Thursday, October 1, 2009

Do you see things other people can't see?

A patient was in the ER the other day who had been previously labeled bipolar... and the physicians were trying to decide if he should get to go home or get PEC'd (Physicians Emergency Certificate)... basically "committed". He'd been drinking in the FQ, passed out, and was brought in by the po-po. The physicians were convinced he needed to be committed (and ultimately they were right)... but in the initial hours I wasn't convinced. At all. I mean, the guy was wacky for sure... but he made sense. To me anyway. Here's a smidge of the psychiatric interview:

(Imagine a 70 year old patient speaking really fast... and occasionally switching to gringo spanish)

Q:Sir, do you see things other people can't see?

A: Well, I think so! I see corruption, I see idiots, I see morons running our government! Nobody else seems to see it!

Q: Ok, sir do you have any special powers?

A: Yes, I have a bullshit radar! And frankly this is bullshit!

Q: Do you think you're depressed?

A: Hell yes, I'm depressed. Isn't everyone?

Q: Do you think anyone is out to harm you?

A: I'm considering your intentions right now as potentially predatory, but other than that just my brother. He only gives me $20 a week!

Q: Sir if I let you leave the hospital right now, where will you go?

A: Home! I already spent my $20 last night in the French Quarter!

Q: And how would you get home?

A: Walk!

Q: Walk where?

A: Ok, Hitler... do you want me to draw you a damn MAP? I walk down Canal, hop on the ferry, and head to Algiers.

Now maybe it's me, but the guy sounds totally fine to me. Wacky, yes. An alcoholic, yes. I don't know what committing him accomplishes... but I guess that's why I'm not a physician yet. Good thing, cause I definitely would have sent him home. Oops!

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