Above all else, do no harm. This is a basic tenet of a physician’s oath, but this oath does not always align with the religious and cultural beliefs of each patient. In cases where beliefs of faith, salvation or religion play a major factor in a patient’s desire to commit suicide, it can be difficult to draw the line between the traditional ethical guidelines of patient autonomy and non-maleficence.
When the pandemic hit, many psychiatry departments across the United States had to rapidly adapt and respond in innovative ways to serve the needs of their patient population. After an initial struggle, many found a platform best-suited for this need and transitioned to telepsychiatry as a way to see and treat patients.
I first met Ruth in the emergency department when I was a third-year medical student on my psychiatry rotation. She was an “elderly female with psychosis — medical workup negative.” My resident had received a page with a request for her admission and sent me to the ED to speak with her first.
I constantly have to deal with racism and homophobia. In Boston. In America. When I leave work and go home, I have to prepare to deal with the same prejudices the following day. Why would I ever go out of my way to read such stories in my spare time, as I recover from the day behind me?
“Hello? Can you hear me?” Tightly holding the phone, I heard only an old man’s distant yelling and the shattering of dishes being thrown against the wall.
“The United States reports first death from COVID-19 in Washington State.” It was the end of February as I glanced over this news alert. For the past month, my inbox was flooded with emails regarding the COVID-19 outbreak. I saw my patients as usual throughout the day, albeit washing my hands and using hand sanitizers more often.
When I found out I was going to be deployed to treat patients with COVID, I dealt with a lot of existential dread. I remember feeling like I was leaving medicine behind when I matched to a psychiatry residency, and again after I finished the medicine portion of my intern year.
It was a beautiful late winter Sunday, and my husband and I decided to drive to Plum Island, in the quaint sea town of Newburyport just north of Boston, for some bird-watching and ocean views. I wondered how my sister-in-law was doing — her wedding was scheduled in just seven days, and she and her fiancé had already been faced with tough decisions because of the coronavirus pandemic.
@PsychResChat is the newest sub-community on Twitter, short for Psychiatry Resident Chat, the brainchild of Dr. Tolu Odebunmi, MD, MPH who is a psychiatry resident at the University of Minnesota. The co-hosts use the account to share information and news relevant to psychiatry residents. Additionally, @PsychResChat is the home of bi-weekly live discussions, aimed at engaging the #PsychResTwitter community.
Over the last year, our collective minds have been captivated by stories about child and family separation, detainment of citizens and immigrants, and the quality of the health care within detention facilities. These stories have been jarring and traumatic, and have also awoken an important level of national consciousness about the nature of detention. What has not received as much coverage in recent discourse is the ongoing nature of solitary confinement in our justice system.
Illness lies hidden in our ways / Influenced by the unconscious gaze.
I recorded a time-lapse video of an entire night of in-house overnight call at the hospital. Mom & Dad — I love how you think of me, but this is what residents actually do.