after 2 months.

Dear R,

I don’t have any major difficulty or issue in CCT. 

I like how my phone has stopped ringing all the time, how I can attend lectures in peace, how I can finally have lunch breaks without interruption.

Seeing patients at the clinic is alright. Certain types of patients make it enjoyable.

 

I still often feel confused, with the medications that never seem right.
Patients can be stable mentally but have side effects.
They can be stable mentally, but don’t wish to continue with the medications, with or without good reasons.
They can have residual symptoms despite our best effort, and we call it their baseline.
We often go back and forth with medications, with the doses or the route.
Why can’t our patients be happy? Why can’t they accept that they need to be on certain medications, just like aspirin or statin for metabolic disease.

Sometimes we can’t do enough. Some patients are stuck, with psychosis and alcoholism or other substance use that they can’t stop.

Things can go wrong when every small step seems right. They can relapse when they have done nothing wrong, when they take no substances and take their medication religiously.

 

Every day I think and feel too much. I am working with many people but I’m on my own at the same time. Some people and the MHRT reports they barely drafted annoy me. I’m often interrupted by mostly non-urgent things. Case reviews physically exhaust me. There are many voices, relevant or irrelevant to the topic. There are never ending script requests.

When I feel unhappy, I have an impulsive thought to pick up a week of night shifts to escape from people and the tedious chaos, to be on my own and to experience acute psychiatry again. But I can’t be immature and avoidant all the time. I know we can always learn something new wherever we are, or from whomever we work with. I have just realised that the world of psychiatry is big. I can’t be confined to my comfort zone. My relentless self-criticism which has just creeped in again is also what erodes me at the same time.