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Sample 3
Surprises provide the most photogenic moments. I have a photo where I am embracing my mother while surrounded by family members on her birthday. On that day, I had just entered a restaurant after flying unannounced from Virginia to California. The surprised look on my mother's face was priceless. From her perspective, it was as if I had "disappeared" from one coast and "reappeared" on another. Now, whenever I look back on this day, I see the picture, but always remember the story.
I have taken many pictures throughout my life, including over 6,000 pictures while in medical school, each day linked with a journal entry. Whether it is taking group photos during every clinical rotation, enjoying my first snow fall, or raising my arms alongside the famous Rocky statue in Philadelphia, these pictures highlight the different moments in my life. Though I do have a passion for photography, for me, it is not the images themselves, but the tales behind the pictures that make them memorable.
In a similar way, I have also been intrigued by the life experiences of my patients. The exploration of the mental and behavioral factors that contribute to an individual's unique makeup, analyzed from both medical and psychological perspectives, captivated my interest in psychiatry. Patient encounters became more fascinating to me when associated with the emotions, feelings, and thoughts beyond the presenting symptoms.
During my psychiatry rotation, I am reminded of Mr. X who was a 40 year-old man, with a history of severe major depression and multiple admissions for suicidal ideations, admitted to our service. Though appropriately managed pharmacologically, it was not clear why he had recurrent suicidal thoughts. I wanted to definitively understand why he was admitted so frequently. His initial "snapshot" diagnosis was borderline personality disorder, but carefully talking to this patient revealed other elements. After several individual afternoon sessions, he finally opened up and tearfully admitted that he was not truly suicidal, but instead afraid to be alone due to overwhelming grief over the loss of his wife. This vital insight provided more comprehensive information than the presenting complaints. As a result, we arranged for outpatient grief counseling. Experiences like these emphasize that, while all details may not be present initially, spending quality time with patients can lead to a clearer big picture.
Features that I enjoyed about photography have attracted me towards psychiatry as well. Both pictures and patients initially present in a certain manner, but there are underlying details that need to be uncovered in order to provide the complete story. While the presenting symptoms may appear alike, there are a myriad of influential factors that make each individual patient unique. Much like how a photographer must understand the mechanics involved in using a camera, a psychiatrist should also be fundamentally comprehend the biological factors that can influence behavior. In a similar way, just as lighting, angle, and timing can have a profound impact on the final image, distinctive life experiences can have a profound impact in molding a patient's personality. With the integration of these multiple factors, I believe I will be able to create a therapeutic alliance resulting in the improvement of their quality of life.
My clinical work with psychiatric patients supplemented by active participation in various research projects with experience in managing an outpatient practice has provided me with a balanced viewpoint of psychiatry. I feel that this is an exciting time for psychiatry, where the recent advances in pharmacology, neurobiology, and brain imaging are poised to make an extraordinary impact in mental health care. I am eager to enter such a dynamic field and face the new challenges and surprises that lie ahead. There will be many more memorable pictures. I cannot wait to see what develops next.
