I was finally able to schedule my anesthaesia electives for the spring, and they're in only 25 weeks! All I have to do is make it through 3 more weeks of psych without tearing my hair out (trichotillomania), 8 weeks of surgery, 12 weeks of eternal medicine, and then the promised land! For the mathematically inclined, I have a two week christmas vacation during which I will sleep.
Psych/neuro has been the nadir of 3rd year thus far, which they will hopefully remain as I would like to enjoy the rest of the year. I don't enjoy the pigeonholing arbitrary nature of psych. Everything has to fit into a neat little DSM IV rubric. If your patient has been depressed for only 3 weeks and 3 days, they aren't technically depressed yet ( or somesuch crap, I don't care to look up the criteria right now), but it doesn't matter any way because they still get an SSRI. What if your patient is 86% of her ideal body weight, but is still binging and purging? Well then she's not anorexic, she's bulimic! (binging and purging are found in both anorexia and bulimia, percentile body weight is actually used to distinguish the two.) But if she loses 500 grams, then she's anorexic! These categorizations are totally arbitrary and more or less pointless because they don't really affect therapeutic decision making.
Psychopharmacology also sucks. The names of the drugs are all confusing, and the trade names sound like the generic versions of other drugs. That, and they're all very dirty drugs which act on multiple receptors and have about a dozen effects and two dozen side effects. These drugs are not like blood pressure meds, for example, which have well understood mechanisms and a relatively straightforward effects. Additionally, there doesn't seem to be any rhyme or reason as to why one patient gets SSRI X while another gets SSRI Y. 2.5 weeks left until I prostrate myself on the shelf exam and hope to heaven I pass.
-SS
2 comments:
As a basically healthy person with borderline HBP who has taken -and failed- a large number of HBP drugs, many for obsure but reportable side effects,(the -il's gave me anxiety attacks & I couldn't ride in a car for example), I wouldn't say they are so straight forward. "Eternal" medicine will help you with that. Ask Dan.
Onward, ever onward.
Amen to the meds comment. MDs are constantly changing the patients meds in the hospital ALL the time, it seems like every other day. Yet outside of the hospital, patients are told it could take weeks for it to become fully effective. I think its more a commentary on the broken system though. I shall stop here before I get too comfortable on my soap box.
Post a Comment