finding my groove

I think I used to think five years and bam, you're a doctor. You learn the knowledge and put it into practice, right? I'm sure you'll agree it's not quite like that. I'm working under a consultant just now who will retire just as I finish the job. He's worked, in various capacities as a doctor for, I'm guessing, 40 years at least. Experience is priceless. Learning how to tackle the concotion of issues patients, relatives, fellow staff, establishments throw up each day is invaluable. As time creeps on, in the space of a year or two, the art of observing, of patience and of calm in the face of chaos, become covetted skills. The art of being able to say, "We can watch, we can wait" even for a moment longer, can bring clarity to a situation looking dire moments before. From cardiac arrest calls to irritatinf relatives to the angry patient that moment, I'm learning is vital. Just as finals are complete at medical school, it's easy to think that's it, but the more I work, the more I realise that was just the very beginning of a long road, a long road of continual learning, adjusting, reviewing, reading, interacting and hopefully, enjoying. Though it times it seems impossible, I'm doing my best to learn from the older folk, they've seen a lot and that counts for a lot.

troubled

His mother strode along the corridor, "oh quieten will you, nobody's after you," something she's said for 30 years or so. Thirty years caring for her son. And now we're at a loss. He's been to many facilities; turned away from many, not coped in many. And here we are again, rejections and options running thin. He shouts, shouts louder, paces, hands failing. The uncertainty is too much. These voices have troubled him from youth, from those early teen years. When the shouting settles, a shell of a man remains, apologising profusely, unable to control these outbursts. A personality somehow evades this chap, destroyed even before it had a chance to blossom. The voices, the thoughts too much for a child to handle. And now a grown man, lost, fumbling, child like in the midst of the harsh adult world. But his mother is still with me, his father hobbles along propped up by a stick. The father is quiet and full of thanks but with a look of defeat, of regret, of a hard life. His mother is tearful, wanting the best for her boy. A boy who is long since a man, yet troubled with the affliction of illness. Illness that has halted a personality, distroyed hopes of a life expected as the norm at birth. Illness that society all too quickly rejects or ignores, frightened of what lies beneath, frightened of the possibility. Even the highest does of the best medicines do not seem to help, the illness runs too deep, too entrenched. This is medicine.

balance

I used to think if you worked hard, did right, looked after yourself things would be fine. Sometimes I long for that innocence. Medicine is tough. I thought it was tough because of the endless exams, the long hours, the emergencies, the difficult decisions. The hardest part for me is chance. Disease isn't selective, the healthiest folk can be devastated, the survivor can be pummelled again and again by disease, the healthy mind can be engulfed by terrifying thoughts. Chance is the possiblility of being born into a family; broken by abuse, drugs, alcohol. Chance is the possiblility of being born fit and well into a happy home.

I struggle with finding the balance; realising that just because we often see the worst of humanity, it does not mean that this accounts for the majority of humanity. Sometimes it's all too easy to lose it. I hope I can work on finding a happy balance.

In the mind

I'm trying to read some psychiatry stuff and I'm thinking what would a mental state exam on me say. What would someone think of my beahviour and appearance, my mood, my thoughts.... and what would I think of their assessment. Psychiatry is so personal, so invasive but this is what makes it so fascinating. What happens in the chemistry of the brain to trigger persecutory delusions, flights of ideas, pressure of speech, florid halucinations and psychosis? It mind boggling and intriguing. It's daunting. I think I'm almost looking forward to getting stuck in. But first a lot of reading, I feel quite out of my depth.
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Listening to: The Wallflowers - Into The Mystic
via FoxyTunes