Tha lack of insight was just amazing

Psychiatrist sat beside bipolar patient in ward. Med students stood quietly in one corner.

Psychiatrist started the conversation.

“Can you tell me what happened?”

“Nothing…i felt down, so i stabbed myself.”

Silence.

Patient continues.

“But i am feeling pretty shitty about it right now. Shouldn’t have done that. that’s why i walked to Emergency with my bloodied arm.”

Psychiatrist nodded, a deep look of concern on his face.

“You need someone to turn to, in between your crisis. You understand what i am saying?”

“Like a friend? I do not want to burden my friends. They are shocked by my moods anyway.”

“Is there no one else at all?” the psychiatrist gently probed.

A long pause as the patient thought hard.

“I guess i could visit a brothel…those girls over there are pretty good, they agree with everything i say.”

I nearly keeled over mentally, aghast at what i had just heard. It was completely off the mark, the exact opposite of what we (the medical team) wanted. We were trying to get the patient to understand his situation, to come up with his own solution, by gently leading him to it. But this?? THIS?!

“And i don’t think my girlfirend will be too happy about it.”

OF COURSE! I wanted to yell out, but i kept my mouth shut.

This is no place for judgement. I keep my opinions in my own head. People have difficulties in their lives; they think differently. The psychiatrist was cool as a cucumber. I was astounded. How disrespectful to the women in the room.

I wonder what the patient’s girlfriend’s reaction would have been had she been present for the consultation.

#1 reason why i will never go into psychiatry. I cannot empathize with the mentalities of some patients. If i can’t hold back my judgement, i can’t provide optimal medical treatment. So thanks, but no thanks.

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