A Good Psychiatrist

“Do you want to be a good psychiatrist?”

When Dr. G posed this question to me, I was a senior medical student on the last day of a month-long elective on the inpatient pediatric psychiatry unit. I knew by then from Dr. G’s teaching, and from his demeanor, that his questions were often not questions. They were, instead, buckets, drawing from the dark wells of patient stories to make the unknown known, the unseen seen.

Do you want to be a good psychiatrist?

On the first day of this elective, I had been flooded with anticipation. The reason I had pursued medicine at all was to be a pediatric psychiatrist. My attending on that first day was not Dr. G, however, but Dr. B, though he was scheduled to be out the remainder of the month. Brimming with the naiveté and starry-eyed hope of all medical students, I asked Dr. B, “How do we help these kids?”

“Meds!” His sharp answer drained me.

Do you want to be a good psychiatrist?

When I met Dr. G, I was skeptical. The white, loose skin around his aging mouth gave him a perpetual frown. During morning team rounds, he reviewed the list of patients he’d inherited from Dr. B. One of them, a patient I’d been assigned two days earlier, was an adolescent who’d been admitted after an explosive fight with his parents for sexual involvement with an older person. Dr. G’s frown deepened as he murmured aloud Dr. B’s opinion of my patient: “Future cult member—needs Abilify . . .” He let out a quiet sigh and said to no one in particular, “That child doesn’t need Abilify.” He zeroed in on me. “He’s your patient. Let’s talk to him.”

Dr. G’s manner with my patient was pensive and gentle. I still recall how he placed an ankle on his knee and leaned forward in his chair as he listened. He was rapt, focused.

Later, on the last day of my rotation, his question sank in:

Do you want to be a good psychiatrist?

“Yes,” I replied at once, as my heart beat a thousand yeses.

But Dr. G offered no advice. Instead, he drew from within me a prophecy that drowned out my inner critic as I matured into a resident, then a fellow, and finally an attending:

I want more than anything to be a good psychiatrist.

Fourteen years later, I still cling to his response: “Then you will be.”

Becca Baisch
Minneapolis, Minnesota