I wrote a previous blog titled Suicide and Suicide Attempts observations. Basically reporting what I saw working as an ER nurse for two years in the ninties before we used computers and used to write volumnous subjective notes using a standardized soap format. I can make telephone calls through the internet for free from France to the USA, and still talk to a friend of mine, who was a tech at the same place back then. I think that me having had to write about all those events kept them so vivid in my mind. I am trying to blog on what naturally is coming up.
The tech and I sometimes recall different experiences. The ER is a rarified environment as being less stressed you could go to the regular clinics. I remember one time we were both so frightened and overwhelmed we both ran in an office and cried and didn't know what to do and kind of both stared out the window. Than forced to leave within minutes smiling and walking breezily as we left and get back to work. Jeese, what actors. Anyhoo, for whatever reason another story came up. This one guy, rather startling handsome, like a young Paccino, probally had gone to a nearby house and took a plastic kids playhouse. Come sauntering up the walk way in front of the ER with the playhouse in one hand and a can of gas in the other. He parked himself in front of the main door and doused himself in gasoline. Then sat there calmly with a lighter in his hand. I had seen him do all this and had already called security who was off site then, now they have a regular guard at all times. I next called my boss as she had a policy if something came up that looked confusing we could call her day or night. I called her and woke her up out of a sound sleep as it was 3AM.
Our boss was great, she told me to get the fire extinguisher and tell him to cover his mouth with his hand and close his eyes and spray the shxx out of him. She was a freak about fire safety. I had never used a fire extinguisher before although you are theoretically trained to use them. I had never actually sprayed one. Just as I was getting the fire extinguisher off the wall, a medium sized one and reading the directions I see the tech coming around with a sack lunch. We often gave people lunches to tame them. So by the time I got the fire extinguisher worked out he was sitting in this puddle of gas with a lighter in one hand munching a sandwhich. Sitting in the middle of his bulky little kids playhouse, a king in his castle and we his minons for a fleeting momment. I was holding the fire extinguisher behind my back and the tech was ready to pounce on his lighter. Well, as much as crew cutted corn fed boys can pounce. The security guard had not arrived yet and there were not any other staff around. I smiling as big as possible and trying to look like his best friend told him to cover his mouth and he said "why" and I sprayed fire extinguisher all over him. It gave his hair a white windswept flocked look. The tech grabbed the lighter, just then security showed up and handcuffed him.
We later found out he was trying to get admitted because he had a prison term waiting and he was cooked up this idea to avoid showing up for his sentence. He never even made it inside the hospital doors. The security gaurd turned him over to the police. I sent a long note and so he would at least go to jail psychiatric before doing his time for armed robbery. I did have compassion for the guy. Fortunately no one was hurt. A lot of innocent people need to use the front entrances of ERs, back then we didn't press charges when people did stuff like that. Now people are automaticially charged with criminal offenses. Strange to shoot a fire extinguisher off in someones face like that with permission of your boss. Me and Greg are normal people we were not used to wrestling with people or anything. I didn't exactly know were he had gotten the playhouse from to return it, and it was ruined with gasoline and fire extinguisher foam anyway. We let maintenance deal with it.
Another time I was in over my head was this woman doctor that was in a very manic stage and had been reported missing from the east coast showed up naked wearing only a see through brindle skirt brought in by some guy she had met in a truck stop. She had a tiny dot of self awareness and seeing what she thought I might be thinking in my eyes I figure pissed her off. Back then, the gave manic patients what we called two and two, two five milligram haldol and two one milligram cojentin. That was 15 years ago and I don't think they even give haldol out anymore, there are probally lots of other medications now. It got to be a joke amongst us, they need a two and two we would mutter. To be honest, it didn't touch her. She had to be taken to the unit with a security escot blowing kisses to her new found truck driver friend.
I gave her the paperwork and she threw the clip board at me and jumped over the counter. She was lightening fast. I was so surprised, knocking me to the floor, I scurried off running out the door and her new friend stopped her from chasing me. I saw the video once. I ran around the side of the building and cried. Came back and let someone else deal with her. Later her family was so grateful for us finding her that they sent the staff a huge fruit basket and flowers. Probally because they knew her and wanted to soften our experience. For all their wealth they were probally burnt out as many families of manics become. It's a very stressful illness. Apparently she had been missing for six weeks and had come from a long line of manic harvard doctors. I heard that once on the unit she diagnosed some rare illness of one of the patients and after getting stabilized was a example of decorum and good manners. One of the residence said that how could you compete against a manic doctor for study stamina, I soppose he had a point.
The mania can make some people very irritated and hyper sexual and super super grandiose to the point that they believe they have special sexual, etc. powers. Basically she had totally lost her insight and judgement. I never gave a manic person a clip board again, they just got paper and could stand at the counter far away from me. Back then our boss always encouraged us to presss charges when assaulted. I never did. I would guess once she got back to herself she put in the vault she deposits that part of herself after she recovers. A lot of people are are high energy. We used to say the defining criteria of a manic episode was someone not sleeping for several days. Not just trouble sleeping but bouncing of the walls couldn't close their eyes if they tried. This kind of sleep distrubance is the cardinal symptom of mania. Although there are many others. Thats the one that define a real manic break is the inability to sleep basically.
We got to know all the residents. I liked them for the most part and enjoyed a good reputation. I used to always try to give the patients tea or coffee or a lunch if we had extra if they wanted one. Sometimes blankets or even I would dig out old clothes out of the donation closet if they needed some. I remember this one lady I gave a cup of coffee and who took a giant crap on the floor. I was so shocked I called a doctor at 2AM in a panic and said please come up here this lady just pooed on the floor. Help. And she answered to me coldly, pooping is not a danger to herself or others. And curtly hung up the phone. That cleaning lady basically hated me for the rest of my work life. The tech and I used to think of ourselves like an old married couple back then on our long night shifts together. Like goat farmers or a mom and pop grocery. Me and the tech afterward would always say that pooping is not a danger to yourself or others in a sarcastic voice behind that doctors back. That doctor was generally not well liked and didn't bath. She was trying to have a baby by artificial insemination and we used to joke that if she had a baby we all hoped she would bath it.
I know these stories are totally strange. I remember this one rather infamous patient shot herself in the parking lot in the side of her chest and later lit herself on fire in a group home. Another patient who used to inject herself with her own urine and fake seizures. This one woman who had made a living out of faking developmental disabilites, going from ER to ER seeking services and compassion acrossed the country. Flashing grossed out doctors eager to get rid of her and write her the benzo script. She once confided in me that she treated an ER like a hotel hospitality area. This one woman who looked like a young boy who carried around bone fragments and had a disturbing propensity towards suicide pacts where the other person died and she lived. This one lady who carried a stuffed animal in her suitcase named after one of the ER staff. We would all tease him about it. This man who would bellow in a sonarous tone, "I'm suffering, I'm suffering." Or this one guy who reminded me of the Mr. and Mrs. William Blake who managed to keep a marriage together throughout longstanding mental illness. He was a gentle soul and read one of my childrens books and wept.
The people with serious mental illness who were caring for infants and the pain of watching that in the lobby by the staff until social services arrived. The older patients with serious irreversable side effects to the antipsychotic meds, which allowed them to live a modicum of normal lives, laying curling and arching on the floor during bad spells. This one guy who was a caretaker for a church and he came in because he had run across the alter in his underwear and felt he should be put to death for his mistake. The guy who had a persistant delusion that all women were masturbating continuously through their clothes, while driving, at the store, all the staff. That this one psychotic person believed that the sperm of a long ago molestation buzzed inside him. This one young psychotic girl would beat on the doors of this church that used to be an orphanage crying to help free the children. She looked like an angel when the police brought her in. The young men having their first psychotic break effectively ending their lives as they knew it. There stunned mothers in the waiting room.
Strangely my very first encounter with a patient on my very first day of being trained always stuck in my mind. I would eventually want to use her as a character in a novel as kind of an outraged hateful medusa like muse that comments from the background. Her witches brew of rotten food. She came in often for false medication refills and talking theatrically about suicide. She had a purse stuffed to the brim with meds which we would dutifully count and record at each visit. I remember on this one time she dumped all her meds on the floor in front of a doctors feet. Loudly yelling and darkly alluding to suicide "I just hope my donor card is up to date", and the beautific doctor from India, lifting her dainty foot over the pile and smiling serenely and saying airily "thats our Lisa always thinking of others", without an rancor and grabbing the next chart sailing blythley past her. I remember her clawing her meds back in her purse crawling to the door leaving a trail of mascara and tear stained tissues. She claimed to work in the fitting room at discount store. It made me swear off that store for life. I self consciously picked up the tissues and put them in the waste basket. I was such a newby. Then all the people we saw each day that where their for a legitimate increase in symptoms and medication or other social services. The tech guiltilty admitted he read my reports like mini-manifestos and others also. I just wrote like a madwoman.
Me and the tech were both so young in our late twenties. Both married and still not certain what we wanted to do with our lives. After I left the ER and started working in homecare and stayed around a social work department, I never did that kind of work again. It was a fluke I got into it. When I was in nursing school the boss took a liking to me when I was a tech and asked me to work there. I had no idea. The cool boss eventually got canned. She had been the director for 20 years during the late seventies until late ninties. The made it a requirement that all management needed to have a masters. The next nurse they hired the staff treated her terribly out of a reflexive loyalty to Mary Louise. The new manager left after six months. I was alreay gone by then.