Tell me about your childhood...

I thought I'd like my psychiatry rotation, because I tend to enjoy interviewing patients. It turns out I like the rotation for completely different reasons. But the interviews -- whether it's with depressed patients or borderlines or even the occasional schizophrenic -- have not been what I expected.

DF once said that the reason he liked psych is because conversation with patients becomes diagnostic and therapeutic. And Dr. S says the mental status exam requires years and years of training to perfect. From what I've seen, I agree. And if regular conversation becomes so loaded with power and danger, it's no wonder there are so many restrictions on its use: Don't introduce yourself by your first name. Don't joke with the patients. Don't bring up aspects of your life. Don't clue the patients in on what you're thinking. Don't try to educate the patients.

Granted, there are very good reasons for these guidelines. I just hadn't realized how much I've come to rely on humor and personal examples on my other rotations. It makes sense that a third year would resort to these means, and now that it's prohibited, I'll probably develop new skills and end up a stronger interviewer. But I'm missing the give-and-take, and the bonds I used to make with patients.