A Wednesday of randomness

First and foremost, Happy First Birthday to my niece, Annalise.


I love that picture. He.

Mags and I are all worn out today. She? Had a busy two days at daycare. Came home soaking wet again, but she keeps licking her paw and I think maybe her paw pad is burned a little. It has been awfully hot around here. I? Had a long call. It wasn't super breakneck busy, so I had too much time between patients to just stay in admissions, but busy enough that I didn't have enough time between admissions or floor calls or whatever to actually fall asleep. So I spent a lot of time lying in that awful State Hospital bed (which I think may have bedbugs, because I get bit by something every. single. time. I'm on call there. But it's uncomfortable and the stuffing's literally coming out the side and the sheets don't fit. They're the same beds the patients have. I'm hoping that's not the case at New State Hospital because those are more or less molded into the floor) staring at the darkness and waiting for the pager to go off.

Call had some interesting moments. I admitted a really scary guy from County Crisis and Assessment, the kind of patient we euphemistically refer to as "well known to our service", after the police found him ranting about various psychotic things, and then searched his scary psycho guy van and found a dagger, two machetes, rope, a video camera, and...of all things...a beanbag chair. We had a brisk interview, to say the least.

I also had a very amusing encounter with one of my former Big Hospital patients. He's a very sick gentleman with some weird and rare neurodegenerative thing, whom we very affectionately refer to as "Lips" because, during a prior admission to Big Hospital, when he was very psychotic, he...warning, this is gross....bit off his own lips. So, needless to say, Lips is a messy eater. I went up to the men's long term unit last night to see a different patient in seclusion, when suddenly there was this big crash in the nurses' station. We all went running, of course, and there, sitting in the middle of the floor, is Lips, covered in pureed food off his dinner tray (which had been taken into the nurses' station when the others were served, because he usually eats elsewhere) from head to toe, shoveling food into his mouth with both hands (half of which, of course, was dribbling out down his shirt), and looking just as giddy as a pig in shit. I couldn't do anything but laugh and help him up off the floor. There was baby food everywhere - all over him, all over the floor, and as I would unfortunately not discover until this morning, all over me. It was one of the cutest things I've seen in a long time.

PenguinShrink and I were talking this weekend...when I went to pick up the boxes from our clinic manager, she says to me, "I really don't know how you guys do what you do." The other day, I said to her, you know, honestly? Some days I don't know either. We get so desensitized, we normalize things that are so far beyond the rest of the world's reality.

We had this grand rounds speaker a couple of weeks ago, who heads up the Trauma program at a prominent psychiatric hospital up north. He's the Trauma guy, really. And our chairman asks him, can you tell us the kind of things your patients are dealing with? And he starts spilling the highlights of these absolutely horrifying stories. And I keep thinking, right, yeah, this friend of mine had a childhood event much like that. My other friend had a similar occurrence. My patient told me something very much like that. Oh, I've been through that. Hmm. Yeah. Okay. Fortunately, I think the majority of my cohorts were more appropriately appauled.

There's a fine line between being desensitized and being numb. Numb is...well, not the goal. Unfortunately, removed (okay, dissociated) is something I do well.

Then again, I've for a very long time said that the key to being a good psychiatrist is having a good psychiatrist....