The awkward moment in a role play when your acted role becomes blurred with your own experiences. You begin to wonder if the psychiatrist can feel that the acting is too realistic. They sound genuinely concerned (see, they are good actors, my friend commented that therapists are cheats pretending to care). So genuine, that you begin to worry if they feel that you are the patient. Then, you almost ask the psychiatrist in the middle of role playing for a corridor consult, feeling that, talking to a caring therapist is quite soothing.

How have you been feeling this week? Do you feel like you should cut down on the drugs? Yes, sometimes people self medicate to drown out the difficult feelings. Perhaps you can find some different ways to cope, how about getting out more and scheduling some activities throughout the day. Another awkward moment. The subconscious transformation of the dinner conversation from social to therapeutic becomes conscious.

The disturbing Mount Misery comes to an end as the psychiatry rotation comes to its last week. The only book I've managed to read during semester without major disruptions to my routine - reason being, I can't stand it for more than short spurts on the train, or in between waiting for patients. Freud, penis and mothers, dude, what were you thinking? Insightfully put in the narration, "the real perversion of Freud and analysis was to take the essence of something and reduce it to something else - the present to the past, love to hate, joy to misery, life to death - and to do it under the guise of understanding..."

Ah, so long, the land of slow coffee breaks, sweet normality of working hours and waiting for patients instead of patients waiting for you. Nodding nonchalantly at a patient's printed book of erotic poetry, stalking patients to their house, and calling them through their bedroom window to wake up and open the door to let you in. Goodbye shrinks with their long silences that forces you to say more than you intended, shrinks who have long buried skills in sucking blood or managing medical conditions, shrinks with a beard and long hair slightly neater than your average hobo, the ever patient shrinks who delivers care to those who slap them or threaten to kill them. Goodbye imposter parents, successful entrepreneurs, rock stars, devil's clutching hands, televisions that give special messages, armed robbers, drug addicts, arsonists, and people who blow up like balloons on medications.

I wish I could say, goodbye human suffering. But we'll just be going back to a different sort of suffering. In fact, we can't escape the groaning pains and decay as long as we are in this world. And unfortunately, I don't seem to be coping with my own emotions any better than before these six weeks began. Sad. Only thing I realised is that I do self therapy, alot. Extract from observing today's session. Now, what would you tell a friend? To take it easy. Maybe you can tell yourself that when you're feeling upset. (Tick.) What are some things you can do to feel better? Apart from eating tasty food. (Tick.) Take a hot shower? (Tick.) Maybe rubbing your arm (Tick.) or massaging your own shoulders? Next time I want you to write down what you're feeling at the time and your thoughts (Tick.)

I'm beginning to enjoy doing mental exams on anyone whose demeanor or expression catches my eye. That well groomed, unpleasant, sour faced, distracted and irritable hairdresser yesterday. Lack of insight. Damn you, you cheat, this is how people get sued. Fortunately for you, no one sues for hair because it grows back. I was offered a tailored therapy (not self therapy this time) - now, you feel that she ruined your evening, but is it true? You want to harm her? Jesus loves her. Pfft, why would Jesus love someone like her. Besides, I'm not Jesus and I hate her. But we're supposed to be like Jesus. Okay, still! Distract me.

Oops we've sidetracked. How strange it will be to go back to "real" medicine. But, the benefit is that our eyes and ears will be attuned to another layer of the patient's story. To some extent, what Roy said in Mount Misery will be true:

"Much of what I saw was psychiatric: belly pain, anxiety, phobias, depression, suicide attempts, hallucinating crazies. Before, these had been "turkeys," unfathomable and untreatable, mocked by us real docs and turfed to the shrink or back out onto the street. Now they were familiar, and easy. In a few minutes I got the feel of where this person stood in the world. I had learned something in my year of psychiatry, something about how to listen to intense feeling without flinching, how to make sense of it."



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