Experiences in an Inner City Psych. Ward

During morning rounds I am observing a patient being interviewed in her room. A small African American woman in purple bell bottom sweat pants and a yellow shirt comes down the hall and pushes at the exit door. It does not open. She turns around and pushes on a "staff only" door. It does not open either. "B-TCH!" she yells angrily as she kicks the door. She gives the door another loud kick. "M--F-cker!" she screams. She repeats this loud, distracting action about 7 more times and we continue our rounds as if nothing is happening.

On another day I am chatting pleasantly with the door kicking woman in the hallway (from the back, she thought I was one of her patient friends who has similar hair length and color) and the man who thinks people are casting spells on him wanders down the hall chanting as he periodically sniffs out loudly through his nose to remove the magic spells that entered through his eyes.

Imagine not leaving your house for four weeks because you were waiting for God to let you know that the towels you wanted to buy were at Big Lots. This is another patient down the hall. These delusions are reality for a few of my patients on the psychiatry unit. Many of them have Schizophrenia. While sad at times, these folks ensure that a day on the Psych ward is never boring. I love them all.

Then there are those who visit for more immediate dangers. A man tried to hang himself but the branch he used broke and he failed at the attempt. A woman ran into traffic after a failed shoplifting attempt because she felt that she is a disgrace to her family. Another man was physically and sexually abused, lost touch with his family, can't trust anyone, and feels there is no hope for him. He banged his head against the wall until it bled, because he couldn't shut out the noise. After he left the conference room I questioned whether PTSD could be part of his diagnosis. The attending physician said I was quite perceptive and he would do a work up for that. Some folks come in because they have hit the bottom and are afraid they will hurt themselves.

I find myself wondering what it would take to push me to the breaking point. A "psychotic break" is what they call it; the first time you lose control of your reality and start experiencing delusions and hallucinations. I've certainly had my share of questionable thoughts. Where is that line?

I have three weeks left in this inner city Psych. ward; I hear we care for some of the sickest patients. It may be the ugliest hospital down town, but I think because of that, it draws the most compassionate staff. I hope to follow their examples as I continue down this road.