My dear readers, forgive me. I have been utterly remiss in my med student blogging. But do not despair, you haven’t missed anything important. I can’t remember the last time we spoke, so I’ll just pick up from Psychiatry.

My rotation through the Psychiatry department at the University Hospital of the West Indies was illuminating in more ways than one.

Psychiatrists are a strange lot. More than any other physician, these consultants understand the blurring of lines that makes illness so hard to diagnose and yet their method of diagnosis is one of the most rigid I’ve seen.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) is the most black and white layout of disease that exists, with clearly defined criteria for each psychiatric problem. It offers absolutely no middle ground. As if human ailment has ever presented itself in neatly packaged boxes. It bothers me that this book is their bible and that they continue to diagnose based on preconceived dictates rather than the individual patient.

Perhaps Psychiatry has the potential to become so uncontrolled a discipline that these criteria are there to ensure that no one gets labelled “mad” without sufficient reason. If this is the case I think they might have gone to the other extreme.

While I disagreed with the consultants, I was absolutely enthralled by the patients.

Psych patients are very convincing orators, and the more time I spent interacting with them the more I found myself wondering if these people really needed to be in the hospital, if they weren’t just some eccentric variation of normalcy. I have had some of their thoughts, have said some of the things they say. If a Psych consultant was to catch me on one of my stranger days, I’d probably be getting Haldol too.

Of course there are the obviously dangerous, disruptive patients who need to be rehabilitated enough to be functional. But then there are utterly fascinating ones who travel the world and want to become international rap sensations. Sure he believes that everyone in his native country loves him and the daily news is always talking about him BUT everyone has dreams. . . and fantasies.

Ultimately, the discipline of Psychiatry had less to offer me than the patients themselves. I don’t think I could work in a field where I’d be constantly questioning my own sanity.

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