A Day in the Life of a PGY-1 Resident

Will

Will Rutland

My Background

Welcome! It is absolutely thrilling to have you with us here in New Haven! As it happens, I am particularly grateful for your visit, as you’ve given me a wonderful excuse to relive the joy of my own winding pathway to this exceptional place. My name is Will Rutland, and I am a first year Psychiatry Resident, here at Yale, but – like many of you – I made a few stops, before I got here.

I was born in the Santa Cruz Mountains of Northern California, but I grew up splitting time between the Pacific Coast, the Eastern Seaboard, and the Deep South. My youth was an impossible juxtaposition of the golden promise of Silicon Valley, the stolid fundaments of the Keystone State, and the abject poverty of rural Alabama. By the time I graduated high school, I was fairly certain that I was meant to be a slightly international version of Atticus Finch.

And so, naturally, I set off to complete my undergraduate degrees, took a brief detour for a career overseas, and came back for a JD. Law school taught me how to understand the structural inequities producing the greater share of the world’s suffering, and so graduation saw me on a course to fight systemic injustice. I joined the fray in San Francisco, but quickly recognized that the battle lines for social justice run squarely through the rural South.

So, I returned to Alabama, fully set – by this time – on becoming Atticus Finch, and yet not entirely certain of how best to help those most in need of helping. It wasn’t until I sat next to a gentleman, squatting on the hallway floor of a stark, under-funded HIV clinic in Selma, AL, that I realized simply arguing for justice is not nearly enough. I determined to go to medical school.

I trained in Birmingham, AL, confronting all of the barriers with which that jurisdiction is freighted. From poverty to rurality to social and cultural marginalization, I met patients staring down insurmountable challenges to simply attaining the health that everyone deserves. Nowhere was this synergy of plagues more acutely felt than in Mental Health, where the need for help is staggering and the resources to meet that need are vanishingly small.

So, I determined to pursue Psychiatry, and for a seeming infinity of reasons, Yale was the perfect place at which to train. Not only is the faculty entirely supportive of the mission of social justice, but the institution, itself, is one of the rare places in the world that harbors the resources and expertise necessary to truly change things for the better (more on this, below ☺). I am ever grateful that my journey led me here, and I hope that you will join me!

Why Yale

At the risk of repetition, probity compels me to reemphasize that Yale is an incredible place. I am not solely referring to the august history of the institution, or the soaring gothic structures of the main campus (though both of these features warrant admiration), but rather, I mean that Yale – and specifically the Psychiatry Department – represents an incredible confluence of intellectual curiosity, technical genius, and the force of will necessary to effectuate positive change. This is not a cloistered Academy. Yale Psychiatry is a community forum where expertise is shared from teacher to learner with the express purpose that our shared discovery and knowledge should work to promote the health of all who seek our care. It is a joy to train here.

Beyond this basic ethos, Yale creates the sense that there are no risks – only opportunities; the sense that passion is a characteristic to be fostered in trainees, rather than a liability to be seasoned out of learners. If you believe you can make a difference in the lab, on the wards, in the classrooms, or under the freeway overpasses throughout the country, then Yale faculty want to hear your ideas and help you actualize your vision for a more perfect solution to whatever problems you confront. You are never alone, and you are always supported.

More than anything, though, you will learn the very best medicine that Psychiatry can offer. Yale clinicians and researchers are constantly advancing the boundaries of medical knowledge, and the quality of didactics, incorporated into the residency schedule, places the Yale curriculum among the top teaching programs in the country. At the end of your training, not only will you have had the opportunity to build your unique professional identity, but you will also enjoy the benefit of the expert base of knowledge on which to build it.

My Schedule

I began my intern year on the in-patient ward at the West Haven VA Hospital. The West Haven VA is considered one of the country’s premiere VA hospitals, across a spectrum of disciplines, but - as the site of the National PTSD Center’s Clinical Neuroscience and Evaluation divisions - the mental health providers are true leaders in the VA system. The close relationship between the VA and the Yale Psychiatry faculty allowed our intern class to benefit both from the resources of the VA system and the expertise of the Yale faculty.

More specifically, my rotation on the in-patient ward involved daily care for veterans often facing a complex combination of debilitating mental illness, chronic disease and failing social support. In the face of so many challenges, I was constantly inspired by the fortitude displayed by the veterans and the skill shown by the attending physicians and care team members, in navigating these fraught waters.

After morning rounds, time spent with the veterans, daily didactics and follow-up work, I often found myself sitting down to a coffee with a co-intern, and looking over the outdoor garden labyrinth in the VA courtyard. The cases encountered on this longitudinal rotation were plenty to keep me busy, but the pace was such that there was space to process, learn and forge the relationships that will carry me through the end of my residency. Against this steady back-drop, the VA In-patient interns also staff short-call at the Yale New Haven Hospital Psychiatric Emergency Department and weekend day shifts at the Yale Psychiatric Hospital, so there was always something to keep me on my toes!

Where I Live

I live with my wife and two young daughters at the Corsair Building on State Street, in New Haven. Our building is new and boasts all of the trappings of newness (swimming pool, roof top deck, outdoor kitchen, coffee bar, dog park, etc.), but it’s best feature is the neighborhood. The Corsair is located in East Rock, which is a vibrant area of New Haven, populated by young professionals, graduate students, and young families. Of particular note, East Rock is home to several of the city’s best restaurants (including two of the “Big Five” purveyors of Apizza!), as well as the best coffee shops, wine bars, and bakery. To top it all off (literally, as it happens), East Rock also sits at the base of famed East Rock Park, which dominates the northeastern horizon of New Haven with its majestic, monolithic beauty. Overall, an awesome place to visit (and a perfect place to raise a family)!

My favorite things to do in/around New Haven

Per the above, you might imagine that eating my way through East Rock is a particular pleasure of mine, and it certainly is! Whether a traditional Tomato Pie at Modern Apizza, a Panang Curry at Rice Pot Thai, Poutine at The Order of Fries, or the No. 3 Burrito at Mezcal, I am always happy to enjoy a meal (and a nice post-prandial) in my neighborhood. But my very favorite thing to do is to explore the greater New Haven-area with my family. From apple picking in Guilford to the antique carousel at LighthousePoint Park, the girls and I have enjoyed adventures all over the county, and we look forward to many more as the seasons turn.

Final Thoughts

You will certainly excel wherever you end up in the world. The skills and talents that have brought you this far on your journey will continue to serve you well, and, indubitably, this service will lead to great things for both you and the patients for whom you care. Knowing that you are poised to make a positive impact, I would encourage you only to consider the scope: the world is beset by great challenges, the solutions to which will depend on willing hearts and minds such as yours. Know that no matter how large the task, how daunting the challenge, Yale Psychiatry has the resources, expertise and will to help you achieve your vision for positive change. It is a rare place in that respect, and I would love to tell you more about it (will.rutland@yale.edu). Be well; do good things.