questions and answers

I am half-way through my first elective of 4th year: Inpatient Child and Adolescent Psychiatry.The following was overheard or asked of me during the week....

Q: Am I in trouble? (asked by a 10 year old new admit who we were about to interview)
A: No, you are not in trouble and no one here in is trouble. We just want to talk to you so that we can get to know you and figure out how to help you. (So that you will stop listening to the voices in your head that are telling you to cut yourself, or at least tell an adult that you are hearing these voices before you do what they suggest.)

Q: Can I have a piece of gum? (asked numerous times throughout the day by pretty much every single patient on the unit)
A: Yes, would you like mint or strawberry?
Q: Can I have one of each?
A: Yes. (Which reminds me I'm almost out of gum, better stock up before Monday.)

Q: When you were a kid did you ever stay in a the hospital like this? (asked of a new patient shortly after I introduced myself and welcomed him to the unit)
A: No. (And I'm so sorry that inpatient psychiatric stays are the norm in your life and that at age 13 you have already had three admissions. I wish I could tell you that you everyone stays in the hospital when they are young and it is normal, but I can't and so I just try to distract you with another subject. But you are too smart and you ask me again, and again until finally I tell you that I was very lucky because I was healthy growing up and my first time in a hospital was when I was working in one. And then you say, "oh" and seem a little sad so we talk about baseball and other things...)

Q: Am I enjoying my child and adolescent psychiatric elective?
A: Yes, but it is bit depressing and I remember why I decided to go to medical school instead of pursuing a PhD in psychology.

Q: If your parents are illegal (aliens) and they brought you here can you be sent to jail?
A: No.
Q: That's good because its not your fault that your parents brought you to the US so that you would have a chance at a better life, right?
A: Right.

Q: Why do I have to stay here? Why can't I go home?
A: Because we want to keep you safe and help you. (And right now you are either a danger to yourself or others.)

Q: Will you color with me?
A: Yes. Always, yes.

Needless to say I have given away a lot of gum, colored numerous pages of batman, spent hours talking about everything and nothing. After a a week I've pretty much decided that these children are simply trying to survive. Children of young, single parents and broken homes. Children that are products of domestic violence and sexual abuse. It is no wonder that they are depressed, defiant, angry, scared. I know that many will never recover but for some I hope that this is simply a respite and that ACS or a new foster family or a new counselor will finally get through or provide the needed structure. My hope is that some of these children may begin to live life and move beyond the depression, the voices, the hurt. I know that many will forever be scarred by their childhoods but I hope that some may show the resiliency that children seem to have and that often amazes us. I have to hope this for them because the alternative is too depressing to contemplate. (I just read this NYT article regarding the adult inpatient psychiatric treatment state of affairs, I think pediatric resources and options are slightly better but still, very sad.)


Meet Sancho the puppy!

In case you are wondering this is a very non-medical school post ahead. So if you are looking for some SGU insight feel free to come back another day. However if you have any new puppy advice or want to just kill some time please do continue.

In developing news the big Bday surprise for Dr. Boyfriend was a huge success! We are now proud new furr-parents of a 3 month old American Staff Terrier/Boxer/Mix.

Meet Sancho!
We picked him up this afternoon and he is home and adjusting very well. He likes his crate and is semi-okay with being confined to the kitchen for now. Housebreaking will start in earnest in the AM but he quickly learned to use the WeeWee pads we put down and has demonstrated great love, playfulness and his personality is really starting to show. For the most part he seems like a happy-go-lucky guy. No whining or crying (yet) and he seldom barks. Although he seems to have a bit of an URI and a cough. We thought maybe it was just the Bordetella vaccine administered nasally but as the night goes on I'm becoming more and more certain he has a doggie cold. He sounds kind of congested, poor thing.

I haven't had a puppy since I was in middle school so I'm a bit new to all of this. We walked him around the neighborhood and despite his initial fear of cars, stairs, other dogs and the airplanes flying overhead (we live pretty close to the airport) he did very well. Everything is of course new to him but it was kind of funny to see him refuse to use the stairs or step off the curb. It was definitely one of the more entertaining dog walks I've ever experienced.

Anyhow after his dinner and our several attempts to have him potty outside failed we let him use the WeeWee pads inside and the he curled up and fell fast asleep. That was at 8:30pm. Dr. B and I made dinner and had chance to relax for a minute but by the time we were ready for bed Sancho was awake and looking concerned. But we put him in his crate and he allowed us a few hours of sleep before Dr. B heard him stirring around midnight. After a quick pee he went right back to bed and sleep. What a good dog!

But I didn't... insomnia kept me up for awhile and then I heard a commotion and found Sancho staring at the Wee Wee pad corner so I let him out of his crate. He didn't want to go back in so I allowed him a quick playtime and then left him with free reign of the kitchen. After faking me out and settling into his bed I left him. But then he promptly decided to use the WeeWee pad again, this time leaving a rather smelly mess (but at least he did it where we asked him to). By the time I had cleaned up Sancho was wide awake and wanted to play, and play, and play. So we had some puppy playtime at 2am. I left him after a few minutes and started to blog from the other room where I could still see him. And I think he just fell asleep as I hear a very congested snore.

Yep, he's asleep. So maybe now I should try to do the same... I have a feeling he'll be awake in a few short hours. Oh the joys of multiple night awakenings. But it is all part of the process. And a fun distraction from Step 2 studying.

Home pictures of Sancho will be forthcoming but in the meantime you can read about him and his family via Petfinder and the amazing work of The Barking Lot rescue group.

Welcome home Sancho, welcome home.


Insomnia- take 2

I'm not sure that this post has a point. I'm wide awake, SUPER wide awake and have been since 4:30am this morning, which considering I didn't fall asleep until after 1am is kind of odd.  I feel strangely hypomanic, this is my third night/day of not needing very much sleep: 3 hours, 5 hours, 4 hours. And this from a girl who is normally vary happy to sleep 8 or 9 or more. So yeah, insomnia is weird.

If I didn't have my exam in 8 days and I wasn't busy with a super B-day surprise for Dr. Boyfriend*** I'd be more concerned. But I think this is my way of displaying stress, or something like that. Not that I feel stressed, I fell strangely calm and ready but at the same time like my heart is pounding and my fingers are trembling and I just don't need to sleep. Or eat. It is all very odd. If this is what bipolar or hyperthyroidism feels like than I totally have new respect and sympathy. Not fun. Or maybe this is like ADHD. My attention span has been whack the last few days as well. Which makes studying and doing a block of 44 questions rather cumbersome. Oh well. Hopefully the exhaustion kicks in and I go back to normal for a day or two before I have to sit for Step 2. I don't feel very confident to sit in a chair for 8 hours at this point. I can't even sleep in my bed for 8 hours right now. Something has got to give!

**** We are adopting a dog! Dr. Boyfriend has been asking me for some time and I kept saying no, well anyhow I decided that it was time. I'll be away at rotations for most of next year and if a dog would make him happy and keep him company than who am I to deny him that? He let his wife move to Grenada and has put up with marriage via Skype for three and half years now. It is my time to do something for him.

Future Fido- I know you are out there... we are looking for you....

(We have an appointment to see some American Staffordshire Terrier puppies at a local dog rescue today and I'm feeling confident.)


This I Know...

I DO want to be physician.  I chose this career, or it chose me?  Either way, I'm doing it.

But sometimes, just sometimes the path is long and wandering and so I start to wonder... not is it worth it exactly, because I believe it is, or I wouldn't be doing this, but sometimes I pause. I guess what I'm trying to say is that I see friends who have families already (kids, careers, homes) and I wonder if what I'm sacrificing is what I truly want. I see young athletes at the height of their careers and can't help but think that they are going to retire before I even get to "practice" my profession. The path is long and the sacrifices great. I think they are worth it, I know they are worth it. But sometimes, just sometimes I wonder what if I had taken a job teaching first grade or actually traveled around the world after college instead of getting on the MCAT/pre-med train if I wouldn't be just a happy as I am today.

I have no regrets. I don't. I fully understand that I chose this life, I CHOOSE this life and in the end it will be worth it for me. And don't feel bad for me in the day-to-day. Sure medical school is "hard" but really what in life isn't hard? And what I get to do and the people I get to meet, those are things that I do not take lightly. I love my life and I love medical school (well now, maybe not so much in Terms 1-3) but overall medical school is an amazing time. I got to live in Grenada and meet some really good friends. I get to see illness and pathology and health up close every day. I have to travel a bit but that just means I get to see a variety of hospitals and different patient populations. I am away from Dr. Boyfriend but I am lucky I have a husband that is so supportive and that we have a strong marriage so that this is possible. So I don't ever regret going to medical school or choosing this life. But still I wonder what might have been....

And yes, I'm know residency will be fine. It will be hard and long and I'll sacrifice some more along the way but that is what being a doctor entails and I signed up well aware of these facts.

I suppose some of my "pause" comes from the fact that Dr. Boyfriend is about to start the last year of his fellowship thus his journey is almost over. I've experienced residency and two years of fellowship vicariously so I almost feel like I should be done too. But I haven't even started. And I don't even have a residency yet. Or a personal statement written to apply. Or all my letters of recommendation completed. So here I am, about to start fourth year and I have a LOT to do.

And right now I'm in the middle of studying for Step 2 (test date is just 10 days away) and Dr. Boyfriend is out of town at a conference so I'm alone with my books and so maybe that is making me morose. Reflective. Pondering. Whatever.

But this I know....

I am lucky. I do want to be a physician. It is/will be worth it. This I know! (along with lots of random medical knowledge, some actually important and plenty of arcane facts that I'm sure I will promptly forget as soon as I take Step 2.)