Loshi Rajen is a psychiatrist in the United Kingdom.
Having returned to the United Kingdom from a vacation back to Southeast Asia, I found myself reflecting on the meaning of being an immigrant.
I found myself intensely missing the sun and the food. The general miasma of security and comfort that comes from being home. Of having access to not one but three cars with a full driving license, which, being Malaysian, is a huge part of one’s identity. Strip …
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The immigrant doctor who belongs to two places at once
I had been driving for fourteen years before I moved to the United Kingdom two years ago. Back home in Malaysia, driving had become almost instinctive. It was something I rarely thought about. But moving countries meant starting over. To continue working as a community psychiatry registrar, I needed a U.K. driving license.
Twice I took the practical driving test. Twice I failed. I could spend hours dissecting the examiner’s decisions, …
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How a failed driving test shook my confidence in medicine
A few days ago, while covering a four-day stretch of on-call shifts, I was asked to step down from my usual role as a psychiatry registrar to cover a vacancy in the senior house officer rota. I have been in the United Kingdom for almost two years now, but during that time I have worked almost exclusively in community psychiatry. Although I had previously worked in inpatient psychiatry in Malaysia, …
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Psychological safety in medicine starts with a text
A friend once asked me a question that stopped me in my tracks. Not externally. Internally. I am a highly verbal person inwardly, and while the conversation continued around me, another one had already begun in my head.
Earlier that day I had been cataloging the various grievances I believed had been inflicted upon me by another person I had once counted as a friend. After listening patiently for some time, …
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Why we need closure, and why we may not
While shadowing a senior colleague during Mental Health Act assessments in the U.K. a few months ago, I noticed something small but instructive. In his documentation for two different patients we had seen together, he referred to me as Dr followed by two different versions of what he assumed to be my surname.
Later that same day, while introducing me to colleagues who were joining us, he hesitated. Unsure which name …
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What medicine gets wrong about names
One of the hardest questions in intellectual disability psychiatry that I have found myself grappling with over the past year as a registrar in the subspecialty is surprisingly simple: Is this person in pain?
Most people assume pain announces itself clearly. A broken bone hurts. A toothache hurts. An infection hurts. The body sounds an alarm and we respond. In practice, as I have encountered time and again, it is rarely …
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Recognizing pain in autism when there are no words
At two in the morning, grief looked like psychosis.
I remember being irritated before I even saw her. At the time, I was working back home in Malaysia. The emergency department fluorescent lights were too bright, my head heavy with interrupted sleep, the air-conditioning turned low enough that the corridors felt vaguely refrigerated. Someone from the emergency department had telephoned psychiatry on call (me) requesting an urgent review of an elderly …
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The night I almost diagnosed grief as mental illness
