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fibonacci

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08:21 pm: today we put a boy (who is in the hospital for video eeg, to see if his "seizures" are epileptic or non-epileptic events) under hypnosis and induced a pseudoseizure.
it was so intense.
this is what i love about brains. this stuff. the territory of dreams and past traumas and mental states we don't understand yet.
shit.shit.shit.
i may not be as wise or thoughtful about all this as a lot of you are. i am not the ideal therapist. *and* i have a stigma about psychiatrists not being real doctors. and i would miss all the stuff i spent the last four years learning. but i do interesting and very related translational research. and i care about this stuff. plus, whatever, by 7th grade i was doing hypnosis on friends at sleepover parties (really.) and reading jung... in a way it is no surprise that i love this.
would you hold it against me if i went into child psych?
honestly. would that be weird?

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(no subject) - (Anonymous)
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From:fibonacci
Date:May 7th, 2009 01:40 am (UTC)
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former: not sure. i like everything. i don't want to give up *any* of it.. but there's nothing in particular that i absolutely have to hang onto. plus, psych seems to result (even in residency) in plenty of time for runs and bikes and woods.
latter: hell yes.
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From:in_parentheses
Date:May 6th, 2009 12:46 pm (UTC)
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Would I hold it against you? God, of course not! It is not for your friends to judge your career path. We're just here to root for you and advise you and support you as you figure out what makes you happy.

As for psychiatrists not being "real" doctors... my dad is one. And honestly, I always thought he was too much of a real doctor (which was maybe a reaction against that stigma of psychiatrists; I never thought of it that way until just now). He wanted to see the brain as a closed-off system, the way that "real doctors" tend to see every system: diagnose problem, apply medicine, see symptoms change.

I remember him using the "it's just like taking insulin" argument when I was conflicted about being on SSRIs in high school. I was furious. My brain is not my digestive system; it's ME!!

I always preferred a more holistic approach, and an appreciation that brains are *complicated* and maybe doctors don't understand everything about them yet (or even a tiny fraction of everything). And I think, from conversations we've had, that you feel the same way.

All of which is a long way of saying that maybe part of why you're digging psychiatry is that it's more complicated than "real medicine"? And you get that complexity, you care about it, and that would probably make you a good psychiatrist.

(All of which is also probably talking out of my ass. But it's a thought, anyway.)
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From:in_parentheses
Date:May 6th, 2009 12:49 pm (UTC)
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P.S. I think my dad is probably a really good doctor, and I'm sure his understanding of his profession is vastly more complex than I gave him credit for when I was in high school. (We misunderstand our parents when we're 15? Shocker!) I just realized it sounded like I was ragging on him, and I didn't want to leave that impression.
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From:fibonacci
Date:May 7th, 2009 01:48 am (UTC)
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no, i totally understand.
and i feel the same as you (wanting to take a more holistic approach to this stuff). the reason i dismissed psych out of hand when i did my adult lock-down ward rotation was that my attending was so all about meds and "evidence-based psychiatry." he didn't want to know the guy's story; just that he was or was not still having delusions, and based on that did i want to change the dose of his antipsychotic. it felt weird and made me think if i went into that kind of field at all i'd want to be a psychologist rather than a psychiatrist.
child psych is different because i think the culture is much less medication-happy. they absolutely prescribe meds, but they consider other approaches too, either along with or instead of meds.
so i think you're right: i like it because it's complex, and because it's beautiful. (one of my kids today was nowhere to be found when i came back in with the fellow... a few minutes later a flashlight was flitting around the bottom edge of her closet (like tinkerbell). she came out of the closet but if the fellow asked her about something she didn't want to talk about (like her transplant) she stared her down and stepped carefully back into it.)
and because you are supposed to talk to your patients.thank god. and because it feels like you are working much more directly with human suffering.
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From:redbeard
Date:May 6th, 2009 05:37 pm (UTC)
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FYI, if you are interested in child psych and want to talk to LR's mom (who is a child psych specializing in autism) arrangements could be made.

Actually, knowing them (and LR's whole family, actually) has given me a whole new perspective on the psych world - who is good at it, and how little it says about who they are as a person outside of the office. Perhaps this is a good direction for you. Only you can tell.

But I have faith that you will go where you feel the most satisfaction.

Out of curiosity, why psych and not something more hand-on-the-brain-y?
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From:fibonacci
Date:May 7th, 2009 01:51 am (UTC)
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ooh! i would love to talk to LR's mom sometime.

hand-on-the-brain-y like neurosurgery? because they're assholes and don't have time to actually think about how brains work. they do head bleeds and tumor removals (which is great but has never been what i have been interested in, especially).

i'm still thinking about neurology. which is definitely full of people who like to think about neural circuitry and how it works and what is happening to it. my research interests have always always fallen into the realm of psychiatry though - cognition and emotion. if i went into behavioral neurology (a pretty narrow specialty field but a cool one - an attending i really like here does that and is studying pathological laughing & crying right now, which is amazing stuff) it would make sense. or maybe i will fall in love with my MS or stroke patients next month. we'll see.

but yeah, .. this is kind of what i've already been doing forever.
well & also neurologists don't get to do play therapy. : ) or hypnosis.
they do get to do lumbar punctures, but...
[User Picture]
From:redbeard
Date:May 7th, 2009 02:20 am (UTC)
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What is life without a few lumbar punctures, I ask you?

And yes, I meant neurology - and behavioral neurology sounds right up your alley. But, yeah, drop me a line or give me a call if you ever want to talk to LR's mom about it.
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From:redbeard
Date:May 7th, 2009 02:22 am (UTC)
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Oh, also LR's aunt and uncle in Palo alto (who are awesome) are in Psych. If you need more folk to talk to.
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From:fibonacci
Date:May 8th, 2009 02:09 am (UTC)
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yes,yes, hook me up!! i would love to talk to them. i have not very much time to make this call.
From:(Anonymous)
Date:May 9th, 2009 02:42 am (UTC)

New posting :)

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Psychiatrists do really important work, and probably get to know their patients (and their stories) better than a lot of other doctors. And there are tons of areas for research, of course...

And on the ped side there's always pediatric neurology. I have a contact back in CT if you're interested.

Glad to finally see a new post!

-Katie
From:(Anonymous)
Date:May 12th, 2009 02:57 pm (UTC)

Tough choice

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There are both true gifted psychiatrists and one who should be run out of the field. I agree with Kaite they do good work in general. I certianly went to a lot of them as a kid to figure out that i was gifted and LD. At least one made a lasting (good) impression on me and it a important field. That said I think you biggest issue is you would be good at whatever you put your mind to and jsut have to decide what you have more passion for.

-Shellock
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