Scars of life another tomorrow9/3/2023 She actively participated in group activities, even taking the lead in uplifting and encouraging other patients struggling with depression and mood disorders. Over the next few days, Sarah’s condition improved significantly. We also discussed the importance of developing healthy coping mechanisms, leaning on her friends as a support system and using exercise and breathing techniques to manage her pain and emotional distress. During our sessions, we explored the impact of her traumatic experiences on her mental and physical health and how her substance use had been a coping mechanism. Through active listening and providing a safe and non-judgmental space for her to express herself, Sarah began to open up and share more about her experiences and struggles. It was clear that building trust with her was crucial to her progress. Over the next few days, I had the opportunity to work with Sarah on her treatment plan. These simple words allowed for a patient-physician connection that strengthened each visit. Patients can be encouraged by celebrations of improvements in aspects of their mental health while also providing a space to address any areas of care that need attention. She always initiated her patient visits with “How are you doing today?” followed by, “What is better today and what is worse?” I saw that these simple sentences allowed patients to feel seen as someone beyond their diagnosis and provided a chance for more in-depth discussion about their care. S provided compassionate, patient-centered care, skillfully utilizing motivational interviewing to reinforce Sarah’s protective factors and instill hope. It was remarkable to witness how effortlessly Dr. S introduced herself to Sarah and asked additional questions to gain a deeper understanding of her history. Together, we decided to prescribe lamotrigine and quetiapine for mood regulation and hydroxyzine as needed for anxiety. When asked what she wanted from our care team, Sarah simply said, “I just want to feel like things are going to be okay again.”Īfter finishing the examination and collecting myself, I presented Sarah’s case to my attending, Dr. With hypothyroidism, she couldn’t take lithium, but her current regimen of valproate wasn’t effective. Throughout her admission for severe suicidal ideation, Sarah expressed her desire to get better but acknowledged that she couldn’t do it alone. Sarah’s story weighed heavily on me and nearly brought me to tears, but I knew I had to be a strong source of support to her. She was never given more than five minutes to tell her story before she was either given an incorrect diagnosis of fibromyalgia or her care was transferred to a different doctor for management. Sarah expressed the disappointment she felt regarding the initial workup of her pain she felt frustrated and dismissed during her appointments. For months, her CRPS symptoms were misdiagnosed by multiple physicians as psychosomatic which eroded her trust in physicians. However, the injuries resulted in a condition called complex regional pain syndrome (CRPS), a severe form of chronic inflammatory pain that occurs following severe tissue injury. Fortunately, multiple surgeries allowed her arm to be reattached and she regained its functionality. She was involved in a severe motor vehicle accident, during which her car flipped multiple times and her right arm was completely severed. Seeking a fresh start, Sarah moved to Florida from Georgia, only to face another life-altering event. I believe these difficult childhood experiences likely contributed to the development of bipolar disorder type I in her late teens. Additionally, her mother, struggling with drug addiction, was unable to care for her. Sarah was born into an abusive family and she had experienced eighteen years of sexual, physical and emotional abuse at the hands of her stepfather. Through our conversations, Sarah opened up to me about her story. Her hair covered her face and she was hunched over in her seat. She appeared somber and pale, with multiple scars on her arms and legs. From the beginning of our encounter, I could sense the trauma that Sarah had endured, shown in the sadness that was present in her demeanor. After orienting myself to the unit for a short while, I came face-to-face with a patient younger than myself. This was an essential step in my training - a step that would equip me to play a significant role in patient care. On the second day of my psychiatry rotation, I found myself feeling a mixture of anxiety and excitement before performing my first complete psychiatric workup.
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