Self Reflection – The Importance of Self Care

As part of the assignment for this rotation, we have to write a letter on the importance of self care. When we are in our intern year of residency, the clerkship director will mail these letters to us to remind us to take care of ourselves. I think this will serve as an important reminder during that stressful period of my life -- if I don't take care of myself, it's going to be pretty difficult to take care of patients.

___________________________

Dear intern me,

1. As Dr. X said, if you’re not waking up excited to go to work and see patients every day, talk to someone. Talking to someone can help solve a difficult work situation, or it just feels good to express your feelings and have someone listen and understand. Whether it’s your superior, a peer, a friend, or a therapist, just talk to someone.
2.   Keep exercising. It really is the best way to deal with the stress, exhaustion, and emotional baggage of the day. Even if you can’t make it to a crossfit workout, at least try and go for a walk or a run. You will feel better. I promise.
3. Make time for family and friends. Even if you feel that you have to study, read about a patient, or prepare a presentation, make time to spend with those people who make you happy. It will be worth it. There will always be another deadline to meet or more to do, but those who you love most won’t always be around.
4. Don’t sweat the small stuff. Try and let negativity roll off your back. You never know if someone else’s rude or insensitive comment was due to their level of stress, exhaustion, or personal conflict. Just remember that 99.9% of the time, it isn’t a personal attack. When it is, try and find the good in the situation. In that comment/attack could be something you can improve upon.
5.  Don’t feel that you have to be perfect in everything. You don’t have to be the perfect housewife, perfect doctor, perfect daughter, and perfect friend.  For example if you don’t have time to cook every night, don’t worry about it. Do what you can, and remember you have supportive friends and family who love you, understand you, and want to help you.

 You’ll be fine. You are a strong, capable woman, and you can handle more than you think.

Love,

M3 me

"This isn't The Notebook"

I've been spending some time in the neuropsychiatric ward, the saddest place I've ever been, taking care of some patients. I guess the neuropsychiatric ward is what people thing of when they think "psychiatric hospital." Patients are either so medically sedated that they are just passed out in their wheelchairs, heads on the table, or they are aimlessly wondering around, going into other patient's rooms, and following you wherever you go.

My first time in the ward, a patient came up to me, crying, asking "can you take me home?" It turned out that she was one of our patients. Talking to her was difficult through her broken sentences, confusion, and word finding difficulties, yet I felt I could follow some train of thought she was trying to convey. She pointed to the attending rounding, and said "I know him." I was excited by this -- she recognized her doctor, but when I tried telling the attending that, he dismissed me saying, "She just recognized a white male figure -- she doesn't know who I am."

Am I too idealistic? Am I biased in working with my patients with dementia to hope for the best, to only see the good? I have another patient with progressive Alzheimer's dementia with receptive and expressive aphasia, meaning she has trouble understanding and using language. Yet, I try and talk to her and understand as much as I can. I ask her name, and she tells me, "Penny*." I ask her where she is, and she tells me, "hospital." Every time I talk to her, I feel that I can see the person behind the confusion -- if I'm patient enough, I can understand what she's trying to tell me. When discussing her with my resident, I reported that she knew who she was and where she was, and that I thought she might know more than we give her credit for. My resident responded, "This isn't The Notebook. She is confused and doesn't understand us and doesn't know where she is."

It might not be The Notebook, and I understand Alzheimer's is a progressive disease that doesn't have periods of improvement/return to normal function, but that doesn't mean we shouldn't try and find the remainder of the person left inside.



*name changed for patient privacy