How would you behave?

A multiple choice question:

You want me to pay attention to you. How would go about it?

A) Ostentaciously clear your throat
B) Broadly gesticulate
C) Say, "Excuse me. Might I have a moment of your time?"
D) Break the plastic cover of a ceiling-mounted fluorescent light, then hold a piece of it to your neck

If you answered D, than you are very much like a patient I took care of recently. I admit the question was vague, what I should have asked is:

I've spent the day mostly looking after just you. It's getting close to bedtime and you are resisting the fact that the communal dayroom closes at night. After a sequence of pleading, bargaining, and threats from you, I conclude that this behavior is attention-seeking and inappropriate. I tell you, "You don't have to go to sleep, but you need to go to your room and be respectful of the other patients trying to get to bed." Then I disengage and walk away. How will you get me to pay attention to you?

Put that way, what other answer could it possibly be but D? Such is the logic of the troubled I guess.

Fun with Spanish

Yesterday in my Spanish for Healthcare Workers class I cracked myself up by composing this sentence:

El bebe el bebé.

Translates as "He drinks the baby." From the perspective of today I realize that I'm stoopid, but dang it was funny yesterday.

Alpha male alert

A little while ago I encountered a new kind of patient. I've seen the incredibly depressed and disheveled, the haunted schizophrenic, the mile-a-minute manic, but this was my first bipolar young turk. The testosterone coming off this guy could stun a rhino (and Barry Bonds). Shirtless push-ups in the dayroom? Sure, why not. Hitting on every female under the age of 50? Of course. Ostentaciously adjusting his package? All in a day's work. Yeesh. I had to have the "it's not appropriate to discuss your sexual conquests here" conversation with him twice.

The kicker was he's tremendously hot. Seriously, best-looking psych patient I've ever seen. How annoying is that? At least he wasn't hot and even-tempered without a trace of grandiose delusions.

Odd psych drug ads

Thanks to BoingBoing, I stared in head-shaking wonder at this collection of Japanese psychiatric drug ads. Some of my favorites:

Serenace® (haloperidol)


"Do you hallucinate that a giant bird-of-prey is after you? Serenace® can help." This and the rest of the Serenace ads are not what I would call soothing.

Rivotril® (clonazepam)


It's not uncommon for me to ask patients where I work if they're feeling anxious. Now I know that my follow-up question should be, "Would you rather feel like a naked child sitting in a field of flowers while a large umbrella protects you from the metaphorical storm? Great, let's see if you've got clonazepam prescribed."

Doral® (quazepam)


I don't know about you, but if just the ad is soothing my insomnia imagine how well the drug works. Ridiculously adorable.

These ads reminded me of a previous posting, this collection of American psychiatric drug ads. Faves:



Not sure how a child slumped over on a swing represents a Stabilized Epileptic, but then I never studied advertising in school aside from a brief analysis of its ever-refined means of manipulating people.



"See? You can poke her in the eye and she doesn't even flinch. Sweet!"



Mom: Umm, I'm a little concerned that Timmy's pupils are freaking huge.
Nurse: Don't worry, Nembutal is the "gentle" barbituate. If he stops breathing, call us.

The hits keep coming

I added a site meter to the blog awhile ago. Every once in a while I'll check the referrals to see how people found me. Mostly it's Google searches where the searcher never even came to the blog. People search for some weird things. Weird ungrammatical things. I'm the 8th return on Google for "picture of opening ladies urethra." 4th for "boy nipple sting dermatology."

Doesn't "boy nipple sting dermatology" kinda maybe sound like a Belle & Sebastian song that was written while drunk and never recorded?

Sounds of the psych unit at night

A/C
snoring
ring binders of med charts snapping open and closed
muttering
jangling keys of the staff
shuffling feet of the patients

I came up with the title of a mongraph, but I don't want to write it. I just like the title: On decreased muscle tone in the lower extremities of psychiatric patients, or Why the mentally ill shuffle when they walk

Reading material...Part II

I went with Douglas Adams, specifically Dirk Gently's Holistic Detective Agency. It's odd that I hadn't read it before being a fan of Adams. It was great. I love comic time machine stories, Connie Willis' To Say Nothing of the Dog is a big favorite of mine. After I finished Dirk Gently's, I polished off that memoir of a guy in a psych ward that I started last week on a graveyard, Nervous System by Jan Lars Jensen. It wasn't great, but interesting and provides good insight on the thought process of psychotics.

Around 6 AM I started in on Michael Azerrad's Our Band Could By Your Life. I'm not much of a fan of Black Flag, Big Black, Mission of Burma, and several of the other bands it profiles. Azerrad's such a compelling writer though that I enjoy just learning more of the history of these bands and the American underground scene of the '80s. Thanks go out to Choo for selling this at Dan's garage sale last year.

Thanks also to jlowe for the Vonnegut suggestions. I've been eyeing Player Piano lately. I'll bring it along tonight, though I'll be reading the Dirk Gently sequel The Long Dark Tea-time of the Soul first.

Reading material for monitoring the suicidal

I worked another 16-hour shift last night/this morning. I wasn't scheduled for it, but when asked I thought, "Well I'm up already, it's good money, and I mostly have to just sit here, read, and make sure this guy who is sleeping doesn't try to kill himself. I'm in!" About 4 AM I was regretting it. Mostly because I was very tired (I'd been up since 7 AM the day before), but also because I was reading a crappy play called Bus Stop written by William Inge that was later turned into a movie starring Marilyn Monroe. Just cliche as all get out, though since it was produced in the '50s maybe Inge was the first to write them. Wait, is that better or worse?

By 5 AM I was slightly more alert and reading Arthur Miller's The Crucible which almost made me cry is was so good and relevant. I'm working graveyards for the next couple nights and I'm thinking of reading Douglas Adams or Kurt Vonnegut. Funny science fiction or rabidly satirical science fiction?

A proposition

Tonight a female patient told me I had pretty eyes and that we should have a baby together. I'd have been flattered, but she'd already tried that line on a male patient and a female staffer.

Dragged around on a rope all day

I was all set to write an amusing account of my day at the lake with friends last Saturday, and then I saw that Joolie beat me to it. Read it, it's funny. If I was talented, or even had the program, I would have photoshopped a picture of Joolie with fins and gills cause she was totally amphibious, if by amphibious you mean "able to get up on skis and wakeboard immediately despite not having practiced in many years."

My two best wipeouts of the day were off the tubes, no surprise if you read Joolie's account. One crash had me barrel-rolling off the side of the tube for two full revolutions. On the second, I ended up skidding backwards on my back so forcefully that I created my own wake at least a foot high and my swimtrunks were yanked below my ass.

Next time we go out, I'm going to record video of the tube wipeouts.

3 PM to 7 AM

My night and early morning was divided into 15 minute increments. Every quarter-hour I would leave the nurses station and walk the unit checking the patients on precautions. Suicide precautions, assault precautions, elopement, fall risk, self-injurious behavior, sexual behavior. Poking my head in to see the patients sleeping or more objectively, to see their eyes closed, respirations deep and slow. Poking my head in to make sure they weren't cutting themselves or going into other patients' rooms or trying to strangle themselves with an improvised ligature. Then I returned to the nurses station to make notes, add paperwork to charts, and resume reading a memoir about a writer who was hospitalized in a psych ward.

I worked 16 hours straight yesterday/today. I'm tired.