Psychotherapy

As the title suggest, the subject is psychotherapy. What is it? Well...I'm not entirely sure, though I'm supposedly supposed to be well-trained in it come the end of residency. Doesn't that bode well...


I had a rather lengthy, and involved discussion with my psychotherapy supervisor this morning, about what exactly psychotherapy is supposed to be. Because again, I haven't the foggiest. We discussed my uncertainties about the modality and how I feel as though I'm not really doing anything concrete or useful. I think that I'm actually a very good listener, but perhaps it's ADHD, perhaps it's just personality, but I'm not overly fond of just listening for three hours at a stretch. Even more annoying is the fact that I often feel like whatever I suggest they don't want to hear, and they want to continue doing the same things that brought them into therapy in the first place---yes Dr. Luckyone that's the point, I'm sure you might be saying. Perhaps it is. But it's annoying. I feel constrained by how engaged I can be, and how much help I feel I can actually be. Perhaps it's inexperience. Perhaps it's having to sit down all day. Perhaps it's having to see a few patients over and over again, that I really do not like as people. Counter-transference is a big deal in therapy.

Kvetching

Dear Pharmacy: on what planet does "Invalid NPI" (itself not true, try google) for one medication equate with "Send Dr. Luckyone pre-authorization requests for every medication but the one where there's a problem"?????

Really...I mean really...

Walking (nay, speed walking) back to my office so I can scarf down some soup and a salad before my afternoon clinic begins I walk past three (or maybe four??) obviously not medical staff seated in a corner by the elevator in one of the nooks of the hospital. They were clearly important people. With a lot of important things to talk about...

"...I mean really, I think Rihanna is better than Beyonce."

Child Psych 101

One morning a week I see nothing but kids. It's never boring. But the best part of child clinic? Parents who defer giving their kids the sex talk...and just sit there and point and say "Listen to the man" after they ask you to do it

Grumpy Face...

Who doesn't love schlepping to work for an 8am appointment....only to find that said patient moved 1000 miles away...8 months ago....

Kvetch

Patient's mom complaining that (among other irrational things) that her son isn't sleeping: I didn't give him the sleeping medication because it made him drowsy and I didn't like that. 😠😠😠

Kvetching...Time flies when you're strung out

The last month or so has been a very stressful time for me. If I'm being completely forthcoming it's been longer than that, but I've been acutely aware of it for about a month. Quite a bit has contributed. I've been feeling in general unsettled and quite anxious for a few months now, much of which has to do with a personal situation--how ironic, no?? 

Professionally/academically it has also been challenging. During the course of the past six months, I have been in a different rotation every four weeks. And all but one of them was a new rotation. This meant that I had a constant back-and-forth with myself about feeling comfortable in the rotation and feeling like I've learned what is appropriate vs. taking vacation time and not getting admonished for not using my vacation days. Add to the mix Step 3, which was a month of studying following by two days of MCQ purgatory. Who wouldn't be excited?? Perhaps unique to me, I was annoyed about having to take the thing because more than 80% of the thing is related to medicine, and the management of medical patients...It may bear mentioning that I'm a psychiatrist. I haven't seen my stethoscope in months because I don't need it. I think it's buried in the trunk of my car. Yet I'm required for licensing purposes to be able to not only diagnose things like gallstones, but also recommend the appropriate intervention and treatment. For hell's sake...I'm a facking psychiatrist. I am not trained for surgery, much less licensed. Yes, in medical school a medical student has 8-12 weeks of required surgery rotation. What that ultimately means is you stand there and hold retractors in ergonomically unsound positions for three hours while an asshole surgeon (that may be redundant...) asks questions to which only he/she knows the answer. During intern year, I handled one, exactly one GI patient--and that, pardon the pun, was a shit show as soon after admission (on a senior-less Saturday morning, no less) Smuckers jam started exiting this poor man's rectum, and GI and the MICU experts assumed his care. So, fast-forward several years and the meshuganna psychiatry resident is taking Step 3 and being asked questions regarding patients he's never seen, and in reality would have deferred out to a consult service. But never mind. What is one to do about this? Could we have a separate board exam for each service? How fair would that be? Probably not very fair, or manageable. So, like many a psych resident before me, I did thousands of practice questions and faked my way through Step 3, which thank God I passed. Now, on to 3rd year and outpatient clinic!!