Why my job is tougher than yours

[Oliver Clozoff]

In just 2 months as a psychiatry resident, here is a sample of what I've had to deal with.

• A woman who was so depressed and hopeless (and character disordered to boot) that she wanted to have a "candy party" in her garage with the door closed and the car engine running so she and her 3 girls could all "go to sleep and not have to wake up"
  
• a schizophrenic off his medication for several months, floridly psychotic and wielding a knife, attempting to cut off his own penis as an act of religious repentence for his sexual indiscretions.
  
• a young woman raised in an extremely religious family so conflicted over her sinful temptation to look at pornographic photographs that she fasted for over several weeks straight, praying almost continuously until she collapsed from exhaustion and malnutrition.
  
• a demented woman with alzheimer's disease with the delusion that "there are chiggers underneath my skin" who had excoriated the skin all over her body in an attempt to remove the chiggers. She was found by a family member with a knife about to attempt to "dig them out" as well.
  
• More suicide attempts by overdose than I can count.
  
• a psychotic man (again off his meds... note the pattern) with the desire for "big breast implants" as well as surgery to implant a metal rod in his penis "so it'll be hard all the time".
  
• A paranoid schizophrenic who attempted to liberate his neighbors from what he perceived to be the prison that they were being held in. It turned out to actually have been their enclosed backyard surrounded by a hurricane fence.
  
• An 18 year-old anorexic woman who had lived for the several months 3 months on nothing but tomato soup, popsickles, and gatorade. Her body, starved for nutrients, cannibalized her own heart muscle which has been irrevocably damaged.
  
• A 68 year-old woman experiencing flashbacks from when intruders entered her home, woke her from sleep, and cut her whole ring finger off rather than going to the trouble of slipping it off her finger.

and many, many more.

Some can be helped. Others, it seems, can't.

Psychiatry is hard.

 

[ExLimey]

So where do you go for help dealing with this?

 

[Sillyman]

I live it pal.

 

[ksmybuttons]

Well, I certainly admire you for your choice of a career. I am glad someone wants to deal with it at that level, I certainly couldn't. Too much reality for me. Especially when you really have very few "cures."

On top of that, you are dealing with "call," long days and insurance company regulations.

Rewards, where are the rewards?

 

[Eumenides]

You win for right now.

Technically I am unemployed until October 14.

 

[FallenSeraph]

Does being a deranged hobo count as a job? If it does...
...I win...
...If it doesn't...


...I need help...

 

[Problem Child]

Still not as depressing/hopeless as an average Pacific Blue thread.

Suck it up and get back to work Ollie. The crazies need you.

 

[Rubyfruit]

Wow, I don't know how you do it, Oliver.

No wonder we haven't seen much of you lately.

 

[Oliver Clozoff]

Good question, exlimey. My family is supportive, but they're understandable horrified by some of the stories and although they really want to help, they can't relate to having to deal with high-intensity human suffering on a daily basis.

Ditto with my non-medical friends.

My physician friends are really my first line of support since they're dealing with the same sort of thing, especially my fellow psychiatry residents. We share stories and console each other all the time.

I've also started to see a therapist myself to vent some of my frustrations to and try to work through guilt over not being able to help a lot of these people.

I always thought of the challenge of medicine as being intellectual, but that's actually the easier part. The emotional toll is what is so difficult. You see so much of the worst that people have to offer.

But when it goes right, there's a rush that I haven't ever felt anywhere else. And it's certainly never boring. There's always some new wacked-out story that's unfolding before your eyes. I don't know if I'll be able to do this for the rest of my life, but it's certainly opening my eyes.

I'll keep the board updated.

 

[Guest]

And that list is why I'm on an extended hiatus. I might just be a gypsy, for the rest of my life.

 

[KillerMuffin]

There are two jobs I never want because they're just too emotionally taxing. Special operations in the military and people how help the wounded (cops, shrinks, docs, social workers, etc.).

It takes a very strong person who has the necessary coping skills to deal with the pain. These things are painful to deal with. Sometimes I wonder what my therapist thinks about or feels toward my personal problems and my history. Whenever I got the money to actually rent 50 minutes of his time.

 

[*bratcat*]

 

[Oliver Clozoff]

Now...I had this dream last night...can you help?

It depends on the dream. If it involved a tub of vegetable shortening, a jai lai scoop, and a vibrating bed, I may be able to help.

 

[freakygirl]

Damn

sounds like my family reunions.

Oliver.. I admire you. I couldn't do that type of work. Way to much stress for me.

Hope all is well with you.

 

[peachykeen]

kudos Oliver but remember, you chose this

 

[Guest]

Yes, I work inpatient Psych, I know your frustration.

No borderlines this month? Check out a yoyo/CV thread. I can't decide if he needs Depakote or Lithium. Or a shot of Ativan in the ass...

 

[SpiceCake]

tougher job

I do all that and I'm just a secretary! And what about bartenders! Dang - we just get paid shit!

 

[Sandia]

You have my admiration for what you do, Oliver.
Don't stop caring.

 

[lookin_in_maine]

In just 2 months as a psychiatry resident, here is a sample of what I've had to deal with.

• A woman who was so depressed and hopeless (and character disordered to boot) that she wanted to have a "candy party" in her garage with the door closed and the car engine running so she and her 3 girls could all "go to sleep and not have to wake up"
  
• a schizophrenic off his medication for several months, floridly psychotic and wielding a knife, attempting to cut off his own penis as an act of religious repentence for his sexual indiscretions.
  
• a young woman raised in an extremely religious family so conflicted over her sinful temptation to look at pornographic photographs that she fasted for over several weeks straight, praying almost continuously until she collapsed from exhaustion and malnutrition.
  
• a demented woman with alzheimer's disease with the delusion that "there are chiggers underneath my skin" who had excoriated the skin all over her body in an attempt to remove the chiggers. She was found by a family member with a knife about to attempt to "dig them out" as well.
  
• More suicide attempts by overdose than I can count.
  
• a psychotic man (again off his meds... note the pattern) with the desire for "big breast implants" as well as surgery to implant a metal rod in his penis "so it'll be hard all the time".
  
• A paranoid schizophrenic who attempted to liberate his neighbors from what he perceived to be the prison that they were being held in. It turned out to actually have been their enclosed backyard surrounded by a hurricane fence.
  
• An 18 year-old anorexic woman who had lived for the several months 3 months on nothing but tomato soup, popsickles, and gatorade. Her body, starved for nutrients, cannibalized her own heart muscle which has been irrevocably damaged.
  
• A 68 year-old woman experiencing flashbacks from when intruders entered her home, woke her from sleep, and cut her whole ring finger off rather than going to the trouble of slipping it off her finger.

and many, many more.

Some can be helped. Others, it seems, can't.

Psychiatry is hard.

I find it a little unsettling that I exhibit many of the above behaviors.....

 

[lovechild27]

Hey...that is WHY I am in school to become a shrink! I cant wait to get out of school and deal with the world!

 

[Spinaroonie]

Well.. corss that off of my list.

 

[TN_Vixen]

It would definitely make it hard to get up & go to work every morning with stories like that, Ollie.

If you ever feel like you need something to "ground" you, let me know. I have this wonderful Japanese massage that must be performed completely naked with one of my breasts in your mouth. You'd love it.

;-)

 

[*bratcat*]

 

[Oliver Clozoff]

Thanks to all for your offers of encouragement.

And those of you offering "sexual healing" have earned a special warm place in ol' Ollie's pants. *tearing up*

Stormy, thanks for feeling my pain. I really appreciate the work of the nurses and techs that constantly do the hands-on work with the patients. It's a tough, tough job that doesn't get nearly the thanks it deserves. I appreciate what y'all do for the patients and for us.

And yes, I frequently force myself that this is the path I've chosen. I frequently find myself questioning if it's worth it, but the moments of healing, although they're much more subtle than in other fields of medicine, are truly magical and very rewarding. I hope they continue to outweigh the failures.

 

[Guest]

You are a good man Doc Ollie.