Psychiatry

A very different specialty to anything i've ever known and yes, I mean different, not, a crock of shit. I was actually very prepared to hate it, the "wishy-washy" (cue every psych consultant rolling their eyes) parts of it but actually for the most part it's an area of medicine that is unfairly ignored for the "sexier" specialties. 

It is hard work too. Gone, are the images of sitting in a 3 grand arm chair listening to a patient talk about how being an only child ruined him. Instead, think of a cramped board room filled with more MDT members i've ever seen in general medicine, pacing patients, talking fast and loud,  illogical delusions, not stopping for breath for 8-9 minutes, answers to simple questions taking 24 different tangent. Think, vacant stares, auditory hallucinations, messages of suicide, completely mute patients, patients that require restraining in a 5:1 ratio - it's very hard work. 

It's interesting because you get so many patients with a similar diagnosis that present in so many different ways. I wanted to become a doctor because I love meeting different people and I love making a difference to people. Psychiatry encompasses probably the most different people you'll ever come across  and in terms of making a difference? Well, there's no health without mental health.

So, aside from the ways real psychiatry is different from TV-psychiatry, what else is different?

Ward rounds take forever and the patients come to you. There's no physical disability preventing these patients from coming to you in the ward round room so they do that.

There is always input from a lot of other people - the main difference to other wards being Mental Health Advocates, Social Workers, Clinical Psychologists etc.

There's so much more to it then medication. I know technically that actually that's the case for all specialties, but it's so much less hands on and so much more about getting people to actually engage with services. So much about it is about managing people's relationships.

People are around a long time. Think at least 3 months in most scenarios. 

You are dealing with sometimes, the most ignored and vulnerable people in society. If your 65+, acutely psychotic, homeless and drawn into a world of substance misuse, well fuck.