the shadows, inverted of memory
given a moment, time remembers,
Working on that one, still.
Went to bed at around 0100 this morning, after playing around with my Angel forever. Got up at 0500, and went up to the hospital to watch an ECT treatment. That's electroconvulsive therapy, the sort of treatment that was given such a bad name in "One Flew Over the Cuckoo's Nest," and the stuff that people who don't believe in psychiatry will tell you is the most wicked voodo-magic of them all.
I'll leave that honour to the frontal lobotomy, O Best Beloved, the single worst Nobel Prize ever awarded.
ECT, to watch, is underwhelming. The patient is anesthetized, electrodes are applied to the temples, a shock is delivered, and the patient has a seizure. Twenty seconds is clinically effective. All we see is the physical manifestation - body tenses, toes point, legs jerk - and sometimes not even that, while the EEG records the spikes and waves of seizure activity. Once it returns to a post-ictal slowing, the EEG is disconnected. Patient wakes up, experiences what will most likely be up to several months of memory haziness, but it seems to be extremely effective in treating depression.
If we only knew why.
ECT was done at 0700; I went to the student lounge and slept another few hours before turning up at 0930 for my clerkship. I needed it.
Saw one patient on my own, today. She was a lovely dark-haired woman, just twenty, with major depression and mood-congruent hallucinations. The voice told her to kill herself. She came to us. So pretty. So desperate. She has a two-year-old son and a boyfriend who sleeps with her best friend, the day after she got her abortion. She got the abortion because she was raped. He was out with the friend that night too. I'd have some depression too, all things considered. Starting Effexor and Seraquel, off to subacute for a respite.
In crisis intervention, in psychiatry, we do not do therapy. We leave that for the psychotherapists. We prescribe medication and get people to interventions. It is not what I expected. I am not certain the psychiatrists believe in psychiatry.
Afternoon was Chemical Dependence lectures, including a pair of guest speakers - an MD and a gentleman who'd been through every drug known to man - to talk about Alcoholics Anonymous. That was intriguing, O Best Beloved, and Wednesday night, I think I will go to my required AA meeting instead of sitting around waiting for Angel to get home.
And small groups, which concentrated on us telling stories and becoming more self-aware. I'm quite aware of myself, thankyouverymuch.
Called Grandpa tonight, to say hi, to chat. He told me about the flowers he saw driving home from Florida, about the cardinal on his back porch, about the programs and dinners he'd been to at the college. We talked about how his children are coming to their mid-fifties, and how he feels about that. We talked about little things - the AAFP conference, the way things seem to come to those with an open mind, whether the nest in the woods is an osprey nest or a hawk. It was soothing, and the words for silmaril's request have begun to filter into my mind.
I slept little last night, and fitfully. I am restless; the weekends seem so short but when I return to this room with its bright, childish colours (I have tie-dyed rainbows on my sheets, and my dresser is a quartet of primary shades) it seems that I have been away forever. I want to go back home, to the two lonely little black-skirt tetras, Oracle and Delphi ("Did you name them? I knew you'd name them!" My mother was triumphant; I name everything) who will have company come next weekend, plants and more fish. I watched them for long minutes, swimming to and fro. I can tell them apart, call them by name.
Consider the sparrows in the field...
I want to go home. Thirteen more clerkship days. I want to go home.