Thursday, January 26, 2012

My life as an intern: Thursday 13.

Dear Diary, 
I started interning last week at The Place. The Place is an acute psychiatric ward in a hospital. And while I realize that there is always a honeymoon period, so far, I am enjoying myself, although I was shocked to learn that while I am an excellent employee, I do not get paid what I should.

According to my internship supervisor,
I've already filled this position.
13. easier than my real life as a diagnostic assessor.

On my first day at The Place there was a huge chocolate layer cake someone brought in, just because! Well, does there have to be a reason?

Well, that was a fucking omen as far as I was concerned: Clearly, this was my world, and these were my people.  And as I am nothing if not a team player, so I had some.  Yes. I took some saturated fat and sugar for the team.

12. It turns out that there are companies out there who do not work the shit out of their people, recognizing in a sensible manner that an overworked, unemployed, bitter employee is not good for productivity.  The Place asked me if I could do a psychosocial. This is what I do for a living in my non-internship job, so I said, sure. (What I actually do is a comprehensive mental health assessment, which sometimes includes IQ testing, and always involves a diagnosis and a detailed treatment plan.) So I looked at their template...

Woah. ...wait a minute.  "where do I record the mental status exam?" 

Oh, the nurse does those.

"what about the diagnosis?"

The psychiatrist does that.

"and the treatment plan?"
OMG I totally want this cup. 
When I'm no longer an intern, that is.

The treatment team does that.

So, I did the rest. Normally, all that stuff takes me nearly 90 minutes. My part was done in 45 minutes. And then..."where do I type this up?

You don't.  You dictate it. 

Yes, they are very nice to me at my regular job. They tell me all the time how awesome I am.  But. they have been adding to my job continually over the past year, with no comenserate raise in pay.

And I cannot bid "awesome" on a NWT Striped White House Black Market sweater.

11. My internship supervisor, meanwhile, told me that so far, they love me.  And, it was suggested that a part time position was openIng up soon. So yeah, I told them, I am interested.  Why not get paid for interning? Take that, VA.  Did I mention that it is my hope that I get a job with this organization? They are a good employer, ten minutes from my house, and I love psychiatric work. Mmboy, I lurves me some crazy.

Oh, and as an aside: it would be about a 50% raise in pay.  After all, I can't bid "nice" for a pair of Kenneth Cole, size 8.5, NIB

10. By and large the most popular thing I have done at The Place has been to give fellow clinicians a link to this video: 

9. Well, I have to work off that chocolate cake somehow, so I've started doing heart zone training on the treadmill. I run, and watch Law and Order SVU reruns with closed captioning, which somehow magically, unbelievably, combines my favorite pastimes: getting skinny, and watching TV.  It occurrs to me that this is a good use of an otherwise untenable situation: it may be dark when I leave and when I come home, but there is aways the treadmill. And TV DON'T EVER PAY ATTENTION TO PEOPLE WHO TELL YOU TO KILL YOUR TV. THEY'RE FASCISTS. And Murder Mysteries.

8. I just cannot get used to being the size I am now. I ordered some dress slacks, and when they arrived, I held them up and muttered to myself, "there is no way these are going to fit my fat ass." but they did. They fit my fat ass. I flirted with the idea that they've changed the sizing now, and that's why I wear an 8, but am really what used to be a 16--the size I wore when I started all this.  Then I accepted that would be way too vast a conspiracy, even for me.

7. So, but, back to heart zone training: My max heart rate is either 177, or 180, or 182, depending on the source. There is apparently a way to find out definitely the value that approaches your max heart rate which WARNING GEEK REFERENCES AHEAD much like infinity, is only approachable. Because according to the theory, if I went one beat over my max heart rate, my heart becomes a singularity that collapses in on itself, much like Vulcan  after red matter hit the core.
See? math, Star Trek, and heart rate zones all in one reference.

6. Now, there is apparently a more exact way to determine my max heart rate, as I mentioned, but it involves sprinting up hills repeatedly.  I had to weigh my need for precision against the fact that I. Am Lazy. Guess what won? Hmm. Let's see: I could sprint up hills repeatedly, or subtract a number from another number.

5. The Place has a cafeteria. I lOVE cafeteria food. Bland, lukewarm, food. It's my weakness, this willingness to eat anything. And it's why I run.

4. Meanwhile, I have made the following observations about acute inpatient with Adults v. Child and Adolescents. First, it's quieter with the grownups. Second, for the most part--and need I say it--   NO CRAZY PARENTS.
I like working with adults. I didn't think I'd like it, but I do. 
Few people think they are the cause
of their own circumstances.

3. But, one thing that is hard to at get used to at The Place is the medical model. I am used to having huge responsiblities regarding diagnostics. It's an interesting adjustment, switching to working on a discharge plan, and less stressful. What services are there for him? Where will he live? How will he get his medications? I get to advocate for the patient from a place of compassion and expertise. 

2. When I meet with people who have severe and persistent mental illnesses, especially women who are my age. I look at them, and I can kind of see a little bit of the person they might have been...that is, before the abuse, before their first psychotic break, before the huffing turned their neurons into a gray pudding.

I am so sad for that lost girl who probably dreamed of growing up and being a nurse, or a lawyer or something--instead, she's living in a trailer with no heat, water, or electricity because she is too traumatized to get out of her own way.

1. Another observation: in the field of mental health, there is crazy, and then there is ku-ray-zee. (It's not that I lack compassion).  But there's always those moments, like when the patient points out a mistake in his file:

After two years of stellar service
I am giving you a 2% raise!

 I didn't say I was POSESSED by demons. I said I was OPPRESSED by demons.

How is one oppressed by demons? Do they pay you a minimum wage on salary and work the shit put of you until you find out that another person doing a similar job under better condtions is making twice as much?  And all the while telling you how AWESOME YOU ARE?

Well in that case, I'm oppressed by demons too.


  1. sounds like a great job. No more Axis I, II, etc? :) Glad you're appreciated. If I can add a request? When you're dictating, please try to do it without eating or snorking or chewing gum or in the car or with babies screaming into the microphone. TIA. :)

  2. I do love this post. I love that you've found a place where you're happy and they're happy with you and wow, it seems like you really get to do what you're in the field to do.

    I guess "The Place" cafeteria food is better than elementary school cafeteria food. I've been here 10 years and eaten cafeteria food less than 5 times.

  3. I am glad that you are enjoying your internship. I hope it all works out for you.

  4. I really love you. My mother is a therapist, and we've both battled depression most of our lives. Reading your blog is always like talking to my mom, except she's my age and not dropping hints about grandchildren or doing something useful with my life instead of training for a half marathon- which is clearly easy because everyone does it.

    You make me laugh so much. And I have lots of days when I am too traumatized to get out of my own way, but you are so blunt that it helps me realize it. Cheapest therapy I ever had. Thanks.

  5. That last part made me cut, paste and post to FB. With a credit to you, of course. Because it's awesome and it made me miss working in the ER.

  6. Hmmmm, so glad you are happy, and recognized for your skills. Awesome combination and convergence of good things. I like reading and running on the elliptical or the treadmill when outdoors just is not an option. TV would be good, but there isn't one in the school gym.

  7. OK this has 2 of my favorite things I've read on the internet:
    "They tell me all the time how awesome I am. But. they have been adding to my job continually over the past year, with no comenserate raise in pay.

    And I cannot bid "awesome" on a NWT Striped White House Black Market sweater."

    "Hmm. Let's see: I could sprint up hills repeatedly, or subtract a number from another number."
    Totally helped me see where I am going wrong with my life.


Comments containing links to commercial websites from people with invisible profiles are deleted immediately. Spammers are immediately deleted.

...and I, I have a goal.

Dear Diary, For the first time in 7 years I have a goal. It takes a lot to get me motivated.  I am the demotivation queen.  The princess...