ok ok...

I've heard the complaints. My posts are too long. I understand...I have little patience to even read my own. No worries...I think I'm running out of things to say. It's my last week of inpatient, and I doubt the psychosis will be quite as severe on consults, but I guess you'll never know in tha D...

Anyways, I completely slept in. I normally set 3 alarms, but I set my pager alarm to the wrong date, forgot that I had to turned off my cell phone alarm (b/c of the 3 day weekend), and ignored my alarm clock assuming another the pager/phone would go off in 10 min. Luckily...I wasn't too late. I woke up at 8:20, when I normally leave at 8:15. Anyways, I digress.

So I arrived about 10 min late but before my resident, so it's all good :). Went to the lower functioning floor to get the vitals and meds...when the fire alarm goes off. All the nurses were saying it's a scheduled test...but I was definitely smelling smoke. It was finally called, "this is not a test." I was then just looking around, not knowing what to do...I was kinda expecting chaos to ensue, but really it was very orderly. The patients just walked calmly over to the day room (minus Tammy), and that was about it. It was really kinda peaceful in the day room under the blaring fire alarm. Though...I still don't know what would happen if the actual place burned down...b/c we did kinda lock ourselves into a room, instead of going outside...maybe there's some special exit that I didn't see (but all the other people could see...is there a term for "opposite visual hallucination"?)

Anyways, one of my schizoaffective patients that I've had over the past week was no longer on the board. I assumed he was discharged and was excited that a) he got better and b) he wasn't around to "annoy" me (though I started to like him better after playing Madden with him on PS2...) So I told my resident..oh "Blake" got discharged? And she's like "What? Did he actually have a stroke?" ..."come again?" Anyways, apparently on Friday afternoon, Blake faked a stroke. He positioned himself exactly outside his room and when he saw a nurse walked by, he slumped in his chair and said he was paralyzed, and couldn't move his whole right side. Of course, this was a ploy to get out of the psych hospital, but my resident and the medical doctor couldn't rule out a stroke and wanted to err on the safe side, so he was sent to the hospital. He got several CT scans, angiograms, and other costly medical work-up. Since he was no longer in our care, the psychiatry dept at the other hospital was responsible for his care. His thought process is organized enough that I know he was able to confabulate a reasonable story to get him out of the hospital. Anyways, I really do hope Blake is being compliant with his meds ... and that he won't end up in the ER anytime soon.

ok...now for some randoms:
1) group therapy and interacting with other patients is good for the patients (they get good feedback from each other and feel human interconnectedness)..BUT bad when your 18 y.o. patient learns from his stay at the hospital that cutting is a good way to cope.
2) a black man wearing a large fur coat with peach colored sweat pants singing opera
3) "I need to get outta here, so I can buy a McDonald's" (and yes he meant the store, not just a Big Mac)

And a psych tidbit (in case you get pimped)...
damage to the right frontal lobe usually leads to mania, whereas damage to the left frontal lobe usually leads to depression (the right frontal lobe tends to be more inhibitory and the left more excitatory).

Not quite as short as I hoped...but I hope you don't mind (I hope you don't mind that I put down in words...)