During our psychotherapy case conference this year, one of our supervisors has often quoted B. F. Steele: "Remember—you’re first of all a human being, then a physician, and only third a psychiatrist." He usually quotes this to remind the budding therapists that it is okay to not have all the answers and that most of the time, the best way to respond to patients is in an essentially human way. In my first year of psychiatry residency, I have found it a great relief that there is often no magic phrase or way of interacting that makes one "a real psychiatrist."
I made it through medical school despite some doubts that it was the right path for me. I found it difficult early on to reconcile my interests in the humanities, especially writing, with the science of being a physician. I found a place for both within psychiatry, a field that blends scientific inquiry into brain function with an emphasis on clinical excellence, including paying attention to the complex aspects of human experience. Having finished my first year of residency, I see some of what it is to be a psychiatrist. At this point, I know that I love psychiatry and look forward to work every day. I know that I make a difference in the lives of patients, in the lives of my fellow residents, and in the lives of medical students—and those things bring me immense joy. I know that each new piece of knowledge I acquire, especially the experiential knowledge gained by communicating with patients, makes me better at my job and reminds me why I chose to do this.
Despite all this, I am far from being able to articulate with any measure of wisdom what it means to be psychiatrist. The further I go, I find myself more and more humbled by what I do not yet know. The education I’ve accumulated to this point should result in more confidence, and in some ways it does, but as I learn more about psychiatry, I see just how much there is still to learn. And I’m okay with that, because the pursuit of more learning has always energized me. Soon I will begin seeing my own long-term psychodynamic psychotherapy patients, and although I’m somewhat nervous, I’m very excited too. It helps to know that this remarkable field I’ve chosen is nearly as wide as the breadth of human experience and that becoming a better psychiatrist really just means getting better at helping other people who are making their way in the world. The skills needed for this include such things as empathy, listening carefully and attentively, speaking and writing clearly and honestly, living with integrity, and offering hope to people who desperately need it. I can’t imagine a better pursuit for a psychiatrist, for a physician, for a human being.
