Overwhelmingly precarious.
Wednesday, September 9, 2009
I'm well and truly into the thick of Psyche Rotation, and true to my word, I'll not be bringing you any patient stories.
All in all, I've found psychiatry a potentially overwhelming area; it's not that the theory is gargantuan or the hours are terrifying or even that it's diagnostically mind-boggling.
The challenge, I feel, is that, for each and every patient under the Specialist Psychiatry teams, their issues pervade through every single aspect of their lives. There's no aspect that seems to escape the ravages of severe mental illness;
Physical Health
Interpersonal relationships
Education
Sociability
Sense of self
Money management
and more.
It all gets absolutely totaled. And it's all such a synergistic failure. Without most aspects of a person's life functioning, they're so vulnerable to falling, as my friend James would say, in a screaming heap.
I understand the management principles and theories for vulnerable patients, and I can see these being applied relatively consistently to a variety of situations. I, like the majority of staff, have great, realistic, hope for the patients, their management plans and their prospects. It's so frustrating when one of, say, fifteen aspects of a plan doesn't work the way it should and the patient's back to square one.
It's astonishingly precarious. And, I guess, when you apply that idea to patients in moderate and milder situations, that any one event or stressor can tip them into a severely dysfunctional state, it's pretty worrisome.
So, in a nutshell, that's my experience in psychiatry; overwhelmingly precarious. Oh, and one of the Fat Man's laws;
On a lighter note, I recently overheard the following conversation between an Australian family arriving into New Zealand and the Customs Officer;All in all, I've found psychiatry a potentially overwhelming area; it's not that the theory is gargantuan or the hours are terrifying or even that it's diagnostically mind-boggling.
The challenge, I feel, is that, for each and every patient under the Specialist Psychiatry teams, their issues pervade through every single aspect of their lives. There's no aspect that seems to escape the ravages of severe mental illness;
Physical Health
Interpersonal relationships
Education
Sociability
Sense of self
Money management
and more.
It all gets absolutely totaled. And it's all such a synergistic failure. Without most aspects of a person's life functioning, they're so vulnerable to falling, as my friend James would say, in a screaming heap.
I understand the management principles and theories for vulnerable patients, and I can see these being applied relatively consistently to a variety of situations. I, like the majority of staff, have great, realistic, hope for the patients, their management plans and their prospects. It's so frustrating when one of, say, fifteen aspects of a plan doesn't work the way it should and the patient's back to square one.
It's astonishingly precarious. And, I guess, when you apply that idea to patients in moderate and milder situations, that any one event or stressor can tip them into a severely dysfunctional state, it's pretty worrisome.
So, in a nutshell, that's my experience in psychiatry; overwhelmingly precarious. Oh, and one of the Fat Man's laws;
4. THE PATIENT IS THE ONE WITH THE DISEASE.
Customs Officer; "I see here that you've put your occupation as Dairy Farmer..." He pauses and looks up.
Farmer; nodding "Yeah mate, that's not a problem is it?"
Customs Officer; "Well, I also see that for the question Have you been on a farm or in contact with livestock in the last thirty days? You've ticked No."
Farmer; "Oh.... Does that count our property too?"
The Customs Officer and Dairy Farmer look at each other awkwardly. Farmer, despite his best efforts, is genuinely not comprehending the problem. The Officer fails to remain calm.
Officer; "Are you stupid?"
.
Probably knew that his own cows were perfectly clean. ;)