short short short...

So sorry to my one lone reader. that was a very long post last night. I am thinking "short" tonight.

I'm excited that my patients are getting discharged...hoorah! Fewer follow ups. And I only have 2 more days of consult left. Anyways, my highlight of the day was finally discharging my "favorite" patient.

She has a history of drug abuse, e.g. alcohol, benzos, opioids, etc. She comes to the hospital for overdose of her suboxone (a partial opiate) and seroquel. Anyways, the history on her was never clear. She had an altered mental status, and she kept changing her history, she denied having visual hallucination, except I saw her hallucinating the day before her. Anyways, she hated me. She had good rapport with my attending, but with me..she was very uncooperative. I dreaded going through the mental status exam. She just gave me those mean gaze, answered my questions very tersely...I was frankly very scared of her. I just didn't know what to say...and wanted to run out as soon as I entered the room.

Anyways, I stopped by her room in the morning knowing she was getting discharged. She was out of the hospital gown, and wore her flannel shirt and trucker hat.
So I said, "I just wanted to say bye, good luck, and follow up with your outpatient psychiatrist."
And then she's like "I want to apologize to you."
I asked, "for what?"
"Oh for the way I treated you. I was rude, mean.."
"Oh no...no...don't worry about it."
"No I truly mean it. I wasn't myself.."
"Don't worry about it...just wanted to wish you the best of luck. Take care."

Anyways, gosh...it was so good to hear. I mean I wasn't really taking it too personally the way her attitude was towards me after all, she was in an altered mental state. But it's still good to hear...that it wasn't me. And she knew that she wasn't nice to me.

Oh and I just wanted to pay homage to my favorite 80 yo pt with lewy body dementia. She was the very first patient I met on C/L.

Her Chief Complaint: "I think I got kinda old."
On mini mental status exam: for short term recall (remembering 3 objects), she needed clues:
clue 1) it's a fruit?
answer: apple? no orange...orange (it was actually "apple")
clue 2) it's something you sit on?
answer: stretcher! (in an emphatic way; btw, it was "chair")
clue 3) it's something kids like to climb on? it's outside?
answer: Potato! (her roommate starts to laugh. btw, it wasn't "potato" but rather "tree")

and in the middle of the interview...
"Can you please tell her I'm sorry?"
-"Who?"
"For the person I'm sitting on."
-"Are you sitting on her now?"
"Yes...and she's trying to get out." (Cue: laughter from her roommate and my own stiffled smile)

and for your fun medical fact of the day: patients with dementia with lewy body typically have visual hallucinations

and last thought: why can I never get to bed before midnight? ugh.