One thing that has startled me since starting rotations is the prevalence of psychiatric conditions. So many patients that come to the hospital have underlying psych conditions that no one addresses and often do not even bother to elicit. However, psych conditions can play a huge role in medical disease prognosis, treatment adherence, and even disease progression and pathogenesis. It is very easy to discount addressing psych issues especially when the patient comes in with many other conditions that need more immediate attention. However, this does not truly take care of the patient as a whole.
It is also hard because talking about psych issues is very difficult. These topics are uncomfortable. One of my biggest struggles has been imagining myself in the patient’s position. So many of these patients are young and have qualities that I find easy to identify with. In almost all other cases, this ability is a good thing. However, for me specifically in relation to psychiatric patients, it is a double-edged sword. On one hand, empathy is always important, however I have found that this could make you easily manipulated.
Identifying with psych patient is also emotional challenging. We have all grown up knowing that we can catch a cold or suddenly develop cancer, but it is rare that we think about getting a mental illness. It is even scarier to think that anything trigger could start the cascade leading to mental illness and that no one really understands why. It is definitely a humbling experience to realize that it can happen to anyone; it is interesting to know that I am just lucky enough to not have experienced the combination of life experiences and genetics necessary to trigger a mental illness.