Saturday, July 23, 2011

It's Called Direction

Henry David Thoreau
How does it feel, having completed my psychiatric rotation? Satisfying -- especially since a scheduling shift allowed me to tack on another week at the end -- and I think I may have learned something about ordinary living that I hadn't anticipated. Henry David Thoreau wrote, "I went to the woods to live live deep and suck all the marrow out of life." I've endeavored to do likewise, drinking at the fountain of each day. knowing the rotation I've waited four years to experience, would pass like a thief in the night, whether I left the front door unlocked or not. Though it may not seem like much, when you're trying to be fully aware, feeling each moment, allowing it to fill you up and splash over like water overflowing a bottle, five days can equal five lifetimes.

And that's what I tried to do with every weary night's walk from A-3 (adult psychiatry) through the behavioral intensive care unit, down the hallway of the Center for Joint Replacement, then up the stairs to the chemical dependency unit to return the key I'd checked out that morning. The key that gave me ready access to office space for interviewing patients. The key that spelled independence, freedom to spend my time going, doing, accomplishing, instead of watching it trickle through my fingers, waiting. The key like one carried by staff members, by doctors, that signified I was one of them and my work meant something. And not just to me.

A quick goodnight, see you in the morning later, and it's down four and a half flights to the ground floor, past Dunkin' Donuts and out the sliding glass doors marking the main hospital entrance. My car is parked two blocks away and in the heat, it's a long two blocks. People I've never seen glance at my tie and smile in greeting. Nurses, assuming one of the doctors is heading home. An internist, driving by in his Thunderbird convertible, waves. It might be late, it might be early, but I look right at the stoplight and see the hexagonal wooden tower that houses the A-3 dining hall framed against the western sky. I'll see you tomorrow, I whisper.

But Monday's tomorrow, I won't. Instead, I'll be preparing to drive north once again, past the familiar turnoff leading to the tiny burg that was my home for rural medicine, and on to Bangor where Internal Medicine begins in another week. I've got a context now that I didn't have seven weeks ago. Rather than simply learning more medicine, gaining skill like a professional Monopoly player, I'll be learning about the underpinnings of psychiatry in the guise of you name it. I'll exchange my shirt and tie for blue-green scrubs, tennis shoes, and a white coat.
Conditions like delerium that I've helped diagnose, now I'll help treat.

But not with a questioning mind uncertain of its goal -- that ship has sailed. Five minutes on the psych unit, I was standing on the dock, waving a hankie and bidding it bon voyage. Everything that is to come is training to be a better psychiatrist, one who can keep a patient alive until the code team arrives if he has to, one whose stethoscope sits on the desk next to a dog-eared copy of Freud's Psychopathology of Daily Life. One whose patients aren't hesitant to call their doctor. More than a context, it's called direction.

(Public Domain image of Henry David Thoreau via Wikipedia; citation from Walden)

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