Friday, September 29, 2006

Stories from my Psych rotation

Looking at my sis' blog entry about her psych rotation experience (as a medical student larr, not as a patient), and talking to her about it, made me think about MY psych days as a med student 7 years ago.
I remember how, despite it being a cushy rotation, many of us were mentally fatigued. I think it takes a lot, listening patiently to depressed, manic or troubled patients. And perhaps I'm not made out to be a psychiatrist in the first place, but I remember being impatient. Thinking, "Snap out of it. What's wrong with you? This is nothing. You're lucky that your health is good!". Thinking that what they had was a poor coping mechanism. Of course, I'd never say it to them. And that's why I could never be a psychiatrist. But many of us actually felt depressed that month, just from all that negative energy we got.
Perhaps this echoes the study out of Oxford some years back (J Epidemiol Community Health 2001;55:296-300) of how psychiatrists have the 4th highest suicide rate amongst doctors.
Of the patients I saw as a medical student on psych, this one story stands out from the rest. Be forewarned: This gets graphic.
He was a man in his 40s who apparently was in the Canadian military's corp of engineers, admitted for severe PTSD (Post-traumatic Stress Disorder). He had done a stint in Bosnia (or was it somewhere else?). He displayed the typical symptoms; insomnia, nightmares, flashbacks, exaggerated startle reaction, irritability and panic symptoms, to name a few. He was haunted by things he saw during his tour. Things he couldn't forget.
Because they were engineers, and because of political reasons, they weren't directly involved in the war. They were not authorized to engage, as that was a civil conflict and did not involve their country. One day, he witnessed a horrifying event. Militia from one side held a couple hostage- a man and his pregnant wife. Because of the hatred they had for each other, simple execution wasn't enough, apparently. Restraining the man, they nailed his wife's hands to a wall. While she was alive and screaming, her belly was slit open. The late-term fetus was yanked out and shot. They then shot her in the head, all in full view of her husband. Only then were they satisfied enough that they had emotionally tortured the man to the fullest, and mercifully executed him.
My patient felt helpless to stop this. And this has haunted him since. Makes you glad that the rest of us didn't have to grow up in those conditions, or to witness that. You pray the ethnic disparities and simmering resentment in your home never leads to civil war.
7 years later, I haven't the foggiest idea what his name was, but I remember his face. 7 years later, I catch myself wondering how he is doing.