Wednesday, December 4, 2013

Psychosomatic Medicine--Should I be here?

So sorry I didn’t post the last two days. No Internet connection will do that to you. And very big lack of sleep.
I had a night shift Thursday, Friday and Sunday. After the night shift on Sunday, I directly went to the train station to catch a train to a town 1.5 hours away from Göttingen. A few friends and I were attending an internship in psychosomatic medicine.
We arrived in the town and took a taxi to the hospital. It is a huge hospital specialized on psychosomatic medicine and psychotherapy.
We found out room on the top floor in the medical directors department. We had a conference room waiting for us including a cart with tea, coffee and cookies. (We had so much of tea, coffee and cookies over the two days that none of us wanted to see cookies anymore.) I was very happy about the offering of caffeine.
The director of the hospital welcomed us and discussed what to expect for the next two days. Then we were asked what our expectations were.
The next point on the schedule was a patient interview done by one of the doctors. Patients in this hospital have psychological issues that cause bodily ailments or the other way around. I tried to listen as much as I could, fighting the tiredness, drinking more black tea and doodling to keep myself awake.
After the patient interview, the patient left and we discussed what had just happened. The interesting thing about how they taught us the patient history taking here apposed to how they do it in the university hospital is that we have a lot more time and we discuss how we felt during the process.
Over the course of the days, I noticed that a big difference in psychology compared to the other specialties, is that the interaction is so dependent on the therapist as well. In other specialties, the patient has an ailment and there is a process of taking care of it (hopefully, and this is a extremely simplified statement). With one patient, half the group thought he was a nice guy and felt bad for what had happened in his life whereas the other half didn’t like him at all. That shows that the therapy could be completely different depending on what the therapist feels, has gone through in life personally and how he identifies with the patient.
I mentioned this point in one of the discussion and was then informed that the doctors have a period in their training where they focus very much on themselves and their own issues to better understand them while treating patients.
We had lunch in the hospital and then were off to music therapy. That was fun. We all grabbed an instrument and started playing and seeing where it goes. Afterwards we discussed it and found that many had had musical training, which might have led to us quickly finding a rhythm.
We had another patient interview to see before the last thing on the schedule. Relaxation therapy! We were all in a cozy room, got a mat, a pillow, a blanket and a cherry seed pillow and the therapist starting explaining a few things to us and telling us how to relax. After 24 hours of no sleep at this point, I totally fell asleep and slept for about 10 minutes.
We stayed in the hospital for dinner before heading to our hostel. There was a Christmas market in town and everyone wanted to go. I was at 27 hours without sleep and managed to go along for one hot-spiced wine before I headed back before the group and slept…like a rock.
The next day we had more coffee and tea and cookies while interviewing a patient again.
Then we had the opportunity to have a one on one conversation with a patient. We were given 50 minutes for the talk. I talked with my patient for an hour before realizing it and having to go meet up with the doctor. My patient and I got along so well. I’d say we were on the same level on 80% of the time. The other 20% is the reason he is in the hospital for treatment and I am not.
After the one on one, we talked to doctors about our experience and got feedback.
After lunch, we had another patient interview. This time a friend and I did it for the group. It was amazing. Again, I could identify with about 90% of what this patient felt and had gone through and those little 10% were the reason I wasn’t in the hospital as well.
It was crazy just how well the patients fit to my personality that I saw yesterday. Maybe this should concern me on some level.
After that last interview, we had Qigong. That was fun to experience. It’s the Asian exercise you see people do in the morning. Slow movements and energy flow.
We had a last discussion with the chief and then caught a cab back to the train station and then headed back to Göttingen.
Tomorrow starts the first of two days psychiatry. Let’s see what that brings.

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