Something To Be Thankful For

Thank God It's Over.

The worst rotation yet. I may have to retake the final exam again, because I just wasn't into it and didn't study that much. But on the bright side, I won't have to do another psych rotation again for the rest of my life. Thank god! That's what *I'm* thankful for this Thanksgiving.

The exam itself wasn't much fun, but we had an "unusual testing condition": one of my classmates started screaming a few minutes into the test. At first I thought it was in frustration at a particularly hard question, and I inwardly concurred, glad I wasn't the only one feeling that way. Then I realized he was having a seizure. I guess my autopilot came in handy, because I found myself directing the students next to him to lower him to the floor and the proctor to call help. I don't even remember seeing him seize before I got there, it's just kind of an unmistakable series of sounds. Responding to an emergency as it's happening is quite different from what happens to medics on duty: you get the dispatch, you get on the rig, you pull on your gloves, get your equipment out of the engine, walk up to the scene, and then you're finally there. That's plenty of mental prep time. But it's quite another matter when you're concentrating on taking an exam and someone seizing is the farthest thing from your mind! It's a little rattling.

Eventually the FD came, and we turfed it to them. Ironically, the neurology department was having their grand rounds meeting in the conference hall right next door, so one of the fellows wandered over. He didn't do anything, which further confirmed to me that emergency physicians are the experts at the first two hours of anything - then they lose interest and hand it off to specialists who pontificate endlessly the etiology of the illness at hand, but don't like to get their hands dirty. To add further irony, while my classmate discovered during this rotation that psychiatry was his calling, he inadvertently helped confirm emergency medicine to be my thing. Anyway, it made for an interesting, albeit a little bit sad, conclusion to psychiatry.

Can't Make This Stuff Up

Excerpts from the psych unit.

36 year old female:
Me: So how's your mood today? (we have to ask this every morning, you'll see why)
Patient: My mood has been following me around.

26 year old male Ivy League grad:
"I started thinking, well, I call my family overseas and so maybe they're wiretapping my phone calls to intercept me. I think people are out to get me, to turn me into a terrorist. Sometimes I can tell myself, 'It's not real,' because I've never participated in any sort of terrorist activities, so why would they want me? But other times it seems they plant magazines and newspapers at newsstands to try to influence me, and the thoughts become so overwhelming that I can't convince myself that it's not real. So at one point I was in [foreign country] and walked into the embassy, because I was sure that they were trying to get me to recruit me into being a terrorist. And that's when this last string of hospitalizations began.

45 year old female who just tried to escape:
Me: So are you able to sleep well at night?
Pt: God comes to visit me every morning around 4am. I just push him away. But he changes his mind a lot. I'm not pregnant anymore.
Me: You're not? You were pregnant with twins three days ago.
Pt: See? He changed his mind. You know the "virgin baby?"
Me: Yes.
Pt: You're God's type, I can tell.

26 year old bipolar male:
"I just recently went through puberty. I found a way to arrange my sleeping bags into a cocoon, and in there, I learned freestyle masturbation, and that allowed me to transition into adulthood."

Asian male in his 40's, psychotic and barely speaks English:
Marching around the unit: White power! White power!

Nuts

I think I've effectively ruled out psychiatry. Even though it was nice to see a former patient today who had found a job since he left, patched up things with his dad, and whittled all his girlfriends down to just one that he actually liked. Even though he asked me when I was going to be a doctor so I could be his doctor. How could I resist, I don't know. I'm an impatient person to begin with, then you give me all these nutty people who are all over the place and can't communicate, and I just don't deal well. Perhaps emergency medicine really is the place for me so I can bring 'em in, patch 'em up, and ship 'em out. What good is an impatient shrink anyway?

Secessionist

I've long thought California should secede, along with a handful of coastal states and other blue states. Some news articles make me not want to share a citizenship with a lot of people "over yonder," east of CA. A lot of them are scary. So Darron and I have thought about taking a trip to better understand these strange gun-slinging, religion-clinging, abortion-denying, so-called fellow Americans, with whom I don't think I have an iota in common.

I came across this piece, which I have abbreviated slightly at the end. It sums up my feelings pretty well.
____________________________________

Dear Red States Cousins:

We've decided we're leaving. We intend to form our own country, Nuevo
California, and we're taking the other Blue States with us. Bye.

To sum up briefly: You get Texas, Oklahoma and all the slave
states. We get stem cell research and the best beaches. We get the
Statue of Liberty and Hollywood. You get Dollywood and Branson.
We get Intel and Microsoft. You get WorldCom. We get Harvard.
You get Ole' Miss. We get 85 percent of America's venture capital and
entrepreneurs. You get Alabama . We get two-thirds of the tax revenue,
you get to make the red states pay their fair share.

Since our aggregate divorce rate is 22 percent lower than the
Christian Coalition's, we get a bunch of happy families. Please be
aware that Nuevo California will be pro-choice and anti-war, and we're
going to want all our citizens back from Iraq at once. If you need
people to fight, ask your KKK members, your evangelicals and
your hockey moms.

With the Blue States in hand, we will have firm control of 80 percent
of the country's fresh water, more than 90 percent of the pineapple
and lettuce, 92 percent of the nation's fresh fruit, 95 percent of
America's quality wines (you can serve French wines at state dinners)
90 percent of all cheese, 90 percent of the high tech industry, most
of the U.S. low-sulfur coal, all living redwoods, sequoias and
condors, all the Ivy and Seven Sister schools plus Stanford , Cal
Tech and MIT. With the Red States, on the other hand, you will have to
cope with 88 percent of all obese Americans (and their projected
health care costs), 92 percent of all U.S. mosquitoes, nearly 100
percent of the tornadoes, 90 percent of the hurricanes, 99 percent
of all Southern Baptists, virtually 100 percent of all
televangelists, Rush Limbaugh, Bob Jones University , Clemson and the
University of Georgia. We get Hollywood and Yosemite, thank you.

Additionally, 38 percent of those in the Red states believe Jonah was
actually swallowed by a whale, 62 percent believe life is sacred
unless we're discussing the death penalty or gun laws, 44 percent
say that evolution is only a theory, 53 percent say that Saddam was
involved in 9/11 and 61 percent of you crazy bastards believe you
are people with higher morals then we lefties.

It's About Time

I wish people would quit saying Obama will be the first black president of the U.S. In fact, he will be the first biracial president of the U.S. And did you know, mutts are hardier, genetically? They can't have recessive diseases that are found in the purebred population, at least in the first generation offspring. Someday asking someone's heritage will be the same as asking what his favorite ice cream flavor is, just an interesting conversation piece, and not a loaded question.