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Katie Nerlino

I loved studying theories of the mind like those of Freud and Maslow as an undergraduate student of psychology. I think of psychology as my first love, in the way that it will never really leave me and will always be the lens through which I regard other disciplines, like medicine, physical science, and humanities.

Psychology has fed my interest and curiosity in the human condition. It has always felt right to acknowledge how fragile this endeavor of being human is. To learn about the vulnerabilities of it, and to serve those vulnerabilities through methods that bring to people a peace, a joy, a wisdom, a strength, a love for themselves, and a special reverence for life… that is exciting to me.

Learning about different modalities for counseling and therapy like psychoanalysis and cognitive behavioral therapy, reading through the disorders in the DSM, studying the “psyche” (whatever that means… mind, brain, spirit, soul?), it all seemed not only to be an education but a process of self-discovery, too. It is said that to serve others is to serve yourself – and this idea of being a clinician has always represented just that to me. Psych meaning “soul” and -iatry meaning “medical healing” in Greek, a psychiatrist is, then, a healer of the soul. The idea of interacting with other humans for the sake of their souls is not just extraordinary. It’s food for my soul. 

I had never considered medicine because I believed the hard sciences were not my “forte.” I felt better at English and writing in high school, but I was self-deprecatingly wrong about this. Interning at a small, private (largely geriatric) psychiatric hospital a few minutes from my house in New Jersey, I looked around on shift everyday at all of the diverse professionals committed to helping the hospital’s patients – there were medical doctors (geriatricians and psychiatrists), nurses, psychologists, social workers, occupational therapists, music and art therapists – and I realized, to my surprise, that I wanted to be the doctor. I wanted to be completely in charge of the health of these patients in every possible way that was relevant, understanding their medications, their physical pain, the nature of their illnesses, their emotional histories, their family environments, and more. I was in love with all of the pieces to health, and I had no idea there were so many. I realized that there is no serving the mind without knowing the body, or vice versa. Health is holistic. I believe there is great optimism and hope in this, too. If there are many pieces to health, then there are many angles, many ways of attack, many avenues which might bring wellness and peace.

One patient in the hospital with dementia, formerly a concert pianist, did not recognize his own family when they visited every Tuesday but was able to play Debussy’s Claire de Lune any time you put him in front of the piano. My psychology degree taught me that procedural memory, which encompasses both musical ability and muscle memory, resides in a part of the brain that is separate from other kinds of memory. A contrast to the inpatient hospital setting, I also worked at the Boston University Center for Psychiatric Rehabilitation, which comprised of outpatient classes for individuals with psychiatric diagnoses. There were exercise classes, yoga classes, art therapy classes, and classes which helped to develop interpersonal and social skills. One of the classes, called “Anger to Forgiveness,” helped patients to let go of chronic and debilitating anger in their lives in order to nurture mindfulness, compassion, and forgiveness. Many of the patients had anger towards their family, friends, and others in their lives who had let them down. They had a hard time forgetting it. The class taught forgiveness as a practice of self-love, and used breathing and mindfulness techniques.

Psychiatry became my particular door into the field of medicine. There is a very delicate and layered stigma around “mental health” – in this technologically advanced year of 2018, it is still not a household term. And the stigma is even more extensive and upsetting within medicine. Jerome Groopman says it best: patients labeled “psychiatric” are often seen by their other doctors as “neurotic, generally delusional, their physical complaints not worth taking seriously because their symptoms originate not in the bowels or bones but in the mind, [likely to get] short shrift from internists, surgeons, and gynecologists, their physical maladies often going undiagnosed or receiving delayed diagnoses.” These words form the foundation of my dream. I want to guide medicine away from stigma through my own practice of psychiatry. I believe that mental health is a spectrum and everyone is in need, at some point and in some capacity.

Despite a new path into medicine, I still think like a psychologist. I love learning about the cognitive errors doctors make, the effect of biases within the physician-patient exchange, and the wide variety of other human errors committed in medicine which muddle the healing process. (A must-read bible of sorts listing all of these errors: How Doctors Think by Jerome Groopman). As a (hopeful) doctor, I will pay special attention to these. Many new psychological studies show that the warmer and kinder the demeanor of the physician, the better the patient medical outcomes. As if feeling supported and feeling like you can be cured plays some critical part in actually curing you. As if nestled deep in the mind is a powerful access to the body. These studies seem to reveal something important about healing. In a cross-cultural psychology class, I learned that less than 7% of the world attends university. Despite different education levels, languages, cultures, religions, and civilizations (first-world or indigenous), there are universal human experiences, facial expressions, and emotions (smiling, shame, guilt, love) which transcend divides. I believe humans are exceptionally diverse but also share profound commonalities. 

Delving into the sciences at Columbia has changed the way I see the world. I am now a great lover and consumer of science, and its potential and its capability. I have since found interest in emergency medicine, trauma surgery, and geriatrics. Regardless, my foundation in psychology will always be with me. I think now more than ever we need clinicians (and women clinicians) who will bring a special sensitivity, tenderness, and “psychological 6th sense” if you will, to their practice… who will tend to the mind and the body as one.
— Katie Nerlino