“Have you ever cured anyone?”
I was thumbing through medical notes with my Consultant Psychiatrist (CP) one afternoon, having seen a few too many patients who were perpetually in Mental Health Services. I felt I had no talent for it and out came the question. My CP replied in an affably egalitarian manner, asking me if I had ever seen an Endocrinologist cure diabetes. Psychiatrists, he continued, help patients manage their chronic disease & have the desired quality of life. Just like Endocrinologists. Mental health, to me is as important as the physical. But it had never occurred to me to look at depression, for example, like I would see diabetes- a chronic condition where a patient has to take precautions & treatment to prevent deterioration, and adapt their lifestyle but not sacrifice their ambitions in life! This gave me pause.
Kindly finding time in his schedule my CP showed me a unique view of Psychiatry. Finding a patient’s unique experience of a common illness, seeing the method behind madness (no offence intended), and helping patients to understand when the organ they use to do so isn’t functioning well. He thoughtfully answered all my constant queries- why this medication, how come he trusts this patient, why is that mental illness, why is that scientific. The Psychiatry he taught me was pragmatic not a collection of wishy-washy, subjective interpretations, and he certainly did not stick people in boxes that did not fit!
You know, the vast majority of physically ill patients with their spirits intact seem to function quite well. But ‘there’s nothing like the sight of an amputated spirit; there’s no prosthetic for that‘. They look devastated even in perfect physical health. The treatments were transformative in some cases albeit time consuming! I began to see this medical specialty as intellectually challenging, extraordinarily multidisciplinary, and omnipresent. So many of us are just a crisis away from suffering from mental illness.
I love my time in operating theatres, on medical wards, and diagnostic clinics! Each with their own sets of skills I am learning to master- not all transferable between specialties. But as a doctor my CP had a specific command of astute listening, perspective, body language, and words- skills that could give us all an edge, irrespective of profession!
The show’s over now, crowd drifted away yet I find myself standing by the door. I know I have to go too yet something compels me to linger. I don’t yet know what I want to specialise in once I qualify as a Doctor. But rather unexpectedly I am finding it difficult to rule out Psychiatry.
(PS: On a slight aside, another excellent Psychiatrist suggested that understanding is crucial, sympathy is not. He was not talking about empathy and was unfailingly compassionate towards his patients. It’s a profound perspective. Sympathy can cloud judgement, and clinical judgement is no different. Reminded me of two things: an interesting article about how sympathy can adversely affect teachers which can easily be extrapolated to Medical School education. And neuroscientist Sam Harris’ podcast with a controversial Yale psychologist, on compassion & understanding. I recommend a read & listen!)