Day of mourning

Today we pause to remember.

DSM V Suggestion 1: Histrionic Blogger Personality Disorder

My dear and wise husband reminded me that I write this blog for fun, and not to be pithy, insightful and win the on-line version of the Booker. So, may I present to you what will hopefully be the first in a series:

Histrionic Blogger Personality Disorder: 

A pervasive pattern of excessive emotional and attention seeking blog-writing, beginning at the start of the blog, and present in a variety of on-line writing locations, such as Blogger, Twitter, Wordpress, the comments section on many other blogs, as indicated by five (or more) of the following:

1. is uncomfortable when not nominated for random meaningless online blogging awards
   
2. interaction with others is often characterised by inappropriately provocative posts or comments on other blogs
   
3. displays rapidly shifting and shallow cartoons, illustrations or impressions of fellow/supervising staff
4. consistently uses appearance or existence of blog to draw attention to self
5. has a style of writing that is excessively lacking in detail, and writes about deep and meaningful concepts at an emotionally immature level (e.g., "The patient cried, and I held her hand, which made me feel like Character X on Medical Show Y.")
6. shows self-dramatisation, theatricality, and puts self in centre of multiple exaggerated tales of adventure, heroism and superior skill 
7. is suggestible, i.e., constantly writes blog posts about other blogs or writes every week with the specific aim of being in every Grand Rounds
8. considers readership to be larger and more loyal than it actually is.

Stay tuned for more tongue-in-cheek suggestions for Blogger diagnoses. May they help us remember the real criteria with a bit more ease. ;)

Ant Attack!

The ants are back in our house, and are attacking in force. They are EVERYWHERE, and I will be lucky if I don't lose another random piece of electrical equipment again before the exterminator gets here. 

In the past, these creatures have destroyed our answering machine, fire alarms and on occasion will start to swarm the bench when I am preparing dinner. It is horrible!

The cats have about ten minutes to eat their food before the hoards descend. 

Sometimes they (ants, not cats) swarm the toilet bowl for no apparent reason, massing under the rim of the seat and making it very easy to get rid of them until they build up again five minutes later. Note: my toilet is clean. 

They have building up for weeks now, so what has stopped me from calling in the exterminator and fixing the problem? Yes, that's right - I am ashamed about the state of my garden. It resembles a wild forest and I feel bad about any exterminator having to work his way through it, machete in hand, finding the source of the ants. 

To be honest, I suspect that one or two of the nests may be working their way into our house, so it is probably better that I swallow my shame and call the bug man in sooner rather than later. Wish him luck. 

Run-Down of Week 3

This week has been more of the same. We have been doing lots of patient interviews, and while they are still interesting, I would like to talk to somebody who is not experiencing psychosis.

Unfortunately, our public psychiatry is so poorly funded that we really only have the beds for the sickest and those in the most dire need. This means that we see the most extreme cases and people at their worst. 

I feel bad for them, know they will probably improve with treatment and enjoy the interviews, but I would like some time doing something a little different, variety being the spice of life and all. 

We have another 5 weeks in psychiatry, and I don't really mind, but it will be nice to do something else for a little while. 

Funny or not?

I have to admit that I had a good laugh at this. I think I know a few people who could use a depressant drug, or perhaps they could go for the natural cure, and spend Christmas Day at our family gathering. ;)

Pop-culture cruelty

Why do people get confused and think that people take antidepressants to make themselves happy? I even overheard a medical student saying that a side-effect of taking antidepressants for another medical condition could be happiness. 

Pop culture references also make this mistake (see "Everyone's at it" by Lily Allen), comparing taking antidepressants with the consumption of illicit drugs. This kind of finger-pointing could be a way to justify illicit drug use in the mind of the user, stigmatise psychiatric drugs to justify their own avoidance of help, or just reveal an overwhelming misunderstanding of the necessity of pharmaceutical therapy to people with mental illness.

Sure, people often treat their own symptoms with alcohol or recreational drugs, but this is never the assumption that is made. It is often thought that people are using prescription anti-depressants to avoid their problems or make themselves unnaturally happy, when anybody who has been on antidepressants knows that there is no such thing as an easy cure. 

It is just so frustrating when stigmatisation of mental illness and its treatments is so openly accepted and present in the public media and everyday life. In general, people getting treatment aren't avoiding their issues, they are getting help for them, and anything that discourages this is just cruel and ignorant.

The most caring Valentine's Day gift

If you want to show real thought this Valentine's Day, please consider giving a gift that will be much more touching and last longer than flowers or chocolates. 

Join those of us who have asked for donations for the Victorian Bushfires appeals instead of these little things. I would feel sick if I got flowers at this time, when so many have lost so much. 

Sure, we should enjoy ourselves and live life too, but a donation would be a brilliant way to show real heart. 

Thank-you.

Bendigo Bank Bushfire Appeal

Australian Red Cross Bushfire Appeal

I feel sick

Every time the numbers go up, it gets so much worse.  You know when there is a heat wave that there is a chance of fires, but something this bad is just beyond imagining. 

Last night when we heard it was in the teens, we thought it was terrible. Now the number has reached 76 and we know it is going to be worse.

All we can do is hope and pray that the numbers don't continue to climb, and send support where we can.

Weekly run-down and some thoughts

I had another good week in my Psychiatry rotation. I really enjoy taking a full Psychiatric history, and evaluating the patient as a whole person. Without sounding twee, it feels like a privilege to hear the details of their lives that they may not have told anybody else before.

I always find it interesting to compare the level of detail that I am told in my friends' and family members' lives to that of the lives of the patients who I interview. I know that there are things that I would tell a therapist that I would not tell my family members, too, so it doesn't strike me as strange. 

It is just easier to tell somebody things if they are there as a professional and you don't really care what they think of you and you won't have to see them at parties and family celebrations. This is another reason that it is important for us to maintain professional distance - the therapeutic relationship is more workable if the patient can focus totally on themselves and not worry that they are upsetting the doctor.

Anyway, I have been interested in psych for a long time (as my brother told me this weekend, I have been contemplating it for "years") so it is a big relief to find that I am enjoying the rotation and have a good beginning level of skill at interviewing and talking to patients. 

I'm also enjoying learning about the drugs and seeing the effect changing the dose or introducing new ones can have on people in a matter of days. Reading about them in action on a daily basis always makes them easier to remember, too. 

I am finding fun ways to remember the drug names, before they get stuck into my memory properly. Clozapine, for instance, should be kept in the "closet" because it can induce agranulocytosis and requires regular blood testing. Quetiapine  (Seroquel) can help people who are experiencing psychosis find some "quiet" from their mind and "serenity." 

I would like to learn more drug names via cool drug pens, but I haven't had enough access to the pharmaceutical reps just yet. (Yes, I am aware of the ethical issues surrounding this, and the evidence that it can affect drug choice. However, I am just a student, and the use of pens as learning aids can only be a good thing, right? ;) )

For those of you who aren't familiar with the Australian training system for doctors, we all do a general year or two of resident training before starting to specialise, so even if I am set about what I want by the time I come to apply for a graduate job, there will be at least a year before I can start to train properly. Thus, there is no rush in making a decision, which is kind of nice, even though I am getting more certain as I progress further through the gamut of study and training that is medicine. :)