A Day in the Life of a PGY-3 Resident
Growing up on the North Fork of Long Island, New York was a privilege that I appreciate far more now in retrospect. We were located on a peninsula where a twenty-minute walk past the vineyards and sod farms could bring you from the Peconic Bay to the Long Island Sound. I grew up with sand, salt, beaches, boats, and fishing. I was the son of a loving, hard-working, but emotionally inarticulate correctional officer who married a warm, intelligent part-time medical office administrator who later ran the church school and dabbled as librarian. My teachers knew me as gifted, but challenging. Throughout high school and parts of college, I worked at a family-run hardware store, so if it’s broke there’s a chance I might know how to fix it. I was destined for a state college (SUNY Geneseo) in order to save on costs. My plan was to become a teacher who moonlights as an author of fantasy novels that were both psychologically thrilling and existentially terrifying. The part of the plan that turned out to be accurate was the psychology. I found myself fascinated by the biological bases of human experiences and of psychiatric symptoms, and how perturbations to the system could alter consciousness. A summer volunteering at an inpatient psychiatric unit shed light on how little we about the biology of an individual’s illness or why they responded to a certain treatment. Concurrent exposures to Eastern spirituality and psychedelics helped me know myself differently. I came to appreciate that my thinking mind evolved as a tool for problem solving, and when not kept in check, it tends to find or create problems for itself through strong identification with thoughts. Easy to talk about, harder to practice, especially when working your way through medical school (SUNY Upstate). I knew from the start that I was attending medical school to become a psychiatrist. In caring for others, I noticed an immediate sense of personal satisfaction, but I also enjoyed the slow burn of research culminating in discovery and a sense of being part of something bigger, like human knowledge and the effort to improve care. Hence, I pursued the MD/PhD and I was fortunate to find an outstanding mentor (Stephen Glatt, Ph.D.), who helped me develop as a scientist while working on studies of blood-based gene-expression biomarkers for psychiatric symptoms and disorders.
Yale Psychiatry for so many reasons. I guess the final decision-point was the feeling I had during the interviews and lab visits. Professionally and academically, it offered high quality clinical training that came with a highly respected and recognizable moniker. The class size and call schedule seemed to prioritize learning over patient care volume. There were several groups of researchers who were working in areas that matched my interests and they all seemed interested to have me.
On a personal level, I wanted to stay in the Northeast, because my family and friends are here. I was back on the Long Island sound, but gazing out from the opposite shore. When I walked through the woods outside of New Haven, my senses told me it was the same slice of mother nature that I knew growing up. When I compared Yale and New Haven to other programs in their respective cities, I found that this was a place that compensated residents well and allowed them to moonlight to augment their training and income. It was a place where I could afford to buy a home near the place I work. It’s a place where I don’t struggle to find a parking spot and a 20-minute ride can get me to the forest or countryside. I was never drawn to big cities, but NYC and Boston are within reach for daytrips or weekends.
As a third year in the Neuroscience Research Training Program (NRTP), my schedule is atypical. Mondays are packed with outpatient visits with Veteran’s Affairs Hospital patients who comprise my panel of twenty-six. The panel skews older (50s-60s) and male (89%), and the primary issues are mood/anxiety (50%), psychosis (25%), trauma (20%), and substance use (5%). I manage their medications and also see some of them for therapy; a mixture of supportive, cognitive-behavioral, and dynamic, based on the individual and what they’re bringing into the session. I have scheduled group supervision with two co-residents, but I can seek out more as needed. On Tuesdays, I work in the interventional psychiatry clinic treating people with treatment-resistant symptoms, some of whom are enrolled in clinical trials of electroconvulsive therapy or ketamine. On Wednesdays, my day is divided, with research time in the morning, and long-term therapy patients and supervision in the afternoon. Thursdays and Fridays I spent my time in the lab; it’s a dry lab, so picture sitting at a computer, not handling Petri dishes and pipettes. I work broadly in human genetics; recently finished a draft of a paper examining the shared genetic risk factors and for psychiatric and immune-system-related disorders. My next project involves applications of machine learning to medical record data in order to develop algorithms that can track the severity of depressive symptoms and tell us about who is responding to which treatments. Sometimes, when its crunch-time, the work follows me home in the evening or on the weekend, but that’s rare. Of course, patient needs don’t follow any schedules, so there’s always a little clinical work and communications to manage throughout the week. I manage to make it to the gym 3 or 4 times per week; in fair weather I run around my neighborhood or find pick up soccer at Rice Field. Additionally, I’ve been in my own psychoanalysis for the past 12 months (knowing myself, yet another way), so I continue to meet with my analyst Monday through Thursday. Moonlighting a few times each month has helped pay for the analysis.
Where I Live
Before starting residency, I did some home-hunting, and ultimately bought a two-bedroom condo in Fairhaven. The balcony (where I dabble in gardening) and living room both overlook the Quinnipiac River and Grand Avenue bridge; in the mornings I see sunrises from behind a tree line that has now become a patchwork of yellows, oranges, and reds as they await the frost. On the 4th of July, the fireworks show comes to me. People say Fairhaven is kind of rough, and sure, someone stole the catalytic converter from underneath my jeep after it broke down a few blocks away, but I love this neighborhood. People fishing and enjoying the park make me happy. When I lost my cat my neighbors tried to help. I have friends here from outside the medical circles and that makes me feel well-rounded. My drive takes either 10 minutes (to YNHH or downtown) or 15 minutes (to the VA).
Things to Do
COVID-19 be damned! It was rough at the beginning. Connecticut and New Haven managed to re-open the doors of businesses quickly. This past summer, I attended half a dozen open-air socially distanced concerts at the Westville Bowl (former tennis stadium; not a bad seat in the house); I made friends with similar music tastes. The restaurants! There’s a great variety given the city size. I have gone on fun outings to breweries/wineries and to do seasonal farm-related activities [berry, apple, pumpkin-picking]. We went on a lab-group outing to a super-fast go-karting place, which I found exhilarating and addictive; you may find this useful practice if you plan to contend with Southern CT drivers. I went on many cute dates at restaurants and bars. I had a blast dancing at the gay bar – I think there may be a couple of other “club” scenes, but have not explored. In fair weather, I find myself running through one of the area’s parks, sucking wind while chasing a soccer ball, or looking for my golf ball (could have sworn it went somewhere over here).
I’m happy here.