On this rotation, I had a patient say to me “I would rather have lung cancer than suffer from a mental illness.” This resonated with me because most patients I’ve interacted with have poor insight into their condition and even if they did, would they agree with such a statement? Throughout my Psychiatric rotation, I have often thought of the impact of mental wellness versus bodily wellness. I have come to learn that treating a mental illness is one of the hardest things providers can do. Treating a bodily function is so tangible compared to stabilizing a mental disorder. I discovered that nothing is black and white in psychiatry. It is mostly a huge gray area that can manifest as a vicious cycle. Often times patients do not always fit into a cookie cutter DSM-5 criteria or are not a good candidate for first or second line treatments. In many instances, patients are non-compliant with medication and find themselves back in the same inpatient setting. Psychiatric providers are trying to find a way to stop such a cycle and work different angles for medication optimization and safe discharge planning. On top of trying to diagnose and treat mental disorders, this specialty is emotionally taxing. 

My psychiatry rotation at Elmhurst hospital was one of the hardest yet humbling experiences I’ve had so far. I went into this rotation expecting plenty of psychotic patients in the inpatient setting. I have come to learn that many of these patients do live and function safely in the community, until they have a psychotic or manic episode. Moreover, I learned that it is OK to live in society and have psychotic traits just as long it is safe for everyone. During this rotation, I had the luxury of understanding what it is like to keep a psychotic patient safe. I was able to witness the court process for treatment over objection and retention cases. I got to see patients go through weeks and trials of different medications before showing improvements. I also learned the art of psychotherapy and how to read in between the lines from the psychologists. Proper treatment for psychotic patients is multi-faceted. Keeping them safe and getting psychiatrically stable before discharing them back into society is the main goal 

Although this rotation was unlike other medicine rotations that required hands-on work, I noticed this specialty found success through the power of speaking. A simple 5 minute conversation could bring a-lot to light about a patient. For example, I was able to assess a patient by just asking them how their day was. I could evaluate their appearance, mood, affect, behavior, speech, thought process, thought content, insight, judgement, and impulsivity. Overall, this rotation was emotional and gave me a completely different perspective on psychiatric illnesses. Besides getting chased by a psychotic patient on the unit, I found a deep love for this specialty. I will gladly take what I’ve learned (I sure did learn plenty) and meaningfully integrate it in my future practice.