>>WOMEN IN PSYCHIATRY: PERSONAL PERSPECTIVES

This is part of a series of biographies excerpted from the new book Women in Psychiatry: Personal Perspectives published by American Psychiatric Publishing. The book was edited by Donna M. Norris, M.D., Geetha Jayaram, M.D., and Annelle B. Primm, M.D. The book may be ordered here; APA members are eligible for a discount.

Embarking on a Career Path: Persistence, Process, and Psychiatry

by andrea m. brownridge, m.d., j.d., m.s.

As a 15-year-old, rambling the aisles of a local flea market in my hometown of Atlanta with my mother, I uncovered this Calvin Coolidge quote, laid out on Egyptian-style parchment paper: “Nothing in this world can take the place of persistence. Talent will not; nothing is more common than unsuccessful people with talent. Genius will not; unrewarded genius is almost a proverb. Education will not; the world is full of educated derelicts. Persistence and determination alone are omnipotent.”

President Coolidge’s published views reflect an independent man who was ahead of his time. In 1924, he spoke out in favor of civil rights for African Americans, denouncing a claim that the United States was a “white man’s country.” As a teenager, I never imagined the impact his quote would have on my life. As I embark on a promising career in psychiatry, today I truly appreciate the role that persistence has played in realizing my lifelong dream to serve as a physician.

Plan A, Plan B, and Back on Track
At Georgia Tech, I gained mastery of chemistry, physics, and engineering, but my grades in the biological sciences were less than stellar. Nonetheless, I was sure medicine was my future. Engineering was not part of my plan. But no sooner had I declared my premed biology major than I got the word from my mother—a physician—that I should consider a major I “could fall back on.” Sure enough, industrial engineering and its solid corollary in health systems was the perfect fold for my growing interest in business and management and my ultimate ambition to practice medicine.

I excelled at my engineering course work as I simultaneously pursued premedical course work. When I was not accepted into medical school in two consecutive years, I was very disappointed. After graduating from Georgia Tech in 1995, thanks to my undergraduate certification in health systems, I worked successfully as an office manager in my mother’s family-practice clinic as I prepared to execute Plan B—attain my law degree. I should disclose that my mother, too, is a dual-doctorate holder in law and medicine. As James Baldwin remarked, “Children have never been very good at listening to their elders, but they have never failed to imitate them.”

After completing law school and passing the bar exam, I set out to practice law for several years and sharpen my legal skills. But though I enjoyed practicing insurance defense law, medicine was a calling. After three years, I again applied to medical school. To my joy, I was accepted by Chicago Medical School at Rosalind Franklin University of Medicine and Science. Again, the first year of basic sciences was difficult, but I soon found my footing. In conjunction with my medical studies, I enrolled in a dual-degree health care administration and management master of science program. Learning alongside future podiatrists, nurse anesthetists, physical therapists, pathology assistants, nutritionists, and business people, I gained an appreciation of the academic rigors of other health care disciplines and how, collectively, an interprofessional team enhances the care and treatment of patients.

It’s difficult to say when I began to contemplate psychiatry seriously. Though my mother often said I had the makings of a good psychiatrist, I regularly dismissed it as an option, believing the field to be not only emotionally overwhelming, but also a bit boring! However, my mother had hit the nail on the head. During the summer after my first year of study, I participated in an exceptional experience in addiction psychiatry at the Circle Program at the Colorado Mental Health Institute at Pueblo. After that experience, I was sold on my future as a psychiatrist.

Psychiatry, the Perfect Fit
The Circle Program is a fully integrated dual-diagnosis 90-day inpatient treatment program for men and women aged 18 to 65 who have failed to respond to all other treatments. Diagnosed with an Axis I mental illness and substance dependence, all Circle Program patients are expected to participate in an intensive cognitive-behavioral program involving more than 40 hours a week of group therapy, homework assignments, and peer-led therapeutic community groups. I was one of two students who, with Annenberg funding, had the unprecedented opportunity to step into the role of patients in this program. As an experiential learning exercise, my tenure at the Circle Program was unparalleled.

The experience as a patient was authentic: two public phones with calls limited to 10 minutes, no Internet access, clothing quotas, no alcohol-containing personal products, and assigned shower times. During check-in, staff members remarked that I was very brave to be living on the wards. This gave me pause. But by day three, I melded into the Circle Program flow and was comfortable socializing with my peers. The range of dual diagnoses at Circle included alcohol, heroin, cocaine, and methamphetamine dependence, and the psychiatric diagnoses of schizophrenia, schizoaffective disorder, anxiety, depression, and bipolar disorders as well as personality disorders. More than 70 percent of Circle patients had an Axis II personality disorder, with antisocial and borderline personality disorders being the most common.

For me, this was where the real challenge began. As a rising second-year medical student, I was completely undone by what seemed to be acts of callous cruelty, untenable attention seeking and grandiosity, and manipulative antics. I met with the program’s medical director, Dr. Libby Stuyt, to review and evaluate my personal progress. In encouraging me to process my unique situation, she called on me to embrace the overall experience, positive and negative, and grow from it. She reminded me that if I should indeed pursue a career in psychiatry, I would be one of the few who could attest to the extreme patience and fortitude required when treating patients with personality disorders, let alone living with them. I am proud that I not only survived 30 days at Circle but also gained an insider’s view of addiction and the positive impact of cognitive-behavioral therapy in the management of disease. At the close of the Circle Program, I knew psychiatry was the perfect fit for my core values and skill set.

There is no doubt that my protracted journey to medicine was by design—just not my design. In the 32 years that preceded my matriculation, each experience, each trial, and certainly every tribulation molded me into the woman I am today and the psychiatrist I will be tomorrow.

Andrea Brownridge, M.D., J.D., M.S., is a PGY-3 resident in the Department of Psychiatry at Morehouse School of Medicine in Atlanta, Ga. She was selected as an APA/SAMHSA Minority Fellow for 2012–2013.

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