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medical school

Know Your Limit

266

Came home from work late today…again.

I’m passionate about my job as a psychiatrist and spent about two hours with each patient that I was called to consult on the medical floor this weekend. Lunch and dinner were an afterthought. I felt the hunger pangs, but pushed on because the appreciation received from each patient for taking time to understand their situation made hypoglycemia worthwhile.

Today, I spent several hours on a complicated case. Coordination of care took place, notes thoroughly written, and necessary calls made. I left the clinic with a goal to leave work behind. However, the patient is still on my mind. Accepting that I can’t save a patient is one of the most difficult aspects of my job. No words of appreciation expected, no reassurance of their safety, no guarantee of tomorrow.

I can’t cure, I can’t heal, I can’t save, but it would be out of my character not to at least try.

December 4, 2012 30 comments

Psychiatry therapy

New Beginnings

written by freudandfashion

Taking in the scenery from my balcony on my last day in Oregon

I’m currently sitting on my couch wearing gym attire contemplating whether or not to head to the gym. Five minutes into a repeat episode of “The Real Housewives of Beverly Hills,” I convince myself of an alternate plan to work out at 5am tomorrow before going to clinic (I confess that this is the 10th time I’ve created this plan, but have executed it only once).

My lackadaisical behavior doesn’t surprise me. Previous blogposts exhibit this behavior (here/) and I attribute the laziness to a recent move. My childhood memories relate the experience to the song “Kindergarten Wall:”

“And remember the seed in the little paper cup:

First the root grows down and then the plant grows up!”

I was uprooted when I moved to Oregon, then eventually established my community and made it my home. Moving is a huge transition. One may need to adjust to a new work environment or find a new job, meet new people, discover the least traffic congested roads, join a new gym, etc. I have several patients who present with depression related to a recent move. Though each case is unique, I don’t automatically treat the depression by adding a new medication because mood may improve over time. I empathize with their struggles and generally offer support through the adjustment phase.

It took me about six months to feel comfortable living in Oregon, though i criticized myself each time I felt sad, homesick, and overwhelmed with change. Now that I’m back in so-cal, it’s taking a bit longer than expected to create a daily routine, but I’m familiar with my pattern of establishing roots in a new area of residence (the exercise routine will get there…eventually).

November 21, 2012 4 comments

Travel

Oregon Trails

written by freudandfashion

The countdown of the last eight years of medical school and residency seemed never-ending, but the remaining seven weeks until graduation seem to fly by way too fast. So much has happened in the last six months since my latest blogpost, which includes securing a new job as an outpatient psychiatrist back home in southern California, finishing my final duties as chief resident, starting/leading a bipolar support group, gaining confidence in my abilities as a psychotherapist, and feeling sentimental about my treasured time spent in Oregon. I anticipate the next few weeks to be packed with fun-filled exploration of the great Northwest, which I plan to share with all of you, starting with a few photos from recent trips to Silverton and the Oregon coast.

May 8, 2012 4 comments

Uncategorized

Winter Treat

written by freudandfashion

I’m ecstatic that it’s Spring, though the stormy weather in Oregon makes me feel like I’m still stuck in Winter. I was proud of myself for getting through my second Winter in Oregon with minimal complaints (for those who know me, that’s major improvement), though my survival required several trips back home to California. A few highlights from my travels this past holiday season include discovering on Christmas day that I had won the Alexander Wang Anita handbag from Beso’s “The Hold Everything Sweepstakes” (see my winning entry here) . I recently went to San Francisco to help my sister pick out the perfect wedding dress and felt the bag was perfect for carrying my necessities while strolling through the gorgeous city.

Photos by Marlon Santos

March 17, 2011 3 comments

Psychiatry therapy

Letting Go

written by freudandfashion

When a stable patient suddenly feels depressed and can’t pinpoint a stressor, I sometimes ask if a loved one passed away around that time of year. After pausing for moments to think, oftentimes the answer is “yes.”

I had a rough week that I initially attributed to having a heavy workload, but realized that the theme I struggled with the most was death and grief. I felt sad to hear news that one of my patients died and grew frustrated each time I heard the word “suicidal.” I’m normally diligent and confident in managing my patients, but my emotions overwhelmed me.

Nine years ago, my grandfather passed away. I regularly blame myself for not attending his funeral in the Philippines because right before he died, he asked that I stay home, focus on my studies, and make him proud by becoming a doctor. I live with regret, but recognize that I’ll keep struggling around this time of year until I learn to forgive myself and accept that my grandfather is gone.

February 12, 2011 2 comments

Psychiatry

1.5 Years

written by freudandfashion

2010 proved to be a remarkable year for me. I’ve transformed from a former struggling medical student (constantly questioning my career choice with each brutal beating from complicated exams, all-nighters, and Attendings pimping me to the point of ridicule) into a now PGY-3 (Postgraduate year) making medical decisions on my own and witnessing the positive impact I can have on patients’ lives. And, after 1.5 years of living here, I can admit that Oregon is truly growing on me (which I never thought I’d say, but who wouldn’t appreciate smog-free skies, environmental-friendliness, genuinely friendly people, traffic-free roads, abundant green landscapes, etc). I’m thankful for the lessons learned in 2010 and can’t wait for the experiences to come in 2011. One and a half years of residency left to go!

December 30, 2010 4 comments

Psychiatry Travel

Back to Work

written by freudandfashion

After returning from a week-long vacation, I dreaded the pile of catch-up work and voicemails waiting for my much-needed attention. I assumed that I’d be in vacation-mode and perform sluggishly on my first day back, but surprised myself at how easily I resumed my normal routine. Even more surprising was noticing the level of comfort I had while interacting with new patients whereas in the past I’d be concerned about whether or not my patients would feel connected to me or question my knowledge being a mere resident instead of a full-fledged Psychiatrist. One word to describe this new-found feeling? — Confidence. Confidence may come easily for some, but for me (and most, I assume), it required self-evaluation and rising after feelings of inadequacy and failure. Once that feeling is obtained, savor the moment the way you savor a great vacation.

November 17, 2010 1 comment

Psychiatry Travel

Vacation Time

written by freudandfashion

One thing I’ve mastered during residency is the timing of vacation and making the most of those few days of freedom. Four months without vacation is far too long, one month intervals is too soon, but a vacation every 2.5 months comes out to be just right. I’m at the point of yearning for some much-deserved time off, which I plan to spend soaking up sun to boost my Vitamin D and eating/shopping/partying in one of my favorite cities. My key to surviving residency incorporates a balance of combining work, relaxation, and fun, because the former can easily dominate over time, resulting in high anxiety, struggles to get up in the morning, a shorter temper, less sleep, and less people wanting to be around me.

November 1, 2010 0 comment

Psychiatry

Pill Pusher

written by freudandfashion

I have a simple theory that I like to follow when it comes to psychotropic meds: “Simple is Better.” Pretty straight-forward.

When I inherit a new patient with a list of meds the length of the Declaration of Independence AND they’re still depressed despite all the designer brand name drugs at their disposal, I don’t think it takes a medical degree to figure out that something’s not right.

Question 1: Question the diagnosis. Question 2: They’re still depressed—what the heck am I supposed to do about it?

Whereas most might seek comfort in adding yet another miracle drug to the list, I was inspired by one of my Attendings and made a goal to venture in the opposite direction of the less anxiety-provoking intervention and instead take a medication out (slowly, of course, before withdrawal throws them into a far worse state) and maximize the therapeutic benefit of a truly helpful medication at the same time.

And, the outcome? Well, it’s worked out in many of my patients thus far. Maybe my warmth and reassurance helps as well. Only thing I need now is the research to show it (my next residency venture).

Image via ramoscentral jpg

October 23, 2010 3 comments

Psychiatry

Just Breathe

written by freudandfashion

{driving on I-395 in Miami}

Two things that annoy me on a daily basis: drivers who tailgate and drivers who drive too slow. Being from California, I’ve learned to drive aggressively and posess a constant level of road rage. I never thought a driver who followed traffic laws existed until I moved to Oregon where the average person makes full 3-second stops, drives below the speed limit, and is shockingly courteous towards other drivers. Now that I’ve lived here for over a year, I admit to some appreciation for the overly-cautious driver though I constantly find myself in a tense, angry state every once in awhile. On my way to work today, I noticed my tight grip on the steering wheel and my frequent glares at a speeding car through my rearview mirrow. I felt my neck muscles tense and head start to feel heavy before I realized that I just needed to relax and BREATHE. Take a deep breath…and another deep breath…then switch to the next lane and simply let the driver go. Breathing sounds like a simple solution to high anxiety situations though plenty of people, including myself, have to remind ourselves to do so. I wanted to attach a video demonstrating the diaphragmatic breathing technique, but the videos online have a cheesy 1980’s vibe. I’ll find one eventually, or make my own.

Tip of the day: Next time you go into anxious or angry mode –remember to breathe!

October 19, 2010 1 comment

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