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One appendix is just like the next, but the variations of the mind are infinite.

That's what makes the psychiatric profession so exciting, challenging and fulfilling. You're not just dealing with fixing broken bones, you're dealing with a patient's mental state. The mind affects every aspect of a person's life, from how they communicate with their loved ones to how they succeed in their job.

"It's really satisfying to see that you've helped someone in such a global way," says Dr. Chris Bojrab.

A surgeon once asked Bojrab to examine a patient who was undergoing an organ transplant. Now in her 50s, the woman had been diagnosed with schizophrenia in her early 20s. Since that time, the patient had been on various drugs prescribed by her family doctor. The surgeon wanted Bojrab to make sure the medication required for the surgery wouldn't create complications.

When Bojrab examined the woman, he found she had all the symptoms of schizophrenia. She was disheveled, made little effort to interact with him and didn't seem to connect at all with the world around her.

Looking over her history, Bojrab learned that she had had a nervous breakdown in her early 20s when she lived with an abusive husband. She was sent to hospital where she received shock treatments and medication.

When Bojrab interviewed her family he uncovered a profile that made him question whether she needed to be on medication for mental illness at all. He ordered the drugs stopped. Two weeks later, the woman returned to his office with her family in tow.

"She looked just like anyone else you'd see on the street," Bojrab remembers. "Her sister was practically in tears. She told me this is what she was like as a teenager. It was both poignant and rewarding because, sadly, she had spent most of her adult life in a [medicated] fog."

But most cases aren't solved that quickly. Patience is a virtue, says Dr. Werner Pankratz.

"If you're looking for a job where there's immediate gratification for your efforts, you'd be disappointed in psychiatry," says Pankratz, who has a private practice in geriatric psychiatry. "Most of the time you're seeing patients for months, if not years, on end."

But when the transformation takes place, it's truly gratifying. Pankratz recalls one elderly widower who had become withdrawn from life and was ready to give up. Within one year of starting treatment, he was golfing and had a new relationship with a 75-year-old lady.

"He told me life has never seemed better," Pankratz says. "You see these people before and after, and invariably the change touches not only their life, but the lives of people around them."

Dr. Diane Watson heads a hospital psychiatry department. She says there's more to psychiatry than a strong medical background and a good bedside manner.

"You have to really like working with people," she says. "You have to have tolerance and empathy. It's not a quality that can be measured. But it's the ability to be intuitive and be more empathetic, sensitive to where an individual is at."

Some of the greatest challenges for Watson have been ethical dilemmas -- for instance, when you have two patients who need to be hospitalized, but only one bed available. "You pick the patient who's not so ill and send them home," Watson says. "That's stressful."

Another challenge, particularly during those first few years, is wondering if you did the right thing. "I think I left the hospital every day with a headache," remembers Watson. "I asked myself questions like: Are they really suicidal? Should I have let them go? There's not sufficient acknowledgement of the responsibility that psychiatrists have in what can be life and death decisions."

But perhaps the toughest challenge is when a psychiatrist loses a patient -- something few openly discuss. Even though a psychiatrist requires empathy, Watson says they also need to learn to detach themselves.

"When you have your first patient suicide, you need to have a debriefing," Watson says. "You need support and learn that you have the ability to work that through."

And there are also ethics to battle in many cases. Dr. Molly Finnerty recalls the case of a pregnant woman suffering from bipolar disorder, formerly called manic-depression. Because of the pregnancy, she was taken off drugs and became very manic, refusing to eat or sleep.

"Sometimes we under-treat, we don't give women the care they need to stay well," Finnerty says. "Ultimately, that doesn't serve either the baby's interest, or the mother's."

The woman was placed back on a lower dose of the drugs. She even underwent shock treatment to avoid an increase in medication. The baby was born healthy and the mother is now in good shape.

But it's a tricky balance. In some cases, a woman with a psychiatric condition could lose custody of her child. The answer is to find a balanced treatment.

But in spite of the stress, Finnerty says her chosen field is a worthwhile one. "It's a very exciting and rewarding field to go into," she says. "There's a diversity of different things you can do and that's more the rule than the exception."