Admit it, you’re crazier than your patients.

Last night I was working on a blog using pictures of the recent events, just the day to day stuff, recorded with my camera.

I was almost done when the power went off and I lost it all. >< Just for that, you won’t see the pictures…

Okay, maybe later.

Okay, here’s one. I present to you: My dog’s girlfriend.

Yesterday was a good day for him. He got laid, a lot.

We’re waiting to see if a baby Zeus is coming out from all this.

Today though, it wasn’t such a good day. For me, not for my dog. He’s still happy.

I started my psych rotation this morning. It wasn’t good.

I’ve been doing great lately, and I went to work today, a little late, but ready to go.

I ended up speechless, irritable, and on the verge of tears.

Two years ago I took my undergrade psychiatry class. I’m very interested in the field, and I thought it would be great and fun to be part of it.  I didn’t get to feel that interested, and it was definitely not fun; instead, the whole thing ended in me having a panic attack and taking a 6 month break.  I could not stand it to be inside the hospital, I was overwhelmed and anxious all the time.

I remembered feeling bad, but I didn’t really remember.

I went in the mental unit again today all innocent. This time as an intern, not a med student.  I found out I had 12 patients assigned; the first one was a 19 year old manic depressive experiencing a mixed episode. My mates told me she was very interesting. She was incredibly chatty, social, and loud. Learned my name and walked around talking about how pretty I was, and how pretty the other nurse was, and how hot the other guy was. Otherwise she was normal, she paid attention to you, and her speech, although fast and high pitched, made total sense. She was talking about how she was the best student, and how she graduated high school, and how she was now taking a 2 year course in accounting, and talking about her boyfriend and how she loves him and lives with him. I wrote in my report that she was pretty stable, although I kept reading the previous notes from just yesterday that were about her getting naked and screaming in the middle of the room, and attacking other patients. Her apparent improvement didn’t last too long today either; just an hour after we had a long chat about her life, she went screaming in pain, crying out loud and yelling inchoherent stuff; later cursing her horrible mother and using a very varied set of swearing to describe how stupid university was for having rejected her.  She couldn’t stop it, and other patients were getting upset and agitated. Later she went on attacking them, so she had to be sedated.

I was very disturbed to see this, even though I know that can happen.  Maybe it’s because I see this girl around my age, with a huge potential, having her life taken away from her because some brain glitch.  She’s been under lots of different sets of medication, but nothing works and they’re planning to do ECT next week. That alone got me into a depressed mood, and helplessness, and fear. But I had to keep working.

My internship mate had already finished her 13 patients (talking to them, writing the evolution note, and prescribing today’s meds). It was 8 am already. I had only half a note about the girl. I wondered how my mate was able to review all the patients in such a short time. Maybe she just didn’t give it too much thought. Or maybe it was me.

12 patients. One worst than the other. Some tied up and sedated because of agressivity, some crying and praying on the floor. One practicing “Karate”, because he was expecting to fight the devils and spirits.  And some aliens, too.

Guy– Do you ever read the bibble?

Girl– I’ve only read the first chapter, and the last one.

Guy– Uhh, they say that if you read the apocalypsis part from beginning to ending, you go nuts!.

Girl– Oh, really. Well, that must not be true, because I read it, and I’m just fine.

Guy– Yeah, me too!

I felt really bad and guilty, as I fell on the floor laughing.

Minute after minute passed and it was getting worse. I started pulling my hair and bitting it, and getting shivers. I was still writing their evolution notes. It was 10 am and I had most of the manic ones saying hello to me and asking me stuff, and talking, and talking, and talking.

The things they were saying didn’t make sense. But I think it was more because my brain was started to disengage. Or so I felt. I was angry, sad, desperate at the same time. I was aware of it, and I was trying to calm myself down and wondering why I was reacting so bad.

The attending psychiatrist came at 10:30. The nurses then started pushing me to finish my notes, and everyone kept talking. I was speechless. I was writing. “The patient is getting worst”, “does not respond to medication”, “the patient is better, he just sleeps all day and doesn’t attack people anymore”, etc. I got the intense realisation that none of them would ever get better. They would just calm down, and go back to their homes, or the street non-agressive, but same as fucked up, until the meds end and they can’t fill the prescription because of stupid administrative issues, and come back to the hospital a few days or weeks later to repeat it all.

I couldn’t even write anymore, and I felt people pressuring me to finish. One nurse went to me and told me “The doctor has finished reviewing your partner’s patients, yours are next.” I saw myself shouting “Leave me the hell alone! If she in such a hurry, it’s her problem, and in any case, she can come and finish the notes herself. She’s the attending damn it!“. She just went away with a confused gaze, and I was going “what’s going on with me…”. At some point I was mean to the patients too. I just wanted to be left alone. I wanted to storm out, to use one of those syringes and give myself some midazolam + haloperidol and just stop thinking. I was cold, and I felt like everyone was staring at me and thinking I was crazier than everyone of them; after all, there I was, hyperventilating, staring on a fixed point, with an expresion in my face like I wanted to kill someone. My hair was full of knots, and my lab coat was stained with fruit salad.

Somehow I managed to finish my notes. But I didn’t speak anymore until I was out. My internmate presented my patients because I just couldn’t talk. She noticed I was acting strange and tried to calm me down, but I really wanted her to shut up.

At some point I really thought I was losing it. My attending is also my psychiatrist, I was sure that in any second she would come in and see me and have me go into the patients area, and I’d be in there in my pjs, staring at the infinite to never be seen sane again.

“Bed No. 22. Vanessa Rojas. 21 year old. Treatment resistand schizophrenia. Subjective: Delusional, she thinks she’s a med intern. Wears an stolen, dirty lab coat”

It’s noon now. I heard my dad, and I really thought that was it. Voices.

But it turned out my dad was really there, my family was at the hospital visiting a friend’s husband who got shot this week.

They were acting normal to me, and then my mom told me “hey, you look good today”. She never uses sarcasm or anything, so I was incredibly confused.

I looked in the mirror inside the car; my hair was nicely tied, my face was relaxed and my eyes were open and live, my clothes were clean, there definitely was some small fruit stain from breakfast though. But that’s normal in me.

Nothing wrong was going on. I wasn’t going to end up in the hospital. It was all part of a panic attack.

5 minutes later I was alright, having lunch and back into normal.

I’m still scared of what happened. I have to go there everyday for the next 2 weeks. But I seriously, seriously don’t want to experience today all over again.

Maybe I just need to get used, and stop trying to empathize. But then I’d be like all the rest of them. Those people I despise because when I was doing bad, they seemed not to care much, and just wanted to write a diagnosis in a paper and a prescription. And they look at you like they were not even seeing you.

It’s probably just a defense mechanism they create to avoid madness.

Two weeks.

Wish me luck.


2 thoughts on “Admit it, you’re crazier than your patients.

  1. Hey, When I was on that rotation many years ago, me and the manic patients sat up all night and played music. Only difference for me was I was able to find a job. As we say in bluegrass, this bipolar ain’t half bad.

    Come visit me at the first physician bluegrass fiction writer’s weblog.

    Dr. Tom Bibey

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