The Importance of Psychiatry to Medical Students

“Psychiatry is the art of teaching people how to stand on their own feet while reclining on chairs.” – Sigmund Freud

After hours of combing through the Internet, I finally laid eyes on this quote that most aptly defines my perception of psychiatry after having rotated in the specialty as a medical student for a mere three weeks. I distinctly remember my first morning as I walked through those double-locked doors on the 14th floor. I can still feel the reverberations of those barrier-like monstrosities shutting behind me as I hurried into the unit. I was apprehensive, no doubt about it, as I found myself under lock and key in the psychiatric ward for the first time in my life.

As I searched for my phone in the blind-ending pockets of my white coat to check if I was on time for orientation, I heard someone exclaim “Good morning!” leaving me almost stunned by the unexpected familiarity. As I looked up, I saw a patient with yellow headphones on his head, holding a book and greeting me with a smile. And let me tell you, that was the first of many such greetings. Curious to find out what brought him here, I spontaneously rushed to find the resident and ask him. Obviously, someone this happy and upbeat couldn’t possibly have anything wrong with them now could they?

To my disbelief, I found out that the patient was admitted for schizophrenia. The resident informed me that when he came into the ER, he was very disturbed, hyperactive, non-communicative, and repetitive with his story, which centered on bleeding from his head. Despite multiple efforts, he chose not to listen to anyone and stayed in his room for an entire week, simply asking for more bandages.

As first and second year medical students, we are quite strongly bound by the constraints of the notebook (First Aid to be precise). While that book probably saved me more times than I can count on Step 1, I was very quickly able to tell from my three weeks on psych that what I thought I knew (definitely) did not go beyond those books that I still hold so close to myself in every rotation.

And I know it seems as though this should be a stated, well-known fact. However, until you are in the unit, behind those closed double-doors, and walking past these patients with real, truly substantial mental health disorders, you can’t wrap your mind around their state of mind.

Seeing some of these patients first hand allowed me the fortunate chance to try and comprehend the mental state of these patients. When I now see them, I feel an intense urge to be patient, sit with them, and try to understand what could possibly be going on in their mind at every given moment. And the most interesting part – seeing them understand you and trust you even with a lack of insight in many instances. Having that kind of access is a true privilege, one that puts a medical professional an arm’s length away from impacting a change. Whether you look at the nursing staff, residents, physicians, or any other member of the team, it is that extra step to understand a patient’s troubles that paves the way for a robust therapy, appropriate counseling, and having the patient on your side.

I will leave you all with a final word of advice from my attending on the first day of my psych rotation. He said his goal was not to push us towards psych, but rather make us realize that these are still human beings who deserve equal respect in society.

My goal, as I share this tiny tidbit of experience, is to make us all force ourselves to “think” and “comprehend” and “consider” when we encounter a person who is depressed or hyper-verbose or just acting abnormal. It is more a responsibility and expectation than an option for us all to take the time and have the patience to truly understand before forming judgments. Believe it or not, the invasiveness of a mental health exam can leave a mark as deep as the slice of a surgical scalpel.

Related Reading: How Crazy Can Psychiatry Really Get? and Is The Psychiatrist Shortage Linked to Mental Health?

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Nirzari Pandya

Is a contributor to The Almost Doctor’s Channel.