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Ms. M came in to the Psychiatric ER on Wednesday evening after being found to be aggressive and hostile at her boarding house. When police arrived, they found Ms. M barely being held down by her mother. She was APOWWed from the boarding house to the Psychiatric ER. According to the history given from the boarding house, she had suffered from a serious case of meningitis two years ago which led to encephalitis, which led to her Psychosis NOS and Dementia NOS. Therefore, two years ago, she was a normal functioning member of society. I met her on Thursday morning when I came in at 8 am. According to the staff she had defecated on the floor in the room she was in and had not given urine as of yet. I tried to talk to her, but she would only stare at me and then laugh and walk away. At one point, she became aggressive and was put in seclusion. At this time, her urinalysis came back which showed a UTI and she started antibiotic treatment.
Friday morning I arrived at 8 am to find that Ms. M was still in the Psych ER, and that every hospital possible had been called and than no none was willing to take her in. When I went to talk to her on Friday, she commented on how she needed something to do, and soon thereafter began pounding on the door and screaming to get out. Again, she went into seclusion. This was the first time I had watched Ms. M being put in seclusion and kept there for a time. She screamed desperately for us to let her out. She knocked on the door repeatedly to try to get our attention. We could hear her clearly inside the Psych ER office. I couldn’t help but feel like we were robbing her of the dignity she had left. At one point, I went by the room, only to find her staring at me with deeply sad eyes. What did she think of me? Did she hate us for doing this to her? That afternoon, when Ms. M came out of seclusion, I approached her to check up on her. She smiled at me, and told me she was about to eat. As she ate her sandwich, she told me about what she liked to do, what her favorite food was, about missing her mom and then asked me what I liked to do for fun. Needless to say, I was stunned by the difference! Later that evening, Ms. M was admitted to 8N and I did not see her again.
Through Ms. M and other patients, I’ve come to realize a sad truth. Before this rotation started, I believed psychiatric patients lived a secluded life, away from society, or at Salvation Army. Yes, some of them do live this way. But at some point they didn’t. They had families, they had goals and aspirations, and then an illness affected their lives that for many of them changed their lives forever.
I think it was denial on my part that I chose to believe this, since I didn’t know how to approach patients with a psychiatric illness. In my mind I decided I might as well act as if they don’t really exist. What a frightening and sad realization! These patients are just like any other patient with an illness; they are in need of a compassionate, caring physician who can provide excellent and quality medical care. The difference is that our society ignores and looks down on psychiatry patients, as opposed to holding a 5K or a benefit dinner or sending get-well cards as is common with other patients.
The person sitting next to me in the pew at church who murmurs and stares at the wall, the lady jumping next to me in my kickbox class, the old man sitting next to a child in the public library, the young man sitting next to me on the DART, the young mother of two sitting in the OB/GYN office asking herself if she should mention that she has been depressed, these have all been part of the stories of each of my patients while on Psychiatry. Sad thing is, it is not just I that have forgotten and ignored them – it is our society as a whole.
For example, Texas used to have drop-in places where they could go for daily activities such as games, art therapy, etc. The programs have been taken out of the Mental Health Texas budget. What can I do? How can I help? I am most frustrated by my inability to answer those two questions. I cling to the hope that maybe with one patient, with one conversation, or with one phone call to a family member I can make a difference today.
Tuesday, February 3, 2009
Monday, January 19, 2009
Happy New Year!
It has been too long since I last wrote on here. Since August or so, I did my internal medicine rotation as well as my surgery rotation, hence why I have not had much time to write! Internal Medicine meant that we were on call every 5th day, staying up to 30 hours in the hospital at a time! And then during surgery, it was 4 weeks of on call schedule every 3rd day, so my priorities became: sleep, eat, study some, and taking care of patients...and oh yeah, not falling asleep during rounds. During Christmas break I went to Chile for 3 weeks, which was wonderful, I will posts pictures as soon as I actually get them here in the US of A. As per usual, I was getting all my stuff ready to come back to the US a little last minute, and I left the DVD with ALL my pictures, videos, etc. sitting on my aunt's piano in Chile, in South America, on the other side of the hemisphere. Luckily, my parents, sister and brother-in-law are heading there in about a week, and so they will get the DVD for me.
I am currently on Psychiatry, which has been very challenging. My patients are mostly people with schizophrenia or bipolar disorder, and a few with major depressive disorder. For the past two weeks I've been in the inpatient psychiatric ward, which is pretty much where the most sick patients, the ones no other hospitals in Dallas want to take, are admitted. Sadly, most of the patients do not get better, even when all the medicines out there for their illnesses have been tried. One of the attendings mentioned that psychiatry is behind other specialties when it comes to pharmacology and research. Many of the patients we discharge home or to other facilities are simply at their baseline functioning level, which may be pretty low. Sadly, they are one of the groups that is most scorned, abused, misunderstood, and mistreated by society. I pray that I would not lose sight of what God can and does do in these patients. I ask that He would give me compassion for them, and that I would learn to see them as He sees them.
I am currently on Psychiatry, which has been very challenging. My patients are mostly people with schizophrenia or bipolar disorder, and a few with major depressive disorder. For the past two weeks I've been in the inpatient psychiatric ward, which is pretty much where the most sick patients, the ones no other hospitals in Dallas want to take, are admitted. Sadly, most of the patients do not get better, even when all the medicines out there for their illnesses have been tried. One of the attendings mentioned that psychiatry is behind other specialties when it comes to pharmacology and research. Many of the patients we discharge home or to other facilities are simply at their baseline functioning level, which may be pretty low. Sadly, they are one of the groups that is most scorned, abused, misunderstood, and mistreated by society. I pray that I would not lose sight of what God can and does do in these patients. I ask that He would give me compassion for them, and that I would learn to see them as He sees them.
Sunday, August 17, 2008
Reality and Hope
Some thoughts after reading this article:
http://www.cnn.com/2008/WORLD/meast/08/17/burned.beauticians.ap/index.html
I have read stories about women in certain countries who have been victims of acid attacks or been doused with petroleum and set on fire. These attacks may be due to an unhappy husband or family member who is angry with their wife/daughter/sister, a father who does not want a daughter, or are acts of violence directed at women and children, which is not uncommon in these countries.
I had a dream about a month ago. I was at school and realized that there was a fire coming. I was at the far end of the classroom near a door. At the other far end of the classroom, there was another door, and through its window I could see the fire fast approaching. The classroom was a science lab, and there were many students and professors hard at work at their desks and using microscopes. I started yelling at them, to get out, that the fire was coming, couldn't they see it? No one would listen, everyone kept working, harder and with more focus it seemed, instead of running from the fire! One guy did get up and walked out, but did not help me warn the others. I realized the fire was too close now, and I had to get out or I too would burn. So I started running out, and as I did, the room exploded. In my dream, I woke up and my face was burned and scarred, but I was alive, and it seemed time had passed since the explosion. There was no regret in my feelings in the dream, no desperation, just a quiet, still peace. I knew I wasn't living for this world, and somehow it didn't matter that I was disfigured and scarred. I had done what I knew had to be done, and that was to warn others. I ran to a room and there were many people I recognized, and some of them seemed to pity me. I told them not to pity me, because I had done what our Father told me to do.
My faith is greater in my dreams than in real life I think. Or maybe it is because God gives the strength and peace when we most need it.
Now, back to the article. For these women, any chance they had for a "normal" life in their country is now gone. They cannot marry, many are blinded from the attack, and often cannot take care of themselves and must rely on family or on someone to care for them. There are organizations that send in plastic surgeons and people who donate to give these women jobs and opportunities in their countries. But what of the hope, the only Living Hope, that is Jesus? Who is to tell them of Him? My heart aches as I pray for these women. Maybe it is because I am unsure of what to pray.
Father, I pray for a Your mighty work be done in these women's lives, and for your eternal hope to enter their hearts. May your love cross boundaries that we cannot cross, and show us how You would like us to be involved in Your work. We praise You, You are good and faithful, a loving father, and a wonderful Savior.
http://www.cnn.com/2008/WORLD/meast/08/17/burned.beauticians.ap/index.html
I have read stories about women in certain countries who have been victims of acid attacks or been doused with petroleum and set on fire. These attacks may be due to an unhappy husband or family member who is angry with their wife/daughter/sister, a father who does not want a daughter, or are acts of violence directed at women and children, which is not uncommon in these countries.
I had a dream about a month ago. I was at school and realized that there was a fire coming. I was at the far end of the classroom near a door. At the other far end of the classroom, there was another door, and through its window I could see the fire fast approaching. The classroom was a science lab, and there were many students and professors hard at work at their desks and using microscopes. I started yelling at them, to get out, that the fire was coming, couldn't they see it? No one would listen, everyone kept working, harder and with more focus it seemed, instead of running from the fire! One guy did get up and walked out, but did not help me warn the others. I realized the fire was too close now, and I had to get out or I too would burn. So I started running out, and as I did, the room exploded. In my dream, I woke up and my face was burned and scarred, but I was alive, and it seemed time had passed since the explosion. There was no regret in my feelings in the dream, no desperation, just a quiet, still peace. I knew I wasn't living for this world, and somehow it didn't matter that I was disfigured and scarred. I had done what I knew had to be done, and that was to warn others. I ran to a room and there were many people I recognized, and some of them seemed to pity me. I told them not to pity me, because I had done what our Father told me to do.
My faith is greater in my dreams than in real life I think. Or maybe it is because God gives the strength and peace when we most need it.
Now, back to the article. For these women, any chance they had for a "normal" life in their country is now gone. They cannot marry, many are blinded from the attack, and often cannot take care of themselves and must rely on family or on someone to care for them. There are organizations that send in plastic surgeons and people who donate to give these women jobs and opportunities in their countries. But what of the hope, the only Living Hope, that is Jesus? Who is to tell them of Him? My heart aches as I pray for these women. Maybe it is because I am unsure of what to pray.
Father, I pray for a Your mighty work be done in these women's lives, and for your eternal hope to enter their hearts. May your love cross boundaries that we cannot cross, and show us how You would like us to be involved in Your work. We praise You, You are good and faithful, a loving father, and a wonderful Savior.
Thursday, August 7, 2008
How do I respond to this?
"Doctor, Doctor! I need CPR!" -guy (maybe drunk and obviously NOT needing CPR) who ran up to me near the Parkland ER.
Tuesday, July 8, 2008
When you dont know the answer but the Fellow does
Today I've had to remind myself at least 10 times that the Fellow I am working with has at least six years more of experience and knowledge in medicine. A Fellow is someone who has finished his residency and continues specializing in a specific field. Everytime that my attending asks a question and I get it wrong (occurs often), he then turns to the Fellow, who immediately gets it correct. The Fellow is a nice fellow, I can't be mad at him for knowing his micro.
I am really enjoying this elective in Diagnostic Microbiology since I am getting to learn tons about infectious diseases as well. Parkland has findings that most US hospitals would never have because of the amount of immigration to the DFW area and the countries where those people immigrate from.
Until next time!
I am really enjoying this elective in Diagnostic Microbiology since I am getting to learn tons about infectious diseases as well. Parkland has findings that most US hospitals would never have because of the amount of immigration to the DFW area and the countries where those people immigrate from.
Until next time!
Sunday, June 15, 2008
Study Study Study
These last few days have been difficult. I've spent most of the time studying, since I am about to take Step 1 in one week! I am pretty stressed out, but now I am just trying to learn as much information as I can, do as many practice questions as my brain can handle, and remind myself that I must sleep some too! Like most things in my life, it takes me a while to give God control. I am learning to give this exam up to Him, study with excellence, and let Him take care of the rest.
I am not saying the following to whine (I know God has put me where He wants me right now) but merely to explain why it is hard to sit inside all day and study. It is beautiful outside, kids are swimming, my family is going to parties and eating yummy food, there are a LOT of movies out that I have not seen, and I have begun to forget people's names because I don't see my friends anymore. Definitely looking forward to a week break and starting 3rd year! Just seeing Joy yesterday (hadn't seen her in a week) and sitting next to a LIVE person while studying brought me much Joy! Ha...Joy brought me joy...
It is 2:23 am so I should head to bed.
Happy Father's Day Dad! I am really looking forward to having lunch with the family tomorrow!
I am not saying the following to whine (I know God has put me where He wants me right now) but merely to explain why it is hard to sit inside all day and study. It is beautiful outside, kids are swimming, my family is going to parties and eating yummy food, there are a LOT of movies out that I have not seen, and I have begun to forget people's names because I don't see my friends anymore. Definitely looking forward to a week break and starting 3rd year! Just seeing Joy yesterday (hadn't seen her in a week) and sitting next to a LIVE person while studying brought me much Joy! Ha...Joy brought me joy...
It is 2:23 am so I should head to bed.
Happy Father's Day Dad! I am really looking forward to having lunch with the family tomorrow!
Friday, May 30, 2008
Healing
We are taught in medical school that healing may come in different ways: physical, emotional, and spiritual (this one is not taught as much). This past week I've learned there is a 4th and more important healing: Eternity with Jesus Christ.
When I applied for medical school three years ago, I was so excited about learning the art of healing. I was so focused on getting in to medical school, learning the material, treating people with medicine and lifestyle changes, and healing them. Then I went to Angola for 5 months and experienced the death of a child in my arms. As I held that child and cried, I realized medicine wasnt a cure-all after all. There were no words that could express my anguish, but even more there are no words to describe the mourning and grieving that went on outside after placing the dead child in the mother's arms. There is absolutely nothing, nothing pretty about the process of death.
This past week, my family and I learned of a Brother in Christ who was diagnosed with lung cancer and was given no more than a few weeks to live. He passed away to be with Jesus a few hours ago. This brother had been our pastor in Chile when I was little, and they had recently in the past few years come to Minnesota following God's call to start a Hispanic outreach ministry there. I was always excited to receive their updates, and God is doing a mighty work there!
In medicine, our professors like to teach us statistics about every disease, risk, ocurrence rate, etc. So, when I am asked to pray for healing, I struggle, because I know the statistics and how medicine works! Yet, I have been reminded time and time again, God is not a God of statistics or human medical knowledge for that matter. He is the God of the universe, HE IS SOVEREIGN.
For this brother, healing did not come while here on earth in the form of physical healing; however, healing has come to him! He is no longer in pain or having trouble breathing. He is united with his Savior, and rejoicing in eternal life! What hope we have in Christ, the worker and perfector of our faith, let us fix our eyes on Him! One of his sons wrote on their blog that one of the things this brother had mentioned was that he wanted to ask Noah how in the world he had been able to fit all those animals into the Ark! Maybe eventually he will do that, but I know that right now he is at the feet of Jesus, worshipping him. What we have to look forward to!
Psalm 73:25-26: "Whom have I in heaven but you? And earth has nothing I desire besides you. My flesh and my heart may fail, but God is the strength of my heart and my portion forever. "
It was also so encouraging to see how God united the body to pray for this family. There were literally people from all over the world praying for them. Also, I think everyone's faith in our wonderful and beautiful Savior was affirmed as this family put all their trust in His will and provision. This family showed a peace and strength that is not of this world, one that can only be given by our Father. He is true to His Word to carry us in our sufferings and hardships.
Deuteronomy 31:6: "Be strong and courageous. Do not be afraid or terrified because of them, for the LORD your God goes with you; he will never leave you nor forsake you."
When I applied for medical school three years ago, I was so excited about learning the art of healing. I was so focused on getting in to medical school, learning the material, treating people with medicine and lifestyle changes, and healing them. Then I went to Angola for 5 months and experienced the death of a child in my arms. As I held that child and cried, I realized medicine wasnt a cure-all after all. There were no words that could express my anguish, but even more there are no words to describe the mourning and grieving that went on outside after placing the dead child in the mother's arms. There is absolutely nothing, nothing pretty about the process of death.
This past week, my family and I learned of a Brother in Christ who was diagnosed with lung cancer and was given no more than a few weeks to live. He passed away to be with Jesus a few hours ago. This brother had been our pastor in Chile when I was little, and they had recently in the past few years come to Minnesota following God's call to start a Hispanic outreach ministry there. I was always excited to receive their updates, and God is doing a mighty work there!
In medicine, our professors like to teach us statistics about every disease, risk, ocurrence rate, etc. So, when I am asked to pray for healing, I struggle, because I know the statistics and how medicine works! Yet, I have been reminded time and time again, God is not a God of statistics or human medical knowledge for that matter. He is the God of the universe, HE IS SOVEREIGN.
For this brother, healing did not come while here on earth in the form of physical healing; however, healing has come to him! He is no longer in pain or having trouble breathing. He is united with his Savior, and rejoicing in eternal life! What hope we have in Christ, the worker and perfector of our faith, let us fix our eyes on Him! One of his sons wrote on their blog that one of the things this brother had mentioned was that he wanted to ask Noah how in the world he had been able to fit all those animals into the Ark! Maybe eventually he will do that, but I know that right now he is at the feet of Jesus, worshipping him. What we have to look forward to!
Psalm 73:25-26: "Whom have I in heaven but you? And earth has nothing I desire besides you. My flesh and my heart may fail, but God is the strength of my heart and my portion forever. "
It was also so encouraging to see how God united the body to pray for this family. There were literally people from all over the world praying for them. Also, I think everyone's faith in our wonderful and beautiful Savior was affirmed as this family put all their trust in His will and provision. This family showed a peace and strength that is not of this world, one that can only be given by our Father. He is true to His Word to carry us in our sufferings and hardships.
Deuteronomy 31:6: "Be strong and courageous. Do not be afraid or terrified because of them, for the LORD your God goes with you; he will never leave you nor forsake you."
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