Chester Bennington was the lead singer of the American rock band Linkin Park and was 41 years old when he took his own life in July 2017. The funeral was held on the 29th and displays of affection, sadness and surprise inside and outside the world of music followed one another during the following months. Aitzol Miguélez was in Oviedo, preparing for the MIR exam at an academy in the city, when it happened. He already knew that he wanted to pursue psychiatry, but Linkin Park was his favorite group and the news of Chester’s suicide shocked him so much that he reaffirmed his decision. He is now 28 years old and a fourth year resident (R4) at OSI Araba; Specifically, he works at the Santiago headquarters of the Álava University Hospital (HUA), in the city of Vitoria. Olga Iglesias is 26, is a resident of the same hospital and was still in the race when the singer’s death was made public. He is R1, still a first-year resident, but in September he will leave his position to the newcomers and will become R2. Aitzol began his career as a psychiatric professional before the health crisis of COVID-19 and ends his journey immersed in it. Olga has not known any other way to exercise. When it started, in September 2020, six months had already passed since the start of the pandemic in Spain.
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For both it has been a period of change and adaptation, inside and outside the service, and they have had to promote personal care to be able to apply it later in their work. “It has been a more difficult time than when I started the specialty, because it has meant many changes. We have had to adapt consultations and the telephone and online have been greatly enhanced,” explains Aitzol. Giving up personal attention has been one of his challenges: “In psychiatry, face-to-face contact and non-verbal language give us a lot of information. It is not just the speech of the person in front of us. It is to see how he dressed, in what state is coming, what do your companions comment on “. To this has been added the concern within the service itself, especially during the months of confinement in March and April. “Attention dropped a lot. We knew that seriously ill patients were still there and we had the uncertainty of knowing how they would be at home, because many day centers had to close,” recalls Aitzol. To their “surprise,” the patients with the most severe disorder “endured confinement better than expected.” The wear, in patients and personnel of the psychiatry service, came later: “Pathologies, adaptive disorders, anxiety, depression … conditions congruent with the moment in which we have had to live have emerged”.
In psychiatry, face-to-face contact and non-verbal language give us a lot of information. It is not just the speech of the person in front of us
– fourth year psychiatry resident at OSI Araba
In Olga’s case, the loss of presence is added to the mask during interviews with patients. “It seems silly, but when we cover the face, the expressions of the patients and the closeness are lost. It is like putting a barrier in the middle of the communication. Nor can we touch or shake their hands, which we could do in another situation. It’s an added distance, “says the first-year resident. Leaving the university, the MIR and starting to work as a doctor in a year like 2020 has been “weird”. “Very weird,” Olga insists. She should have joined the psychiatric service in May last year, but the epidemiological situation postponed her entry and that of many other residents until September, when she had to join a unit “adapted” to the pandemic. He had no “formed idea” of what his entry into the world of medicine would be like, but he had expected a “closer contact” with patients and their environment. Now, almost a year later, the Álava University Hospital has recovered “practically all” the face-to-face consultations and Olga and Aitzol’s work is a little closer to “normal”.
Another key aspect in Aitzol’s last year of residence and Olga’s first has been taking care of her own mental health. Dedicate eight hours a day, more if they had a guard, to that of others, but find a space for their own. For the R4, it has meant “learning” as a future assistant doctor: “Tense situations are already experienced, and COVID-19 has made us more tense. It has forced us to reinvent ourselves and accumulate added stress. To do half-hour interviews with the PPE on. They are very different experiences that stress and force us to do our own work on a personal level. ” Also the service as a whole has been worn out. Aitzol explains that “many have been infected”, others have been hospitalized and have had to take care of each other. “If you don’t take care of your own mental health as a professional, you will hardly be able to help others. The group has been very resilient and we have helped each other,” he emphasizes. The way they have been cared for is similar for both residents. Olga has chosen to look for “moments to stop” or to do what she likes and her body asks of her. Alone. “Listen to me and find moments only mine,” he says. Aitzol mentions physical activity, eating well, and “looking for personal islands of pleasure” every day. He emphasizes that not all care should be derived from the pharmacological: “They are a very important crutch on which someone relies, but they are not miraculous nor will they be responsible for a complete improvement, nor for a worsening. They help, but there are to do more things. ”
Tense situations are already experienced, and COVID-19 has made us more tense. It has forced us to reinvent ourselves and accumulate added stress
– fourth year psychiatry resident at OSI Araba
After a year in which 6.4% of the Spanish population has seen a mental health professional, according to data from the Sociological Research Center (CIS), the two residents of the HUA psychiatry service consider that they do You can get a positive note: mental health in the media spotlight. “I hope it lasts, although there are times when I am somewhat pessimistic about it,” confesses Aitzol. For him, it is an issue “that has been around for many years”, but that “tends to cover itself up” and that “realities such as suicide or drug use” are not discussed. “That which is not talked about does not exist. It is important that people make contact with it,” insists the almost assistant doctor. Olga also believes that the “taboo” has begun to be broken, but is not sure if it is a real change.
One of the places where Aitzol has noticed it the most is in the hospital itself, where there is “a very important stigma among health professionals” in mental health issues. “With the pandemic they have come into contact with it. Many have had anxiety and insomnia problems. We have created special programs to support ICU or emergency physicians,” he explains. Remember that many colleagues came to the service “affected” and “have experienced for the first time what is an anxiety attack.” “Before maybe someone came to the emergency room with an anxiety crisis and they did not give it as much credibility or it was minimized, but by living it in their own flesh they have realized that it exists. We have to continue working so that the wheel that has started on mental health keep spinning, “adds R4.
Would they choose the specialty of psychiatry again after the last year? A resounding yes from Aitzol and a resounding yes from Olga. “My emotions and the experiences I have had during the pandemic have helped me to improve as a professional. I am a better doctor,” believes the first. “I am very happy with my decision and if I went back I would choose psychiatry again”, concludes the second.