I have a ton of work to do, so I thought I would be really diligent and blog a bit instead. I am in psychiatry this month (yes, I know I skipped chronicling a month; a post on that is coming), and it is interesting, in that wow-crazy-people-are-crazy way. I don't think I could do it for a living, but there's something really fun about dealing with schizophrenic people.
There was the guy who sounded totally lucid until he told us very seriously about his affair with Jackie Kennedy.
There was the lady who told us a dog was bleeding on the floor just behind us.
There was the lady who was convinced she had acid on her bra that wouldn't wash out, put there by an attacker who messes up her PJs every night while she sleeps.
There was the not-primarily-English-speaking lady who kept referring to her female case manager as a man; when the, er, discrepancy was pointed out to her, she got irritated and said, "man, woman, I don't care. She is a female man, do you see?" Well... no.
The rotation site I'm at is a nonprofit that offers treatment services to the poor, so of course meth and crack and such make diagnosis and treatment more difficult. But regardless of the etiology, my attending gave me a wonderful piece of advice for talking to psychotic (= limited or no hold on reality) patients: "If you don't know what's going on, neither do they." The lesson being, if you suddenly start wondering, "Wait, what? Is what they're talking about even real?" then chances are the patient doesn't know either. Don't make premature judgments, though, because truth can be stranger than fiction. Jackie Kennedy might in fact have been a terribly loose woman when she came through the homeless areas of the Midwest. We'll never know.
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