Psych: Day 19

Today was my final day in the Inpatient Psychiatric Hospital, and it ended on a positive note. One of the patients which I have been following had active psychosis when I first arrived at the hospital, and he was also in an active manic episode. When I first met him, his hair was out of place with mismatched clothing (disheveled appearance), he was pacing up and down the hallways (akathesia), talking incessantly (pressured speech) about some amazing plans that he had devised (grandiose ideation). His speech was illogical and tangential. His concentration was markedly decreased, and he needed to be redirected often during the course of an interview. He was highly irritable, sleepless, short tempered, and impatient. His judgement was skewed, and he had absolutely no insight into his current condition. Just to sit at group therapy was more than could be asked of him. He had features of paranoia as well, thinking that the staff were harming him and that his girlfriend was plotting against him. Amazingly, his mood was able to be stabilized with the right medications. Today, he was discharged out of our unit with hope for the future and thankfulness for helping him to feel "back to himself again". It was like witnessing some kind of miracle. He went from being completely unable to function in public due to safety for himself and those around him to a stable mood with hopes, goals, and ambitions. This was the most amazing thing I have seen on my psychiatric rotation, and I am happy to have been a part of this transformation.


Another patient which I have seen during my time on inpatient psychiatry came into the treatment group meeting and spoke with us. After asking about his goals before being discharged, he said "I'm goin-da georgia. I got my record comp-ny there, I gotso much music to make, I gots-ta go...my brudda, he gots my money, you-know, need ma-money 'fore I can gets-ta georgia...you aint' tryna help me! you know I rich, you know I got ma money, you know I'm famous, you know I'm T-Payne, Lil Wayne, all you afta is ma-money, you a broke a** (racial slur) (sexist comment) (degrading occupational comment)!" After he stormed out of the room following his single-ended conversation, it took all I had to keep from bursting out in laughter. After seeing depressed patient after depressed patient, this definitely took me by surprise!

I gotta give it to psych - no two days are ever the same, there's always something crazy about to happen!