I have been out of residency close to ten years and have seen a lot of patients in those years. Psychiatry is more complex than other fields of medicine and learning the subtleties of it can take some time. Certain knowledge only comes with experience and time. I wanted to share some of the knowledge that I have acquired over the years that one will never read in a textbook, but is still interesting, nonetheless.
I have met God/Jesus on several occasions as well as the Antichrist. In general, the Antichrist is a much nicer person. God/Jesus is usually not a very nice person, although there are a few exceptions to that rule. Jesus seems to like to smoke a lot of pot.
A lot of dentists are in cahoots with aliens and the FBI and implant radio transmitters in people's teeth.
Any patient that threatens to sue me for keeping him/her in the hospital against his/her will is far too manic to be discharged. These patients will always call numerous attorneys in an attempt to sue me. They have so far never succeeded in hiring one.
A patient that presents as "an excellent therapy candidate" at the on sent usually is a lousy therapy candidate.
Antisocial patients (meaning criminal, not shy) almost always present as the most charming and likable individual one would ever want to meet. For anyone who would question this, I would recommend they watch "The Last King of Scotland" to see how effective the antisocial mind is at winning over allies.
Sometimes the incredulous things that a schizophrenic says that sound like delusions are, in fact, true.
Sometimes the very believable things that non-psychotic appearing patients report are, in fact, quite delusional.
Every single patient who is admitted to the psychiatric unit is going to complain about problems with bowel movements at some time during their hospitalization. Even the young ones.
In fact psych patients, even if seen by a primary care doctor, will fail to tell him/her about their gross rash, genital sore, hemorrhoids, etc. They will save those problems for me. When I ask them why they did not ask the primary care doc, they all have the same response: "I forgot."
When a criminal is sane enough to figure out the idea to plea not guilty by reason of insanity (NGRI), he usually is not NGRI.
The criminal who is truly NGRI is too sick to realize that he is NGRI and usually ends up in the criminal system as a result.
An amazing number of patients have tried a drug only one time in their life. Even more amazing is that that night just happens to be the night before they are admitted to the psych unit as it always seems to show up on a drug screen. Sometimes they have tried that same drug only one time in their life on multiple occasions, each of those singular occasions being the night before they are admitted to the psych unit.
A lot of patients will expect you to believe that two beers will give you an alcohol level of 0.460.
Most patients that are sighted running naked in public are not the people one would really want to see running naked in public. Most incidents of people caught running naked in public occur in the Spring.
There is a phone number that civilians can call to contact the Pentagon that is apparently accessible to the public. The Department of Defense will not necessarily show up and investigate if one of the patients calls that number, fortunately.
If someone makes any sort of statement that could be interpreted as a threat to the President, the Secret Service will show up.
The guys from the Secret Service and the DEA do look like the guys from Men in Black. They are not accompanied by a cute alien pug, however. To the best of my knowledge, I have not have not had my memory erased by one of those flasher devices, but I guess if I did, I would not.
Real men do cry.
Lots of women return to abusive relationships repeatedly and there is nothing I can do to stop them.
We can provide the best care humanly possible to our patients and there are still going to be patients that commit suicide. Some people are just in too much pain to continue and there is no intervention that anyone can provide that is going to alleviate that pain.
Some patients that curse my name when they are admitted thank me for their help by the time they are discharged.
Try as I might, some patients are never going to like me for various reasons that may, or may not, have anything to do with me personally. It is a fact in this field that one must accept and not take personally because if one does, it will eat one alive.
One hundred years ago, many, if not most of these people would have spent their lives locked away in "lunatic asylums" never having any freedom or dignity. This was perhaps better than being chained up in a relatives attic like a rabid animal. Now my patients have hope and many of them live perfectly normal lives once stabilized. If it were not for the stigma that society unfairly places on the mentally ill, many more would comply with treatment and do better as well.
We need to open our mind as a society and rethink our beliefs.
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