Tuesday, September 18, 2007

The Questions You Asked

As I go through my day, I often think about the things people write in the comment section of our posts. Often we get questions, sometimes we forget to respond, sometimes I simply forget they are there, sometimes we save them for the Podcast, and sometimes, well, they are too out there to even begin to address.

I'm going to take a moment here to backtrack and talk about some stuff that's been asked...doing it as a post instead of in the comment sections.

Flash recently visited an old post and asked:
A third year med student also considering psychiatry. I have liked many different things in all of my rotations but I keep coming back to psych. I just had a daughter and suddenly lifestyle is very important. Have psychiatrists on this blog found that they could have controllable hours/live decently/pay back loans with psych? I would love to work part-time when I complete residency, but is this even possible?...Can I retain my fun-loving self if I become a psychiatrist? Obviously I am serious, sincere and compassionate in my patient encounters. I wouldn't be considering psych if I was otherwise. But could psych drag me down?

Hi Flash and thanks for visiting. In terms of money and lifestyle: many issues here. We're all so old-- back in our day loans had to be paid off in 10 years. Now, I hear residents talk about their quarter million dollar school debts (no, I'm not kidding) that go on for 30 years. Mortgage number two, essentially. I work part-time and psychiatry is particularly amenable to part-time work and controlled hours. Employed spouses help. Lottery tickets are good. I don't know any starving shrinks, but the ones I know who are the sole support for their families do work long hours. Rich dead relatives can be useful as well. If you're heavily in debt, if your spouse is a school-teacher, if you have a fondness for vacation homes, Versace bags, and large boats, don't be a psychiatrist. You can retain your fun-loving self. Psych could drag you down, but not as much as a lot of other medical specialties. I do know a psychiatrist who got through school working as a professional clown.

And Lily wrote in one of her comments:

My psychiatrist never seems hopeful. I don't get it. I think all of the three of you are too good to be true.

Are we too good to be true? I've been thinking about that. ClinkShrink and Roy are definitely as good, if not better, in real life than they are on the blog. How can a guy who names his bird "Monkey" be bad? And someone who loves cats and devotes herself to society's criminals? SuperClinkShrink not only runs zillions of 9 minute miles, cares for thousands of downtrodden criminals a year, but she stays with my dog and my kids when I'm away.

Me? I think I'm better on the blog. In real life, I'm just a shrink with a strange sense of humor and a blog. More often then not, I click (not clink) with patients, occasionally someone credits me with saying something that really helps-- usually something that makes them feel understood or vindicated -- and often people credit me with writing prescriptions that help them feel a whole lot better. Hopeful? I am kind of hopeful and excited at the beginning of someone's treatment. If it's gone on a while and the patient is getting discouraged and the meds aren't working, I keep plugging away, but the excitement wanes. When we're talking years.....well, in terms of hopefulness, I readjust the goals, at least in my own head. Here and there, someone pushes my buttons and I think I do all the things all the other shrinks out there do. My strengths: I return phone calls, I'm really good at that, and being a psychiatrist who does psychotherapy as well as prescribes medications reasonably competently (I hope) has become a niche market-- all those folks doing 10 minute med checks make me look really good.

And for the final question in the comment section:
When is pizza?

In my personal experience, there is never a bad time for pizza. Pizza is best in New York City (the greasy stuff at Penn Station is particularly fabulous). I don't like many toppings and pepperoni is totally out, destroys the stuff if you ask me. Happy to try the latest greatest Baltimore's best as soon as I shake this cold. Please send chicken soup.


The Girl said...

Great post! I wish I could work my way through as a clown, but sadly, I am afraid of them. I can't trust somebody who disguises him/herself and squirts me with water for no apparent reason other than their own amusement. :D

And yes, pizza is for any time, no matter where in the world you live!

Midwife with a Knife said...

I have to admit, pizza was one of the first "real food" items I've eaten after some recent tummy trouble (and not eating for 4-5 days). The first was a bacon cheeseburger and fries. It did occur to me that it might not be a good idea, but I've never let that stop me before! (it was yummy and good).

I worked as a blackjack dealer in medical school. It's not exactly being a clown, but my feet are too small for the shoes. ;)

ClinkShrink said...

We'll have pizza when you're feeling better. You sounded horrible tonight :(

I think I may have a fifteen year old can of Campbell's chicken noodle soup I can bring over for you if you need it.

NeoNurseChic said...

Uhoh - do you have a cold? I'm just getting over one that I've also passed on to Jason. Lucky for me, when it started last Thursday, I was just about to embark on 4 12's in a row. Can you guess how much Advil Cold and Sinus I downed in a 4 day period? I must say between that, Vicks, and Cepacol throat lozenges, I somehow appeared like a normal human being. It's done quite a number on my head!!

Hope you feel better!! :)

Rach said...

mmmmm Versace purses and pizza... what a noble combination.

Flash said...

Thanks Dinah for your answers. Overall I feel good about psychiatry, I think it suits my personality. When I think about doing psych it feels good: I will enjoy the work and the residency and practice would be a good fit for my family. When I think about trying to match into radiology I feel instantly stressed and anxious. Although interesting, I think I would miss the patient contact and I'm not convinced that is the lifestyle it is cracked up to be. I hear all the time from men how it is a great specialty for women but the one female radiologist I know really struggle.

With regards to you comments about med student indebtedness you are right: average medical school debt in 2006 was around $130,000 up 8.5 percent from the previous year. So, unfortunately, the ability to pay these back IS a consideration when choosing specialties. Here's my rationale though. Maybe I would make half as much as a surgeon as a psychiatrist but it seems I would work half as much (I'm thinking of the surgeons I know who routinely work 70-80 hour weeks). I have a professional non-physician spouse which is a big help. But he may take a hiatus for awhile depending on how residency with kid(s) goes. Up in the air yet.

The most expensive handbag I have is a nice little Coach my mom got me for college graduation. I'm currently sporting the Lands End "Little Tripper" diaper bag, so I can handle no Versace. My husband WOULD like a boat some day (we are from the great lakes area and he wants to travel around) but we'll just have to see. I think he wants a sane and happy wife more.

Thanks again Dinah, this blog has been a great find. I am enjoying the podcasts too.

PS Hope you feel better
PPS Having pizza tonight and super excited about it

NeoNurseChic said...


Where in the great lakes area? I used to live in Vermilion, Ohio, which is a small little fishing village about 45 minutes west of Cleveland and a half hour east of Sandusky, where the famous Cedar Point is located. I'm a boat girl at heart - can't imagine my life away from the water, and I hope to own a sailboat someday! My boyfriend doesn't know how to sail, but all that can be remedied!! ;) (I wonder how many fights we'll have when I start teaching him to sail!)


I bet you've never heard of these, but I just ate left overs of an Oval. We have this place out near my parents' in Chester County where they make great cheesesteaks (better than the true Philly cheesesteaks if you ask me.....but don't tell Jason I said that!) and they have these ovals, which are like little oval pizzas you can have made however you want. BBQ Chicken oval is the favorite of my mom and I, and when I was out there the other day to get my hair cut (I now look completely different!), we had ovals. My mom gave me the leftover of hers, and I've just now finished it! Very tasty....

Are you feeling any better yet? Hope so!! My cold is finally going away...though I slept about 14 hours last night, so I've definitely been trying to rest it out of myself! Now back to my regularly scheduled cleaning that I should have started on this morning! ;)

Take care!
Carrie :)

Anonymous said...

It's just occurred to me that neither of my co-bloggers, who know me in real life, disagreed with my statement that I'm better on the blog than I am in real life.

Anonymous said...

dinah: how does that make you feel?

Anonymous said...

What? What's wrong with a school teacher salary as your spouse? Can you be single and be a shrink, then? A single parent, perhaps? A close friend of mine makes $65K as a high school teacher in Los Angeles. Is that too little for spousal support? If not, what is too little? 50K? 30K? I just think that comment was a little crazy, considering that half the (male) shrinks I know have stay-at-home wives and very nice lifestyles.