Featured, Mental Health and Wellness, Patient Advocacy, Words from the Wards

The Ward as Medicine

When people asked me why I wanted to become a doctor, I always had my answer ready: “Because I want to be the person in the room.” My shadowing experiences impressed the physician’s privilege of being the person in the room during a patient’s most vulnerable moments: giving birth to her first child, receiving a life-altering diagnosis of chronic illness or opening up about mental health struggles. As someone interested in psychiatry, I knew the power of vulnerability as an agent of psychic change, and I wanted to be the person my patients could confide in. While my desire to treat through empathic listening has not changed, my third-year clerkship in psychiatry has taught me that it is not only the physician who has the power to do this. The other patients receiving care are equally potent sources of healing. 

A few weeks into my rotation, I met Mrs. A, a vivacious woman in her 50s who had brought herself to the hospital after realizing she did not want to live anymore. While her official problem list included suicidality, Mrs. A would tell anyone who would listen that her main complaint was anger: anger at her husband to the point that she had kicked him out of their shared home the week before and anger at her adult children for feeling like they sided with him. Despite her tough words, however, I found that I never knew what side of Mrs. A I would see when I checked in on her. Often, yes, she was caught up in the memory of a slight against her and wanted you to listen as she hotly recounted her family’s injustices, but rarely she would be overcome with emotion, voice shaking as she described feeling like a failure as a mother. 

Then something unexpected happened. Without any pharmacological intervention from us (we were waiting to connect with her outpatient psychiatrist before adjusting any medicines), her temper softened. 

The nursing notes were my first clue that some sort of transformation was occurring, as they went from “another outburst from this patient” to “patient expressing gratitude to staff; appearing to enjoy group activities.”

Asking Mrs. A about this change brought a soft smile to her face. She described her blossoming relationships with many of the younger female patients on the unit, who came to her for advice. I pointed at a card she had hung on her wall from another patient, who had addressed it: “Dear Mama Duck.” She laughed and admitted how nice it was to feel loved. I wondered aloud if the relationships she had built here were affirming to her identity as a mother, and she agreed whole-heartedly. She also added that it was making her think more and more about her own children and the type of relationship she wanted to have with them. While my rotation ended before Mrs. A was discharged, last I heard she was setting up a time for her kids to visit her in the hospital. 

My time on the psychiatry ward showed me firsthand why the inpatient psychiatry unit emphasizes group activities. Mrs. A taught me that the other patients on the unit promote healing in many ways: they can hold up mirrors to one’s life outside of the hospital, be teachers or be inspirations who motivate a patient to strive for more out of life. They can even resurrect forgotten strengths and identities.

Image credit: Photo by Nadiia Ganzhyi on Unsplash

Nicole Wong Nicole Wong (1 Posts)

Medical Student Contributing Writer

David Geffen SOM at UCLA

Nicole is a fourth-year medical student at the David Geffen School of Medicine at UCLA in Los Angeles, California. She graduated from Washington University in St. Louis with a Bachelor of Science in biomedical engineering. She is applying to psychiatry with the intention of pursuing a child and adolescent fellowship. In her free time, she enjoys playing tricks on her cat.