Is There A Psychiatrist In The House?

When the first three patients who register on your shift are all suicidal, you know the day is shaping up to be a good one.

There wasn’t too much amusing about them. They all had substance abuse problems and two of them had alcohol levels more than 300. One got mad at me because I admitted her instead of transferring her to the psych facility where she wanted to go and she flipped me off while being wheeled up to the floor.

That got me thinking about the funniest psych patients I could remember. I came up with two.

The first was a guy who didn’t appear in need of psychiatric care, but apparently needed somewhere to stay. He figured a psych admit would get him a few days out of the cold.
First he said that he was hearing voices. That didn’t pan out, so he said “fine, then I’m suicidal.”
The attending at the time asked him what “suicidal” meant.
He got this look in his eye and said “it means I’m going to do baaaad thinnnngs.”
The attending told him that we don’t keep people for being “that kind” of suicidal and that he was going to discharge him.
The patient then said “you can’t discharge me if I’m crazy.”
The attending raised his eyerbrows, looked at me, then looked at the patient and said “Wanna bet?”
With that the patient started making noises like a car alarm - like the type that cycles seven different noises.

WeeeooooWeeeeooooWeeeeooooWeeeeoooo
Annnnnk Annnnnk Annnnnk Annnnnk
Ooooooooooweee Ooooooooooweee Ooooooooooweee
Eeeeee Eeeeee Eeeeee Eeeeee Eeeeee Eeeeee Eeeeee

This was loud enough that everyone in the ED could hear it - as well as the patients in triage. When you peered through the little window in the door of the psych room, the patient would look at you, wave his hands up in the air and scream. Then the whole siren routine started all over again.

We figured he would tire himself out. He didn’t.

After about 15 minutes, the attending shook his head, said “this guy is giving me a headache,” and ordered some Haldol. Problem was that we then couldn’t find anyone to take him home. His persistence paid off. He got admitted overnight. “Three hots and a cot” coming right up.

The second patient was just the opposite. He was an African American fellow well known in our ED for his psych issues. He had been drinking, was suicidal and didn’t want to be admitted. He knew that if he was admitted, he would be going to the psych facility that “f—ing sucked” across town. Sorry, pal. Rules are rules.
When he found out that we were planning to transfer him to his nightmare inpatient psych institution, he made a big stink about wanting to sign out AMA. He had been through the system enough times to know that he had been drinking too much to make decisions on his own, though. So he tried to convince us otherwise.
“I am NOT drunk. You hear me? Look, I know my sh__! The year is 2001. I’m in the motherf—ing hospital. The president is George F—ing Bush. You gotta let me leave now. I’m not drunk.”

Of course I had to yank his chain a little bit, so I said “We stopped asking who the president was because too many drunk people knew the answer. Now you have to answer this question: Who is the Secretary of State?”

He sat there for a second and his face got red. Then he yelled at me.
“You know Goddamn well that’s a racist motherf___ing trick question!”
“Whaaat? How so?”
“They don’t teach us that stuff in black school!”
I was going to ask him about the Speaker of the House, but left it alone.
And I did “smile and wave” as he rolled by on the ambulance cart on the way to his archnemesis hospital.
Fortunately he was sleeping.