Wednesday, December 7, 2011

Conversations from Psychiatry

I have only a short post for you, since I only attended parts of my already short Psychiatry rotation.Other than that, do let me know what you all have been up to, how are your rotations going, and for my co-interns, how bad is the exam fever?

An ongoing discussion about various ways in which funds can be used by the department.

J: Sir, we can get carrom boards in the wards for indoor patients, some entertainment for them. Both the side rooms are empty only most of the time. We can keep it there.
Y: Yes, that's a good idea, but who will take responsibility for taking care of the carrom boards, that is the question.
P: Oh yes, always good to entertain the patients. Tell me, is the TV in our ward working?
J: Yes sir, the one in the male ward is working, the one in the female ward isn't.
P: Okay, don't you people want to install a treadmill in the ward? Let's get a treadmill. All you junior doctors can work out on it, patients can work out on it, good for everyone.
J: <Says nothing>
J: (trying again) We should get some games for the patients to play and pass time. We can get something like playing cards.
P: Yes, let's get them Tarot cards.
Me: <mouth hanging open>
J: Sir, the psychotic patients will make predictions with the Tarot cards and become even more psychotic.
P: Yes, that should be great.
J: (looks at where I am sitting) All you interns, please go sit in the next room.

{J=Junior Doc
Y=Unknown in pyramid
P=Senior doc
Me=Bottom of pyramid}

Intern: (Shouting in the ward for a patient) ABC, ABC... ABC kaun hai?
X: Haan ji, yahaan hoon.
Intern: Aapka khoon nikalna hai, chalo so jao.
<proceeds to collect blood>
Intern: <handing over a bulb> Issme Urine collect karke table pe rakh dena.
X: Theek hai Doctor sahab.

<Intern goes and starts studying>

<After some time>


<Everyone gets scared and looks at each other>

Intern: <bravely gets up and goes out> Yes, sister. Kya hua?
Sister: <gives murderous look>Why did you collect the patient's relative's blood? And Urine also!!!
Intern: But, but, I was calling for the patient, and he came!
Sister: But, don't you know admitted patients are in hospital clothes?
Intern: But...
Sister: But what?
Intern: <shuts up and goes to collect the patient's blood now>

{Yeah, this story wasn't even related to psychiatry. But it happened during my Psyche rotation. You will have to just grin and bear it.}

I have had this love-hate relationship with Psychiatry since I joined MBBS. As a subject, it has always fascinated and intrigued me to no end. All the oppurtunities the field brings, to people-watch, and psychoanalyze, and counsel (which very ironically I think I would be good at, believe me or not!) had me in this excited state for a couple of years, and I seriously thought that this is what I would get into. But then, my family explicitly forbade me to even consider this an option, and gradually I realised the field is very sidelined in India, with most people looking down upon Psychiatrists as well as their patients.

But then, I was faced with an even bigger problem. I could not find a single Psychiatrist who would command some respect, in the professional sense, and in the way they conducted themselves. I found no one I could look up to. And I looked. But all of them seemed to have issues. When they came and conducted lectures for us, the lectures were huge embarrassments. None of them seemed to treat their own profession with respect and/or like a science. Disheartened, I gave up.

I know, I'm probably sounding like a demented snob right now. But I have nothing else to blabber about so bear with me. I eventually decided Psychiatry would not be a good career choice for me.

But then, during this rotation, I think I may have finally come across a sane Psychiatrist who commands some respect. Not too sure though. Let's see.


  1. Believe it or not, I was waiting for the second story to happen with someone, including myself. 'Strange' it hadn't happened yet.

    You could always be the first sane psychiatrist.

  2. Haha. Second story happened with my cointern. You should have heard about it by now.

    And like I already said, Psychiatry is now not an option for me.

  3. Well, I agree with you to a large degree. The subject is very fascinating but somehow sometimes it doesn't sound very scientific. Have you noticed? The definitions of stuff like schizoaffective disorder sound very subjective for some reason.

    In our department, there's exactly two 'sane' psychiatrists, I'd say. It takes a very empathetic person to take up the subject in the first place, so you see more talky people rather than you know, the regular stern doctor types.

    But what I personally dislike about the practice of psychiatry is how it's so psychopharmacology based and how the therapy aspect of it is not practiced all that well.

    And as for psychiatrists being looked down, I think amongst the specialties everybody looks down on somebody else. The Surg ppl look down on the Med ppl and vice versa, everybody looks down on Dermat and Psych, and Ortho ppl look down on everyone else. :D Cant help it?

    But I agree, there is a sort of social stigma attached to mental illness simply because most people really have no idea what these illnesses are really like, and Bollywood depictions have not helped.

    We were luckily never asked to collect blood in psychiatry since our head of department said we were to do only those things which were specified in our logbooks, so we actually sat in the OPDs, looked at patients and attended CBT and REBT sessions. It was pretty good but only if you have the patience for a LOT of talk.

    And why have I ruminated so much over psychiatry you might ask? Umm, my dad's a shrink, too. :D

  4. @Tangled... : The definitions in psychiatry are definitely vague and subjective, many a times. Not that I have studied enough of it ever to be able to pass judgement.

    Your psyche department still sounds quote great. And you are so totally right about all the specialties looking down upon each other, hehe.

    Ortho definitely, definitely takes the cake. they all think they're super studs from heaven :D And most times, others agree as well! :D

    I understand how abroad the field is much better developed and advanced, guess India just hasn't reached that stage as yet, with many more other diseases and health problems rather than the mental ones being in prime focus as of now. Also, with India's family system, inherently lesser mental conditions are actually treated as illnesses and treated. Most of the patients just get along in their daily lives, without ever receiving medical attention.

    Your Psychiatry rotation seems to have gone very well, I would say.

    And hah, so you must have seen this profession up close. :D Hope I didn't say anything too offensive about the branch. Haha. But everything you said makes a whole lot of sense, especially about the therapy aspect of it not being practiced that well.

  5. Hey,

    I didn't know you had a knew blog and especially since I was away from blogger.

    Love this place. It's cosy. I love the name of the blog. Though it evokes a strange mix of feelings: sterilized syringes, mouth ulcers and ethereality. I mean you WOULD love Dannie Abse.
    Read him?

    May be I will keep coming back here.


    p.s.: Oh forgot to introduce myself: I used to write even odd if you remember. I posted about Saarang Writing Awards on your fb wall.

  6. And I have shared one of your posts without your permission. I hope you wouldn't mind.

  7. @TheUglyCaterpillar: Hey, I still miss Even odd! Where do you put all the stuff you used to write over there?

    This blog is basically my non-poetry baby :D Quite full of Medicine.

    Haven't read Dannie Abse, will now.

    I hope you keep coming back, inspite of all the medical drivel.

    Which post you shared? Doesn't matter, I don't mind anyways.

  8. Personally, I think psych is a very subjective field. Can be very demanding n satisfying but most often ends up as a farce!
    Won't recommend u take it up. Consider Opthal, ENT n Pathology.
    And never judge a branch by it's internship experience. U'll probably start preparing for VJIT BTech admissions!

  9. I guess psychiatrists have to be crazy to understand crazy people. And they ARE looked down upon - but I don't think this attitude will last for long. They're way too needed.
    I have met psychiatrists I dislike - the famous Dr. Anjali Chhabria. After waiting for two hours, I recently got to meet her for two minutes for some information I needed. And I can certify that she's a nut.
    And then again, I think the HOD of Psychiatry in my college is one of the most pleasant and helpful people I have met. So are the others in the department. I guess you have to be very strong and stable mentally to take it up as a job. I'd never do it though...I Think I'd get bored.