Reflections on Psychiatry

I leave my psychiatry posting with a huge sigh of relief. I didn't really get to enjoy the posting because there were so many other things happening - family, getting sick, etc. but I think I wouldn't really have enjoyed it anyway if I had that time to spend on it. I might even have loathed it. My aunt gave me a disbelieving look when I mentioned psychiatry as a specialisation option to her what seems like lightyears ago, when I thought I could cope, and now I understand that look, and that I was wrong.

I guess, like many other medical students, I get hypochondriacal about the stuff we learn about, even more so when we're attached to that firm (e.g. in GI we think we're having peptic ulcer disease, in rheumatology it's chronic fatigue syndrome on rheumatic arthritis, etc.). It's relatively easy to dispel thoughts of having those diseases, but in psychiatry things are less well-defined, and more possible. It's like everyone can have certain symptoms of any one mental illness, but those under treatment just have it worse and it's interfering with their lives. One has a bad night's sleep and low mood - could it be depression? Or a feeling of deja-vu - could someone be putting thoughts in your head, meaning that you have schizophrenia? Or one's short-term memory's failed, concentration's shot, and easy words desert oneself - is it the onset of dementia? Or I psychoanalyse myself - why am I acting this way? Is it because someone did something to me last time and I'm having a mini post-traumatic stress disorder and avoiding all triggers of the stress and more? Or is it something in my childhood that's conditioned me in this way?

It's not confined to the self, but to others as well - this psychoanalyses and pseudodiagnoses. She's terribly thin, and doesn't eat - anorexia (I'm half-convinced)? Oh, he must have turned out that way because of a traumatic childhood (it seems everything in psychiatry can be blamed on parents and childhood events... sad.).

Psychiatry leads me to think too much into stuff that way, which isn't good. Talking to the patients also requires the effort of plunging yourself into their abnormal worlds, first to understand it and then to sift normal from abnormal. Some of their worlds are deceptively normal, until you ask the other partiees involved, who tell you the real story. After 1 hour of intensive questioning, or even after months of consultations with a patient, you might not know everything you need to know at all. My team-members told of a patient who was normal in every sense except his perception of himself (he thought he was someone else, in a totally different job and situation), and an anorexic patient who was in consultation for something else and kept her anorexia secret for 5 years.

So, no, psychiatry's not for me. I'm half-mad after 5 part-time weeks - what about 50 full-time years? No thanks!