Wednesday, May 26, 2010

The Only Thing Worse Than Getting it Wrong...

We had a lecture today by a very peculiar prof. He fluctuated between funny, rude, interesting, irreverent, and sarcastic. He was asking a lot of questions during the lecture and people were being fairly silent (as he would hear an answer and say something like, "who said that?" and then find the person in the crowd and say "no, that's wrong").

Near the end he asked about ECT and if anyone had any opinions on it.

Another long dead silence.

I finally offered, "it can be a very useful treatment for certain patients".

Him: "What kind of patients"

Me: "Patients with depression"

Him: "What kind of depression"

Me: "Severe depression, like catatonic depression*"

Him: "You are completely right. You are going places."

Yeah, like the 7th circle of adult-learner-nerd-never-going-to-make-friends-hell.

I searched for a way to climb into my empty pop bottle.


Tonight while walking to do laundry I saw a group of guys from my class (who I hardly know except in passing). They waved and then as I passed one yelled,


Yeah,  thanks for that Mr. Prof Doctor Weird Man.

*I only said this not because I am a super-nerd-gunner but because I worked in acute psyche as a student nurse (and as a casual for a year after I graduated). I was amazed by the recovery that some of our most desperately ill patients made from ECT and was always dismayed by the bad rap that ECT got in the media/medical field. I was trying to give it a little plug while I had the opportunity. Now I basically have a 'kick me' sign on my back. Sigh, oh well!


Grumpy, M.D. said...

"Depressed patients, and creepy professors like yourself. In fact, I can see the burn marks behind your ears."

Albinoblackbear said...


I swear I saw a hint of tardive dyskinesia! Actually!

Beach Bum said...

damned if you do, damned if you don't...don't be afraid to let people feel the weight of who you are...

Albinoblackbear said...

BB--I like the sounds of that.

Tobie always tells me to enjoy the advantage while it lasts! :)

OMDG said...

Also useful in pregnant patients with depression, FYI, which is (or at least used to be) a favorite for shelf exams.

Robert said...

OMG, I do this to myself all the time. I have a permanent Kick Me sign.

Anonymous said...

Good for you ABB! Who cares if the guy validated you, good for you for having the guts to speak up and for using your clinical background like you should.

Just wait until you get into clinicals, no other med students will be jealous of you then, they will be too busy asking for help! :)

Anonymous said...

As Dr Seuss said: The more that you read, the more things you will know. The more that you learn, the more places you'll go.

RH said...

I am sorry, but this entry made me actually laugh out loud (and got me some dirty looks in the library)...and I am pretty sure OMG is right.

Nature Nerd said...

Phew. Finally, I have someone to hang out with in adult-learner-nerd-never-going-to-make-friends-hell. Welcome, and thanks for joining me.

E. Greene said...

Did you like working as a psych nurse? I was on a 1:1 observation for a girl who came in with severe hyponatremia. Most of the ICU nurses wanted nothing to do with her because they "can't stand psych patients." I always thought these kinds of cases were fascinating..but it seemed like it required undying patience to actually spend time with her .

Albinoblackbear said...

OMDG--Yes, he mentioned that. ECT and TCA's apparently totally safe as well.

NX--My friends who were residents and med students told me just to keep my mouth shut for the first 2 years if I ever wanted to make friends.

I'm just not very good at staying quiet.

Ninja--Hahaha, a few of my classmates have already told me they want to request me for clinicals! And follow me (nursing) as their special study model (we have to follow a non-MD for 2 weeks in 2nd year).

I am actually a fairly big dunce when it comes to a lot of the picky details like biochem and genetics etc. but I figure I'll make up for it in clinical (as long as I pass).

Then there is this problem about the USMLE....

CH--Indeed! I love that quote.

RH--Well then that makes two of us that got dirty looks over it! hahahah

NN--I think you are probably a bigger nerd than me actually. You have an almost unnatural love of ferns. :)

Must be why we all get on so well (i.e. including your *very* nerdy husband).

E.Greene--Yes I really enjoyed psyche. I worked on a 6 bed acute lock-down unit and an 8 bed crisis unit (with my BFF Keith). It was a wild place because it was where the most high security psyche patients from all over the province would come for assessment and treatment. You know, the place where you have to *wear* a panic button at all times and they are placed all over the unit?

The nursing staff were a mix bag of hilarious and mostly supportive colleagues. The patients that we worked with were so ill that it was astounding at times to watch their (complete to minor) recoveries with the right meds/treatments/psychotherapy.

When I graduated I got a job at a posh ER in an upscale suburb and stayed on as casual in the gritty psyche ward because for the most part I enjoyed the rawness of the homeless/marginalized patient population over the obtuse sense of entitlement middle/upperclass gang that came into the ED.

I don't think I'd have liked reg/outpt psyche as much though. It was harder to see the revolving door and lack of community resources. The really acute stuff was more my bag.

Cartoon Characters said...

ABB: I too didn't really like the revolving door syndrome. Seems tho, when you have psych experience, no matter where else you go, the psych type patients are handed off to ya...
EG: You are very observant...most nurses that don't work psych, don't really like to deal with it.

Keet said...

I read a study (i know - cite your source! - but i read it a few years ago when putting together a course on ECT for psychiatric nurses and psychiatrists and can't remember who it was), and this sociologist studied ECT usage in the USA, and found that over 60% of people who were treated with ECT were women over the age of 65, leading her to believe that ECT was in fact yet another form of male-dominated medical oppression and control of the fairer sex. Yet strangely the correlation between depression being a disorder that affects more women than men, and the fact that as people age, their tolerance of pharmaceutical treatments becomes more risky was somehow missed in the analysis. But it did make me think a little about the broader Public Health picture of mental health, and how little we know about the systematic and social causes and prevention of mental health distress. Having worked in psych in/out patients, in both Canada and the UK, all I know is that for some people, ECT is the one thing that makes their lives livable, whether they are men or women, young or old.

Another thing I think I know, is that you ARE going places! LOL
I love it!
He sounds crazy (my personal favourite diagnosis) and strangely wonderful. Did you learn anything from him??

Keet said...
This comment has been removed by the author.
Dragonfly said...

ECT is fascinating. And of course you are going places. :-)

Albinoblackbear said...

ANurse--Yes, and on my shifts the crazy waves would start crashing in the ED! :)

I was the one who brought out the acute psychosis in people...but at least I wasn't a Princess Dark Cloud (you know the nurses that *always* have messy codes on shift to the point where people want to switch shifts if they are working with them?)

Keet--You would have poked your eyes out if you'd have been in that lecture...seriously. But it *did* remind me of the days of yore at Ye olde RAH with you! Such happy times...when we were young and carefree...

Did I learn anything...hmmm...yes! The best way to assess if someone really is taking their anti-d's is to ask about their dreams. If they say that they are having dreams or report vivid dreams then they are not on their meds (apparently REM is suppressed with the TCA's, SSRI, SNRI's, etc.) Haven't looked it up to check but...interesting.

I suggested checking their pharmanet but apparently they don't have that wondrous technology here.

DF--I agree. On both counts. Hahahah. Glad to see you are still alive out there!

Rogue Medic said...

Tonight while walking to do laundry I saw a group of guys from my class (who I hardly know except in passing). They waved and then as I passed one yelled,


This was just a confirmation that you haven't been missing a thing by not knowing them, except in passing.

OMDG--Yes, he mentioned that. ECT and TCA's apparently totally safe as well.

TCS'a totally safe? I am assuming that you mean at standard doses, because the only ones I tend to see disproportionately fall into the unsafe use category, such as overdose.

NX--My friends who were residents and med students told me just to keep my mouth shut for the first 2 years if I ever wanted to make friends.

People give me advice on how to make friends, too.

So, I don't have a lot of friends. The ones I do have are worth having.

The rest are not worth giving up who I am, just to be who they want me to be - at least as long as I never do anything that would make associating with me awkward. That might last a whole day - even longer if I am not around.

Besides, I love to read. Reading is an anti-social activity. Unless I am reading out loud or reading for a book group. However, reading to children is very social. :-)

Many people cannot get along with psych patients, attempted suicide patients (initially psych patients anyway), addicts, and other patients they cannot understand.

As if these patients are any more mysterious than people who work 9 to 5 jobs and other normal people. As if they are any more unpredictable than people who work 9 to 5 jobs. We don't need to understand what they are thinking to be able to treat them as humans.

Him: "You are completely right. You are going places."

Maybe you just had your bus pass out on your desk. ;-)

Albinoblackbear said...

Rogue--Maybe it was my track suit...

Rogue Medic said...

Rogue--Maybe it was my track suit...

The other possibility was that you were wearing Nikes (maybe Nike Apocalypse) and he was a recruiter for Heaven's Gate. They might use a slogan along the lines of, No regrets.