I started inpatient psychiatry this week, which is already turning out to be one of the most ridiculous clinical settings I’ve ever been in—for a variety of reasons. My very first patient of the day was a 40-year-old man who claimed that he was 10 1/2 months pregnant. He was fairly certain that he was going to give birth in the next two weeks, claiming that he was carrying 50 babies. He was very adamant that he was the mother of the children and that his cousin was the father, prompting my attending to say, “That’s the craziest fucking shit I’ve ever seen in my 20 years in psychiatry.”
I certainly expect odd behavior from my patients. However, I’m sorry to see that many of the psychiatry residents and attendings also exhibit severe personality flaws. Already in my second day, I’ve diagnosed my intern as being manic. He told us on the wards that he was a player, and then proceeded to hit on a social worker, two pharmacy students, and was even flirting with several of the committed patients. I’m pretty sure that he’s going to be one of those psychiatry residents who ends up marrying a patient.
He talks incessantly. He tells us that he’s such a wonderful teacher, and then proceeds to read to us from a PowerPoint slide. While the med students are diligently writing notes and filing them away in patients’ charts, he is idling his time by surfing Facebook.com and telling us, “This is such a hard rotation. I can’t believe the amount of work I have to put in.” I wonder how a person who lacks insight and judgment got put in charge of managing a dozen patients who also lack insight and judgment.
Probably the most offensive thing I’ve had to witness so far on this rotation is the dress code. Nothing seems more out of place that a psychiatrist who wears a white coat. As if they’re real doctors! The pockets are typically empty. There is never a stethoscope, a reflex hammer, penlight, or anything else that might make a person believe that psychiatrists practice any kind of real medicine. My service consults out for every medical problem: diabetes, hypertension, shin pain, and pregnant men. Then, the shrinks all get upset and offended when other specialties state that they aren’t real doctors.
But I think I may have found a woman for my intern. I was sitting in on an interview today when the patient stopped addressing my partner, turned to me, and said, “Hey handsome, if you give me 69, I give you 69. You can get me pregnant.” Seems like a perfect match to me.