Thursday, July 15, 2010

Blessings of Child Psychiatry

Child psychiatry is a hidden blessing. I've shadowed the same doctor twice, and each time, I learn a few new things. They're all relevant and all important, but in shadowing the life of a doctor, I've come to understand many things about life, many things about death, and many things about chronically ill children.

It is astounding to me how many of my pre-conceived notions about the field of psychiatry were dispelled as soon as I walked into the first consult of the day. Mentally ill children, chronically ill children, developmentally delayed children all have one thing, if not many things, in common. They're children!

The innocence of a child doesn't leave him/her as the result of a psychiatric illness, medical trauma, or otherwise. Patients still asked us why things were happening, they were scared, they were frustrated, and they were confused.

Their smiles, their laughter, and their authentic emotion made me understand one thing: Life isn't something to ever take for granted. To always wonder why things are a certain way is a very healthy, proactive attitude. Honesty is your best policy always, but especially with children. Often, they're more perceptive than we give them credit for being.

In private dialogue with the doctor, I discussed with him what he thought about my abilities in psychiatry, as he saw me in case reviews, case conferences, patient-parent interactions, and socialization with other doctors. The one thing that has caused a smile to permanently grace my face is the fact that he said that he believed every single one of my demonstrated abilities were natural. The funny thing is, though, that doesn't matter. To avoid narcism, I'll say that if something we did as a team brightened the life of a child, even for just that moment, it was all worth it.

A face to face encounter with an actively dying patient isn't ever easy, but my first encounter happened with a teenager on this psychiatry service. I realized my love for life, my zest for people, and more importantly, my longing to make medicine a career for a lifetime, Death is a difficult concept for many people, and the experience was tough, but it was the most rewarding thing I've witnessed.

Though this post is pretty jumbled, there's one thing you should know. Kids are still kids, regardless of their labels. It's all too often that they are treated as soup cans. Second, you might be reading the ramblings of a future psychiatrist. Only time will tell!


  1. I'm glad you enjoyed it! I'm assuming from your usage of the word consult that this was an outpatient setting? If you get the chance, see if you can do inpatient, then tell me about the differences! It'd be interesting to hear from your perspective.

  2. Remember to take pride in what you did with the abilities that you have but remember that you're dealing with people and their lives at the same time. What you do may change the direction they take in life in either the way they think about situations or the fact that they might be able to walk again.

  3. Erin, you say:

    "The innocence of a child doesn't leave him/her as the result of a psychiatric illness, medical trauma, or otherwise."

    Yes. Innocence doesn't leave, it is taken away. And it is taken away by people. I don't know whether it can come, grow back ... A writer, Hal Porter, said, "I had to learn to be innocent" (in his adulthood: read The watcher on the cast-iron balcony if you can).

    And your next sentence - about the whys - is really moving and true. Keep respecting this "why" as you search for a "how".

    "To avoid narcism [sic], I'll say that if something we did as a team brightened the life of a child, even for just that moment, it was all worth it."

    I am always happy to break bread and eat soup with you on your blog, and sniff its salt.

    If and when you do become a future psychiatrist, you will be entering the field in a time of change and strength for all of us.

    That second last paragraph about Death was sobering.

  4. Yes, Erin. You might condense this down to a 3 minute Cinchcast. I'm flirting with it. There's something about a human voice that I'm find more and more compelling.

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