As most people close to me know I have not been the biggest advocate for appreciation of psychiatry. I know that it is a very important specialty and that psychiatrists help a lot of people but for the most part psychiatry, as a discipline, scares the CRAP out of me. But there have been touching moments in this field just like any other and the patients often warm your heart (unless they have BPD (borderline personality disorder) and then they just annoy you).
Today I went and saw ECT (electroconvulsive therapy) being performed. This is the good ol' shock treatment that people thought was extinct. Well, it's not and it is actually not nearly as barbaric as I thought it was. The patient DR said that it had improved his depression 60% already after 5 treatments and none of the medications had worked nearly as well. A lot of patients who have deep or psychotic depressions benefit greatly from this procedure. In fact, psychiatrists say that if they had a major depressive episode they would want to go straight to ECT. And the actual procedure is done in the recovery room near the OR, the patient is put under general anestethic for about 2 minutes and bagged and masked with an anesthetist present. The actual "shock" lasts 30-60 seconds and is not at all violent, you almost can't tell it's happening. This realization was a pleasant surprise to me.
Yesterday we had a patient TD who was recovering well from his depressive episode in his bipolar disorder and is being discharged today. He wanted me to read the poem he had written for the nurses to gain a "female perspective". I walked to his room and he was in front of me, some guy who I believe was psychotic was behind me and another woman who we certified on Tuesday and who has been violent to staff was passing in the hallway - physically surrounded by mental illness. It was a bit scary but I took a deep breath and all was well.
This woman who was psychotic that I just mentioned is quite hilarious because at 60something she believes that she is 10 weeks pregnant. She also tried to hit my preceptor, a very lovely 5'2'' East Indian man who she believed was "M" from James Bond and was going to lock up her brother. The other inpatients came to my preceptor's aid discussing how this lovely Indian man was nothing like Dame Judi Dench. Psychotic people are funny.
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One of the nurses at the care home I work in used to work in psychiatry. She told me of a patient who thought Jesus was telling him what to do, and another patient who thought he was Jesus. She put them in a room together and they got along quite well. Psychiarty is a strange world.
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