Progress Notes

Dear psych patient:

Anup ShahBy Anup Shah, MS3

There is no experience in medical school more socially baffling than the psychiatry rotation. Patients who seem to have completely lost their grasp of reality are coming in to get their lives back in order, and are instead bombarded by clueless medical students who probably know little more about their condition than the patients themselves.

In fact, it often felt like the patients were doing more for the students than the other way around. One particular visit on my outpatient psychiatry rotation left me feeling this way and since the situation wasn’t appropriate for me to express this to the patient at the time, I wrote a  letter to him afterwards to let him know my thoughts (although sadly he will likely never see this).

Dear Mr. “G,”

You sit here in my preceptor’s office with your head in your hands talking about how nobody in your life wants anything to do with you anymore. You talk about how you have burned every bridge from your past and how much your children and family hate you. You say you can’t eat, that you feel guilty,  and that you have no energy or interest in any of your old hobbies. You talk about how you can’t even concentrate on the television and that if you could end your life today you would because nobody would even notice. You say you have nothing left to offer to anyone in this world.

But clearly you have no idea what you are doing for this medical student. You are showing me what depression looks like. And even though I may not be able to help you right now, I’m going to remember you. When I see my own patients several years from now and I come across someone who feels the way you do, I’ll remember you. All of these antidepressant medications you are discussing with my preceptor right now – I’m going to remember them as they relate to you. Which ones work for you, which ones give you what side effects.

You have no idea how much I’m taking away from this conversation. You don’t realize that the things we are talking about in this room right now may help me save a life down the road. You don’t know that. But I wish you could know that. Not because I want you to feel like you’re a lab rat for medical students, but because maybe you’ll realize that you can help people without even knowing it. Don’t give up Mr. G. You look like you have plenty left in the tank.

– Anup

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