I was accepted to the University of Colorado psychiatry residency in Denver. It was a large group of residents: fifteen per year. I had less psychological background than the other residents, as my college major started as “Biochemistry,” and shifted to “Government.” I never took a psychology course in college, and simply had the usual six weeks of psychiatric training in medical school. I had never experienced psychotherapy, and my father had died five months before I started my residency.
The first year of residency training (immediately after completing medical school) was outpatient treatment. We were assigned one new patient per week.
My first patient was a very attractive young woman whose serious boyfriend was a nationally popular musician. He was on a small airplane with his musical group, and they had all recently been killed when the plane crashed. She sought grief therapy from me. I asked questions but had no idea how to help her. We set up a second appointment, but she never showed up, and never answered my phone calls. She either quit therapy or sought a more experienced therapist.
My second patient was a young man in his 20’s who had recently married, and was a school teacher. He reported that his problem involved driving his car. While driving, he would suddenly think that he may have run over a person; he would use his rear-view mirror to look for an injured body. He would then turn his head back to normal, but feared that he may have hit another person as he looked into his mirror (and ignored the road in front of him). So, again he looked into his mirror to view whether he had just hit someone. This went on several times: checking the rearview mirror for possible injured or dead bodies, but fearing that he may have hit someone while not paying perfect attention to his driving. He would eventually drive around the block to check whether there were people whom he had run over by accident. Of course, he then feared that he had hit someone while looking for injured people. He would drive around the block several times. He eventually arrived home. Then he would call the police to report that there may be injured or dead people recently run over by a car.
I had never heard about someone with Obsessive Compulsive Disorder, but I worked with this young man for two or three years. There were other obsessive-compulsive symptoms, and he gradually improved a little bit, likely from the typical nature of the disorder. He also started to describe some of the marital arguments. Years later, when I lived in Minneapolis, medical treatment for this disorder became available, and I hoped that he had received it.
Those were my first two patients. During the rest of my first-year residency I saw a number of patients (and received excellent supervision), but none were as memorable as my first two.