Sensory overload

I'm still in a low, funky mood tonight and therefore feel compelled to write more. Since third year started, I've experienced periods where my sleep is completely off. Not because of call schedules and long hours. In fact, I've come to love post-call days in a perverted way because the exhaustion makes for such solid, dream-less sleep. No, I think my problem is "sensory overload." Much for third year is so novel and raw. On gyn onc, it was the open laparotomies where we'd literally be digging and pulling out chunks of tumor - ovarian cancer - in 40 year olds. In peds, it was kids with anorexia, CP, kidney failure. In psych, well, psych is constantly sensory overload. Even radiology didn't spare me, as I'd spin stories from the films - patients with traumatic brain injury and the like. And it's not limited to patient experiences. Even day to day interactions with residents, attendings, and the rest of the clinical environment can be challenging.

In the hospital, it's usually go, go, go, and I end up unconsciously suppressing whatever reaction I have to a situation out of necessity. Things I don't even realize affect me at the time reveal themselves at night. Nighttime is when I do the processing, the reflection, and yes, sometimes the ruminating. It does not make for good sleep. I suppose medical training is about character building, but right now, I have yet to build a thick enough teflon coat.

Quick update

Feeling kind of blah today...many things that I feel pressured to do (i.e. navigate this university system and find a research project and mentor, write my psych report) and yet am procrastinating on. That, and a few worries creeping up like if I'll getting all that I can out of third year, if I'll ever be competent, and what I want to do when I grow up. Neuroses should be a DSM diagnosis, because I have many of them! Of course, I deal with all of this by doing PreTest.

The ah-ha moment (or perhaps self-admission) came today in psych didactics. We met an inpatient in psych today with schizoaffective disorder who was clearly psychotic and perhaps manic - impaired reality testing, bizarre delusions, expansive affect, pressured speech, the whole bit. Afterward, the psychiatrist said: this is a defining moment - either you think "this is utterly fascinating" or you think, "this is cool but not in my department." I fall dead in the latter camp. Fascinating, yes, and certainly amusing, but not something I could do long-term.

As an aside, this past weekend, I met up with some high school friends who I hadn't seen since high school! It was so fun to catch up. And go [big high school] - many of my high school classmates seem to be doing quite well these days, although it's not entirely surprising!

Psych

1 week of psych down. Finished with radiology. I'm assigned to a locked inpatient unit and am glad to be talking to patients again, although this time it's really different! One of my patients has MDD with catatonic features (so you can imagine how much talking is involved). He seemed much better today and was actually able to hold a conversation! The other has some schizoaffective features combined with anxiety and depression. Being on the ward is kind of surreal. Also, apparently our chief resident really loves squirrels and we're her baby squirrels. Psych people are nice.