When a Residency Feels Like a Chance to Catch My Breath

Returning to residency in mid-2006, I felt enriched to have the perspective that came from my time at war. I considered myself extremely fortunate to only have the minor scars that I do for the irreplaceable personal and professional insight that I gained.

I remember discussing with a fellow resident some of my thoughts on perspective and utilizing my memories of hardship as an emotional armor. I will always remember that she confidently told me that it would fade.

Additionally, it was a luxury to finally narrow my focus to the specialty of my choosing. I wanted to become a psychiatrist and I knew that I had seen enough blood and guts for one lifetime. I realize that others have a greater appetite for such things, but my stomach was full. The steady stream of casualties that were Marines and Sailors, whom I knew and had served with, led me to adjust my aperture to focus better on the mind. Lastly, I hoped that my experience would forever guide my empathy for the unique experiences of combat deployments. My experience would also direct my vision for an individualized and optimal path to recovery for those affected by war’s invisible wounds.

Immediately upon completing my psychiatry residency, I was presented with an opportunity to deploy to the NATO Role-3 Hospital at Kandahar Airfield in Afghanistan. The use of the word opportunity may seem ill chosen, but as I had discussed in some detail prior, it was truly just that—for both selfish and altruistic reasons. Selfishly, it presented the opportunity to massively decrease the uncertainty that loomed over me as well as to further show my colleagues and future patients that I had the credibility that comes with not giving into fear. Altruistically, helping Service Members—as far forward as possible—for me, is the height of gratifying work.

Not to diminish the value of the work I have done with all my highly deserving patients, but I cannot compare the psychiatry that I practice within the comfort of my office in the lovely San Diego area to the work I have done “forward.” Actually, there is a never-ending continuum of “forwardness.” As a Psychiatrist on a large and relatively secure multinational base, I was hardly “forward” compared to the Navy Corpsmen and Army Medics who rendered their care under the same fire that took down their brothers in arms. But, to be “in country” with the Service Members whom I would care for was something that I knew, from my time with the Marines, was an unrivaled therapeutic opportunity. All the therapeutic work that will be done and the therapeutic alliance which may develop (delivering care forward) rests on the foundation of the patient’s understanding that the provider has come to them; he/ she has placed him or herself in harm’s way to be with them, to access them and to treat them. This foundation underlies much of the successful field psychiatry and accelerates the course of recovery.

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