Psych Rotation, how my own well-being improved and why that speaks to the medical profession

Third year of med school can be a grind: Long, relentless hours. No time to study, let alone take care of yourself. Rotations that just keep coming with nothing but a “golden”, rotation-free weekend in between. That is, until you get to your psychiatry rotation. Some have even called it psych-cation. So is the psychiatry rotation the vacation of 3rd year?

The answer is…not quite, but close. In comparison to inpatient medicine and my neurology clerkships, psych has been a welcome change of pace. My hours are 8 am to 5 pm, with a workload that can include maybe 2 or 3 new patients a day. I am currently on psych consult service, meaning I get called when a psychiatric patient comes through the ED doors or a hospitalized patient requires a psychiatric evaluation. As you can imagine, patient loads can ebb and flow. For unknown reasons, psych patients rarely show up at 7am to the Emergency Department, but combine a full-moon, a pleasant Friday night and our service can get pretty busy.

Being able to sleep 8 hours at night and come home around 5pm with enough energy to go on a nice jog has done wonders for my mood and my marriage. Because we have lulls throughout the day I can get my studying in while I am on service and that leaves my evenings free to do something I haven’t done since 3rd year began…relax. My husband is shocked to suddenly have me hanging around the house with free time. I’ve been so busy previously, his go-to answer anytime our friends call was “Maja is at the hospital.” Now, here I am asking if he’s up for a movie or binge watching TV shows–on a Tuesday night!

On a personal level, having this extra time to re-connect, even if for just a few hours a night is super important. I find us laughing more, talking about meaningful things (you know, going beyond the logistics of who is making dinner) and waking up smiling. So without trying, my psych rotation is improving my marriage and mental and physical health.

The hours of 3rd year had began taking their toll on my health by making me too tired to work-out. It turns out walking around the hospital and eating free cookies do not make a healthy routine. And de-conditioning is pretty much the worst thing you can do for POTS. Sorry folks, nothing can replace the heart benefits of a good cardio work-out. Luckily, I am back at it, logging some miles with my running shoes.

It wasn’t until I had time to slow down that I looked back to notice the unsustainable pace I was moving at. Of course when you have the time it’s easy to say here’s all the things I need to be doing to stay healthy– it’s when you are in the thick of it, sleeping 5 hours, feeling overworked and burnt out that your focus turns simply to surviving–who has time for the other stuff? So therein lies the dilemma.

My hope is that all the healthy choices I’ve been making in the last 2 weeks will continue as I move into my Ob/gyn rotation…at least those are my intentions. This slow down in my schedule has got me thinking a lot about how exhausting the other weeks felt at times. As a medical student we are lucky in the sense that those hours are fleeting and we can move on to more humane rotations (enter Psych). But as a resident those hours– the daily grind– it becomes your life.

For decades medicine has asked of us to become super-humans. The humans who need only a few hours of sleep, who can see the worst in people, who can face death and tragedy, who look in the face of hopeless situations and “fix them”, who can continue to log work hours when others are at home with their family….all with a smile and understanding heart. Thankfully my generation is seeing the ridiculousness of the above, no one can be that superhuman indefinitely–not without a cost. I won’t go into the depressing statistics of physician depression and suicide, or the abysmally low satisfaction rates. All I know is that a culture shift is way over due.

I don’t have the answer but I do hope that we can incorporate more balance into our profession. After all, physicians who are healthy and happy are more empathetic, productive and innovative, and more likely to stay in the field (just look at this wonderful research Stanford is doing). Somehow we must find a way to sustain the enthusiasm and dedication seen in medical students throughout our careers. The future of our field depends on it.

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