It was a busy day:
There was the guy who spoke with enthusiasm about his doctrine of RUL (“Righteous Unconditional Love”); the man who stared through me after I asked him about whether he had eaten that morning; the fellow who made no efforts to hide his nose-picking while expressing his frustration with the court system; the young man who wouldn’t let me inspect the wound on his hand, though I soon recognized that he had crafted the wound out of a packet of juice crystals; the man who hadn’t taken a shower in several months, though the odor bothered me more than it bothered him; the guy who boasted about his abilities to run a mile in two minutes; the man who refused to acknowledge my existence; the fellow who advised me that he would prefer to take his medications in the morning because that’s what his nurse practitioner told him to do; the man who apologized for masturbating, but argued that he is young and “that’s what young people do”; the fellow who said that after he used “bad heroin”, he realized that his parents aren’t actually his parents; the guy who found lithium energizing and was in the process of tapering off of methadone; and the man who simply said, “I’m not sick,” when I asked him why he hadn’t been taking medication that the state psychiatric hospital had prescribed to him. Nurses paged to ask for orders for medications to reduce the discomfort of heroin withdrawal, medications that patients had asked for three days ago, medications that patients took before they entered jail. The phone rang as callers shared information about diagnosis, treatment, and next steps.
I tipped my head back in the chair, stretched my arms up, and sighed.
“You okay?”
It was my second year of residency and I was the only psychiatrist in the hospital that night. My duties included addressing any issues that occurred in the psychiatric unit and providing care for any patients that came to the emergency department with psychiatric concerns.
My classmates had warned me about a particular emergency medicine attending physician who was working that night:
- “Last week he told me I was useless.”
- “He rolls his eyes at me all the time.”
- “He’s just angry. He won’t ever thank you for anything you do.”
“Hi, Dr. Angry,” I said around 7pm. “I’m the psychiatry resident on call tonight.”
After glancing at me, Dr. Angry grunted.
Well, I guess that’s how it’s going to go tonight.
Less than three hours later, after Dr. Angry referred four patients to me, he muttered in my direction, “I’ve got another one for you.”
Shortly after midnight, a patient’s husband was pulling her out of the ED while she was screaming at me.
“I’M GOING TO GET YOU FIRED FROM HERE! YOU’RE A TERRIBLE DOCTOR! I KNOW THE PRESIDENT OF THE HOSPITAL! YOU CAN’T DO THIS TO ME!”
I was shaking, but I wasn’t going to admit her to the hospital. Dr. Angry caught my eye and nodded once. I wasn’t the only person who knew I was shaking.
It was close to 3am and I had already seen seven patients.
Dr. Angry had a slight smile on his face as he approached me while I was slogging through my notes.
“Dr. Yang, there’s another one for you to see.”
please make it stop
“Thank you. Who is it?”
As I was beginning my note around 6am for the ninth patient I saw, Dr. Angry stopped by.
“Dr. Yang, you did all right. Thank you.”
“You’re welcome, Dr. Angry.”
I tipped my head back forward in the chair in the jail and dropped my arms.
“Yeah, I’m fine,” I replied to my colleague. “It’s busy, but it’s good to be busy. And when I think about my intern year, this isn’t bad at all.”
Maria Yang, MD 