...for the psych eval...


Always amazes me when we get called to evaluate possible psychiatric patients. Reading a recent post by Medicblog999 reminded me of a fellow who not only has psychological issues, but had math issues as well.

THE EMERGENCY

A man has called from a payphone stating he is a threat to himself and requires an ambulance.

THE ACTION

The police have "cleared" the scene. In this situation, they were waving us in while standing away from a man dressed mostly in denim lying in the bus stop shelter next to the phone off the hook. He is motioning towards his left arm which strikes me as possibly an injury.
Off the ambulance we make contact and our scraggly beard patient has that distinct odor of week old urine. A smell so thick and so penetrating I hesitate to even breathe near him, let alone put him in my office.

Throughout the course of our assessment we find he is complaining that no one will listen to him at the VA and get him a complicated hip surgery necessary due to injuries he received in battle. His pointing is to the Airborne patch on his dirty denim sleeve.

Our patient identifies as a veteran.

A quick aside from the tale before someone gets upset when I describe what happens next. No person who served in uniform deserves to be put or find themselves in the situation I found this man in. These men and women are serving in a field I am not cut out to do. I admire anyone who chooses to stand and fight for me and my family.

Our veteran friend has a valid VA card, which the staff almost requires for evaluation in the ER. We get him loaded and covered in a blanket to cover the smell and get underway. Gathering his information I ask about his living conditions and situation in an effort to guide him towards other veteran's services in the area.

When I asked what branch he served in he rattled off the division, unit and details I didn't completely understand. When he answered after I asked where he served, my ears perked up and I scratched my head.

"I did 2 tours in 'Nam, man." Was his response. According to his VA card, he was 51 years old.
"When did you get sent over? Were you drafted?" I wondered aloud, more curious than accusatory.
"I don't have to tell you anything kid, but I'm a veteran." he grumbles.
"If you don't mind sharing, how were you hurt?" I thought was non-threatening, he did not. He began to scream that my generation had no idea what service meant and that he and his brothers in the service in the 60's knew more about everything than I ever will. I can't challenge that statement, so I'm back on the bench finishing my report.

I never doubted my new friend had served his country, but I now doubted where he served. By my math he would have been 12/13 at the height of the conflict and just turning 17 when combat was winding down.

At the VA facility the staff was upset our patient had the aroma he did and spent very little time talking to him while we were there. Last I saw him he was falling asleep in the bed in the corner, likely to be kicked out when he awoke, no better off than when he came in.

Comments

Anonymous said…
You guys don't get nearly enough credit for all the blood, guts, odors and crap that you have to put up with everyday on a daily basis. I was barely able to handle when one of my kids was hurling....and I like them! Keep trucking man.....glad I'm in a nice clean office every day. Whew......