Life is 1 day at a time. And thank God! I could not take much more.
—Daniel Patrick Moynihan, 1994
Begin at once to live, and count each separate day as a separate life.
—Seneca the Younger, A.D. 65
There was an ordinary day in the second year of my residency when, as I literally turned a corner walking home, I had a stunning insight: everything I had thought was brilliant intuition about other peoples’ natures, motivations, and qualities—the things that I thought would make me a "good" psychiatrist—was, in fact, just my projections, assumptions, defenses, prejudices, hopes, and beliefs.
In short, I realized that their stuff was not my stuff, except some occasional perhaps random points of contact. I also realized that I’d been thinking that my stuff was their stuff for years and years. A crisis ensued. This insight was truly disorganizing to my self, my self-understanding. This intuition thing was a big part of why I went into psychiatry (or so I thought—a topic for another day). How was I going to figure out what their stuff was? How was I going to be able to do this when I only had my stuff, my self, to work with in understanding others? How was I going to become a sound psychiatrist? (By the time I’d walked home, I’d given up on becoming a "good" psychiatrist … now I was just hoping for some semblance of competence!)
Over the years, I have come to recognize this day as one of the most important in my life and certainly in my professional development as a psychiatrist. It marked the birth of a thin, tentative, wobbly legged observing ego taking the first few steps away from the psychological safety of what is known, or posited as "known." It marked the moment when I could see myself, others, our interactions, our perspectives, our roles differently—with some emotional distance and with less investment in certain beliefs, if not wholly objectively. It was not an easy day. It marked the day when I adopted other ways of learning, communicating, knowing, verifying, and it was clearly the day when I understood the conscious/unconscious alloyed nature of "intuition." It marked the day when I actually could become a sound (or, possibly, even a good) psychiatrist.
In this issue of
Academic Psychiatry we have assembled a collection of papers on two similar themes: A Day in the Life of an Academic Psychiatrist and A Day in the Life of a Psychiatrist in-the-Making. Depicted are ordinary days of 19 people at different points in their academic development as psychiatrists—medical students, residents, fellows, assistant professors, associate professors, professors, chairmen and institutional leaders. This is our second collection of this kind—our first was the wonderful idea of Philip R. Muskin, M.D., and was published in Fall 2003 (
+1). The initial set focused on the diversity of roles of 23 academic psychiatrists, whereas this second collection looks more intentionally at these "slices of life" across the professional developmental spectrum. The pieces by psychiatrists-in-training have brief comments by a mentor or supervisor with whom they work closely. These papers together offer an interesting overall perspective on the path of becoming and being a psychiatrist.
So, as I think back to 14 years ago, it is natural to wonder why that particular "ordinary" day became so extraordinary. I really cannot say for sure. There was something about noticing things, about being open to the insight, tolerating it and its fulsome implications. I can say, however, that each day as psychiatrists we find ourselves in an extraordinary position—of being invited into the lives of our patients, of hearing their stories, and of being entrusted to intervene and to help. Each day as academic psychiatrists, we have the opportunity to work as teachers, researchers, clinicians, professional colleagues, leaders, advocates, and citizens in our society. It is clear that, for us, each ordinary day presents something extraordinary worth noticing.