Friday, November 12, 2010

I have officially seen the face of Crazy.

All this month—and next—my fieldwork takes place in a geriatric psych ward, so right now I’m dealing with behavioral health issues on a full-time basis. In the past two weeks I’ve seen depressed patients, patients with organic mood disorders, agitated patients, hallucinating patients, delusional patients, schizophrenic patients. Some are high-level as far as function goes. They’re conversational, cooperative, pleasant. Those are the ones that don’t stay very long, and they’re also the ones who help me maintain a positive outlook.

I’ve also had to deal with low-level people who are basically in a catatonic stupor, incontinent, unable to feed themselves, unable to convey their thoughts. They sit for hours at a table staring off into space, or sleeping, or fighting nurses who are trying to administer meds or change their diapers without getting kicked in the stomach or spit on.

Speaking of getting hit, we have some truly psychotic ones admitted at the moment. I had to help carry a naked woman around today, actually pick her up out of her chair in the activity room where she had removed her clothing, and lug her to the bathroom for a shower, which she probably hadn’t had in weeks. Of course, she was resisting and screaming the entire time, and I was doing my best to soothe her, making eye contact, displaying a sympathetic expression, speaking in low tones. I went to brush her hair out of her eyes and she tried to bite my hand. That’s the thanks I got. Not to mention she also tried to come on to me while three nurses were washing her (well, one was washing her, while the other two held down her arms).

It’s weird, though. As exhausting as it is, it’s also exciting.

My typical day might consist of trying to calm a panicking 95-year-old woman who can’t even tell me why she’s anxious, then talking with another woman who is smiling at me one second, then screaming at me to leave her alone the very next. During a co-led group session, I’ll talk with an old man who, by all accounts, seems normal as can be, except for the fact that he somehow works into the conversation that he’s been arguing lately with the Archangel Gabriel and when he called the angel a liar, the Virgin Mother gave him a spanking, and if she does it again he’s going to “go tell the Almighty and Mother Mary’s gonna get her own butt beat.” Later, after lunch, a 71-year-old woman calls me into the activity room and sweetly asks me to hand her a box of Kleenex, then tries to grab my arm and when I move away she throws the box at me and accuses me of fathering her child. She says she just peed all over herself while hissing a litany of curses, lifting her pillow off her lap to reveal she isn’t wearing pants, then throws her urine-soaked gown at me.

What a day, huh?

I’ve had clinical instruction in rehab and home health, as well. I haven’t decided yet if psych is for me. But I’m certainly not bored like I was in rehab. That’s definitely not for me. But psych? Well, considering all of the above, no small wonder that by the time I get home, I’m entirely depleted of all energy. I know I’m still learning the ropes and trying to take everything in. My CI (clinical instructor) has been urging me to put in my résumé. I might. But right now, at this very moment, all I can say is ‘Thank God it’s Friday.”


  1. What a week! How do you help someone that not only doesn't want any help but doesn't have a clue that they need it? Whew.

    Good luck deciding. It takes a very special person to do this week-in-and-week-out.

  2. Brian, you're absolutely right. That's something I struggle with right now. When to push therapy on someone and when to recognize I need to back off before they go to "that place" from where they have such a hard time returning. With some folks, there's hardly an indication, or as my CI says, "Watch out, because that one can turn on a dime."

    My decision would be a little easier if I didn't have to spend a total of 90 minutes commuting everyday; that, on top of an eight-plus hour work day. If I do apply for the job, I'll probably ask for part-time, as I'll need a three day weekend to maintain my own sanity.