Psychiatrists are not like other doctors. You
can tell this straight
away when they talk
about postmodernism.
If an orthopaedic
surgeon even said
postmodernism, none
of their colleagues
would trust them again.
You as a medical
student have to learn to
cope with this
altogether different world within a short time.
Here are some guidelines to help you adjust.
1 Avoid guidelines. Psychiatrists don't like
guidelines (too modernist). Whenever you
use a guideline, make the following
disclaimer: "Of course, at the heart of
guidelines there is a conflict between the
idealised circumstance embodied in the list
and real world complexity." As you are saying
this stroke your fledgling beard and clench
your fists emphatically when you say "heart."
2 Attire. White coats are out. They might
even prompt ridicule: "Why have you
brought that instrument of oppression with
you?" A nice woolly jumper or some tie-dyed
clothes, rings on your fingers and bells on
your toes are even better. Try growing a beard
(whatever your gender).
3 Taking blood. If there is a lithium level
that needs doing, the task of taking blood
may well fall to you. Many psychiatrists
proudly declare that they haven't been near a
needle for years. Therefore, make sure your
venepuncture is of a high standard before
beginning.
4 The problem of believing one has the
disease one is studying occurs throughout
medicine. Medical student hypochondriasis is
worst in psychiatry. What you previously saw
as amusing idiosyncrasies in yourself and
others become full blown neuroses or
obsessions under the DSMIV classification.
Stay calm; it will soon be over.
5 Do not call the individuals in psychiatric
care mad or insane. It is not difficult to
empathise with them if you consider how you
would react if you believed everyone on the
bus wanted to kill you.
6 Many psychiatrists have idiosyncrasies,
perhaps through long study of mental illness.
Allowances have to be made. Don't bring up
their peculiarity or they'll pick up on yours.
Be careful of applying this advice in other
rotations. When physicians, ask what an
endoscopy means, they don't want to hear
you ruminating about the loss of the secret
inner sanctum of the body's insides.