I know I didn’t blog during this rotation. It’s complicated. Coming into my psychiatry rotation I kind of expected to be love-struck. I thought it would feel a bit like coming home and that I would agonize over the decision of whether to pursue family medicine or go on to a longer residency in psychiatry. I think I was ok (for a student) at psychiatry and really, I should be. I’ve seen a lot of it first hand. However this “coming home” just didn’t happen.
Personal aside for post clarity and context: To avoid shrouded mystery and/or dramatic pretense let me lay open the psychiatric elements you would find in my family tree: Alcoholism, suicide, bipolar illness, anxiety, depression and psychosis. Now let us move on…
I guess what I’m trying to say is that at some level, I was expecting the practice of psychiatry to be a completion of sorts for me. I was expecting that by learning the diagnostic and treatment algorithms for people with mental illness, it would confirm that despite a strong family history of mental illness, I was ok. And not only was I ok, but that somehow I had beat this thing and come out on top. Victory, and all that. Goodbye troubled past.
Oh, but then there’s the other element, the one that everyone knows about…I have a child with mental illness, too. There’s a lot of guilt that comes with having a child with mental illness regardless of how irrational it may or may not be. It’s difficult not to live back each one of the mistakes you made as a young, unprepared parent (and there were many). So in light of this, was I also expecting to redeem myself? I don’t know who can answer that question, but I’m quite sure it isn’t you. As you can see, I had a lot at stake with this rotation.
So here’s how it played out: It didn’t heal me, it didn’t crown me victor and it certainly didn’t redeem me. Maybe it is because psychiatry did none of these things for me that it provided closure in a different way. As I went through this rotation I was expecting some great moment, but here I am at the end, frankly surprised by my lack of emotional debt. I’ve opened the door to a room I was afraid of for a lot of years, and the room was dark and empty. And who knows. Maybe it’s not all over because it makes me a little angry that I spent so much time standing in front of that room at all. True closure would surely require more apathy. I don’t know, but I’m done thinking about it for now. And I’m happy with this, because I feel like now I can go through the rest of this year with a clear and open mind to evaluate exactly what kind of medicine I like best.
Anyway, for those who know me better, fear not. Psychiatry as a medical discipline may not be for me, but I still have a passion for the needs of this population. As a medical professional, as a contributing member of my community and as a mother I still have plenty of psychiatry related plans. Practical resources for those with mental illness are dismal and I was exposed to many systemic problems during my rotation that can’t be ignored. The thought of working on these projects does still excite me. I expect you will hear a lot about these things in future years. But for now, Psychiatry as a rotation is complete. On to Ft. St. James and Rural Family Practice!