When Psychiatry Transforms

 “You meet a new person, you go with him and suddenly you get a whole new city. You go down new streets, you see houses you never saw before, past places you didn’t even know were there. Everything changes.” – Samuel R. Delany, Dhalgren

My first experience in Psychiatry was on the inpatient ward at the Veteran’s Hospital. Before the clerkship, I had very little knowledge of the specialty or experience working with veterans. There is a plethora of psychiatric stereotypes in pop culture, continuing skewed views based on historical perspectives and some from the not so distant past. While many people honor veterans for their incredible service to our country, I have also heard numerous others in the community using the term “crazy vet.”

Before my rotation began, I took a moment to attempt to expose my own biases – to visualize my city, streets and houses. Have I been buying into some of these stereotypes? What are my thoughts of these patients before I even arrive? Am I going to give them a fair shot? How can I help them? Transform them?

My psychiatry rotation, unlike the movies, did not involve lobotomies or straitjackets. There was no torture. There were just people who whole-heartedly wished to get their lives back on track. There were people who were searching deeply for meaning and drive to keep going, and, in some cases, simply were people with nowhere else to go. There were no “crazy vets.”

It was Saturday morning when our team was paged to see a patient in the emergency department. He was an army veteran, employed as a cook, with a complex medical history that made basic movement difficult. He lived in a state of chronic pain and declining health. Due to his weakness, he was unable to handle the heavy workload in the kitchen. Cooking was his passion ever since he started cooking in active duty. He would light up when you asked him about ingredients, recipes or the bustle of kitchen life. Because he could no longer cook, he felt there was no reason left to live. Tearfully, he confessed he was either going to kill himself or come to the emergency department. He made the decision to come to the emergency department for help.

After sitting with him and hearing his story, he decided to allow us to admit him. I was able to follow his care for the week. I watched him in one particular heart-felt session where he discovered many reasons to continue to live. I learned about his loves for reading, drawing, and playing with his grandson. We also assisted him in finding strategies to help cope with his numerous medical conditions. He started a new medication and attended group and occupational therapy.

He was able to safely discharge home after a few days of inpatient treatment. Before discharging, he gave me a beautifully hand-drawn color picture of a mill with the above quote from Samuel R. Delany on the back.

Despite the sessions, medication options, and coping skills, I am left thinking after my psychiatric rotation it is not me who transformed him. It was him who transformed me. My city will never look the same again.

Correction: April 18, 2017
A previous version of this blog included extraneous medical information.  This information has been removed.