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From Marathoner to Miler and Inpatient to Outpatient Psychiatry

Emily S. Goncalves, MD, MBA

Disclosures

August 17, 2021

As a third-year psychiatry resident, I felt like I was blindsided as I realized I had no idea how to manage basic psychiatric needs. A complex schizophrenia case or a psychiatric consult on the medical floors…right up my alley! I can manage a patient on clozapine like a pro! I felt like this was an impressive feat that I learned as an intern.

But now, managing cases of ADHD, depression, and anxiety…I clung to my Stahl's Prescriber's Guide like my life depended on it! Of course, I know basic treatments for depression and anxiety, but managing it on my own was a new challenge.

As a marathon runner, this transition to outpatient medicine reminded me of preparing for a 1-mile race this summer. Sounds easy in theory to go from running 26.2 miles to 1 mile, but much more difficult in execution. I've run thousands and thousands of miles, but to race just 1 mile is like figuring out if I should prescribe Adderall or Concerta for my patient with ADHD. I know the basic principles, but it is intimidating to try this out on your own.

For the 1-mile race, I did have a strategy in mind and had been doing some faster runs on the track. I logically felt like I had some ability to run decently, but my nerves were overtaking this logical side.

As I warmed up for the race, I scanned my competition, and everyone looked fast! One guy told me he was aiming to break a 5-minute mile. I was wondering what I got myself in to! As I got to the start line, I made my way to the front and enjoyed the moment of being surrounded by some very fast runners. I went out hard, running under a 5-minute mile pace and quickly realized I needed to slow down in order to not crash and burn.

My goal for the mile was to break 6 minutes, I glanced down at my watch a few times and it looked like I could do it. I pushed the last 400 meters of the race and clocked a time of 5:49. I was elated to have run under 6 minutes!

This confidence in my running translated into a confidence as my potential abilities as an outpatient psychiatrist. I felt that if I could get better with unfamiliar territories of running, my mind could get equipped to handle the new challenges I face as an outpatient psychiatrist. With a month of outpatient medicine under my belt as well as studying new topics in psychiatry, I was beginning to enjoy this new world of psychiatry.

I did some more reading on psychopharmacology and ADHD and felt more prepared to take on my patients. It is still a big learning curve, but I feel like I am growing into a more competent and well-prepared psychiatrist.

Running has shown me time and time again that I am capable of more than I think I am, and it has continued to help me grow personally and professionally.

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About Dr Emily Goncalves
Emily S. Goncalves, MD, MBA, is a psychiatry resident at Delaware Psychiatric Center in New Castle. She is a competitive runner and ran for Syracuse University. She continues to live an active lifestyle and has competed in eight marathons, including the Boston Marathon. Emily hopes to share her passion for running with her patients and is interested in pursuing a career in consultation and liaison psychiatry. She also enjoys writing about her running adventures.

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