there really is no better way to go to the grocery store than in your own dear little car, listening to Rachmaninov’s second piano concerto, under a violaceous evening sky. better yet for the briskness of october air that greets you when you swing open the door and walk across the parking lot with a fistful of coupons and the age-old question of which kind of ice cream to buy playing on your mind. i love october. in fact, i probably love it more and more every year. often it taps september on the shoulder and dances with it for a week before spinning onto center stage in a colour-blazing solo, but this year it leapt in front of its mellow predecessor with no intention of engaging it in a pas de deaux. suddenly, it’s sweater weather.

the last time i pulled out my box of sweaters, i was in the middle of learning how to perform the head/eyes/ears/nose/throat (HEENT) exam. and just a few days away from failing my injections competency for re-capping a needle. and up to my ears in neuroscience. now every morning at 8:30 i pull out my key from my white coat pocket and let myself into the locked behavioral health unit at mercy hospital. and spend eight hours seeing patients and discussing their cases with my preceptor (a short indian psychiatrist with a perpetual grin). and it is a-w-e-s-o-m-e. half the patients stay for three or four days, but the other half have been there since i started in september. and they and the staff and i make a large, emotional, noisy family. i’ve seen patients scream obscenities as they stomp down the hall. i’ve seen patients get into fistfights over some perceived injustice at dinnertime. and i’ve also seen them comfort each other, share their spiritual struggles, and paint the beautiful pictures that line the walls.

in psychiatry, medicine is even more of an art than usual. they taught us how to give a mini mental status exam in school. they didn’t teach us how to convince an emotionally volatile schizophrenic patient that it’s really a fun game, or what to do when the patient starts doing karate moves two inches away from your face. and they certainly didn’t prepare me for how i’d feel after finally completing the exam, congratulating him on “winning the game”, and watching his face break into a rare smile as he literally danced around the room shouting “I won! I won!”

of course, there are the borderline patients who burst into tears and accuse you of not caring, the psychotic patients who yell that they don’t need to be hospitalized, and the depressed patients who have been hospitalized five times before and are brought back again for not taking their medications. sometimes it’s disheartening. but i only have two weeks left at this rotation, and it’s october. i’m determined to make the most of it.