Couch 214: The chihiro couch

Up all night again tonight to reset my schedule for the night shift. I'm so sick of this.

It seems like doctors would know that it's unhealthy to constantly mess with your circadian rhythm.

One would think! Yet here we are

I hope once all this madness is over chihiro that you take a well deserved break. They’re really putting you through it.

Also what your roommate did to your island is heinous.

My understanding from my parents is that residency is part of the initiation—hazing, if you will—process into becoming a doctor. To test you, and for you to see whether you really want to do this. In some cases to see if the hospital wants you on staff.

I’m not justifying it (it seems like a bad idea overall for both residents and patients), but out of curiosity, do you really want to be a doctor? Do you find it rewarding? I know my mother found her specialty (diagnostic radiology) intellectually rewarding and my father found his (corrective surgery) emotionally rewarding.

It's a good question, @@. I find medicine to be both intellectually and emotionally rewarding. I like the intellectual conundrums, the interactions with patients, the opportunities to teach burgeoning doctors. But it's hard to experience those rewards when I'm being so egregiously overworked and undervalued. It's difficult to like anything when you're doing it in the middle of the night, or for 80 hours per week.

Also I talked to my roommate and she apologized, said she wouldn't do it again and would pay me back the in-game currency ("bells"). Though she didn't explain why she did it, and seemed a little miffed that I was upset about it.

I just don't know about this girl sometimes. She's the same one who can't seem to understand that what I'm going through at work right now is really intense and it's sort of incredible for her to expect support from me about, like, the COVID pandemic leading to decreased job prospects when she graduates with her PhD several years from now or grading papers or something when I'm being asked to do all this ridiculous stuff with actual patients who are dying from this thing. It reminds me of this 2013 LA Times article "How not to say the wrong thing."

Yeah. We're supposed to have another Zoom session next Tuesday.

I sent him an email after session and he left me this 10-minute voicemail asking me to think about some stuff. Dude can be really thick-headed but he does care.

I dunno what to do/think.

If I really want this I have 2 years to get my life together. Let that be my motivating factor.

I was actually thinking a similar thing tonight while writing my paper. My class is integrating behavioral health into the primary care setting. I just read a chapter on depression and assessing for SUI and SH. I wonder if I'll be absolutely horrible at this when I graduate and if I'm getting my degree for nothing.

I doubt it. I am a doctor with serious mental health problems. I strongly believe that my intimate experience with psychiatric suffering makes me a better provider. I "get it" in a way that most providers don't, and patients respond to that. Patients can sense that I understand their pain on a visceral level, and are open with me about their struggles accordingly. I don't BS them or offer fake platitudes (because that sort of nonsense drives me nuts when I personally am struggling). I respect their pain and respond sensitively to it, and they appreciate that.

I had a lot of the same doubts and fears, about what it was going to be like to be a doctor who is often sick. But it turned out okay in the end, for me and for my patients.

I feel like a therapist who has personally struggled with mental health issues themselves is likely to be a better therapist. Because they'll understand their clients better. I feel like Dr. T is puzzled by many things I feel and do, related to anxiety, OCD, and depression. Obviously, I have no idea what he's personally experienced (he said as much when I asked him, but it's not like he shared anything). He's come to understand me much better, but it's been a big learning curve. So I think if a T knows personally what depression, anxiety, and certain desires* feel like, even though they wouldn't be exactly the same for everyone experiencing them, it could go a long way toward empathy and understanding of the client.

I think empathy is more a personality/intelligence thing. It doesn’t come automatically with experience. I’ve had therapists who admitted to their own mental health struggles and they were not any more empathic than those who didn’t admit to them, in fact they were often less empathic and even unable to understand the differences between our experiences.

My case manager didn't graduate me out of the program last night. She said probably by the beginning of June. She wants to get a couple of things in place for me before she graduates me out of the program. I am kind of glad I'll probably get to talk to her two more times, but I was also ready to say goodbye last night so I am kind of like, now what?

Thanks to all of those who offered suggestions on what to get the 18 year old graduating senior. I tried calling her parents to see what she would like but they were busy at the time and said they would call me later and then didn't. So my Mom and I just went to Target and got what we could. I got a gift receipt, so that should make it easier. I got lots of things and put them in one of those collapsible totes. I got some self care stuff like nail polish and masks--the cosmetic kind not the Covid kind, lotion, and body wash. I got a Starbucks gift card. Then I got some school type things for when she goes to college (assuming she does) a journal which she can use for journalling or notes for class, some purple pens, some binder clips with inspirational words on it, a smaller notebook, that is just pretty and cute, a painted box with blank cards for prayers, some accessory boxes that could hold jewelry or things like binder clips, paper clips, stuff like that, an inspirational/devotional style book (since she's from my Church, I figured that would be okay) a tea cup, lots of snacks, and a tee shirt which has a Monet painting on it. She is in French club so I thought she might like that. I probably spent about $100 and my Mom about $40 so it's a pretty decent gift I think. I thought on the day we deliver it, we could get a bunch of balloons and tie it to the box (there's a supposed to be there circular hole in the front of the tote). So I will try to arrange with her parents to deliver it this weekend. Hopefully she likes it. Hopefully it will make her feel special. And if there's stuff in there she doesn't like, she can return it, or regift it if she does that. Nothing has her name on it or anything. Thanks for all the ideas and suggestions!

Today, I learned that Dr. T, even before Covid, washes his hands right after shaking any client's hand. I mean, I presume that makes sense from a hygienic standpoint, both for himself and for other clients, but it felt a bit odd to me for some reason. Especially because he reasserted afterward that he's not a touchy-feely person in general, but can handle handshakes. Also, pretty sure ex-MC didn't wash his hands after, as he'd retrieve us from waiting room just as a previous client walked out. (This all came up because I was talking about how it would go when things return to normal--he said he was going to be extra careful and wait till it seemed really safe before he saw clients in person again--and wondered if he'd ever allow handshakes again.)

I'm with Dr. T. on this one LT. The worst part about Church for me is the hand-shaking part. I have to be very conscious not to get out hand sanitizer after the "stand up and shake everyone's hands" part. I would rather give hugs than shake hands. I just don't know that other people washed their hands and then they are touching my hands.....eww! I hate hate hate that part.

PS is it conscious or conscientious? whichever!

Oh, I could see myself being like that as well, as I have OCD. I tend to be really careful before I eat anything. So it's been tough for me if it's a meeting or gathering where people are shaking hands or otherwise touching each other, then eating. But I also feel some sense of Dr. T being like, "Must wash LT off of me as quickly as possible!" But that's just my own thing...because it's not just me, but all clients. I do miss his handshakes...despite his not being a touchy-feely person, they tending to be very warm.

And I mentioned to him today about how someone on here (I think?) talked about possibly touching the screen at the same time as their T to be like hands touching. I said I figured T would think that was weird if I suggested it, and he said, "Like this?" and held his hand up to the camera. So I held my hand up, too, and it was nice if a bit silly.

If handshaking started as a way of showing you had no weapons, it’s totally outlived its usefulness.

Plus, it gives left handed people an advantage in weapon-carrying. And they’ve got grievances from millennia of discrimination. Best to put it aside.

I insisted on handshakes goodnight as a child, fwiw.

That makes sense and I'd probably have some of those same thoughts to be honest because with former T I often had the sense that I was contaminating her despite her telling me I wasn't. But we didn't shake hands. Occasionally we would hug but I don't think she would go wash her hands after that. I would always wash my hands before session with her though and often after session. Not sure why. Just try to think of it like this maybe, if it helps, all people have their own quirks, including T's and Dr. T's quirk is washing his hands after handshakes! Kit

My mind today.

Going....going....gone

Apparently my therapist is having a rough day too. He last minute cancelled our Zoom. Which is okay I guess because I wasn't feeling 100% up to it anyway. We've rescheduled to Friday.

Info’s internet went down, so I took a nap instead of therapy. It was a worthwhile exchange.

I'm glad you got the nap but I'll miss the Info fashion report!

Thanks, Kit! Helps to think of it that way.