Fed up down under

Like me, The Helix is med student currently on a psychiatry consult / liaison service.

The big difference is that he's in Australia, and I'm in a place expecting a foot of snow tomorrow.

Browsing through some of his recent posts, you can appreciate other differences, too. Our EKG is called an "ECG" over there. And they get a paltry 20 minutes for their exam/interview at the end of the block.

We get 25 minutes.

Another difference is he can't wait for his rotation to finish, and wonders how I'm getting along with my team. The truth is, they're really, really good. So good, in fact, that they have me believing that 25 minutes is actually enough time to establish rapport, get the narrative, get neuroveg symptoms, get a quality mental status exam and a Folstein.

Color me impressed, they've given me something to shoot for. I think they pull it off with gentle interruptions, smooth transitions between patient answers and examiner questions, an empathetic demeanor, and a ton of experience-guided intuition.

Plus, having the med students collect all the collateral info in advance... helps.

Maybe I've been lucky, but my C/L team has also been wonderfully medical-minded, thoroughly exploring (and explaining) organic causes for the psychiatric illnesses we've seen. It doesn't hurt that we've seen steroid psychosis, HSV encephalitis, frontal-lobe strokes, Wilson's disease, and a rule-out for Diogenes syndrome (among others). Neat stuff.

One of the residents said it best: "Psychiatric problems nowadays are as managable as other medical problems. And interviewing someone with mania is a lot more interesting than someone with chronic hip pain."

UPDATE: Helix has the best psych presentation I've ever heard.