Behavioral Medicine Rotation

I finished my last rotation about 3 weeks ago.  I really liked it.  I was in a center working with patients who struggle with alcohol and drug abuse and dependence.  At first I was not looking forward to this rotation, but it grew to be one of my favorites. I did not do a lot of this rotation; I mainly observed psychiatry appointments and group therapy.

The psychiatry appointments were interesting; they were either medication checks or psych evaluations.  Many of these patients who I saw in the psychiatry appointments are some of the same individuals that I saw in-group.  One thing that I realized is that a lot of patients feel comfortable in either a group setting or individual setting but very rarely both.  There were patients who did not talk during group who really opened up to their psychiatrist. 

Group therapy I enjoyed the most because you get to see a wide variety of stories and experiences.  Each person, while different from the next, over time found the similarities in their addiction and helped each other through hard times.  Many of these patients are at different stages of their treatment, each with a different substance of choice.  Many have additional documented psych issues as well or even other addictions such as gambling or retail theft. It is amazing how some of these individuals bring each other up and are able to reveal such emotional struggles to their peers.  A lot of the stories I have heard are tough to hear: sexual abuse, physical abuse, enduring the loss of friends/family, and personal experiences of being shot/stabbed.  It is amazing to see the stepwise progression of a patient in treatment. One of the quietest patients began to open up during my last week, he said "I have no money in my pocket but I have a full heart and a strong mind."  Another patient who sold drugs for years and was known to people throughout the area for doing so stated,“ How do you become someone new when you are essentially famous to all the people around you.” One of my favorite days during group therapy was the day everyone on in the room talked about their families.  Many have children.  They spoke about how they are now able to spend time with their family and put them first.  One man talked about seeing his daughter walk for the first time and say dada.

I was very sad to leave this rotation and the people who I became close to.  While I am certain that I will not be going in to behavioral medicine as a PA, I do know that I will take this experience with me when I practice medicine. Having seen first hand group therapy and psychiatry appointments I can give an accurate account to patients about these experiences and what to expect.  I also can see how much improvement it can make in someone’s life.  At the same token I have seen how many friendships have been made during this experience.  Addition and dependence is a struggle that at times is dismissed by the unknowing public.  For patients with these problems finding a welcoming community of peers really makes a difference.