Tuesday, September 18, 2007

The Questions You Asked

As I go through my day, I often think about the things people write in the comment section of our posts. Often we get questions, sometimes we forget to respond, sometimes I simply forget they are there, sometimes we save them for the Podcast, and sometimes, well, they are too out there to even begin to address.

I'm going to take a moment here to backtrack and talk about some stuff that's been asked...doing it as a post instead of in the comment sections.

Flash recently visited an old post and asked:

A third year med student also considering psychiatry. I have liked many different things in all of my rotations but I keep coming back to psych. I just had a daughter and suddenly lifestyle is very important. Have psychiatrists on this blog found that they could have controllable hours/live decently/pay back loans with psych? I would love to work part-time when I complete residency, but is this even possible?...Can I retain my fun-loving self if I become a psychiatrist? Obviously I am serious, sincere and compassionate in my patient encounters. I wouldn't be considering psych if I was otherwise. But could psych drag me down?

Hi Flash and thanks for visiting. In terms of money and lifestyle: many issues here. We're all so old-- back in our day loans had to be paid off in 10 years. Now, I hear residents talk about their quarter million dollar school debts (no, I'm not kidding) that go on for 30 years. Mortgage number two, essentially. I work part-time and psychiatry is particularly amenable to part-time work and controlled hours. Employed spouses help. Lottery tickets are good. I don't know any starving shrinks, but the ones I know who are the sole support for their families do work long hours. Rich dead relatives can be useful as well. If you're heavily in debt, if your spouse is a school-teacher, if you have a fondness for vacation homes, Versace bags, and large boats, don't be a psychiatrist. You can retain your fun-loving self. Psych could drag you down, but not as much as a lot of other medical specialties. I do know a psychiatrist who got through school working as a professional clown.

And Lily wrote in one of her comments:

My psychiatrist never seems hopeful. I don't get it. I think all of the three of you are too good to be true.

Are we too good to be true? I've been thinking about that. ClinkShrink and Roy are definitely as good, if not better, in real life than they are on the blog. How can a guy who names his bird "Monkey" be bad? And someone who loves cats and devotes herself to society's criminals? SuperClinkShrink not only runs zillions of 9 minute miles, cares for thousands of downtrodden criminals a year, but she stays with my dog and my kids when I'm away.

Me? I think I'm better on the blog. In real life, I'm just a shrink with a strange sense of humor and a blog. More often then not, I click (not clink) with patients, occasionally someone credits me with saying something that really helps-- usually something that makes them feel understood or vindicated -- and often people credit me with writing prescriptions that help them feel a whole lot better. Hopeful? I am kind of hopeful and excited at the beginning of someone's treatment. If it's gone on a while and the patient is getting discouraged and the meds aren't working, I keep plugging away, but the excitement wanes. When we're talking years.....well, in terms of hopefulness, I readjust the goals, at least in my own head. Here and there, someone pushes my buttons and I think I do all the things all the other shrinks out there do. My strengths: I return phone calls, I'm really good at that, and being a psychiatrist who does psychotherapy as well as prescribes medications reasonably competently (I hope) has become a niche market-- all those folks doing 10 minute med checks make me look really good.

And for the final question in the comment section:
When is pizza?

In my personal experience, there is never a bad time for pizza. Pizza is best in New York City (the greasy stuff at Penn Station is particularly fabulous). I don't like many toppings and pepperoni is totally out, destroys the stuff if you ask me. Happy to try the latest greatest Baltimore's best as soon as I shake this cold. Please send chicken soup.