Psychiatric patients can be either frustrating or enjoyable, depending on their demeanor. With six of the first ten patients I saw having psychiatric issues, I got to see both sides of the spectrum today.
First was a woman who was having dizziness. She also made it clear that she was “bipolar and a little schizo.” I wasn’t sure what the threshold was between “a little schizo” and “a lot schizo,” but trying to find an answer to that question wouldn’t have been very productive. She apparently wanted to be admitted to the hospital. When we told her that she could be discharged after receiving some IV fluid and some medication for her dizziness, she was upset. Then she said she felt suicidal. The psychiatrist knew her well, evaluated her, and cleared her for discharge. Then she said she was having chest pain and forgot to tell us. We added a set of cardiac enzymes and performed a normal EKG. The old records showed that she had a clean cardiac catheterization four months ago. We dutifully ran the case by the cardiologist who also cleared the patient for discharge. As the nurse was walking out of the room after giving the patient her discharge instructions, she yelled out the door “I had brain cancer once, too, you know.”
I looked at the nurse. She looked at me. We both stood there for a few seconds wondering about the significance of the statement. Then simultaneously we shook our heads, threw our hands up in the air, and went back to our business.
Then, there’s the lady who came in for a disappearing lump in her armpit – for the past 8 months. The lump only appeared when she rolled on her deodorant. We couldn’t find any lump on exam – even after having the patient pretend to roll on deodorant. I told the patient that she would need to see her family physician and could bring her deodorant with her to the appointment. Then I left the room to start the discharge papers. The patient yelled “hey doc, come here” to the resident, so he went back in the room. About 30 seconds later, he came out beet red in the face.
“What happened?”
“She said ‘watch this!’ then she pulled up her shirt, whipped her boob out of her bra, and squeezed it. Milk squirted across the room. Then she laughed.”
Then we laughed.
Then came the comments.
“Clean up in aisle 8!”
“It does a body good. Pass it on.”
“Somewhere in this world there is someone that would pay money to see that.”
All this entertainment and a paycheck too …
This and all posts about patients may be my experiences or may be submitted by readers for publication here. If you would like to have a patient story published on WhiteCoat’s Call Room, please e-mail me.
