| | About Me, Becoming A Child Psychiatrist
Finishing my last year of post-medical school training, Chief Resident in the Child Adolescent Psychiatry program. I'm proud of what I've accomplished in these last 10 years, late life career shift with all its insecurities and blunders. This year is a journey onto itself. Trying to navigate my way through and find my own clinical style within a field full of as many contradictions as value (and a widely diverse set of values at that and not all of them palatable).
I am finding my skills and joys at being a child therapist, more confident about working with families, respecting their expertise and intentions for their children, but still feeling comfortable with offering my clinical expertise, confident (and humble) suggestions about what might be operating and unfolding within their children and their families and their communities. My direct work with kids has progressed. I am more at ease listening, being interested and curious without needing to establish diagnostic certainty. I've been working more dimensionally than categorically, and I take pride in being conservative and patient about choosing to prescribe medications.
My life is full with my work, and what's left I try to surround myself with my wife and kids and our lives together. We have such a sweet and exciting family. I don't spend enough time "meditating," on the joys in our little household, the interdependencies, rituals, deep love and (at one step remove) comical conflict.
I'm seeing kids in two outpatient clinics, one county run, more a clinic of last resort, and the second a UC Davis affiliated clinic, part of the training program. But I feel my relationships with my patients and their families are our own, these relationships we create together being a necessary component of any healing or supporting of their normal development. I am surprised to notice I have been seeing some children consistently for two years now, therapy expanding their potentials and scaffolding their successful and (hopefully) satisfying movement through childhood and adolescence. At the MIND Institute I see children with their families in an autism clinic, families with the worry and icy fear (although at rare times it seems more like a an entitled wish or insistance) that their children have Asperger's disorder or autism. I evaluate for autistic spectrum disorders and aim to help shape the choices that will best address these uniquely idiosyncratic children in their unique families. Other time I work in the local child and adolescent inpatient hospitals, stabilizing acute crises of psychosis, mania, abuse, behavior, inappropriate medication regimens or family dysfunction. Shriner's Hospital where I see kids with devastating burn injuries or spinal cord injuries and try to help them withstand these irreparable life altering wounds and maintain the hope that seems to be so abundant in children if their are encouraged in meaningful authentic ways and ultimately "allowed" to experience it.
Then there is my outside work, outside the training program that is. Weekends and holidays at the county psychiatric hospital, assessing patients for admission or discharge in the crisis unit. I wish you could be behind my eyes to see the magnificence of human beings' broken thinking, absurd delusions, bizarre phantasmal hallucinations, mania, anger, methamphetamine psychosis, delirium, depression and personality disturbance. The things I hear. You wouldn't believe me if I told you, and often I don't when I am there.
And none of this could have happened without my wife to work her magic in the family, inspire the kids to levels of creativity, imagination, friendship, responsibility, sense of self, character and love. I suppose I could have done it if I were single or if I didn't give a shit about the family, but to have done it together and make the choices we have for staying close, active, engaged with each other as a family. No, that I could not have orchestrated, that's her.
So meanwhile I still struggle with midlife angst, death panic, neurotic Jewish anxiety, feeling like an imposter, wishes for youth and the freedom of an open book of limitless choices, abundant energy (no need for naps...hehe). But I have a terrific therapist (have even considered going into formal analysis with him but a person can only handle so much, there are limits). I bought a beautiful acoustic guitar for myself, a rare generosity on my own behalf. That was a good thing. Makes me happier. And we have 5 chickens, 1 for each member of our family (Lulu, Fabrice, Cola, Crispy and Cleopatra) roaming around our tiny back yard, laying eggs in their coup and making more huge piles of bird shit (on the lawn, on our porch, in their coop etc...) than I ever imagined was possible, not that I spent any significant time imagining chicken shit prior to owning our own producers.
And then at the end of this academic year, next July, it finishes, finally, after post-bac-premed, med school, internship, residency, and fellowship. Then we have to pick our spot. Where to live, where to work, do we buy or keep renting etc...
That's about it for me, hope someone finds it interesting.
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| | Posted 7/25/2008 8:53 PM - 94 Views - 18 eProps - 10 comments
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