Life of a medical student

Psych Ward 1.1

Life of a medical student part 7: January 2019

Current activity: Studying Psychiatry notes at Seattle Coffee shop (my second home for the past few months).

Pro: There is...COFFEE!! I can people watch when I unable to concentrate and I am nowhere near my bed so the temptation to sleep is not available at the moment. Nerd mode initiated!

Con: I have so much work to get through...

Music track: Cursed by Jacob Lee (Listen to the lyrics – I feel like they perfectly describe psychiatry patients and it makes me want to cry).

WARNING: This chapter will contain a lot of my own opinions and views based on my own experiences. Key words being "my own" which means that they are not meant to be offensive or agreed upon. It is just my perception and you are perfectly entitled to your own views on the same subject.

Okay so the main topic of discussion as usual is what I am currently focused on study wise at this moment in time: Psychiatry.

Some things in medicine are not easy to be exposed to (understatement of the century). I am aware that some of my colleagues are made of stronger stuff than I am...but I am not yet (and I don't think I ever will be) as desensitized. I acknowledge that it is a coping mechanism for countless who work in the health care system. It is hard not to be but I still feel everything. And to watch how someone's life is falling apart or how all their decisions are made for them...it is not something to be taken lightly. Especially when you do not agree with the system making those decisions. As a student you have no say in the matter which makes it so much worse. You are there to learn, clerk patients and observe. Your opinions mean nothing and you cannot change the system. You are literally at the bottom of the food chain. Face the reality early one. If you DO want to make a change learn the foundation of the system first and see how you could approach it to achieve an actual intended outcome.

Many systems (generally speaking) are carefully laid out, discussed and planned. They are very pretty on paper yet completely different when applied to real life situations. A perfect example is the concept of Communism. The idea that everyone is treated equally and given equal rights sounds amazing yet history has shown and proven how corruption can take over and dictatorship rules nations. The same can be said for psychiatry. In this field of medicine a multi-disciplinary approach is used. It makes use of a large pool of specialists (a multi-disciplinary team; MDT): psychiatrists, psychologists, social workers, nursing staff, physiotherapists, occupational therapists and holistic approaches too such as spiritual support. Ideally when an individual is admitted to a psychiatric hospital (I will be referencing to public hospitals which run differently to private in South Africa) he or she will be interviewed and observed by each of these specialities. Then a large ward conference will be held where each specialist will report their findings and together they will decide future actions to be taken – Will this individual be admitted or not? What medication will be prescribed? Does this individual go home eventually or require permanent care?

Funnily enough said individual's personal wishes do not really play a role here. Yes, they will be mentioned during the conference but do not be mistaken; they hold no weight. This ideal process sounds reasonable enough does it not? By comparing notes delusions, malingering and psychotic episodes can be identified. Considering that even the best liar slips up when he retells his story a million times. True the ultimate liar will pass but the average individual will be properly processed in this system. I am not denying that these individuals need professional help – they honestly do and mental health is a major and significant issue. I am merely pointing out that the system is not in any way perfect. For this system to work you expect each of these specialities to do their job and the sad truth is that this is rarely the case. Because if one of these specialities falls through then the whole system crumbles and the system that was supposed to be the pillar of hope and salvation to this individual is the same system that does not do him/her justice. This system fails, disappoints and utterly annihilates all faith I have that a true difference can be made in this branch of medicine.