Emergency Medicine and Psychiatry

So unlike most of the people in medicine, I have developed insomnia. I think it really comes from the perpetual jet lag of being on call. On the other hand, you always get to do more stuff on call. As my psych resident tells me, the patient to paperwork time ratio is the highest on call (she happens to think this is advantage residencies where you take MORE not less call since you get to do more). For example, I got to see two patients last night. Both were depressed. The first, a gruff looking, burly 50yo gentleman who was crying and wringing his hands as we talked (kind of like a big ole teddy bear). He had developed depression and insomnia over the last few months and had some suicidal thoughts after losing both parents and having his son move away. I think he felt guilty because he cared for his mother who had a terminal illness and literally tried to kill her by illegally cranking up the morphine machine to double the rate. The second was a 16yo who slept with a 45yo for money and had been depressed and suicidal for several weeks. Both were pretty cool and I felt myself wanting to be the one helping them “explore their inner conflicts” especially the first guy. Somehow also hearing a story like that, of a guy who is usually not a whiner as he describes who had a very close family and is now dealing with two recent deaths and having trouble sleeping really struck an altruistic cord in me. I guess it must be my mom’s influence somehow countertransferred onto the patient.

Anyway, the other funny thing that happened while I was on call was I bumped into my resident Chatterjee who was running a trauma and really felt like I wanted to be doing it, doing the procedures, evaluating and diagnosing the patient. In short, it made me feel like I really wanted to be an ER doc. Plus the shift work and schedule sounds pretty sweet – 8hr shifts 3 X per week, 4 days off a week and once you leave the hospital THEY DON’T CALL YOU BACK.

I wonder if there is a psych ER residency out there?