Measures: A Medical Student’s Reflection on a Psychiatry Shadowing Experience

Julie started her first visit to the psychiatrist by talking about Summer, her teenage daughter, who had the warmth and hope of her name and a laugh of morning birdsong. Julie had walked into the office with narrowed eyes, a frown, and crossed arms. She was hunched over from the weight of expected failures: psychiatry failing Julie, Julie’s mind failing her, Julie failing Summer. She said other doctors used rhetoric she, a math teacher, could understand—numbers over words. She needed quantifications, millimeters and margins, techniques to convert catastrophe into concrete objectives. Between sobs, Julie begged for measures, for calculations and equations, for a list of supplies and equipment needed to scale the sheer ice wall of her mental health. The psychiatrist carved her a foothold and mapped out the dosages and time course to the summit, interspersed with questionnaire checkpoints along the way. She wanted specifics: “A few days” became “3–5,” the cloudy made clear. Julie strapped in and started climbing, taking a jagged but steadily upward course toward her summit. She visualized Summer cheering at the top. At follow-ups, each score was noted carefully with a honey-yellow #2 pencil with a chewed-off eraser, put down on paper with the gentleness of handling a newborn. At her most recent appointment, the psychiatrist told Julie her scores showed remission. Julie sobbed with relief beyond measure. With shaking hands, she documented that her numbers were down, and her hope was finally rising, rising like the numbers she’d marked with the same pencil on the drywall above Summer’s head, both of them cheering, reveling, and content to ignore that Summer was standing on her tiptoes.