![\"daniel_whitney\"](\"https:\/\/stg-blogs.bmj.com\/bmj\/files\/2016\/11\/daniel_whitney-1.jpg\")
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It\u2019s late morning; little piles of lists and notes from assessments carried out in the past 24\u00a0hours are littered between me and the PC. The assorted paraphernalia that seems to accumulate around me after a night on-call clutters my surroundings: a dictaphone, the British National Formulary<\/em>, Maudsley guidelines, and the semi-completed audit I glance at guiltily every time I find something more urgent to do.<\/p>\n The medical students enter. I welcome them and realise that I had agreed one could present a history they\u00a0had taken. I had felt guilty earlier; they had been struggling to find patients who met their tick box quota of “cases,” and I sent them all to the ward laden with suggestions of who might talk to them.<\/p>\n I listened patiently, with occasional encouragement, to the student’s account of a\u00a0patient who I knew was debilitated by her sudden onset of manic symptoms\u2014disinhibition putting her at risk of serious exploitation and chaotic thought disorder making it almost impossible to follow her train of thought. The student’s confusion about the complex terminology describing psychotic symptoms was evident; the fact that the patient had told them \u201cI am a lemon\u201d particularly perplexed them. Using my best teacher\u2019s persona, I guided this student through the confusing maze of what they\u00a0had described, using Socratic questioning to help them\u00a0find the answers to their\u00a0own questions.<\/p>\n As this student\u00a0was leaving, and I resigned myself to completing my audit, I said \u201cI hope that was useful and my explanations made sense.\u201d They\u00a0smiled slightly patronisingly, \u201cDon\u2019t worry, it\u2019s not your fault, I just don\u2019t believe in psychiatry.\u201d I thought my mind must be dulled by hours of being on-call and my thoughts distracted by\u00a0audit standards\u2014had I misunderstood?<\/p>\n \u201cHow do you mean?\u201d I asked, trying to keep a note of incredulity out of my voice.<\/p>\n \u201cI don\u2019t believe in this stuff.\u201d<\/p>\n To my shame, the only response I could come up with was an indignant, \u201cBut the lady you saw was really unwell?\u201d<\/p>\n Few aspects of\u00a0my work really vex me these days, but things that stigmatise my patients are\u00a0one of them. The implication, of course, that the illnesses our patients have are somehow less valid, less worthy of help, or simply feigned is something\u00a0we fight daily. But perhaps it was having this idea voiced by someone of the same profession\u2014a future doctor and presumably a person sensible and compassionate enough to have got through nearly five years of medical school\u2014that left me reeling.<\/p>\n It started me wondering about other specialties; how often are infectious disease doctors informed\u00a0by students that they don\u2019t believe in germ theory? Or geneticists told they don\u2019t believe in evolution? There certainly are people who don\u2019t, even medical students, but it says something about how psychiatry is viewed that it can be said to us so brazenly\u2014as if this was a fair point of view we should be willing to accept and work with. \u201cParity of esteem,\u201d an egalitarian sounding government catchphrase, felt a long way off that morning.<\/p>\n Daniel Whitney<\/strong> is a core trainee in psychiatry in North Yorkshire.<\/em><\/p>\n Competing interests:<\/strong> None declared.<\/p>\n","protected":false},"excerpt":{"rendered":" It\u2019s late morning; little piles of lists and notes from assessments carried out in the past 24\u00a0hours are littered between me and the PC. The assorted paraphernalia that seems to accumulate around me after a night on-call clutters my surroundings: a dictaphone, the British National Formulary, Maudsley guidelines, and the semi-completed audit I glance at […]<\/p>\n