The One That Got Away

Random memories from clinicals on the psych unit:

The young child who asked me if I had ever heard about human sex trafficking. My response: "I have. What do you know about human sex trafficking?" And in return a story about a parent who had gone too far with warnings and ended up with a child believed to be inexplicably terrified to set foot outside.

The clinical nurse remarking about a patient who was just admitted, "Twenty one and already shooting up in her foot? She won't be around for very much longer."

Two grown men in their forties sitting on the patio in a rare moment outside, trading tales of their suicide attempts the way some men trade fishing stories.

The number of patients who go off their medication because they gain weight. (They'd rather be depressed and suicidal or manic and psychotic than fat.)

A patient describing the experience of a self-inflicted gunshot wound: "I put the gun up to here and I pulled the trigger. I could hear a whooshing sound"--the air escaping as his lung collapsed--"and my wife tried to put pressure on it to stop the bleeding but three of my ribs were cracked so she couldn't. She was yelling, "What have you done? What have you done?" And then I just blacked out."  (It's not the first time I've seen someone who has survived a self-inflicted gunshot wound or heard someone describe what it sounds like when their lung suddenly, violently collapses.)

A group of patients in the art room singing along to David Bowie's Space Oddity ("ground control to Major Tom--commencing countdown, engines on...").

The young man, possibly schizophrenic and learning disabled, often homeless, but very sweet, when I asked him, "Do you talk to your family?" answering, "I do, but...I wear my family out."

Getting so angry at a schizophrenic patient's rudeness that I let The Brain indulge for a moment in the idea of smashing her face into the wall. Instead of smashing her, I explained to her patiently that I would be back around when she felt better.

Later, I wanted to laugh at the temper tantrum of a short, stubby, disgruntled patient, an irritated troll, who was angry that patients are not allowed to have dental floss.  There was cursing and slamming things and angry waddling around. The other patients were told to return to their rooms and I watched as nine staff members amassed in the hallway outside the troll's room and donned blue nitrile gloves, having removed watches and put their cell phones aside. The nurse had hurriedly called the pharmacy for an IM injection of haldol, an antipsychotic that chills you the fuck out. It all seemed like overkill to me, but I guess it takes a lot to take down a troll.

Two patients--one a child, one barely not--who I suspect have been profoundly, horrifically sexually abused. They have never met, but they could be twins, both devastatingly beautiful and both nightmarishly passive, sweetly blank-faced, and terrifyingly psychotic.

The incredible relief at being released from the locked ward at the end of the day.

Happy Saturday.