Diagnosing One's Identity

I have started my psychiatry clerkship and I think I'm in love.

The staff is nice, funny, accommodating, kind. The physicians are crazy in their own way. The patients, well, the patients are all fascinating--there's something so complex about mental illnesses that makes it hard to reduce any one person to simply medicine alone.

And yet, with my patients, I feel like I keep reducing them to their diagnoses.

We are always told that patients are people--that we are treating them, not their illness. But with mental problems, the person is their illness because, well.... hmmm....

What is identity? It is the way we interact with our environment. It is our behavior. It is our thoughts, are consciousness. It is who we see ourselves as. It's what comes to your mind when you're asked to define yourself. Throughout college I told people I was "biracial, bisexual, and bipolar," because 1) I liked the way it sounded and 2) it seemed to partially capture the fact that my entire life I've seen myself as someone stuck in a huge gray area between the black and white poles of the various identities constructed by society. Definitively nothing, unquestionably everything: Elora Kathryn Apantaku.

But back to psychiatry and patients and their identities. I didn't realize how chronic most psychiatric disorders were. A lot of the older patients--in their fifties and sixties--a lot of them have been suffering from these illnesses--manic depression, major depression, schizophrenia--for decades. Their lives are so strongly influenced by their diseases... and although medication and therapy can help them stay out of the psych ward, their presence on the floor argues that they are doomed to continually function in a way that is maladaptive--either to their family, their friends, or to society.