Wednesday, July 05, 2006


We Both Know That I'm Training To Be A Cage Fighter

In typical fashion, I've abandoned my blog after two posts. This is not for lack of ridiculous topics to write about. On the contrary, I have so much good material that I'm at a loss as to where to start and I fear that my post could turn into one of those marathon posts that seem hilarious at first but quickly degenerate into tedium, and you feel obligated to finish them because you know how much time I spent writing it, but really, you just couldn't care less anymore and you'd like to move on the other websites you haven't visited yet today, such as your 14 year old niece's myspace page and Tim Gunn's Project Runway blog. Perhaps, though, since I'm now facing five days off, I can write in short bursts about the hilarity of my life over the past few weeks.

We started out orientation for psychiatry with a day of CPI training. Most specialties are required to receive training in advanced life saving techniques. For residents who will be interacting with adult patients, this includes a two-day Advanced Cardiac Life Support class, which features a young instructor wearing a pink and purple vertically-striped technicolor dreamcoat and a diamond-studded crucifix around his middle finger who calls the ladies "Hun," and claims to have a "wife." (Were it not for his blatant, nonstop sexual harassment of the females in the group and his out of place references to Jesus during scenarios of pulseless electrical activity, I might have found him charming.) Pediatric residents have several variants of life-saving training, including PALS (Pediatric Advanced Life Saving), NALS (Neonatal Advanced Life Support), and the recently-added FALS, which the conservative-leaning AMA has now instituted to teach residents how to resuscitate the nonviable fetuses mercilessly murdered by the OB residents down the hall. For psychiatrists, though, all of this is largely irrelevant, as everyone knows that we don't actually care about saving lives and are just in it for the sweet leather chair and the possibility that LSD might someday be reinstituted as a psychomimetic and we would get first dibs. We are concerned, however, with the possibility that our patients will one day attack us or even attempt to kill us. (This is actually in many ways a complete falsehood. While psychiatric patients are slightly more likely to commit acts of violence, the base rate remains extremely low and most psychiatrists are never assaulted during their careers.) For residents, the chances of injury seem particularly high, as studies have demonstrated conclusively that patients are more likely to be violent once they realize that their doctors have absolutely no idea what they are doing and no business wearing a white coat. In light of all of this, psychiatry residents are required to receive training in CPI (I actually have absolutely no idea what this stands for, despite having attended a day long class. I was going to go get the brochure from my closet and look it up, but I decided that it would be a colossal waste of time. I'm pretty sure one of the words is "crisis.")

I had very definite visions of what CPI training would entail. To start with, I imagined the training space would in many resemble Rex Kwondo's dojo, and that the instructor would be wearing the requisite zoobas. I envisioned lots of blue and red mats arranged on the floor and I figured we would be given complimentary bandanas with the Japanese rising sun emblazoned on the front. I had glorious visions of finally learning how to execute a standing dropkick and an arm-drag-takedown. Needless to say, my dreams were crushed almost instantaneously. I arrived first, at 8am, to find a short 60ish woman with curly red hair wearing tan slacks and a pink blouse standing behind a podium attempting to launch her Powerpoint presentation. I find it a bit disconcerting that we've arrived at a moment in history where self-defense training is taught via Powerpoint. Once the remaining members of the intern class filed in, we were treated to a five-hour lecture on patient safety procedures, which featured a riveting video news program which was second only to that featured during Day 2 of ACLS. (On Day 2 of ACLS, during a video about acute stroke protocol, we were all stunned to find out that stroke victims frequently lose the ability to properly use articles and begin speaking with a vaguely offensive Japanese accent, as in the following dialogue: Daughter: Mom, what is the matter? MOM: I havin' stroookkee.) The CPI video did not include any racist impersonations, though it did make use of state-of-the-art stick-figure digital rendering to further demonstrate specific moves. Finally, after lunch, we were given the opportunity to practice on each other. I can safely say that if any of us gets attacked by a patient, we will most definitely get our asses kicked. Even something as simple as escaping from a wrist-lock was a monumental task for most of the trainees, and it's clear that we won't be fielding any winning intramural teams in the near future. I am in no way exempting myself from this criticism. I couldn't figure out how to escape from the hair grab and I don't even have hair. I did get bonus points for having "Excellent stance technique," which was a total accident as I wasn't paying attention when the instructor yelled freeze. Apparently you are supposed to stand with both hands at your side, palms flat, which everyone knows is by far the most awkward position to stand in and nobody could possibly last more than 10 seconds like that. (My preferred stance involves one hand in my back pocket and the other holding a gin-and-tonic, but the instructor said this was "a bad idea.") In the end, nobody died, and we all left feeling a little more terrified about our chosen profession.

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