Crazy Tuesday

But then again, what day isn't crazy day in my world.

Such a long day at work. Ohhhh, dear.

My patients continue to be really, really, really sick. One of them is getting a little bit better, the college girl who had her first episode of schizophrenic psychosis...can you imagine how horrible that must be? For her, for her family...and, really, a little for her psychiatrist, who's like, wow, I didn't see this coming, but in retrospect, I so should have...which, no, he couldn't have until she actually had her psychotic break. Which, by the way, seems to be a very fitting word. She's done broke. And now she's broken. And hopefully we can fix her, at least a little. But, you know, two years ago she was a straight-A student. Now she's completely psychotic and trapped in the false reality of her own head. Her very sweet and loving and supportive parents are devastated, and I can't imagine how they could possibly be anything else. And in truth, I think the part of the girl that was that's still in there somewhere is struggling and fighting and really conflicted by what seems real. The meds are helping a little. It's heartbreaking.

My other really, really sick patient has gotten worse. She'd been doing better, and we were going to send her home at the end of last week. I said it, Thursday, that if we didn't discharge her, she was going to decompensate over the weekend. Sure enough, she's a whirling dervish now. Who's being rude and acting out and was caught with her hand in some other patient's lap this afternoon. Which is when she nearly found herself on a bus to the state hospital, but my attending told me not to be so impulsive. I hate to tell him this, but she's been walking that line for over a week, and I would've sent her a long time ago if he would have let me.

Tomorrow, I have a really crazy pregnant lady coming down to my service from the crisis unit. Seems appropriate, huh? She should be interesting...

But then again, it's always interesting on the psych ward.