Tuesday, May 19, 2009


Everybody think encouraging thoughts for Chef. He and Peng headed out for a nice weekend in the mountains and ended up having his appendix yanked. I told him (well, I told Peng to tell him) I haven't missed mine for a minute. Still, yeowch. So, send good mojo his way.

Today was long, as Tuesdays always are. I had a much better show rate today (7/8). Two of my intake patients today were actually very enjoyable, even if one was 30 minutes late. One was a big ol' help-rejecting complainer (Fix me! Nothing you do will work!), although, I understand his frustration (I was still annoyed). My Tuesday afternoon is my psychotic disorders clinic, which is always interesting. I said goodbye to two of my patients today, as they will be following up with new residents (the current interns) the next time they come in, because next year we're only half time clinic (half time inpatient), so we have to pare down our clinics. Both are doing fine, will be delightful patients for whomever gets them, but one of them is one of my very favorite patients. He, unfortunately, may need more care than I can make available to him (I'm keeping 9 psychotic patients; they suggested we keep two or three) if circumstances advance as they might, so I'm passing him on, but, it was sort of sad. He was one of the patients that was in the NIMH trials back in the day when they decided to try psychoanalysis for psychosis. It doesn't work. But it gave him some really interesting perspectives on things, and he's a really smart guy, so he's always so interesting to talk to.

I've told a couple of my patients already that they probably won't be seeing me again. But, our psychotic clinics are smaller, and we tend to know the patients better, so this is the first time I've really been sort of sad about it. But it's the first of many of these goodbyes, since I'm only keeping 30 patients or so (ehhh...or so) next year, and then am giving those up the following year when I start fellowship.

Something about closing doors and opening windows, blah, blah, blah.

But I made it out almost in time, and headed to the gym, because I had my weekly ass-kicking scheduled. Gomer and I had rearranged this appointment, and we happened to be texting about this shortly after some annoying stuff had happened. We've been talking about pulling out the boxing equipment for a while, so I was like, "Can we hit things tonight?" And so we did. And it was good. He wiped the floor with me (actually, he made me stop after about 20 minutes when I couldn't especially breathe...), but I loved every damn minute of it. And I didn't even barf on him. And I did another 30 minutes on the treadmill afterwards.

I'm always the girl who fixes things, you know? Keeps her shit together and takes care of everyone else. I never get mad. I get incensed, but mostly about things that happen to people I care about, you know? And so even in this small, controlled, removed sort of way, being able to be a bit more forceful was really cathartic. And believe me, I've got plenty of untapped latent aggression yet to be liberated...

But then again, I'm a shrink. It's always either about sex or aggression with us, isn't it?


robin said...

first of all, psychoanalysis was never a good idea for psychosis. who REALLY thought that was gonna work??

secondly, i think we are separated at birth. the end.

Tiny Tyrant said...

OOH You need a kickboxing class honey.

See if there is a UBC affiliated center near you.