Psychiatry has been a much more complicated rotation than I had thought. The hours are light — pretty much 8:30 to 6 — but it’s so emotionally draining that I feel just as tired as I did on neurology. I’ve been stress-baking, much to my roommates’ delight.
One thing I will say for psychiatry — you really get to know your patients. I spend anywhere between a half hour and an hour with each of them every day, and they stay for at least a week. One of my patients has been on the unit since mid-July; he’s probably going home early next week, and he’s so excited he apparently did a jig. (The nursing note said “breakdance,” but this is a frail man in his 70s. If he’d busted out moves like this, I’d want to get paged.)
Today, though, I finally sat down and busted out this presentation I’ve been “working on” for two or three weeks. I’m going to be speaking on “Delusional Misidentification Syndromes,” which is a fancy term for the Invasion of the Body-snatchers. (Oh, the 1950s, you and your sci-fi horror!) Capgras, Frégoli, Intermetamorphosis, and Subjective Doubles: bizarre delusions in which the patient thinks that family members — or even themselves — have been replaced by imposters. There’s no consensus about the etiology — it’s either organic or psychodynamic (what else is new?); at least one case of ECT-induced psychosis — but it’s pretty fascinating nonetheless. And I managed to cite some literary criticism, which always makes me happy.