So It Begins

Psychiatry clerkship orientation today. In which we were told how we would be graded (clerkship performance: 75%, Shelf examination: 25%) and then reviewed the major psychiatric illnesses: major depression, schizophrenia, anxiety, personality disorders, and substance abuse.

In the review of the major psychiatric disorders, I learned some new things:

• How much it costs to keep a schizophrenic patient on Haldol ($30/month) versus the same patient on an atypical anti-psychotic ($500-$800/month)
• Of the effort to revoke the Nobel prize from Egas Moniz, who was awarded the prize for developing the frontal lobotomy. The frontal lobotomy became the treatment of choice for severe mental illness despite the fact that no controlled research established its clinical effectiveness. (But it also gave us One Flew Over the Cuckoo's Nest).
  
• Apparently electroconvulsive therapy (ECT) works. Not sure why.
• Schizophrenic patients LOVE nicotine. You can often recognize a schizophrenic patient by the yellow nicotine stains on their fingers. They like to remove the cigarette filters and burn their fingers as a result.
• Schizophrenics also like to get high off gasoline fumes. The poor gas station attendant near school apparently has to chase these people away from his pumps.

And some not-so-new things:

• I remember precious little from the pre-clinical years. Things like...oh, drugs, how to take a patient history, how to put on a tie.

My first official day in the clinic is tomorrow. Deep breaths.

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And thanks to Kinjo and Cathy who guest-posted every once in a while, during my thesis writing phase.