-ology v. -iatry

I realized this weekend (for approximately the 34th time) that a lot of people don't know the distinction between a psychiatrist and a psychologist.

Let's do a Q&A, based on common inquiries about my career choice.

1. "Psychiatry? Don't you mean you're getting a PhD?" - Why no, that's not true at all! Psychiatrists are, in fact, medical doctors, aka MDs. They can prescribe medications and write orders for lab work. Some of them actually use their stethoscope a few times a week! Psychologists can have either a Master's degree or a PhD/PsyD in psychology and are unable to give you anything stronger than good advice and a box of kleenex.

2. "But I thought you wanted to practice medicine." - Ok, skeptics. Just because you can't see a shortage of serotonin or an overzealous dopamine-producing neuron doesn't mean it's not there. Last time I checked, the brain was an internal organ and, based on precedent, internal organs can misbehave. If you have high blood pressure, your doctor will use clinical judgement and treat thusly. Same goes for schizophrenia; it's a legitimate medical condition like hypertension, except it makes you go bat-shit crazy. Bottom line? Psychiatrists fix sick brains, and that seems pretty darned doctor-like to me.

3. "Aren't you going to get sick of listening to people's problems?" - There are a lot of talented psychologists and social workers that will talk to patients 'til the cows come home about the root(s) of their feelings. I, however, don't really have an interest in doing therapy. I want to know your symptoms, what makes you feel better or worse, and how long it's been going on... medical-ish things. The goal is to find a legal drug that will get you on the road to feeling better.

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A good friend and future psychiatrist described the difference between practitioners of psychology and psychiatry like this: think of them like physical therapists and orthopedic surgeons; both fix musculoskeletal problems, but they do that from completely different angles. It's an efficient and accurate explanation.

Now that you've been educated, spread your new-found knowledge to the masses. Only YOU can prevent psychiatry confusion!

Oh, snap.

In regards to healthcare reform: "It must be REALLY hard to watch democracy work when you are rich & white & powerful."

I normally keep my mouth shut about my personal politics. But, when I read the above quote in a Facebook status today I decided to throw etiquette aside and put in my two cents.

I'm not going to mince words. I come from a fairly affluent upbringing and have never wanted for anything. I don't have any student loans. My parents are conservative and don't particularly like parting with 42% of their income and I really don't blame them. Call my father an asshole if you want, but realize that he is 52 years old and still works 7 days a week. Actually, I didn't know that dads didn't work every day until I went to play dates on Saturdays and noticed that every other dad was watching sports and drinking beer. For all of the critics out there, yes, I did play with middle class white kids and I know plenty of other parents worked their asses off to scrape by.

I digress.

My family's business is in some potentially serious financial shit because of the new mandates to carry health insurance. And the best part about all of this is that there has never been a time where they didn't offer health benefits. Moreover, everyone from the CEO to the minimum wage workers had the same exact insurance plan.

Do the math. For an industry that makes no more than 3% profit each year to be stuck with new rules, fines, and costs to provide something that is already in place is frankly devastating. No profit = no company. No company = loss of 250+ jobs.

And where does that leave the poor white rich man? Wait... don't powerful white men like to lay people off or dissolve their 40 year old business to stay afloat? Yes, my friends, the powerful white wealthy man certainly has had his comeuppance!

Fuck that.

I could not have asked for a better role model than my rich white father to teach me the importance of hard work and treating everyone with respect.

Nothing about these new laws is without flaw... not for doctors, insurance companies, politicians OR patients. Neither were the tactics used to get this whole mess passed. That's just politics. But, ignorance such as the above statement should not be tolerated, regardless of race or income.

Early Career Low

Let's talk about some straight-up bullshit, people.

I'm sure all of you are expecting me to go on a rant about this health care reform stuff. You're wrong, because I'm frankly sick of hearing about it.

No, friends, today the police were called on me and my attending physician by a patient. This all occurred while she was in a room inside the clinic.

Here's a nickel's worth of free advice - don't call 911 and complain of harassment and expect that the doctor will still be willing to see you. Bad form.

The short and medicolegally correct version of the story goes like this:

- Patient delivers baby by c-section 2 weeks ago after nearly dying. Both mom and baby are healthy post-partum.

- Patient has mild wound infection. Instead of immediately returning to a medical facility, she obtains legal counsel.

- THEN, patient returns for a 1.5 hour appointment where her incision is cleaned and re-dressed. An oral antibiotic is also given for back-up.

- At the instruction of her lawyer, patient goes to other hospital to confirm the diagnosis. No further action was recommended.

- Patient returns to clinic in order to record the physician and nurses to use against them in court.

You know, I don't fancy being recorded so my words can be taken out of context and used to nail my attending to the wall. Neither does my attending for that matter. But, asking* to see the phone to make sure it's not on record is tantamount to harassment and battery.

When did the collective opinion of doctors sink so low? Was is when health insurance companies began their rapacious pursuit of profits instead of delivering recommended care? Or maybe when lawyers started to advertise the option of suing the shit out of them when anything less than (the patient's idea of) perfection was achieved? Before you start to play devil's advocate, I get it. There are bad doctors out there. Just like there are bad hair stylists, gardeners, actors, CEOs and lawyers. But there are few, if any, professions requiring the time commitment of medicine that are subsequently governed by the interests of other industries.

I don't know where I'm going with all of this. Let's just call it venting.

Just don't call the cops on your doctors, ok?

* I didn't ask her because she scared the shit out of me. Just to clarify.

Updates, etc.

I have been immersed in the mystical land of baby-catching for the last few weeks, leaving me little time to write. Please enjoy the following random compilation of adventure.

- Since February 15, I have delivered 13 babies. They are the only things I've come across that are both slimy and adorable at the same time.

- The love of my life, Violet the 17 lb cat, was mercilessly attacked by a Brown Recluse spider. No lie, her vet told me that her layer of blubber saved her life by not allowing the venom to get to her muscles. I'll eat a cupcake to that!

- I will be doing some research this summer at the Center for Retired Athletes on the rates of depression/anxiety in football players with more than 3 concussions. WOOT!

- While walking through the halls of Florida Hospital, I noticed that there was a door that opened to the roof, a la The Hangover. The irony? The staircase originates in the psych ward.

- I met some new girlfriends at an old friend's bachelorette party. Hanging with an awesome friend begets meeting new awesome friends!

- A classmate called me the most confident person he knows. Fake it until you make it, baby!

- I worked an all-time high of 93 hours in 7 days.

With the exception of a few speed bumps, it's been a great few weeks. I always feel better about things when I have a structured plan, and now that my 4th year schedule is set, I'm really calming down. I see the light at the end of the tunnel, and it is beautiful.

Rantings from the Call Room

One thing I will never understand is why women can be so intimidating to each other. And, why it's so uncool for a chick under 30 to have a plan or goal that doesn't involve mass makeup application and/or alcohol consumption. And why men generally don't think lady doctors are as cool as fashion merchandisers, models/actresses or a teachers.

Spending so much time on the L&D floor hasn't been good for me for two main reasons:

1. There are beautiful nurses and nursing students that constantly remind me of how little attention I'm able to pay to myself.

2. Being on 24-30 hour call shifts leaves me a lot of time to over-think things. Also, way too much time to peruse facebook and look at other people's fabulousness.

It's pretty obvious that I'm feeling a bit beaten down. It's not so mystifying when taken in the context of the last month-ish. I'm also in a rotation group with a pack of boys that like to (lovingly) make fun of me when my hair needs brushing or when I "look like [I've] given up on life."

Right now I want to have my cake and eat it, too. Stupid priorities!