Halfway through my psychiatry rotation at the Bronx Psychiatric Center, I've gotten a better sense of what kind of a place it is. In a sentence, it's the end of the road for psychiatric patients who have failed treatment, run out of insurance, or had criminal pasts. The patients are kept in wards behind double-locked doors. We all have panic buttons. We have to swipe our ID's to get both in and out of the building. My impression of it two years ago, in first-year ICM, was that it was a depressing place; how could anyone work with patients who had so little hope of getting better? At least, so little hope of getting well enough to leave?
First impressions go a long way. Halfway through my rotation, however, I've realized that there is so much more to be said for this place. Up on Ward 12, the patients are prepared for living in society again after months or years of treatment. They take classes, go to off-site programs, learn how to care for themselves. They have community meetings, where they all gather and voice their opinions and concerns about life on the ward in an open forum. These are people who have committed heinous crimes in the past - molesters, murderers, drug dealers, anything you can imagine - but it truly feels like a community, and the patients are people you would want to chat with in a grocery line. Their lives have been turned around by proper recognition of their mental illnesses and appropriate (and oftentimes heavy) treatment of their diseases.
Ward 7, however, is slightly different. An all-male admissions ward that houses patients with acute exacerbations of long-standing disease, it's where I've been assigned to work for these six weeks. These patients have similar stories as the ones on Ward 12, but they're not well controlled by treatment. Several times a week, there are incidents involving emergency medications for acute psychosis, injuries to one another, attempts to escape, and defiant behavior (e.g. moving furniture around at night with disregard to roommates). My patient has been - and still is - refusing to take his medication, insisting that he does not have psychiatric illness. His hallucinations and delusions are complex and concrete, like the fact that he has billions of dollars, that Mayor Bloomberg is trying to kill him, and that Magic Johnson manages his bank accounts. This is a smart man who has completed high levels of education, but his illness has taken over his ability to function in society. We learned about schizophrenia during second year, but I never imagined that it would be so recognizable and real.
Halfway through my psychiatry rotation, I'm beginning to understand the devastating reality of mental illness.
First impressions go a long way. Halfway through my rotation, however, I've realized that there is so much more to be said for this place. Up on Ward 12, the patients are prepared for living in society again after months or years of treatment. They take classes, go to off-site programs, learn how to care for themselves. They have community meetings, where they all gather and voice their opinions and concerns about life on the ward in an open forum. These are people who have committed heinous crimes in the past - molesters, murderers, drug dealers, anything you can imagine - but it truly feels like a community, and the patients are people you would want to chat with in a grocery line. Their lives have been turned around by proper recognition of their mental illnesses and appropriate (and oftentimes heavy) treatment of their diseases.
Ward 7, however, is slightly different. An all-male admissions ward that houses patients with acute exacerbations of long-standing disease, it's where I've been assigned to work for these six weeks. These patients have similar stories as the ones on Ward 12, but they're not well controlled by treatment. Several times a week, there are incidents involving emergency medications for acute psychosis, injuries to one another, attempts to escape, and defiant behavior (e.g. moving furniture around at night with disregard to roommates). My patient has been - and still is - refusing to take his medication, insisting that he does not have psychiatric illness. His hallucinations and delusions are complex and concrete, like the fact that he has billions of dollars, that Mayor Bloomberg is trying to kill him, and that Magic Johnson manages his bank accounts. This is a smart man who has completed high levels of education, but his illness has taken over his ability to function in society. We learned about schizophrenia during second year, but I never imagined that it would be so recognizable and real.
Halfway through my psychiatry rotation, I'm beginning to understand the devastating reality of mental illness.
Bronx Psychiatric Center
