Monday, December 5, 2011

A Whole Bucket O' Crazy

I've been on psychiatry for the last two weeks. And the best thing that I can say about this rotation is that there are only 7 days 17 hours and 13 minutes left until it's over.

I thought I was going to like this rotation, I even thought at one point that I might want to be a psychiatrist. Especially one that studied serial killers, which just goes to show that there's something wrong with my brain. Or that I'd watched too much Criminal Minds. The jury is still out. But it didn't really take more than about 20 minutes at the inpatient psych ward for me to realize that if I wanted to retain the little sanity that I still possessed, I needed to get out of there.

I've been struggling with anxiety for a long time, anxiety that has been getting progressively worse for the past year. Anxiety that, at times, makes me feel like I'm going crazy, that my body is going to explode any minute into a million little pieces. Anxiety that makes me check the locks on my car door 3 times before I can walk away, that convinces me that the whole world is going wrong and it's just better to stay inside my house, in my bed, where it's safe. Anxiety is a bitch.

Suffice it to say, on my own, on a typical day, I feel like I have a precarious hold on my own sanity. And then I had to get locked in a mental hospital with 25 psychotic people. I need to take some mental health leave from my mental health rotation. Oh the irony.

About three seconds after I'd walked onto the ward, on my first day, I was greeted by Jose, the longest standing resident, a chronic schizophrenic, whose baseline involves a lot of imaginary friends and a compulsion to converse with them in unrecognizable Spanish. Jose, recognizing that I was fresh meat, beelined over to me and said hello by dancing for me (with his untied hospital gown fluttering in the wind) and then rubbing my bare arms muttering "soft." Awesome.

Funnily enough, he's been my favorite patient so far. He just left a couple of days ago, and I was sad to see him go. He'd follow me around and sing me new songs each day while he slow danced with no one. We'd talk, too. If you can call him mumbling something in "Spanish" (which the translator said doesn't even amount to real words) and then me talking back in English (mostly requesting new songs).  And then he'd wink at me and walk away.

The real problem with the psych ward is, surprisingly enough, not the patients. It's the staff, or maybe the system, I don't know. Psych patients are hard to deal with. They have so many weird quirks, they're agitated, they're compulsive, they're brains are just plain not working right, and that makes them hard to deal with. Hard enough for a month that I can't imagine how the staff deals with them day in, day out for years.

The staff doesn't really seem to like the patients, and one of the doctors doesn't even look at her patients when they come to her office to be evaluated. The patients are often combative (you'd be too if someone locked you up in a creepy building where everything smells like week-old cafeteria food and your roommate talks to the walls). For whatever reason, the staff argues with the patients! One day the doctor spent 5 minutes arguing with a schizophrenic that "God helps those who help themselves" is actually in the Bible. The patient was right (It's not) and the doctor was wrong, but he just couldn't let it go. And all I could think was, why are we arguing with crazy? Doesn't that make us crazy too?

So I just sit in these meetings where everyone is talking at once and no one is listening (my mother calls this "Too many chiefs and not enough Indians," otherwise known as "Welcome to my extended family.") and there is so much passive-aggression (and sometimes just plain old aggression) and paranoia ("How come you're lookin' at me? Make her stop strarin' at me.) that it takes everything within me not to have a heart attack.

I don't do uncontrolled chaos well, and these meetings are like a field day for my anxiety. It's like my anxiety has just taken PCP and is now throwing chairs around the room and beating it's chest like Tarzan all while yelling "I'm the King of the World!" at the top of it's lungs (Because obviously that's what happens when someone's on PCP, just go with it). So in order to not have to voluntarily commit myself to the ward along with my patients, I sit in these meetings and do my breathing exercises while thinking about tranquil imagery like unicorns prancing in a meadow of wildflowers underneath a rainbow. It works surprisingly well, but then again, so does making finger guns and pointing them at my forehead when no one is looking.

Needless to say, I like to minimize my time there whenever possible. I show up late and leave early and talk to the least amount of patients possible. This might make me a bad medical student, but I'd like to think it's making me a better human being because I am not in the staff room rocking myself in the fetal position while mentally calculating how many Xanax is too many Xanax.

7 days 16 hours 34 minutes 17 seconds. Not that I'm counting or anything.

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