Psychiatric patients are some of my favourites, just behind deaf old people. I could sit and take calls from them all night. My record spent on the phone with a psychiatric patient was one hour and forty minutes. It was quiet on call taking but there was a shortage of ambulances in her area, and because she was non-violent and non-suicidal — the reason she’d rung was because she was scared there were monsters in her house — she was a low priority call and I offered to stay on the phone until we got there. I had nearly lost my voice by the time we did.
I had the following conversation with a psychiatric patient yesterday:
Me: Emergency ambulance, blah…
Him: (in calm and friendly tone) I think I need to go to A+E. I self harmed yesterday.
(At this point I am thinking “Yesterday? And you want an ambulance *now*? Timewaster!)
Me: How old are you? Are you feeling violent? Do you have any weapons?
Him: (fairly cheerily) Thirty-eight. No, I’m not violent. I just think I need to see a psychiatric and get myself sorted out. Nope, no weapons here.
Me: And when you self-harmed… what did you do?
(I’m expecting him to say “I cut my arms” at this point…)
Him: Well, I tried to cut my penis off! That’s not a good thing, is it? So I think I need to go to hospital to get my penis sorted out. And then some psychiatric help to make sure I don’t do it again. Oh yes! And I tried to burn my house down with me inside it. Then I thought better of it and I managed to put the flames out! That was lucky, wasn’t it? I dread to think what could have happened!
Me: Oh! Um! Er! Yes. I see. Er. Are you burned? How is your penis now?
Him: No, I’m not burned. I managed to put it out in time. And my penis just has superficial cuts on it. It’s harder to cut it off than you think, you know.
(I have to say this isn’t something that I have considered at great length before, but is nice to know.)
The dispatch desk decided that our crew would wait for the police, and a few minutes later we got a message from a rather shocked sounding police person: “Ambulance asap please! Call as given! Male is not very well!” We took him to the hospital and I hope he managed to get himself into a good psych ward somewhere. I still can’t quite get my head around the way he was burning down his house and chopping his bits off one minute, and the next calmly and almost cheerfully describing the events to me as if he were ringing about someone else!
September 22nd, 2007 at 12:39 pm
Münchhausen’s?
September 22nd, 2007 at 2:02 pm
Vic, I doubt very much it’s Münchhausen’s, (speaking from experience here) you can easily go from being the happiest person in the world to wanting to self harm/commit suicide if you are suffering from bipolar disorder (older readers may know this as Manic Depression), all in the space of about 5 minutes!
I do hope this chap is OK and gets himself sorted out properly. Medical help nowadays for mental illness is incredibly effective, I know because I can now see the light at the end of the tunnel.
Keep up the good work Mark, as usual the post was thought provoking but informative.
September 22nd, 2007 at 2:49 pm
I agree with Black Dog. If he suffered from Bipolar it may be that he was feeling so different the following day that he could bearly relate to his own feelings the day before. Being able to think more rationally the day that he called, he may even have been feeling bemused by his own actions the previous day.
I’m interested to know why the police decided that an ambulance was needed as soon as possible though.
September 22nd, 2007 at 2:52 pm
I presumed it was in case he had another mood swing and decided to have another go at chopping his penis off…
September 23rd, 2007 at 1:36 am
…Or they took one look at a slightly hacked penis and panicked.
September 23rd, 2007 at 5:59 am
My favorites are the people with dementia. Not that demetia is a very nice disease at all, but in our service, we often do transfers to hospitals that are 3 hours away. It can be hard to keep a conversation going for that long, but with a demetia patient, you basically answer again and again three main questions. (where are we going? Are you a nurse? Where are we going?)….ok, two questions.
September 23rd, 2007 at 1:37 pm
Lol Mark and Tom!
September 25th, 2007 at 1:26 pm
I’m wondering if he just didn’t “pretend” to burn his house down (i.e. do it in a way very easy to contain or to put out, if he did it at all), and then “pretend” to chop is penis off (stopping just after some minor scratches are visible, so he can claim he did).
But then, the reasons that might have pushed him to pretend might mean that he needs help anyway, although it may be more in the realm of counselling or psychology than psychiatry.