Tuesday, February 1, 2011

haldol, np: the reason for the season

And finally, a contribution from one of our psychiatric brethren, Haldol NP. I'm especially appreciative of this, because I've been played by some of psych's frequent flyers before. Still a little bitter about that. Thanks, Haldol!

19 year old Patient began her relationship with me by missing her scheduled appointment. She decided to instead drop-in unannounced later in the day to be fit into the schedule. She flopped down at my desk and shoved a piece of paper in front of me.

"Can you sign this?" Patient asked. "This" appeared to be paperwork from the state that proved that she was actively engaged in mental health treatment. I explained to her that I couldn't sign it because this was the first time I'd met her and that treatment had yet to begin. "Whatever," replied the young lady. Emphasis on "lady."

She was actually pretty good at talking and snapping gum loudly, if one considers this a talent.

As the psychiatric evaluation opens, Patient's chief complaint seemed to be anxiety. "I need Valium, I need Klonopin...this is what makes me anxious, talking to you." Patient's cell phone started blaring tacky hip hop; of course, she answered it.
I waited until she was off the phone.
Tacky hip hop again.
I requested that she silence the ringer.
Patient informed me that I was mean.
I insisted I was not mean, but rather straightforward and trying to do my job.
In response, Patient immediately began texting on her cell phone.

She followed up this singular act of respect with knocking on the window of my office to get the attention of a young man in an extemely puffy white coat with dog fur trim. She was trying to guide him to the office. I told her that I consider texting on a phone the same as talking on a phone. The delicate young creature exploded. "I don't understand why you can't just give me Valium. This is why I hate doctors!"

I tried to get across that the point of a psychiatric  evaluation is to collect a history and get to know the patient in order to guide diagnosis and treatment options. I shared with this sweet, sweet girl that I hadn't gotten an opportunity to know anything about her, as she has been otherwise focused.

Patient, the darling turnip blossom that she was, jumped from her chair and stormed out the door. She screamed: "I'LL JUST GO TALK TO MY THERAPIST! AT LEAST SHE HELPS ME, YOU FUCKING BITCH!"
I called back after her: "Happy Holidays."

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