Psychiatry Rotation #3 Part 3

My second site on Psychiatry was on the inpatient Child Psychiatry consult service. I also went to clinics in the afternoon.

I saw a cool case of conversion disorder. It was a sweet 11 year-old girl who suddenly lost the ability to walk. A close family friend of hers who was only 17 years old died a few weeks earlier. The day after I met her, she was able to walk again. It was fascinating. Conversion disorder means she wasn't consciously not walking, she really couldn't walk, but there was nothing biologically wrong with her.

What I gained most from this rotation though was meeting 5 teenagers who attempted suicide. I remember being very nervous about meeting the first patient. What does a stranger medical student say to a teenager who just attempted suicide? Realizing that their attempt was really a call for help helped me get over the nervousness. I remember 2 teenage girls who were relieved that I asked these invasive questions. One of them was raped before she attempted suicide and hadn't told anyone until she told me and my attending. The other girl was diagnosed with lupus and had been struggling with suicidal ideation chronically with previous attempts, and she requested to be put on antidepressants.

This rotation was my most rewarding one in 3rd year so far. I am very proud to be the kind of person people can open up to about the most serious topic of wanting to end one's life. I couldn't help my aunt, but I can help many others.

Speaking of my aunt, one of the clinics I went to in the afternoon was the Transcultural Wellness Center - a mental health clinic that specifically targets Asian Americans. MIND BLOWN when I found out such a clinic exists. I truly, deeply love the purpose of this clinic. What they do is pure goodness, they are filling such a huge need. After rotating there, I was torn. I was torn between Family Medicine and Psychiatry. The TWC reminded me that at my core, what I want to achieve most as a doctor is to promote mental health of Asian Americans.

I've gone back and forth too many times to count. Somewhere along the way, for some reason, I stuck with Family Medicine. And I'll miss Psychiatry. My interest in it was genuine, and my interest in it reflected who I truly am. But sadly, my limited experience in Psychiatry has shown me that having an M.D. and treating mental health means prescribing psychiatric medications. I'll do that as a family physician too, but I don't want to do it all day everyday. "They" don't want to pay M.D.'s to do therapy. Anyway, I'd rather be at the front lines anyway. I'd rather be the primary care physician who knows my patients well enough to educate them about mental health. And hopefully I'll have a lot of Asian patients.