TSH: Behavioral Unit

Today all five med students (Randy, Kyle, Sital, David, and I) were assigned to sit in on Dr. P's treatment team. (we also worked with her in Admissions our first Friday night here). Dr. P is in charge of the behavioral unit, where the very sick, very ill-behaved patients end up, so we knew we'd be seeing some interesting patients. The first patient we saw, JO, was the same guy David and I saw last Monday who was screaming in the ward. He was a lot calmer when Dr. P spoke to him (though he was a bit incoherent), but after he left we heard him yelling at people on and off for the rest of the morning. Another lady was only sleeping 2-3 hrs every night and could barely lift her head up when Dr. P tried to talk to her. We also saw EC, a patient David saw that same Friday we worked with Dr. P who had attacked another patient; EC said he still sees the devil's face on other people, but when he touches these people, the devil's face fades away. That's good for him, but not for the patients getting poked. One young bipolar guy was going to get released this later this week, and he said he plans to take his lithium faithfully and stay away from alcohol and other drugs "except during holidays." Dr. P shook her head and said if he even drinks one drop of alcohol while he's on lithium, he'll be spending his holidays at TSH. He was disappointed, and it's understandable; young people like to get drunk during the holidays. Another guy had his radio taken away when it made the voices in his head worse, and throughout treatment he kept asking for his radio back. Instead of telling him "no" directly (which probably would have set him off), Dr. P said he'll get the radio back once he moves to Level 5 (he's currently Level 6 and doesn't have as many privileges yet)

The more interesting cases were the women. Two women, the "meanest" of the group, got into a huge "street-fight" the other day; SW spat in CS's eye so CS slapped SW hard. We interviewed them both today to see what was going on. CS was calm, but her hair was unkempt and there was a wild look in her eyes that was a bit unnerving. SW, too, had wide eyes, and she had some major pressured speech as she talked freely about smoking cocaine and living on the streets. One patient Dr. P kept wanting the psych techs to bring in was JF, the same bipolar patient I saw exactly two weeks ago, but she kept refusing to come. She was originally sent to Ward 7, not Dr. P's ward, so I figured that her behavior must have gotten lots worse if she was sent here. On our way out, however, I did see JF across the room, and she saw me too and came over to me. I said, "Ms. F, how are you?" and she immediately burst into tears and threw her arms around me. I wasn't really sure what to do at this point and tried to push her off, and she cried, "You have no idea what they've done!" The techs said, "All right, Ms. F, let's go" and led her away as she began wailing about her husband. Unbelievable. Two weeks ago she was talking about how she knew Adolf Hitler and how she was a strong woman, and now she's hit rock bottom. It was very sad to see.

Tomorrow we'll see some ECT treatments starting at 7 a.m. When I heard that, I immediately drove back to TSH even though we had lecture in FW today. If I have to be in the hospital at 7, no way am I getting up at 5:30 just to drive from home to TSH. Anita said we've become too spoiled; back when we had OB, we had to be at JPS by 5:30 a.m. =P