it will keep you sane.

11:26 PM  
Blogger Sarah said...

This comment has been removed by a blog administrator.

1:42 AM  
Anonymous Anonymous said...

thats very unethical of a medical student laughing at a schizophrenic.

3:59 AM  
Anonymous Anonymous said...


my psych term (earlier this year) did the SAME thing to me... me and another med student had talked to a lady who told us she was jesus and queen eliz was her brother and woudlnt stop talking about such things doing all sorts of fun pysch things... circumstantiality, clanging - it was all there...

we got down all ready to present the case to each other all proper like... got two words out... and didnt stop laughing for 5 minutes...

its the first time in the 5 years of my med degree (1 to go!) ive lost it.. and couldnt stop laughing... sorta makes you feel bad but great at the same time feeling!

4:35 AM  
Blogger Ally said...

This comment has been removed by a blog administrator.

8:12 AM  
Blogger Ally said...

I don't think its unethical to laugh... it would be unethical to strip naked and run through the ward. Laughing, no big.

I have felt your pain. I worked in a hospital that worked to rehabilitate schizophrenics back into regular life. I was doing a study on their success rate, reading medical records, doing interviews. One lady would only sing to you. She sang EVERYthing. Your name, the lunch menu, that she had to pee. It was great. Broke up an otherwise unbearable day.

8:14 AM  
Blogger The Neurotic Worrywart said...

It's my first time commenting but I really have to say this:

Are you SURE you're OK?????

Lol. Whatever works for you;)

10:20 AM  
Blogger Nightshade said...

Laughter is the best medicine; you'll be healthy and sane if you laugh.

11:55 AM  
Blogger Brittany said...

Lol nice. Poor guy, you really do need to just get away for a week..or year. Hang in there and think about the days when you, yourself will get to torture unsuspecting med students.
Oh, and uptight law student..Nice picture. Did you hear about the Iran president (that Bush helped into office) recently musing over whether or not to use oil as weapons against the U.S.?

12:23 PM  
Blogger Carina said...

My hubby had a similar moment during his psych rotation. What got him through that time was when they switched him to following an attending who worked with the court. Much better--very interesting cases, and he got to sit in on the trial and listen.

I think everyone reaches a breakdown moment like that in medicine and reaches it again periodically throughout his or her career. See if you can get more sleep.

7:52 AM  
Blogger Dayli said...

Great post! hang in there and keep laughing, sometimes it's the only we can do.

1:44 PM  
Anonymous Anonymous said...

As a fellow med student I know the feeling. Between the combination of call, long days and the expectations to study in the evenings and weekends it drives you to question your choice at times. I agree with the fellow comments sleep is a huge factor. Once you get off the rotation and have a chance to rest and do outside medicine things you will feel better.

7:18 AM  
Blogger Pats said...

This comment has been removed by a blog administrator.

9:38 AM  
Anonymous Anonymous said...

One time, while I was working as a lawyer in the legal department of a large US corporation, I had to supervise someone who must have been an undiagnosed schizophrenic. (Not that I'm a doctor.) She was incredibly smart and completely nuts.

Once, when she was telling me how upset she was that her landlord had entered her apartment and taken her underwear, and not just any underwear, but only the really good stuff, I started laughing. It was completely uncontrollable and nervous laughter on my part and I wanted to stop, but I couldn't and I offended her.

Since she was not in mental hospital, but passing as a sane person,I was afraid that she was going to show up with a gun someday, which she hinted might happen, so I quit that job soon thereafter.

9:31 PM  
Blogger Twanna A. Hines | FUNKYBROWNCHICK.com said...

Oooooh, look at you ... dangerously flirting with that thin line between sanity and insanity. I love it!!! :)

3:48 AM  
Anonymous Anonymous said...

I never did the typical med student believing that I had every disease we studied. Except on psych. Schizoid personality? Who doesn't have it? And when I interviewed some young adult paranoid schizophrenics (not the ones wandering around lip-smacking, but the ones anxious to tell me their view of the world) I often thought that they had once been extraordinarily intelligent, and that somehow they'd seen behind the curtain and found truth, and that it blew their minds.

12:31 PM  
Blogger Carol said...

Oh man, don't go getting all Pollyanna on us now.

2:26 PM  
Blogger ArleneWKW said...

As I read this, I started to wonder if we all aren't really just walking back and forth smacking our lips and guided by our own sense of reality. I haven't yet answered this for myself.

5:04 PM  
Anonymous Anonymous said...

get some sleep!!

6:08 PM  
Blogger S. said...

You are my idol.
Did I mention I'm a single female Jewish human being?
And that I'm applying to medical school this summer????
Well, maybe I'm too young for you, but just wanted to tell you how much I like your blog, you are incredibly witty and funny.
So, keep it up!

10:22 PM  
Blogger MedStudentGod (MSG) said...

Since I'm studying this right now in anticipation of my board test next week - humor is considered a mature defense mechanism. I think that's why it works so well and is also so hard to do. Can't wait for clinics to start next month after reading all of your "inspirational" posts. Thanks...

1:50 PM  
Anonymous Anonymous said...

"My dad thought laughter was the best medicine. I guess that's why most of us kids died of tuberculosis." (Jack Handy)

8:50 AM  
Anonymous Anonymous said...

I have a theory that laughter is an expression of fear... Think about it and by all means get some rest!

8:57 AM  
Anonymous Anonymous said...

quit being a fag and get used to it. I hate the fact that you lost your humanity and are laughing at someone who undoubtedly is outcast by assholes like you. He is not a 'schizophrenic patient'...he is a human being who lives with the unfortunate affliction of schizophrenia. Dickhead.

2:01 PM  
Anonymous Anonymous said...

After reading through a few of your blogs, I have to say they are very amusing, if not a little over the top. Being married to a physician, the easiest part of the whole jouney were the third and fourth years. Less lecture, intersting rotations, and except for the step one boards, pretty easy. I hope this helps you cope with your little med school traumas but seriously, you'll need to pull it together to make it in your residency!

10:50 AM  
Anonymous Anonymous said...

This was perhaps your most brilliant post... succeeding even your "Feeling Blue" post (http://ahyesmedschool.blogspot.com/2004_11_01_ahyesmedschool_archive.html).

However, just like that time, it appears very few understood what you truly meant. At least ArleneWKW was close.

I don't know where your heart truly rests with your medical education. But whatever it is that you chose to do, you'll be good at it. You get the big-picture, your articulate your thoughts carefully and clearly. That is, except when you're writing quite as brilliantly as this post and the election post.

Good luck bud.

3:55 PM  
Anonymous Anonymous said...

I feel your pain. I was a social work intern in the acute psychiatry ward at the VA last year. Most of the psychiatrists are burnt out, or like using the patients as their own personal med cocktail experiment...it's unfortunate.

8:36 AM  
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