Tuesday, May 24, 2011

psychology: the patients.


Salam 'alaik.

We had our second practical lesson for medical psychology subject this morning. Today, we've been given the opportunity to interact with two patients (we didnt know their problem at the beginning), mine with moderate depression and the other with obsessive-compulsive disorder: an anxiety disorder that causes people to have unwanted thoughts (obsessions) and to repeat certain behavior over and over again for instance handwashing, locking doors or counting. We were divided into two groups of 4 and 3 members each. Our task was to make contact with them and we've been given the freedom to talk about whatever we wanted within 7 minutes.


I was in a group of three, together with Zikri and Neo. The first student was a bit nervous and didn't get enough time to prepare therefore he didn't manage to get many information which I thought was quite an advantage for me since my goal was to gain as much informations as possible related to her daily lives that allow us to make diagnosis. I would say it started a bit awkward(?) I dont know... I'm not good conversing with strangers and the fact that this lady was not a regular patient I used to see in wards made me a bit anxious. It was different compared to talking with patients in internal medicine subject, at least for me. In wards, I know what informations are necessary and would be useful in making diagnosis, for instance is it painful, to where it's spreading, what ceases the pain, etc etc... Yet talking to a mentally unstable patients made me worried and restless because they are extra sensitive and I wasn't sure what's the best way to talk to them, you know.. since we're total strangers and all. And I wouldn't have known if any of my questions made her feel offended. As we know, gaining trust from the patient is super important to ensure the effectiveness of the treatment. And good doctor-patient relationship relies on communication between them.

our supercute instructor. kekeke :p

After that, we sat on the ground and talked about our opinion regarding the activity today. The discussion has proven me that different people obviously have different way of thinking and different goals. As we went through the problems, we can see our weakness in communicating with patients. I guess I did okay, but somehow I wasn't fully satisfied with my performance. I didn't manage to gain 100% of my patient's trust. All I did was asking for relevant informations, listening to her complaints and made some remarks on that. I think I was more like interrogating(?) her. Haha. Whereas the student after me was more like sharing her experiences, giving advices and recommendations which seemed good to me-more like a consultation session. And of course, here the language barrier is the major factor that is limiting the our communication with the patients. English is not my mother tongue and the lady-my patient aint a native English speaker either. So the conversation turned out to be a bit forced *imo* and didn't come out naturally. It was hard for her to explain certain things and it was difficult for me to understand what exactly she was trying to say. One important thing that I've learnt today is that it's really uncommon for Czechs to have body contact between doctor-patient which I think is quite surprising. They usually openly display affection towards each other. But slight touch on hands, shoulders or knees are considered very intimate and they may take it wrongly. Different to our culture back in Malaysia, holding the patients' hands while comforting them is quite normal (but not between man and woman for sure! it'll be mistaken as sexual harassment).

I've always have this mindset that mentally unstable patients are disoriented, loss in their own world.. to put it simply: crazy. I've once visited a psychiatry ward in HUSM and all I could see were patients talking nonsense. But today being a medical student I could see how broad the psychology field really is. People with depression are sick too. Most of the time, we don't even realize that how serious this problem could be. I used to think that being stressful is okay, I'll just get over it later. However there are some people seem to not capable of solving this problem. This if prolonged can lead to other serious problems. Just talking about stress made me think about the activated sympathetic system that leads to vasoconstriction of peripheral vessels and later on will develop hypertension. I wont talk about the harmful effects of hypertension. I'll just leave it to pathophysiology exam later. Hehe :P

I feel pity for this lady because she found her life empty. There is no one that she can really hold on to and nobody seems to understand how she feels. The main problem is that she lost interest in things that she used to love before. Somehow I'd give props to her because she's brave enough to seek for help, i mean not everyone would admit that they are in need of help right? Most people tend to suppress their feelings and eventually are bound to succumb. Till then I didn't realize how lucky I was. I have family and friends that will always be the shoulder to cry on whenever I'm in need and I'm very grateful for that. And most importantly, I have God who'll always be there, at my highest high or my lowest low.

"And when My servants ask you, [O Muhammad], concerning Me - indeed I am near. I respond to the invocation of the supplicant when he calls upon Me. So let them respond to Me [by obedience] and believe in Me that they may be [rightly] guided."
[Al-Baqarah, 2:186]

Alhamdulillah ^^

credit: Patrick for the photos