A Post-post post

Oh my GOD I'm so tired. It's weird - the post- post-call day is often worse than the post-call day in terms the exhaustion. And today was my first day on the Psychotic Disorders Unit (like, schizophrenia, psychotic mania, etc). Which....wow. I have some really sick patients. Whew. It would've been an exhausting day in its own right, but when you factor in the preexisting exhaustion, I actually nodded off in the work room. Oy.

It's chaos up there. Even logistically. Like, there's no space for us to work in, really. I have no where to put my lunch, even, much less work and type notes and make phone calls. And the unit is a lot dingier and more disorganized than the Crisis unit. In a weird way it sort of embodies the difference in the patients that are housed there.

I have, like I said, some really sick people. Fortunately for me, my co-intern and I have two very different services, and it's weird the way they're split. She has all the really aggressive and just batshit crazy ones; mine are more psychotic in that personality disordered way. Which is nice, because they're quieter, spend less time attacking people, and don't end up in seclusion as often, and I have a real interest in personality structure and disorders and formation and whatnot, so it's good in that way. But, it also means they're a lot harder to treat. Some of them are also sort of interesting - I've got a former nurse who keeps trying to escape in the laundry bin. I've also got a very sweet, soft-spoken, very intellegent African man who was so despondent he tried to immolate himself, which, his burns are pretty bad, but he took the whole house down with him and caused significant damage to both neighbors' houses (how he got out with just the burns he has beats the hell out of me). I have a couple of people who just don't know where the hell reality is. I've got one who had all manner of delusions about bringing a referendum to legalize marijuana - and curiously, he has a roommate who is a baker and thinks the panacea for everything is marijuana cookies. One woman had a big crying fit today because she wanted a room with a roommate and threw all her stuff across the dayroom. But seriously, kids. It's a weird place.

My co-intern, we'll call her Ruthie, is also crazy. I mean, I knew she was a little nuts, but she's crazy. Which, not in a bad way, and I really do like her a lot. But I think she's a bit nutser than I thought. We also have two medical students who started today. I got the one who is very small and cute but doesn't look like a Barbie doll. Which is good, because she's the one I wanted. Barbie...well, I hate to admit I'm making such a judgement on her looks when I get so annoyed when people do that to me...and maybe it's more her demeanor and carriage...she just seems a little too self-important for my tastes. At first blush. We'll see how it goes.

Anyway, now that I'm finally up from my nap, I'm going to bed. Thanks, also, for all the supportive comments on the last entry. You guys rule.