Paul Verona

During my time in hospital rotations, I had the privilege to visit the local psychiatric hospital.

I feel movies often give psychiatry a bad name. They focus more on the frightening aspects that people oftentimes associate with it. I do not agree with this because this field of medicine has changed completely since its early days and now, psychiatric disorders are very common.

That said, I was shocked by the conditions there and remember telling myself this was no way to live. My heart went out to the patients being treated there. I felt sadness and horror. I am aware that every culture is different and views illnesses differently but why do we literally have to shut these patients away from the world in order to help them and prevent them from inflicting harm on others or themselves? When they are having an episode, are they aware of what they are doing? Is it their alter ego that overtakes their normal self?

On a subsequent visit, I was not nearly as shocked as the first time because I knew what to expect and was better able to prepare myself mentally. Besides, this time, I would have the opportunity to speak with multiple patients. After all my other visits and time spent with the patients, I realized that, yes, psychiatry is medicine but a very unique kind of medicine. It deals more with communication and opening up to the patient. It is hard to truly understand mental health and psychological disorders as an outsider because you are not the one dealing with those issues on a day-to-day basis. Up until now, this has been challenging for me and I am still learning. I personally am very emotional and sensitive and don't feel as though I would be able to handle these situations if I decided to pursue psychiatry. What I have realized now is that it takes a very special kind of person to go into this field of medicine. Ultimately, all I can do is try to help. In the end, it is up to the individual dealing with those negative voices, those feelings of insurmountable sadness and worthlessness to help themselves.

Part of me did not understand why the living conditions need to be so harsh. Even in the United States, the conditions are depressing. Perhaps the intent is to instill the idea that if it is this bad, maybe after living there, the patient will never want to end up there again; almost a scare tactic. I know that personally, I would never want to return to a psychiatric hospital after spending time there as a patient. If I were to be a patient, I would rather have a regular hospital setting, one where I was not restrained and confined to a solitary room. However, I realized after visiting the psychiatric hospital in Grenada that this is for the patients' safety despite how inhumane it may seem. I have developed a profound new respect for the field of psychiatry.

While I was on this rotation it was initially challenging to talk to patients. I was unaware of their mental status, was unsure of the wording I was using. Were there trigger words I should avoid? What if the patient tried to harm me? Am I crossing a line? These are a few of the emotions I felt every time I spoke with a patient that day but nevertheless, I soon felt more comfortable speaking with them. That day, I saw two patients with schizophrenia and two with severe depression.

What was remarkable to me was when one of the patients stated that they were there for their child, and were determined to get better so they could go home and be with them. Such patients have the greatest will to get healed. This one even said that the Bible had become a greater part of their life. I too, enjoy scripture and praying. This connection made me feel closer to the patient and eased our conversation as we had a common interest. There were times where we would talk about a book, or I would say something that made the patient smile. To me, seeing a smile on the face of someone who is suffering from depression is quite rewarding, more so when I am responsible for that smile. It is remarkable to me the lengths that patients will go to get better for the ones that they love. It is an incredible power.

Looking back on my first experience in the local general medical clinic, I have to say I have completely changed my outlook and approach to communicating with patients. I felt more confident in obtaining history. It was very rewarding to see a patient smile or laugh again during a conversation with me because I realized I was able to make them feel comfortable. As a patient myself, I would want my doctor to connect with me on a personal level instead of just as "an illness that needs to be treated."

However, one thing that had me concerned was when we watched one of the staff members aspirate a young kid's knee joint. They did not give the patient any numbing agent and in my opinion, it seemed a little rough and forceful: especially when inserting the needle. The patient appeared afraid and once the needle was inserted, the doctor just left it there and began to talk to us. In the meantime, the patient kept looking at the needle and looking back at the doctor. I wanted to speak up but was afraid; something I regret. Next time, I will speak up. A patient's comfort is more important than getting reprimanded by an attending.

I do not understand why the doctor went about it in this manner. To me, it felt like he was lacking in any bedside manner. This is something I will never do to a patient. I will treat each one as I would a family member or a close friend. If I were the patient, I would want a doctor with a great bedside manner, so why shouldn't I treat my patients as I would want to be treated?

I realize now that every doctor is different and they all have different approaches. There is nothing much I can do to change that except aspire to become the best doctor I can be; one that is caring, compassionate, knowledgeable, and places his patients first.