Beginnings

It's now half a week until I actually turn into a psychiatrist. Jennifer (my fiancee) and I arrived in Seattle on the 25th of May, found an apartment, had our stuff delivered on the 30th, and were finally unpacked by the 13th of June. We've had three weeks to explore Seattle and the University of Washington, and so far are greatly enjoying it here.

Despite it being a week till the start of clinical residency, I've been on payroll for two weeks in order to get a bit of a jump on research. This is a large (16-person) residency, with two spots set aside each year as "research track". That mostly matters in later years, when I start to get a little extra time that I can use for laboratory work instead of supplemental clinical training. However, waiting until then to actually start a research program would mean I'd waste a lot of time learning techniques. My hope is to use these first three weeks of June, plus little snippets of stolen time throughout intern year, to at least start climbing the learning curve and getting socialized to a lab. That also has the nice side effect of dipping me into the information stream of who's writing what grants, where the overall direction of the field is pointed, what projcts might start up soon, etc.

For these first three weeks, I'm hanging around with these folks, who might seem more appropriate for a neurologist or neurosurgeon than a psychiatrist. The trick is that their "Neurochip" technology might have some unrevealed applications in psychiatry. Without going into too much detail (although I want to talk more about this in a future post), there's growing interest in brain stimulation for medication-resistant disorders. It's a tricky field, because it raises the spectre of abuses committed during the lobotomy era. Nevertheless, given that we seem to have more problems with the medication armamentarium every year, it appears likely to grow.

My argument is that what's going wrong in a variety of mental disorders is feedback. Your normal regulation systems get out of whack, such that you're acting on impulses you normally wouldn't (mania), over-suppressing normal behaviors (depression), unable to regulate your fear responses (anxiety, PTSD), and so on. The whole point of the Neurochip is to establish new pathways (feedback loops) within the nervous system. Applied correctly, that's a powerful new tool for letting patients take some control of their own minds. It also might help resolve some very thorny ethical issues; more on that some other time. For now, I'm trying to learn as much as I can about the technology and experimental methods, so that I can plan preliminary experiments and get a little "proof of concept" going.