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Saturday, 12 June 2010

The Psychiatry Ward

I have manged to survive two weeks of practice in psychiatry, which means am half way done with my psych rotation. I spent the first two weeks in the the chronic ward.. While I move on to the acute ward for the next two weeks ( going up tempo), thought I'd share my time in the chronic ward..

So what kind of patients did I meet there, well basically patients with chronic conditions, meaning more than 6 months or milder presentation of psychiatry conditions.. Amongst which are:

Depression was the most common I saw.. either as major depressive disorder or bipolar disorder (aka mood disorders). Most cases where brought in after an unsuccessful suicide attempt or in the case of bipolar after a manic episode. quite sad stories but was good to see how therapy was helping them get back to their normal life.

Delusional disorders (a fixed belief that is either false, fanciful, or derived from deception) was the most fascinating to me. What fascinates the most is that this people have no insight to their problem, you cannot convince them that what you believe isn't true. Another thing that fascinates me is how hard is it for you as a doctor to tell this are delusions, what if what the patient is telling you is true? because there were cases where it wasn't possible to obtain hetero anamnesis (information from someone else).
here are some types of delusional disorder,

  • Erotomanic Type (erotomania): delusion that another person is in love with the individual.
  • Grandiose Type: delusion of inflated worth, power, knowledge, identity, or special relationship to a famous person.
  • Jealous Type: delusion that the individuals sexual partner is unfaithful.
  • Persecutory Type: delusion that the person (or someone to whom the person is close) is being malevolently treated in some way.
  • Somatic Type: delusions that the person has some physical defect or general medical condition.

(not all cases) the most interesting for me.. spoke about this in previous post.

Personality disorders.. basically a behavior that deviates from your normal expected behavior. one interesting one is borderline personality disorder, not quite there but almost there. this is between psychosis and neurosis. individuals are emotionally unstable

Alcohol Withdrawal or generally withdrawal from any substance of abuse (crack, coke, marijuana etc). Who knew how hard it is is to quit an addiction? you actually need to be admitted to a hospital facility because you could die from withdrawal symptoms, or in most cases relapse.. So please drink responsibly and stay away from drugs!!

and lots more can't mention/remember all.. One thing I kept asking myself, which am sure is the same for everyone is, doesn't everyone have some kind of psychiatry condition? because if there is one thing I know is that I have diagnosed myself with a lot of psychiatry condition.. I mean almost every one has some sort of personality changes or mood changes, or delusions at some point. (for example there are time I am walking in the night and I see someone and think they want to harm So what brings you to the Psychiatrist? (cause obviously not everyone out there is gonna go to the psychiatrist when u or someone notices a change in your normal behavior/personality). Well just when this 'change' interferes severely with your daily life.


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Monday, 7 June 2010

Music Therapy

Honestly I cannot really say what this was meant to be (creative therapy was way fun). We got in to the room for the session, patients students and doctors, some very soothing music was played for about five mins, then we went up tempo :-), the music was switched up to some very playful  tune, like something you would hear in a silly cartoon. we listened to it for about 10 to 15 mins. The music made me feel like dancing and laughing, but since no one was, I just nodded my head a bit and smiled.. ha ha.. Then the worst came for the next 45 mins there was a discussion with the patients in Hungarian. this was serious torture as I did not understand a single thing and had to sit there  (like a moron), because it would have been so rude to walk out. They were laughing and talking and yours truly just looked.
The other day I went for a large group session where doctors, patients and students sit to discuss (a larger group than the music therapy group), and for one hour I had to sit there not understanding anything. Seriously this is real torture, whats even worst is that no one explains anything to you after (well I should have ask rite? yeah rite like they would explain an hour session to a bloody medical student). This language barrier is really getting to me, it puts a big barrier in front of my learning. And for a career like medicine, especially in the psychiatry ward, communication is key to learning.. So tell me how can I learn?
Advice to anyone who is yet to go study medicine (Don't), go where you fully understand the language. If you are like me already in a foreign speaking language country, learn the language. and if you are more like me that after 5 years you realize ooh I should have learned the language. Well its too late so bare it.. (note, I have no regrets coming here).

If you have the ability to hear and understand/ make sense of what is being said be grateful. There is a medical condition where patients have the inability to understand spoken language (kinda like me today) which they normally understood before.. How frustrating.


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Sunday, 6 June 2010

To be a friend or not?

Hold on wait till you have had this experience......
I meet a patient on my way to a group therapy session, I knew nothing about this patient, but we exchanged gestures, talked a bit, some weird question was even put in but we (me and my mate) chose to ignore/handle it well :-). The patients looked kind of sleepy, so I would guess was under sedatives this could mean mania, but I may be wrong. whatever the diagnosis was, it doesn't hurts to give a smile to the patient, so I do just that and got to my seat.
Stares at you half of the group therapy session (creepy) and every nook and cranny I found myself in the hospital that day, I happen to see the same patient who comes to ask me for my help when it actually wasn't needed.. scary huh? yeah, that sent me out of the hospital (well not literally, I had to attend consultations, but I was the first one to get there and I even hid at the coat hanger ) cos honestly I was scared to death. I have no idea this patients diagnosis, but some part of me tells me it might be bipolar (manic-depressive disorder).

So I ask the big question to be a friend or not? should I have paid more attention and given more of my time to this patients? Or was my little time I spent with the patient and smile appropriate?As doctors we are taught to never get to attached to a patient.

  • This blog is nominated at the Nigerian blog awards, under the Health, fitness or sport category (not a surprise) I have added a link on my side bar or click here, so please go vote for 'Becoming a Doctor'.
  • All apologies for any grammatical error you find in my posts, I have lived in Hungary for 6 years so English is not my first language anymore, actually, I don't have that much time to re-read and spell check and all that stuffs as I am quite busy, (I do love blogging don't get me wrong) but I do come back to correct when someone notifies me or I realize. So please feel free to correct me, or if you want the post to be my editor, hola (I think I might know some one who is interested, ha ha.).
  • I know the medical field is filled with so much jargon's, so please if you don't understand any of the jargon's, let me know, I will explain further.

pretty please..keep smiling, love
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