Notes

Over the years, I’ve come to opine that, arguably, Psychiatry is the only field of medicine that permits meaningful conversations and genuine interactions with patients. After several such exchanges, I was often left wondering how so many of us are anxious and challenged by life, how we are thrust in this world with the instincts to survive but not the skills to live a purposeful life. Our brains are incredibly
intricate and yet remarkably fragile. It mesmerizes me to reflect on the fact that subtle changes on a molecular level can alter our perception and subsequently our definition of reality. I am often bewildered by the query – why is that despite having the necessary resources to survive, some of us choose to end our own lives? This leads me to believe that human beings are prone to enormous psychological torment, which then begs the question, why do we do so little to communicate our vulnerabilities? These are some of the existential questions I hope to answer for myself and my patients, armed with a background in Psychiatry.
My first experience with Psychiatry was when I was an intern during medical school. One of my patients had been hospitalized to the in-patient unit for psychosis. It was a profound experience to witness how severely mental illness could impact an individual’s functioning. The prospect of having a disease but not being able to pinpoint the exact location, like you would for a tumor or a bruise, was unsettling for my patient. When coupled with the fact that mental illness is still considered a stigma in India, my patient was left in an unenviable and a rather defenseless position. While shadowing an oncologist at an out-patient clinic in Houston, I saw several patients diagnosed with cancer who had developed major
depressive disorder. I thought that this concurrence must surely be a cosmic joke of some kind. What possibly could a psychiatrist do for the mood of such patients while they are battling cancer each day to see their children graduate college or their spouses frantically manage work-personal lives to care for them? As a volunteer working with the homeless population in Houston, I was dismayed to see a sizeable fraction of them with depression, bipolar disorder, schizophrenia and substance abuse. I witnessed first-hand how this under-privileged population, that faces the most challenging life conditions, is also heavily burdened with mental illnesses. I was saddened to see the chasm in the access to and the quality of care received by the under-served population as opposed to the relatively affluent patient population. I was drawn to learn more about mental illnesses and decided to pursue a career in Psychiatry. These experiences helped me cultivate an empathic approach, humility, a caring attitude and the skill of actively
listening to my patients. I realized that these values are often more important to our patients than psychopharmacological management. As a prospective Psychiatry resident, I am committed to inculcate these skills in my practice.
By nature, I have a deeply inquisitive and an introspective personality. I am enamored by the different psychoanalytic theories especially the attachment theory by John Bowlby and the works of Donald Winnicott. I am very interested in learning why different people manage and respond to psychosocial stressors differently. I am fascinated by the complex interplay of environmental and genetic risk factors that come together to precipitate the onset of mental illness. Over the last six months, I have been involved in clinical research with schizophrenia subjects in a large in-patient psychiatric hospital at Houston. My background in public health has helped me navigate the complexities of research and I have strived hard to learn more about Biological Psychiatry with three scientific papers in progress and an
abstract which was submitted for a poster presentation. I have come to appreciate the fine balance my mentor seeks between his clinical and research duties. His calm and unruffled demeanor, non-judgmental attitude and compassionate listening are the ideals I have strived to replicate during my interactions with patients. Despite working with a diverse group of patients, I have managed to gain their trust
and seeing them open up during interviews is remarkably rewarding. It is amazing see how a non-verbal response like a simple head nod or a brief interjection like “Oh! I see” can help build rapport quickly, even with the slightly difficult patients. On numerous occasions, I have witnessed the success of such a therapeutic alliance between a psychiatrist and the patient. Consequently, I have developed
tremendous faith in this process.
I’m confident about my skills and my ability to handle the unique challenges and the stressors a Psychiatry resident can potentially face. However, it wasn’t easy getting here. I had to break cultural barriers and battle with the stigma of going into the field of psychiatry because my family was ashamed to let me work with the ‘crazies’. However, involving myself in clinical research and working in the
out-patient and community clinics has rekindled a deep appreciation and a passionate fondness for the field. In my opinion, a good psychiatrist should work like a detective, collecting evidence piece-by-piece thorough careful and meticulous observation and questioning, remaining objective, and using deductive reasoning and analytical thinking to arrive at well-informed conclusions. A successful psychiatrist is one who can be a good physician, listener and a healer. These are some of the qualities that I believe I possess and look forward to apply during my residency.
Recently, there have been enormous neuroscientific advances with significant therapeutic implications for clinical psychiatric practice. With that being said, I am extremely fortunate to be alive at this juncture of time as I seek to embark upon the most enlightening intellectual voyage of my lifetime. If I end up doing a residency in your program, I can perhaps see myself getting exhausted after a long day, but I can never see myself getting bored or heading back home unsatisfied. Psychiatry is immensely captivating and gratifying. I am thoroughly committed to such a field which offers so much room for not just professional, but personal growth as well.