Sunday, August 08, 2010

Famous Titles

Dolly Parton!

That was in honor of Will Ferrell, who has a new movie out which is evidently not horrible. And now on with the post:

A patient came up to me the other day.

Patient: Do you remember my name? (Remarkably I did, since he wasn’t my patient, and I’d only met him once, at 3 in the morning.)
Me: It’s [patient confidentiality]
Patient: Good. Are you a doctor or a psychiatrist?
Me: I’m both, I’m doing by psychiatry residency right now.
Patient: So you’re a doctor, and after this you’ll be a psychiatrist.
Me: Sure.

The first thing I thought was, why aren’t my patients this friendly? I get all the cranky ones. Probably because I don’t smile they just give me the ones that never smile. My second thought was, I guess that’s a good way to describe my job.

Titles and labels are funny things. I don’t really like them, but they’re fairly important in medicine. For all of undergrad I refused to call myself a pre-med. Because anyone can call themselves a pre-med, and many do. I felt like it was a bit presumptuous to call myself pre-med, when my eventual med status was not guaranteed. Which is a bit odd, because my ego didn’t really permit me to doubt to heavily my ability to get into med school. In any case, I was not a pre-med, I was a neuroscience major.

In medical school I was perfectly content calling myself a medical student. However, I hated the title “Student Doctor.” I would only use it when my attending was standing right there. I introduced myself as Chris the med student. Inadvertently I sometimes introduced myself as just “the med student” reinforcing that we were all the same. But never Student Doctor, unless my grade depended on it.

Now people ask me what I do for a living. I feel like the most accurate answer is resident, but I realize this may not mean anything to those unfamiliar with medicine. So sometimes I jump straight to doctor, which is accurate as I have my MD. But it still sounds a little pretentious to me. Sometimes I answer psychiatrist, but then invariably they’ll want to know if I’ve been analyzing them. I deal with people who believe they have siblings in their testicles all day long; I’m not terribly interested in analyzing the person I just met at this party. And if I answer psychiatrist we also invariably get into the psychologist/psychiatrist clarification.

Now I knowingly went into psychiatry. I know that a significant portion of the population thinks psychiatrists are quacks. I had a guy ask me if I felt quack was offensive the other day. I don’t care if you don’t like my job quack-labeler. I also know that most of the population doesn’t know the difference between psychologists and psychiatrists, and that’s perfectly understandable and not bothersome. I can’t tell you much about civil engineering. And if I can explain the difference for less than three sentences and we move on, I have no issue. But too often it gets into one of these:

Person: So what’s the difference?
Me: Psychologists go to graduate school and do therapy. Psychiatrists go to medical school and do therapy and drugs.
Person: So you went to medical school?
Me: Yes.
Person: For how long?
Me: 4 years.
Person: How long do doctors go?
Me: 4 years, psychiatrists are doctors.
Person: And then you go to graduate school?
Me: No, we go to a psychiatry residency.
Person: And the doctors start working?
Me: No, the doctors go to residency also.
Person: But a longer residency.
Me: No, some are a shorter, some are longer.

On and on and on. I have no problem with you not getting it, I do have a problem with having to talk about it. But I guess [patient confidentiality] had the best way to describe it. I’m a doctor. In 3 years and 11 months I’ll be a psychiatrist. The end.

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