Island Med Student

Even the most floridly psychotic patients have many important things to say. Sometimes, their words are profoundly wonderful.

Today reminded me of this fact.

To protect confidentially, I’ll change the words, but the gist is this.

Today, I sat in on a music therapy group.

After listening to the Bill Withers song, “Lovely Day,” a patient said, “that’s a biscuit song.” When asked why, the patient responded, “because it’s fluffy and has lots of layers.”

That remark is one of the millions of reasons why I really do love my job (that I pay to have).

The abbreviated lyrics are below:

When I wake up in the morning love
and the sun light hurts my eyes

And something without warning
love
bears heavy on my mind.
Then I look at you and the world’s alright with me

Just one look at you and I know it’s gonna be -

A lovely day – lovely day

When the day that lies ahead of me seems impossible to face

And someone else instead of me always seems to know the way
Then I look at you and the world’s alright with me

Just one look at you and I know it’s gonna be -

A lovely day – lovely day

When the day that lies ahead of me seems impossible to face

A lovely day – lovely day

Today’s pic was taken on Barclay Street in Baltimore, not far from my apartment. This was an incredible find. I saw one of her legs a few feet away. It reminded me of Hole’s song, Doll Parts, so I thought I’d include the lyrics here:

I am doll eyes,
Doll mouth,
Doll legs,
I am doll arms,
Big veins,
Dog bait.

Yeah they really want you,
They really want you,
They really do,
And yeah they really want you,
They really want you,
But i do too.

I want to be the girl with the most cake.
I love him so much he just turns to hate.
I fake it so real i am beyond fake.

And some day you will ache like i ache.

I am doll parts,
Bad skin,
Doll heart,
It stands for knife
For the rest of my life.

Yeah they really want you,
They really want you,
They really do,
And yeah they really want you,
They really want you,
But i do too.

I want to be the girl with the most cake.
He only loves those things
Because he loves to see them break.
I fake it so real i am beyond fake.

And some day you will ache like i ache.

“Baltimore – The Greatest City in America” photo series

Someone commented on my last post wondering how I could afford to commute from Baltimore to DC every day. Well, I have a surprising answer. My Del Sol is the bomb! I recently calculated the gas mileage I get with my car, and it’s up to 40 miles per gallon highway, and it averages around 34 MPG for my commute (which includes a little city driving, and sometimes stop and go traffic on the highway). My commute is about 40 miles each way, so I end up using about two gallons of gas for the entire commute. The gas at the closest station to my house has been hovering at just over $4.00 a gallon, so my commute costs me about $9.00, round trip.

Now here comes the interesting part. I once tried taking the MARC train and Metro Rail to and from work. The commute took me almost twice as long, and get this, it cost over twice as much! Now, if you buy the monthly passes, and get all the discounts you can, it costs a little less, but it’s still twice as much as driving my little Del Sol.

I know that there are other concerns in this equation, such as emissions and pollution, etc. But given the fact that it takes almost twice as long to commute by mass transit, and costs over twice as much, I really do find it difficult to go that route. I’m sorry, environment!

With gas prices soaring, and no hope in sight, many people are making drastic changes to their lifestyle in order to be able to afford things other than driving. People are finding it incredibly difficult to sell their gas-guzzling SUVs, and I recently read an article which commented on the fact that little, fuel-efficient cars like Geo Metros are now becoming “chic.” The lady in the article actually paid 4 times the Kelly’s Blue Book value for the Metro!

What does this all mean? Well, there could be a Del Sol Revolution on the horizon. Who knows, when gas prices hit $10 a gallon, maybe my Del Sol will be worth tens of thousands of dollars. Sadly, I still don’t think I could sell her. She’s just too awesome of a car to let go. In the meantime, I’m very glad that I can still afford to drive her!

I have finished the second week of my psych rotation. I absolutely adore every aspect of the rotation, except for the commute. It’s actually very strange for me being a med student on a psych ward. I previously only knew the experience as a psych tech. You get so much less patient contact as a med student…and so much more paperwork. But I love it. I mean, I really do love it.

I am commuting from my apartment in Baltimore, MD to the St. Elizabeths Hospital in Southeast Washington, DC every day. The drive takes me anywhere from an hour on a good day to two and a half hours on a bad day. Given the heat (lately, in the 90′s), and the lack of AC in my car, it can be a hellish commute. Pretty much the only redeeming quality of the commute is listening to NPR, which I love.

I realized the other day that I am commuting from Martin Luther King Jr. Boulevard in Baltimore, MD to Martin Luther King Jr. Boulevard in Washington, DC. I am also commuting from one stadium (Oriole Park at Camden Yards), to another (RFK Stadium).

Chris Rock famously once said, “If a friend calls you on the telephone and says they’re lost on Martin Luther King Boulevard and they want to know what they should do, the best response is “˜Run!”

So funny, yet so true!

Note: I didn’t take the pic above, but rather, I stole it from Google Images. I promise to take some good pics of my commute in the future.

Another pic stolen from Micah. This time it’s a Holga pic in color. The building with the sign on top is the Copy Cat, our home.

“Baltimore – The Greatest City in America” photo series

Today’s pic was taken from my living room window. It’s the MARC train at Penn Station. I love everything about living above a train station EXCEPT the fact that on the weekends, they shut the train down, but leave it running so that it makes this horrible clicking sound for two days!

“Baltimore – The Greatest City in America” photo series

Oh my goodness, I have learned so much in my seven days of rotating at St. Elizabeths hospital. But, as I have mentioned already, I am suffering from amotivational syndrome right now, so I will give a very abbreviated list tonight, and try and post more often in the future.

Here is a short list of what I’ve learned so far:

1) TONS about pharmacotherapy for schizophrenia and mood disorders including indications, side effects, contraindications, etc.

2) Capgras syndrome is when you think your family has been replaced by imposters.

3) How to classify various disturbances in thought process such as circumstantiality, tangentiality, loose associations, and echolalia. I’ve seen patients with just about every one of the various disturbances.

4) How the laws of psychiatric commmittment work in DC.

5) Some nurses can be a little mean at first, but once you gain their respect, they are incredibly nice and helpful.

6) The DSM criteria for many different psychiatric disorders.

7) How Freud had his research in cocaine as a topical eye anesthetic stolen from him.

8 ) How to distinguish between the different subtypes of schizophrenia, and that paranoid schizophrenia doesn’t necessarily mean that a patient has paranoid delusions.

9) My experience as a psych tech is incredibly helpful to me on the wards.

10) The difference between bizarre and non-bizarre delusions. For example, thinking that you are being followed by the FBI is considered a non-bizarre delusion, whereas thinking that your heart was removed and replaced with Jesus Christ’s heart, giving you supernatural powers, is a bizarre delusion.

More goodies to come!

Oh my goodness, I’m quite tuckered out. I started my psych rotation last week, and I just had a full day packed with all kinds of psych goodies. I promised to share my feelings about my first clinical rotation, so here goes. To sum up everything that I’ve seen in six days on the psych ward: I am soooo in love with psych!

As I’ve mentioned before, while just out of college I worked for three years at a state psychiatric hospital. My undergrad degree was in psychology and neurobiology, so I do have some decent experiences in psych. But since leaving the field years ago, I’ve really considered going into a different specialty. I’ve recently been leaning towards emergency medicine for various reasons. However, being a “green” third year medical student, I realize that I simply don’t have enough experience to make a definite specialty decision. And I have one of those personalities where I tend to enjoy just about anything I do, so I am always suspicious when I fall in love with anything.

All that being said, man I really do love psych. The hospital that I’m rotating at is in Washington, DC, and it’s a district (DC is not a state) facility. What this means is that the patient population consists of clients with very serious mental illnesses. The facility is not a place for persons with simple psychological problems. Everyone who finds their way into the halls is extremely ill.

This patient population is exactly where my experience lies. Having worked at a state hospital, I’m very familiar with schizophrenic patients who are refractory to treatment. I’ve worked with homeless folks, and while I’m no expert, I do have experience helping those who are less fortunate.

I know I still have many rotations to complete, and I’m sure that I’ll probably change my mind a few more times. But right now, psych is certainly starting to look like a very tempting field.

The population of very ill patients really grabs my attention. Those who end up in state facilities tend to have a lot in common. They are the poor, the neglected, and the ones that have very little hope left. Often times, their friends and family have abandoned them. In the past, society has overlooked many of these unfortunate souls.

I guess what I’m trying to say is that to be able to share with these folks, to be able to help them in any way, to be able to make even the smallest impact in their life — in my opinion, that’s one of the greatest gifts I can imagine.

Click Here To View the Original Post on Medscape

I’m sooo tired right now. I get up early, drive for a million hours, work all day, drive a million more hours, and go to sleep. I owe all of my friends countless emails and calls. I promise to catch up. But for now…I sleep.

I finished the fourth day of my psych rotation today. I have so much to say, yet I am so pooped, that I don’t feel like writing. I don’t know what the hell is wrong with me, but every day when I’ve come home this week, I feel like all the life has been sucked from my body. I don’t even have the energy to put my thoughts into coherent sentences.

I promise to post very soon about the hella fun time I’m having at St. E’s.

In the meantime, I’m pretty sure I have mono.