Today was a very looooong but awesome, rewarding, challenging and amazing day in in-patient psychiatry. I’m too tired to write in coherent paragraphs, so let me give a list of today’s highlights:

1. While walking to work today, I stopped to say hello to my favorite Trinidadian bus driver. As always, we ended with “have a blessed day.”

2. I was put in 4-point restraints. No, I was not out of control, but I wanted to learn how to use my hospital’s restraints and I never pass up an opportunity to learn what it feels like to be a patient.

3. I purchased sushi for our team but didn’t get to eat it until 4 hours later, as I became preoccupied with emergencies on the unit.

4. I had a patient re-enact scenes from the exorcist. I can’t give the details for HIPAA sake, but it involved a lot of spitting, self-induced vomiting, general “bizzareness,” “calling a code” and medicating a patient against their will.

5. I did a butt load of pschoeducation.

6. I convinced a patient to accept a Haldol Decanoate injection using my super-hero strength powers of persuasion.

7. I wrote for a bunch of PRNs.

8. I learned how to write titration discharge prescriptions.

9. I purchased dominoes for the unit out of pocket, because we were in desperate need (and I made more than a few patients happy) and forms suck and it’s going to be a long Labor Day weekend.

10. I convinced a patient to dance AND take a shower.

11. I helped develop a “Behavioral Plan” to prevent a patient from eloping and being sexually inappropriate.

It’s Friday. I’m on call in the CPEP (psych ER) tomorrow all day. It’s Labor Day weekend. I live in the Caribbean capital of the US and the BIGGEST festival, the West Indian Carnival will take place right smack dab in my neighborhood this weekend. I’ve never lived here for this event, but I’ve been told to expect hundreds of thousands of revelers, and no sleep due to the constant music and drunken celebrations.

Not looking forward to working tomorrow, but I had an awesome day today. Working hard never felt so awesome.

I made a decision a few hours ago. I could either go out with all of my fabulous fellow interns for a fun birthday celebration, or I could spend what FEW hours I had left in the day cleaning my apartment. The decision sounds simple on the surface. But my apartment had become quite dirty this week, as my landlord had brand new windows installed, which created quite an insane mess. I also happen to be hypomanic and OCPD. I thought carefully over my options, and I chose Peace of Mind over Party. Looking around at my clean apartment right now, I think that I made the right decision. But hey, if I could only learn how to not require order for Peace of Mind….

Photo: “The Sushi Boat,” yummmmmm…

Please check out my latest post on “The Ink Blot” at Medscape/WebMD to read about my inability to say “no.”

Click Here to View the Original Post on Medscape

At least I feel like one lately. I do fulfill the CAGE requirements:

I have considered Cutting down on my work hours.
People have Annoyed me by criticizing my working.
I have felt bad and Guilty because of my working.
I have to work Early in the morning in order to steady my nerves.

I have great things to say right now, but I have to finish a case presentation, which I will be presenting tomorrow morning. (I just found out today that I will be presenting tomorrow…to the director of the hospital, no less!)

I started my first patient on Lamictal today. I totally feel like a doctor.

Part of My “Trash Talkin” Photo Series

It’s Friday night. I just got off work about an hour ago. Since then, I have cleaned my entire apartment and am about to walk my doggies, feed my doggies, feed myself, shower and go to sleep. I’m on call from 8 a.m. – 8 p.m. tomorrow in the CPEP (psych ER). I had a great week. I experienced another medical emergency today, and it was an incredible learning experience. I had to give a STAT dose of a medication, and my patient survived and is now doing well. I also had a member of my team today tell me that she had seen many doctors and students interact with patients in her many years of work and was particularly impressed by my ability to develop a good patient rapport. It really, really was a great way to end the week. I love my job, really I do. I learn, I treat, I make a difference. I hugged two patients today who will be discharged this weekend after I treated them for about two weeks. Both patients presented with acute psychosis. I worked with both of my patients’ families on an almost daily basis. One of my patient’s fathers said to me today, “thank you doctor, you have done so much for my daughter, and you did it with so much compassion.” I can’t imagine doing anything else right now.

Photo: Taken on my walk to the hospital.

Part of My “Trash Talkin” Photo Series

MAJOR SUPER KUDOS to Nicole, an “MS-2 with nothing better to do!” She was able to do EXACTLY what I had intended, but had not the time to do, and create an actual flow chart from my concept piece last week. Nicole, you are awesome! You totally perfected it!

Please check out my latest post on “The Ink Blot” at Medscape/WebMD to read my thoughts on learning from the “perfect patient case.”

Click Here to View the Original Post on Medscape

Today was long. I went in at 7 a.m. and just got home at 10:30 p.m. Not much energy left to write a lot. But I had a great day today. I spent the beginning of my day on my in-patient psych unit. I worked my little tooshy off to get all of my tasks completed before going on call. Hypomania is a very good thing, sometimes. And my work did not go unnoticed by my attending. He thanked me at the end of the day and said “great work.” Those two little words motivated me to work my little tooshy off again for the next 5 hours in the CPEP (psych ER). And my supervising resident also noticed my work. He told me that I did a wonderful job of interviewing a patient, who just so happened to be a very defiant teenager who at first didn’t want to give me the time of day, but eventually opened up to me after I made him feel comfortable. Let this be a reminder to everyone who supervises others. A few kind words can go a very, very long way. For me, it went a good 15 hours. Now, it’s dinner time and then dreamland.

Photo: My most famous bar trick. Yes, I can balance a salt shaker on a single cube of salt. (Thanks, Howster!)

No, I don’t think I actually have Chronic Fatigue Syndrome. But there is certainly a part of my right now that wants to curl up and die. It’s Friday at 8:00 p.m. I put in just shy of 80 hours this week. All I can think about right now is pigging out and curling up to watch a very nonsensical movie. I feel like I say this every day, but I have so many great stories/insights to share, and yet lack the energy to put those thoughts into coherent sentences at this time.

The ONLY thing keeping me going right now is the fact that this is a GOLDEN weekend coming up. Yes, I have both Saturday and Sunday off. Thank my lucklicious stars. Okay, I’m not even making sense anymore. I have outlined a list of “to do” items to get accomplished this weekend. My goal is to complete them all, while “sleeping in” until at least 8 a.m. on Saturday and Sunday (even though I doubt my body will let me do so).

Good night sweet world. And enjoy the photo with this post, taken on my walk to the hospital today. I always see the sign and want to walk up to the car parker and say “did you know that I was going to come here?”

Part of My “Yo Brooklyn, Fuhgeddaboudit” Photo Series

That’s right. I just got my brand, spanking new health insurance card in the mail today. It’s official…I have health insurance…finally!

I have joined the ranks of other health insurance-carrying members of society. Actually, I have an entire rant brewing on the subject of what it means to be privately insured, but I will have to save that for a later date. Right now, it’s time to search for some providers. Next up, doctors appointments to be made!

Enjoy the photos with this post. Both taken today during my walk home from the hospital. A special shout out to my fellow psych intern Mudassar, who alerted me to a better photo angle.

Part of My “Yo Brooklyn, Fuhgeddaboudit” Photo Series