An underwhelming first week of psychiatry...

This is, technically speaking, the end of the first week of my psychiatry rotation, but I've only spent about six hours actually seeing patients, and all of that has been basically watching the doctor talk to patients. Granted, my actual preceptor is on vacation this week so we're only seeing the covering physician doing his rounds at an inpatient facility, so I'm sure it'll improve once he's back at the end of next week, but as of right now I'm not impressed.

Plus, the drive to get to this rotation is ridiculous. It takes about an hour and 15 minutes to get to the site...it does get pretty as you get into the suburbs, but it gets old. Luckily (I guess), I only had to make the drive three days this week!

The inpatient facility we go to (I say 'we' because one of my classmates is also at the site!) is really more of a holding facility, a sort of in-between for people that can't stay in the ER but either can't find a bed in a long-term inpatient facility or will be cleared to go home after just a few days of observation. This includes a lot of suicide attempts and people who would like to go to rehab for various addictions but can't find a place with an open bed. Those two groups probably comprise 95% of the patient's I've seen so far, and the other few are people from group homes who were violent and got involuntarily committed from their other institution.

As you can imagine, most of the stories you hear from these patients are just awful. It's not exactly an uplifting rotation. I'm hoping that when the actual preceptor gets back from vacation and we get to see some outpatient stuff that it gets a little better. At least in an outpatient setting you can see garden-variety anxiety and depression that is (hopefully) getting better with medication. I have seen some interesting things so far, though...including a (very paranoid) schizophrenic, and a person with borderline personality disorder. So that was interesting to see!

I'm really hoping that this rotation picks up next week. It might take until the week after to get really interesting, though, since the main preceptor doesn't get back until Thursday. But I'll be sure to post if something interesting does come up!

Goodbye, Montana!

Tonight is my last night in Montana! I am definitely sad to be leaving this rotation and this town, but I'm also really excited to get back to Pittsburgh and see my friends from school (and be able to shop in any of a number of big stores within five minutes of my apartment!). The nurses from the clinic actually threw me a party on Monday, which was so great!! There was a ton of delicious food, and everyone from both the clinic and the hospital came, which was really nice.

This week was relatively quiet clinic-wise, which was good because I had a lot of packing to do! The most interesting thing we saw was this teenager who came in for "sinus problems" and turned out to have this giant polyp (we think) between his nose and throat. He couldn't breathe through his nose at all, and it had been that way for a month! His CT was amazing to look at - the polyp must have been at least 2-3 inches in diameter, which is a lot of space for something to take up in the back of your throat. Anyway, he obviously got a referral to a specialist in Billings.

I'll really miss it here, especially my preceptor. He always told me to say, when asked where I learned a skill or fact that I learned from him, that I learned it from "that country doctor who was wacky, but wise." He's kind of eccentric, but he's easily the best doctor I've worked with on rotations, and I am truly grateful to have learned from him.

My next (and last!) rotation is back near Pittsburgh, and it's psychiatry! I'm sure I'll have some interesting and/or entertaining stories from that one, so stay tuned!

Winding down in Montana...

Well, believe it or not I only have three days left at the clinic here! Today was my last Saturday clinic day, and it was a busy one. Nothing too exciting, really - just a lot of the same types of things I've been seeing the whole time I've been here. We did have one person come into the ER with a persistent nosebleed, and I got to cauterize it using silver nitrate sticks, so that was cool!

Last week was actually relatively quiet in the clinic. I think it was because the weather finally got a little nicer, up to the 50s (and even low 60s!) most days, so people decided they didn't want to be sick or didn't want to come in. I actually got home by 5:00 twice last week! My previous record was 5:30, so that was pretty exciting.

I don't have much to say beyond that...I will definitely miss it here, though. I had a chance to drive around and explore a little today, and Montana is just beautiful. And the people are so nice! I've learned a ton of medicine here, too, and feel pretty well prepared to be a practitioner myself. Now I just have to make it through one last rotation, a few weeks of review, graduation, and the boards (and the job hunting process), and I will be! :)