Another Wrong Diagnosis: Week 2

Submitted by EXP student Pankhuri Jha '13

A wise man once said that practice makes perfect. I used to believe in that phrase, until I started attempting to create consensus diagnoses for different subjects here in the lab. No matter how many times I looked over the data for each subject, saw the data from the CNB and MRI, the effort was fruitless. Every single time the patient had a degree of schizophrenia (or was on the road to becoming psychotic), I thought he was a control and vice versa. Luckily enough, Dr. Calkins and Cat did not make a big deal out of this. They said it was one of those things that took years to understand and master and that I was going to get good at it.


Although the statements were pretty encouraging, I knew I had to do something, especially in order to guide myself through things like case conferences (where subjects and their disorders are discussed). So, upon recommendation from Cat, I read all about these disorders, symptoms, onset, etc on the DSM-IV website. DSM-IV is basically a set of rules that has the checklists for each disorder (what symptoms must a person have to have a certain disorder). After that I completed a packet and met with Dr. Calkins to go over a review powerpoint to master these disorders once and for all. It  requires so much more memorization than stuff in APUSH or AP Bio (for those who know those great experiences :)). It took a long time, actually a really really long time, but hopefully I will finally be able to diagnose some one correctly!

A lot of the past week was sitting in on assessments and interviews or the NAYA, GO 1 and 2, and 22q studies. One thing I learned is that you have to pay so much attention to every move that the subject makes--because everything is significant. The good thing was that I was able to analyze subjects with varying degrees of the disorder, from an adorable little nine year old boy who gave completely normal responses, to a 22 year old man who was on the road to becoming psychotic because of his beliefs in the difference between a person and a human. It is tempting to laugh sometimes at responses that participants of the study give, but when they do start talking about a soon to be zombie apocalypse (just one example), you cannot help but feel bad and find a way to help them. Unfortunately, at that stage of the disorder, the delusions and hallucinations are difficult to cure.

The most "important" subjects, those who requested feedback and must be discussed about, or those that are very ill, are the most important topics at Case Conference, which is every Tuesday. So, I attended one today. I finally got to give my input about a subject that I observed, and it was the best feeling because everyone takes what you say very seriously. I had to be so careful about what I said and say it correctly, because patient confidentiality is so important. You must speak with the individual's initials and use all of these acronyms (that I'm still getting used to) and several medically-correct terminologies.

Making packets and copies of important documents was another task that I learned how to do this past week. Because I am dealing with human subjects, several papers about consent and privacy tasks are needed at every interview and test. And being the intern, I was responsible for creating blue, green, orange and yellow folders (all with different documents) for the clinical assessor. Cat showed me the NAYA drawer which had all of the forms necessary for all of the folders. Needless to say, there were so many forms, especially because I had to make at least ten copies of each. Actually, I had to make more than that because I had to make ten of each for the folders, so there had to be some copies left over. But organizing the folders and putting the appropriate documents in there was not the problem, copying them was. I killed so many trees, because I messed up with the copier a seemingly never-ending number of times. Even though I had a rough experience at first, it is now my job to make sure that there at least ten copies of each form in each folder! It sounds like a small job, but all of these forms are so important to have, before someone in the office gets sued.

I also observed what is called a PsychoPhys today but since this blog entry is getting way too long, I will write about that this weekend. The subject I observed looked just like Ian Harding from Pretty Little Liars, so it was a great test to do for 3 hours :).  Also, tomorrow I will finally observe an MRI (those colorful pictures of the human brain!) and go through CNB training, so that I can finally administer the tests to actual subjects. Finally, Dr. Peretz will come and visit on Friday so I cannot wait for that!

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