Tag:

medical

Intern Year Memories in Smitten Scrubs

{Smitten Bliss Scrubs c/o Smitten Scrubs via Scrub Shopper}

The last time that I wore a pair of scrubs was several years ago as an intern physician doing internal medicine. And they were the standard pale blue hospital scrubs that you practically live in as an intern rotating through the hospital wards as part of the internal medicine, family medicine, general surgery, emergency medicine, and ob/gyn teams. I recall running up and down the hospital stairs in them, zipping through the emergency medicine floor in them, and getting various bodily fluids splattered onto them despite my best obsessive-compulsive attempts to keep them clean. Then, the routine was to fall asleep on the couch in my scrubs within seconds upon returning home from a 30-hour shift. Hence, scrubs have provided me with memories both exhausting and accomplishing.

As a psychiatrist, I no longer wear scrubs, though I miss the ease of getting up in the morning without having to dedicate minutes contemplating what to wear to work. Therefore, when Scrub Shopper reached out to me to promote the relaunch of one of their brand lines, Smitten Bliss, I was excited to wear and experience the new generation of scrub designs and styles.

The following is my opinion regarding the Smitten Bliss line scrubs that I received:

Warmth – I was out running errands on a cold, chilly, yet crisp day in so-cal. These scrubs kept me pretty warm and I was able to wear them without having to wear layers underneath nor a jacket over it.
Comfort – the scrubs are made with polyester & spandex and provide enough stretch to allow ease of movement.
Style – these scrubs are far more stylish than the standard hospital scrubs! The material is of high quality. They come in a variety of colors (berry, heather grey, royal blue). The ones I’m wearing are in navy. I also love the pink trim, which adds a pop of color.
Sizing – I love that the pants come in petite sizes (which is perfect since I’m 5’2”). The top in size small was slightly longer in length than I prefer, but I’m sure would be perfect for those taller than me.
Functionality – The pants and top have several pockets, which are much needed while on the job.

And what I really like about Scrub Shopper is their Give Back campaign in which Scrub Shopper offers donations to Susan G Komen, Doctors Without Borders, St. Jude’s, the Abandoned Pet Project, and the Greta James Scholarship Foundation. Customers will have the option at checkout to choose one of those options, and they will donate $1 per order to the organization of their choice.

And as an added bonus, Scrub Shopper and I have collaborated to host a GIVEAWAY for one of my followers on Instagram to receive a free pair of Smitten Bliss scrubs! Check out my link here for simple rules on how to participate!

Do you wear scrubs to work?? And if so, what is the most important factor about the type of scrubs you choose (cost, style, pockets, color, etc)??

March 1, 2017 7 comments

Medicine Psychiatry

Why I Chose Psychiatry As My Specialty

written by freudandfashion

{Rancho Cucamonga, California}

I am often asked why I chose psychiatry as my specialty, yet as one of my readers pointed out, I’ve never described my reasoning in a blogpost! So here goes my short story of why I chose the path to become a psychiatrist…

The time to solidify your choice in medical specialty and apply for residency training programs occurs during the Fall of the 4th (and final) year of medical school. Students have various reasons for choosing a specific specialty, some knowing which specialty they wanted to go into since childhood, others typically contemplative until right before application season. Some people even change their minds in the midst of residency training and decide to switch specialties.

As a medical student, I attended most class lectures, yet spent majority of the time passively writing notes while chatting on instant messenger. However, when it came to psychiatry, I woke up every morning with excitement to attend each lecture (quite unheard of since I practically dragged myself to every other lecture series), paid attention (and even turned off my instant messenger), thoroughly read the textbook, diligently took notes, and excelled at every exam.

During third year of medical school, students start clerkships, which consists of rotating through various primary care specialties (typically family medicine, internal medicine, Ob/Gyn, pediatrics, psychiatry, and surgery). When interacting with patients during each rotation, regardless of the specialty I was assigned, I ALWAYS spent more time with my patients asking about their psychological and social backgrounds. As a result, I eventually became identified by my senior resident and Attending physicians as the student who would generally be assigned the patients with a history of mental illness or medically-related psychiatric issue. Also, if a patient was admitted to the hospital for physical symptoms, yet the extensive medical workup failed to determine any causative explanation for the symptoms, I was told to assess if there were any emotional issues that might be contributing to a patient’s intractable symptoms (such as cyclical vomiting syndrome, intractable pain, etc).

I specifically remember one patient — a young woman with intractable nausea/vomiting, who was unable to keep down food and fluids. Her medical workup was normal and the medical team could not identify a cause. While the medical team spent only a few minutes to check in on her (to do a quick medical exam and see if she had eaten), I went to visit her after rounds to chat. My intuition told me that there was more to her issue than solely a physical complaint. She was quite shy and spoke only a few words, yet after a few minutes of engaging in conversation, I believe she saw that I wholeheartedly cared about her wellbeing. As it turned out, she experienced ongoing stressors at home due to a recent move with her boyfriend and often felt isolated since she was often home alone with no friends in her new area of residence. I promised to check in on her after daily rounds and she thanked me for taking the time to speak with her.

On the third day, I saw her untouched food tray, and after a few minutes of talking, I asked if she liked ice cream. I brought her vanilla ice cream from the supply in the nurses’ station. We talked about how she missed her family back home. After several minutes into the conversation, I watched her open up the ice cream cup and slowly start nibbling on small scoops. After eating 25% of the cup’s contents, she politely asked for a cup of water. I quickly got up to pour ice water and asked about her little brother as she took a few sips from a straw. Before I left the room, I closely watched her for a few minutes to observe if she’d vomit the contents. She appeared comfortable with no sign of nausea.

The following morning, I viewed the nurses’ report, which noted that she had no episodes of vomiting overnight and even ate a jello snack. I said ‘goodbye’ to her that morning since our medical team informed her that she’d likely be discharged home after lunch. I couldn’t help but wonder if she’d be okay returning home to the same environment that triggered her symptoms. However, the empty plate on her breakfast tray was an indicator that she ate that morning, which reassured me.

Others docs may feel this way about their own specialty, but in my view (currently and as a medical student at the time), there is an art to psychiatry. There are no labs to rely on and although psychopharmacology is of importance, I immediately noticed the value of a therapeutic connection and communication necessary to fully understand an individual’s situation and the context of their symptoms. Despite such a strong emphasis on pharmacology during medical school, I recognized early on how much certain symptoms (even physical) could not be improved solely by medications and standard treatment alone. I recalled reading The Diving Bell and the Butterfly as a medical student, which inspired me to try various different creative ways to communicate with other patients who struggled to verbalize their needs, and had a bit of success with many.

I have several other reasons that contributed to my decision to pursue psychiatry, but wanted to emphasize how much the nature of my connections with patients empowered me as a medical student. The psychological components of a person’s history are often not prioritized when it comes to a patient’s medical care. Throughout medical school, I often felt inferior particularly because I didn’t achieve the highest grades compared to my classmates. However, I knew one thing for certain when the time came to apply for residency: as a psychiatrist, I could play a vital role in emphasizing the importance of an individual’s psychological and social background in order to fully address health and wellness. And I felt confident that I’d do whatever I needed to be damn good at my profession.

Photo by Marlon Santos

March 18, 2016 24 comments

Medicine Psychiatry

4 Reasons Why I Don’t Wear A White Coat

written by freudandfashion

I absolutely love this post written by Dr. Kristin Prentiss Ott about why she believes we shouldn’t wear white coats to work. To carry on with her sentiment, I thought I’d write a few of my own reasons why I personally chose to ditch my white coat even when required to wear one since completing my internship (except for professional photos, of course). Aside from the fact that I’m a psychiatrist, you’d be surprised to know there are still some hospitals where psychiatrists wear their white coats on the unit (the psychiatric hospital where I did my internship was one of them). I used to think it was a bit odd to wear white coats on the psych ward because the look can be intimidating, but I was an intern at the time so I complied. And yes, I recall asking one of the supervising psychiatrists the reason why white coats were worn and remember being told it was by choice? I may have also been delirious and sleep-deprived at the time, so don’t quote me on that.

The following are the reasons why my white coat remains unworn and in pristine condition hanging in my closet:

1. White Coat Syndrome. Yes, such a syndrome exists and is also known as “White Coat Hypertension.” The condition is self-explanatory: a person’s blood pressure is elevated while in the doctor’s office, but is normal in other situations. I was initially quite surprised to learn that anywhere from 15-30% of people experience the syndrome, though I’d have to say the statistic is quite synonymous (frankly, I believe the percentage is even higher) with my own experiences in practice, especially when meeting patients for the first time.

Though one explanation for the fear-based physiologic response might be the association of hospitals/clinics with disease and illness, I believe psychiatric patients are even more prone to anxiety when in the psychiatrist’s office due to disclosures of more personal information and possibly also from bad experiences with previous doctors who weren’t empathetic to their psychiatric issues.

2. Prioritize the doctor-patient relationship. In a study done in an outpatient psychiatry clinic in Upstate New York, 96% of the patient population surveyed preferred that their psychiatrist not wear a white coat, while 58% did not think it would make a difference in their doctor-patient relationship.

Having an aligned doctor-patient relationship is important in any specialty, but even more so with psychiatry due to the personal content discussed. Due to the pressures of time constraints and also the trend of several behavioral health clinics having patients see whomever random psychiatrist has availability, patients are less likely to establish a therapeutic connection, which I imagine would exacerbate anxiety during each visit. I mean, would you want to re-hash your story to a new psychiatrist during each follow-up appointment (but then again, most psychiatrists don’t have enough time to review your whole history, so sessions become mostly limited to a discussion of symptoms only)? Minimizing any factors that can contribute to anxiety (such as wearing a white coat) would at least help a patient feel more at ease.

3. They’re filthy and teeming with bacteria. I have traits of OCD (Obsessive-Compulsive Disorder), yet vividly recall disgusting moments during internship (where I rotated in various hospital departments) when I knew that my white coat was dingy and long overdue for dry cleaning, yet was way too busy to wash it (think buildup of splattered bodily fluids from various orifices and the numerous times that my white coat sleeves probably brushed my face or came into contact with food I’d scarf down during quick breaks…ewwww). Dr. Ott points out in her post that research has shown that a mere 8 hours of routine patient contact leaves white coats teeming with infectious microbes. These days, the average work week of all medical residents is limited to 80 hours/week and most practicing physicians work an average of 40 to 60 hours/week, which equals a heck of a lot of microbial buildup.

4. Sure, a white coat has maintained its iconicism as a symbol of power, prestige, and intelligence, but a doctor’s identity shouldn’t depend on wearing one. Obviously, I was excited when I received my short white coat during my medical school induction ceremony, but later hated being identified as a novice med student as I walked the hallways of the hospital. Meanwhile, other health professionals from various levels of training wore long white coats indistinguishable from those worn by physicians. After graduating from medical school and transitioning to the longer white coat, I was so excited, yet recognized that I formed too strong of an attachment to my white coat. My dependency on an object didn’t sit well with me. I felt as if I had to wear one in order to possess a sense of worth and importance.

By first acknowledging that I attributed much of my value to an external object (the white coat), I took steps to detach myself from it. I began to curate a wardrobe that conveyed professionalism and my individual sense of style. I made sure that I properly introduced myself to patients and staff, especially when I was mistaken for a nurse or psychotherapist. And I’m not going to lie — initially, I was frustrated by having to correct people on a regular basis, but as I gained confidence in myself (yes, psychotherapy helped) and my skills as a physician, to this day I am rarely ever bothered. Interestingly, I am acknowledged to be a physician far more frequently and I believe it’s because I project a much greater sense of who I am, both personally and professionally. No white coat needed.

PS: A special “thank you” to my friends on Snapchat (freudandfashion) for contributing your opinion when I posed the question of whether or not you’d want your psychiatrist to wear a white coat (11% said “yes” to wearing a white coat and 89% said “no” ).

February 9, 2016 18 comments

Personal

Brighter Days

written by freudandfashion

{Napa, California}

I am so appreciative of the supportive comments I received after sharing my personal experience of physician burnout. I’ve had similar experiences, especially during medical school and residency, but never felt comfortable enough to share until recently. In my practice, I work with so many patients who suppress their emotions. I identify with them wholeheartedly because I am just like them. During residency, I made excuses to avoid meetings with my supervisors because rather than discuss patient cases, the meetings would somehow turn into therapy sessions where I’d cry and feel embarrassed for exposing my vulnerabilities. At the time, suppression and isolation were the only ways I knew how to cope, but it’s a pattern I am actively trying to break ever since I started seeing a psychotherapist during my fourth year of residency.

A common phrase that I mention to my patients (which was told to me by my amazing sister, who is a marriage and family therapist) is that “if you suppress yourself, you depress yourself.” We all suppress ourselves to some degree, but once able to overcome the barriers {our own internal barriers (i.e. cultural, self-criticism, etc), in addition to external barriers (such as the immense pressures and expectations placed on physicians)}, then we have a better chance at achieving wellness and exerting more control in our lives and our careers.

June 27, 2015 6 comments