goodbye psychiatry

about 50% of medical students change their intended choice of specialty by the time they graduate.

i entered medical school with psychiatry on my mind. maybe it was because, for some strange reason, i tend to attract people with problems. it was an egoistic choice because i found satisfaction in picking people’s woes apart, listening to what they say and practicing with them a wrong and totally primitive version of cognitive therapy that would make aaron beck gag.

but now, i’m gonna be a statistic. i don’t think i wanna be a psychiatrist anymore.

it’s not that i don’t find it interesting. i enjoy analysing what patients tell me, how they express themselves, the way they behave. it’s also very encouraging to see the changes in the patients after being put on treatment. they do improve, somewhat. it angers me a little that mental health is a neglected area of medicine in this country. the supportive services are severely lacking. there aren’t enough clinical psychologists to carry out the necessary assessments and management. so i guess i do still care.

but every story of being raped as a child, living with a mother with mental illness, a suicide attempt, going from job to job, divorce, separation from children, an abusive relationship…just breaks my heart.

yes, i know that evidence shows most forms of accepted treatment are highly effective in achieving full remission if the conditions are right, but how can they ever really fully recover from all the events that have preceded the illness or have made it worse? i wonder if the human mind is really that resilient.

i know for sure now that my own mind may not be.

helping one or two friends with psychiatric disorders is one thing…seeing the (too) many psychiatric patients in the wards and clinics is a totally different ball game altogether. i’ve always known that i take my friends’ problems too personally at times, but it’s never occurred to me that it may actually be detrimental to myself. it’s no wonder psychiatrists get an extra fortnight off a year.

sigh. so what will it be now? paediatrics? surgery (urgh)? or perhaps i’ll end up humouring my parents and get involved in opthalmology/dermatology? i don’t know.

anyway, after these 5 weeks in psychiatry, i have to say that i have an even greater respect for psychiatrists. it’s not an easy job, they’re not easy patients, and the lack of support in malaysia makes it very difficult indeed.

so thanks for your passion. i only wish i had enough passion of my own to still consider psychiatry as a possible career path.

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