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The emergency room from an insider's perspective

by Bill White

Created on: April 24, 2009

It had been an extraordinarily busy night. Case after case. But then, it was Saturday night, what should I have expected?

In the midst of working with a suicidal woman and an adolescent who had had the mother of all panic attacks, one of the nurses told me about a new case. A man in his late fifties was brought in by his daughter with psychotic symptoms that began only a month ago. Seems he and his wife were in town visiting their daughter and family and a decision was made to stop in for a look-see.

I was looking forward to talking with the patient, his case fascinated me. I mean, why would a man his age with no mental health history suddenly experience psychotic symptoms? Sounded like a medical situation to me, and apparently his E.R. attending that so as well because he ordered a CT scan. That meant I'd have to hold off for about a half-hour before talking with him; however, it gave me plenty of time to talk privately with his daughter. I wanted to learn more.

While the man was having his head scanned, his daughter and I talked in his room. According to this upset, but poised, young woman, the family was concerned with her father's sudden change in personality. Indeed, some thirty days ago her father began making frequent references to the Bible, something he'd never done before. And the man was telling family members his long-deceased mother was talking to him. And if that wasn't enough, he reported hearing other voices, but told his family not to worry because they were happy. Needless to say, the family was justifiably frightened.

After about fifteen minutes, in rolled a gurney carrying the subject of everyone's concern. Having a look at him, the man was tall and his tan lined face gave the appearance he performed manual labor most of his life. He had very kind eyes and what seemed to be an engaging personality. Well, the first thing I had to deal with was a language barrier because he spoke no English. But that wasn't a biggie as his daughter served as our translator. Funny after being introduced and shaking hands, the first thing out of his mouth was a request for his pants. I had to tell him to hang on a bit on that one.

On to the interview. The first order of business was to assess the man's mental status. So, after explaining I meant no disrespect by asking such things, I asked him if he knew his name, what day it was, where he was, and why he was here. Well, he did alright, with the exception of believing he was at another hospital. That was a concern,

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