Friday, June 5, 2009
This was truly bizarre.
The security guard wheeled a young man into the unit at about 19h00 last night. This man was totally unresponsive and slumped lifelessly in the wheelchair.
He did not look chronically ill. He was not bleeding. He had no bruises. He had no broken bones. Also, he had no escort with him.
Thus - we had absolutely no history other than that the security guard found him lying on the floor at the entrance to the hospital.
The man was warm, and alive. Blood pressure, pulse, respiration, temperature, oxygen saturation, haemoglobin, urine and glucose were all perfectly normal. But patient was totally unresponsive.
We tried all the cruel ways they taught us of trying to elicit a response:
Deep pressure on the fingernail beds,
knuckles pressed hard into the sternum,
pinching the skin under the tricep,
and my worst - twisting the nipple.
Alas, he gave us nothing to work with.
We have no other tests available to us after hours, so we referred him to a secondary hospital for further investigation. While waiting for the ambulance to arrive we kept him on the stretcher in the unit.
Whilst processing the constant supply of patients, we kept monitoring him. But he stayed horizontal and unresponsive, mouth agape and eyes open.
I became worried about his corneas so I taped soft pads over his eyeballs to protect them from drying out.
The health factory continued to process patients well into the night.
At about 23h00, we were suddenly shaken by a huge commotion.
Our unresponsive friend had, in a spectacular and violent manner, suddenly jumped off the stretcher, pulled his drip out and was swearing that we should stop "putting shit in his veins". He was a very tall, well built man who was by then frothing at the mouth and glaring at all of us with mean intent. He climbed onto the desk and proclaimed ominously while gesturing around the unit: "All of this is mine. I want it. It's all mine."
The security guard in trauma tried to coax him down, but he bolted, and ran through the hospital in his underwear and hospital gown screaming, until he got outside where he began trying to open the doors of the cars in the parking lot.
It took four security guards and an electric tazer to take the man down.
They then "escorted" him to the police station next door and I didn't see him again.
What a sneaky psych patient!
Such strange things happen in this part of the world. This man must have been psychotic. He did not display any classical signs of delirium, or dementia. This was psychiatric...I'm beginning to develop a sixth sense about these things.
They seek me out these psych patients.
My colleagues are calling me the psych whisperer.
I'm still not sure what exactly happened there...no use dwelling on it though. No doubt I'll get a similar case in a few weeks time. History repeats itself often in this trauma unit.