Originally, I wasn’t going to enter the fellowship match. I had started my psychiatry residency fully intending to do the four years, then maybe a fellowship. Then, in my second year while sharing dinner with friends who had just certified lists for the general residency match, my plans to go into child and adolescent psychiatry came up.
The first time I saw her on the ward, I was instantly curious. There was something so innocent about her; she looked younger than her age, like a little girl. She was barefoot and had uncut, unkempt hair, as if she had accidentally wandered in from a different time period.
For children who have been reunited with their parents, though, the damage may have already been done. Let’s discuss some of the key consequences associated with parental-child separation in detail, starting with the notion of toxic stress.
The hospital is a stage and rounding is the show. It’s a daily performance, a dance of sorts, that takes place each morning on the floors. The performers congregate outside a patient room.
Physician burnout has emerged as an increasingly concerning phenomenon in medicine. As high as 51% of physicians in a Medscape survey report symptoms of burnout. Doctors face higher demands with less time and support. Academic medical centers, which historically have been insulated from outside forces, are now seeing larger patient censuses, leaving less time for physicians to work through each patient’s case carefully.
At the beginning of my intern year, I bought a ukulele. I started intern year at a sprint, like anyone does, arms full of hope. This was quickly extinguished, lost in an atmosphere so devoid of hope that it all flew out of my arms to settle into places so far apart, it might as well have been floating in the vacuum of space.
I first heard of Yayoi Kusama last year when her spellbinding exhibit came to the Smithsonian’s Hirshhorn Museum and Sculpture Garden in Washington, D.C. Admittedly late to the international zeitgeist of Kusama, what initially drew me in was her story — a Japanese-American avant-garde artist who suffered from severe mental illness and successfully transformed that suffering into riveting artwork.
“And your socks, too,” I said / She stooped to reach her feet / And the liner of the exam table crinkled and popped
Lunch hour on a Thursday
in the skies above
The below poem was written during a weekend away in Indianapolis. I watched an apparently homeless older gentleman sitting outside a coffee shop for several minutes while I read. It was a generous reminder that our patients should be seen in their environment and not only in our own, with fluorescent lights and temperature control. We all have different backgrounds and life circumstances and drastically effect our behaviors and choices.
You’ve seen Mr. H before. He comes in occasionally, usually at the end of the month, when his Social Security money runs out. He’s homeless, has no family to speak of, and his success in the community is tenuous, effectively measured by how many dollars of disability money he has saved.
Over the course of residency and fellowship training, it’s likely that almost all trainees will encounter veterans through rotations at Veterans Affairs (VA) facilities. With mandates from Title 38 and long-standing relationships with academic institutions nationwide, the Veterans Health Administration plays a significant role in shaping the education of future medical professionals.