M3-- WEEK THIRTY FOUR

This was week one of six weeks of psychiatry training for me. My week got started a little late because I'm spending the first three weeks of the rotation at the VA, and Monday was President's Day! (The VA closes for all federal holidays) I had orientation in the morning but I didn't have to report to the hospital in the afternoon -- so T and I went to an early showing of Monuments Men. We both really enjoyed the movie and our dinner at Lenny's after! If any of you know T well, then you probably know he loves sandwiches. They are probably his favorite food. He had been sick and without an appetite for a few days so a sub from Lenny's was my way of bribing him to eat some real food :) Plus, I'm a fan of their cookies.. T is doing much better now if you were wondering. He ate his whole half-a-pizza when we went to Mama's with some friends last night. They have super good dessert pizza if you are ever in the mood...

We love how spontaneous we can be at this stage of our lives! Our friends text us an hour before they picked us up for dinner - it's the best. I am trying to do a better job at "enjoying every stage" like people say when they have young children. I am in the middle of applying to two accelerated residency programs so I find my mind focused more on the future than the present. But what an awful way to live life! You could find yourself trapped focusing purely on the future and distracted by those dangerous "I'll be happy when ___" thoughts.  So I'm trying to be proactive and find the blessings in this stage as well.. even if it is stressful and uncertain!

I'll write a little blurb about this week thus far because people have been extra interested about psych. A lot of people tell me they envision me in an outpatient setting doing therapy.. which is pretty different than what I am actually doing right now. At the VA, we are working in the Psychiatric Intensive Care Unit (PICU). The unit is set up like a community (lounges with TVs, group dining, etc) but it is a locked unit. I have to badge through two steel doors to open the unit - and you can't badge through the second until the first is full closed again. The furniture is mostly made of plastic but it is super heavy and it has the ability to be bolted to the floor so that it cannot be used as a weapon.

These beds are very similar to the ones at our hospital

Patients may be there because they are having thoughts of suicide, homicide, or they are unsafe to be unsupervised (they may be a danger to themselves or others due to their aggression, inability to care for themselves, or their current delusions/hallucinations/illusions). Some patients are there willingly and others have been ordered to be there by the state. We were able to view one of the hearings that decided whether a patient would be required to take medications against their will - it was a very interesting process! The majority of the patients I was involved with this week were admitted with a longstanding mental illness and had not been taking their medications for a period of time. They stayed with us until they were stabilized again and then they moved on to a unit where they would have more freedom to continue their treatment. We mostly managed their medications and lined them up with whatever treatment they could benefit from next (substance abuse, therapy, etc). The one difference from what expected was that I imagined that the majority of patients would be suffering from severe PTSD and that their illness would be service-connected - that has not been my experience so far. That's not good or bad.. just different than what I expected!

The rotation has been emotionally exhausting but it has been a pretty low stress. I've been able to leave the hospital each night incredibly grateful for the health that my family and I experience, my job, my home, and the support of family/friends as opposed to feeling down from the disease and social situations my patients were experiencing. It has been helpful to have fun social things this week like a super cute first birthday party and lots of chances to volunteer and be social!

This next week will include a dinner for one of the accelerated residency programs as well as a (belated) dinner with friends to celebrate T's graduation. It should be a good one but we will sure miss watching the olympics in the evenings! Have a great week!

xo,
Krista