Tuesday, July 23

Psych wk 4, day 16:

i just got off from call, now, at 12:45am. from 8:45am this morning till now, 12:45am. and i have to be in by 8:45 next morning. this is ridiculous.

so many wonderful things that happened today. i don't know if i can report faithfully.

first, another of psych's wonderful moments: psych patients singing karaoke, "living la vida loca" (living the crazy life). the irony is rampant in psych. too much for my easily tickled mind to handle.

whizzed thru my patients at my unit. i'm getting pretty good at what i do, now. i can easily do what residents do. finished at 12:30pm, but stayed until 3:30pm, after which i headed to the pysch ER for my scheduled call night.

we had a shortage of residents (1), and 1 attending. which meant that there were 3 medical students, covering a full house. i saw my patients, wrote em up, admitted them. i did the whole bit, from start to finish. i'm so proud of myself.

so, i had a really interesting pt today. tells me that he's from a diff country, ****, and that he won 3 Olympic medals. i'm thinking, "oh boy...WHACKO!" but as he goes on with his story, the more realistic it sounds. he knows details about that day, the other athletes, details that a liar couldn't possibly have known. then, he tells this incredibly sad story about how he was married for a long time, but his wife was unfaithful to him, recently...he looked so broken. it's just an incredible history, and i want to list all the wonderful things this man has done in his life...the many degrees he's earned (he speaks VERY intelligently...) but, i don't want to ID him. (confidentiality issues, u know)

so, i'm completely stunned by his incredible history...and i'm thinking, this man shouldn't be admitted, he should go home tomorrow morning. i excitedly present my case to the attending, who lifts his eyebrow. he opens up google.com, and looks up the Olympic year and event of my pt. my patient was not listed. i couldn't believe it, so i searched on several more engines. all same results. he simply did not win those medals. and yet, he knew details, that a normal person could possibly not know! like winning times(confirmed by fellow student, who was a track star in hs, and knew such things), and names of other competing athletes, etc.

i was totally confused. his story is too sincere, filled with too many accurate details, for his hx to be a lie. and yet, there it was, the record, and his name not on it. my attending lost all faith in my patient's story, as did the other resident and students. i, well, i couldn't deny the record. but i still believed his story. everything else thought the whole thing was bogus. the result: patient gets admitted, for being delusional and grandiose. the attending has final say, of course. meanwhile, i'm feeling terrible, because i still believe the pt, but he's mad and refuses to give any names and numbers to confirm. i'm the only one that he trusts and talks to, but he even won't tell me, given the circumstances.

he gave me his private number, and told me to ring him up someday, for any kind of help, or even for dinner. if his story is true, he is a very rich and influential man. i can easily believe this, given his manner, intelligence, wealth of knowledge, and vocab. i mean, this is definitely not some dude off the street.

but, he's going to be admitted as a delusional dude with psychosis NOS. that's why i stayed till 12:30. i talked with him for hours, to try to get the story, and coax the names and numbers. to no avail. i feel terrible. i believe he is sincere, that he's telling the truth, but he is going to be admitted, b/c the attending doesn't believe him, and the pt is too stubborn to give collaborating resources. argh. this shouldn't be happening. i'm gonna follow up on this guy and see what happens to him, and esp to see if he's telling the truth. was i so easily duped, or was my gut feeling about ppl right? if he is lying, he is an amazing liar, of a greater skill than any killer/mafia player i have ever known...

ok, i'm pooped. time to crash.

yakob at 2:08 AM

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