Emotion ruins algorithims

He was finally licensed. He had fancy letters dangled next to his name,Dr. and M.D. The fancy letters meant he could diagnose those struggling with mental health issues and prescribe appropriate medications to them. It was a good profession in a lot of ways.

What he did not realize was his initial naivety towards his patients' ultimate needs. Of course, he had dutifully studied for all his exams and passed each of them with flying colors. The real world was not so kind and awarding though. He had become a psychiatrist because he really didn't know what else to do with his life. He knew he had a knack for the medical field and he was good with memorizing and following rules. That was no different than virtually everyone else in his graduating class.

Growing up, his mom had some mental health issues that were appropriately dealt with through small dosages of various medications. He enjoyed watching her take the pills because he knew they were helping her.

So, he had some respect for his profession that came with personal experience, and he had knowledge that he would be helping at least some people mitigate some issues that they could not get rid on their own. It also paid well - he had tons of medical school debt.

His job was very demanding almost instantly. He first had to shadow his boss and learned his daily duties that way for about a month. He was struck with how quickly his boss could diagnose and then determine the appropriate medications with confidence. She was a veteran in the field, but he immediately worried that it would take him way too long to get that good. He knew it was unwise, but he hoped that he would be naturally gifted and able to diagnose with speed and ease.

After shadowing, the training wheels were expected to come off. He had already expended significant time in clinicals, in which he practiced meeting and diagnosing patients under close supervision. He passed them with flying colors back in med school given his affinity to follow rules. He didn't develop rapports with patients he would only see once to pass a class. He could still seek guidance from his supervisor after leaving the shadowing leave, and he most certainly did.

Random patients would matriculate into his office every weekday, from 8 to 5. It was exhausting. Since he was new, he hadn't built a rapport with these patients or had time to intimately understand their medical needs and history. Many were in obvious distress, and he felt a strong need to mitigate that stress but with little information.

It was like almost like speed dating. He had to make quick notes of his new patients' appearance, dress, and manner of speech. All of that was just as important as the substance of the conversation. He would ask them questions, listen to their complaints, and make quick notes.

Caffeine was not enough to sustain the rigor of this daily exercise. He went home mentally exhausted each night unable to read for enjoyment.

Within a few weeks though, he noticed patterns within some of the patients that helped him connect the dots to their appropriate medication needs. Some of his patients were in dire need of help, so he saw them either a few times a week or at least twice a month. They were diagnosed with SMI, or seriously mentally ill. He was in the trenches each day.

He would build a rapport with most but only clinically. He was certainly not supposed to become friends with his patients. One of his patients became almost obsessed with his approval, so he made sure to tone things down. He was aware that some of his patients lacked strong friendships, or friends at all, and some of their family members had abandoned them. He understood their need to be understood, so he listened to all intently.

He found that his patients disclosed more information once their comfort levels with him increased.

The new information was always critical. Sometimes, he would realize the patients' true diagnosis after a few sessions because they shamefully withheld certain key symptoms. He was taught that that was normal and to be expected in medical school. He tried not to show any signs of surprise or concern on his face whenever it happened. He wanted to blend in the background as they spoke.

A few months in though, and this was all starting to feel repetitive. He learned quick. He would also fill and re-fill constant prescriptions robotically. Some patients clearly were not taking their meds purposefully, while others lacked support systems to help remind or motivate them. He had job security forever.

He felt compassion towards many of them though. Trauma may have caused their mental health issues, which required more intensive approaches beyond mere medications, such as therapy.

He wished he could offer more tangible help, besides just a pill. But his job was confined to the pill. Nothing more. But at the same time, he felt a great weight of importance. His title offered him an opportunity to transform lives.

His boss maintained the robotic approach and he didn't dare question her. But he wondered whether his other colleagues felt the same way he did. Some had been practicing for years and he noticed that they exhibited a general attitude of detachment towards their patients. So maybe they were too far gone to ask.

He figured it was how they survived the profession and maintained a healthy mindset. Leave work at work and emotions at home. He felt ashamed for judging them. This profession was supposed to be clinic and sterile.

Emotions ruin algorithms.

But he couldn't really ignore his thoughts forever though. He had a young male patient come in who just seemed lost. This poor patient had a rough childhood, which led to some mental health issues as he hit his 20's. Over time, a deeper conversation ensued.

"Are the medications working?"

"Yeah. But they only help alleviate symptoms. They don't give me a sense of purpose."

"That is a really good observation. They aren't magic, though very helpful. What do you feel that you're lacking?"

"Purpose."

The psychiatrist felt an epiphany brewing.

He continued his usual regiment with his patients, but aimed towards asking about their intended purpose in a variety of areas- medications, therapy, life, career, family, goals, future, finances, etc. The list goes on. This may seem like, duh, he should have been doing this all along, but it was not the orthodox approach and none of his colleagues were practicing this way.

He was no longer under close med school supervision that required checking certain boxes everyday with precision. Now, he could understand the humanity behind his patients. He could get a feel for why they were in his office. He could build a rapport, which led to more substantive conversations and treatments. Heck, he was carving out his own way to help his patients that could be empowering.

Funny how medical school did not teach him this important lesson. Sure, he was still repetitively filling prescriptions, but he was more than a pill.