Something Happened in California

It was a painfully slow day. There was a football game on TV which always clears out the ER. At that time there were 2 docs on shift. The doc and I weren’t the latest shift there. In fact, we were fixing to move upstairs to the fast track section of the ER. It’s where all the runny noses, watery eyes, and finger cuts go. They don’t require the big workups the patients down in the ER will need. We set the fast track people in a room, throw some meds at them and if some stick in their mouth, we discharge them with a 1-2 day work/school excuse.

The room we were gathered in, due to construction, had plans to be divided into multiple rooms. I had gone over the dimensions and had mentally calculated the best way for them to divide up the rooms to give them the most usable space.
We were *that* bored.
The doc let out a painful groan, stared into his coffee cup, then looked at me. I shook my head. No, no new labs were back. He didn’t have to ask, I didn’t have to say.

Moments later, two new patients popped up as needing to be seen. One was an old lady with a head injury. Another was a 59 y/o lady complaining of depression.
I showed the doctor. He looked and asked, “Which should we see?” He was to the point he didn’t care. Such slow days suck the life out of you…much worse than the busiest hardest days. I looked at the clock and realized we were to go upstairs soon.

I rested my chin in my hand and looked over their past medical problems and meds. Yikes! Head injury lady was on Coumadin and would need a big workup, not to mention a CT scan. I chose depression lady and told the doc.
He nodded and took a few sips of coffee before grabbing his stethoscope and standing up, reaching towards the ceiling in a stretch. “If she takes forever, it’s your fault,” he warned me.

The woman sat in a chair in the room, not on the bed. Her legs were crossed, her arms were folded. She certainly didn’t look happy.
The doc starts with the typical, “What brings you to the ER?”
She looks up and I think, “oh dear”. She reminded me of my step mother. Bat-shit-total-loon with a side order of bible thumping crazy (no offense to the religious folk).
I parked it across the room from her. The nurse stood next to me. I gathered she had the same sense. The doc, well, he doesn’t care about that stuff and sat on the exam table across from her.
“My shoulder hurts,” she tells us. Immediately I recall a suicide attempt, reason being because the guy had a bladder infection and thought this would be similar.
“Your shoulder hurting is why you’re here,” the doc questioned.
“Well, it all started with my shoulder,” she said to us indicating that it was story time. Oh joy! Story time!
“A screw came loose,” when she said it, I tried not to laugh at that, “and the surgeon refused…REFUSED to fix it.”
“Okay,” the doctor said.
“I kept telling him that it hurt,” she said, tears filling her eyes, “but he wouldn’t do a damn thing.” She stabbed her finger towards the floor with each word, “Not a damn thing.”
“Uh-huh,” said the doc.
“And I’m worried about my son. Since something happened in California.” She looked at the doc. We all knew what she wanted, including the doc. She wanted him to ask what happened, but he wasn’t about to open that can of worms.
“My son hasn’t been right ever since.” She wiped her eyes and twitched her foot. She was wearing Keds. They were plain white. She had some green pants on with a purple shirt and a grey hoodie over it. Her pants rustled when she kicked her foot. She still had her arms crossed and wore a scowl on her face. Her lip quivered, “So I just don’t know what to do. I used to see a psychiatrist before something happened in California.”
“When was the last time you saw them,” the doc asked her.
“A year ago. That was before I had to get out of California.” She looked at him again. I could see it in her eyes. She wanted him to ask so badly it was almost painful to her.
“Were you on medication,” he asked her.
She nodded and kicked her foot again since he didn’t ask about California. “I was on several things for depression. None of them worked.”
The doctor asked a few more questions then said to her, “Let me tell you how things will go. I’m the emergency physician. I don’t have training in psychiatry so all I will be doing is just clearing you medically. Then we’ll have a social worker come to talk to you–they have more training in psychology than I do–and they’ll set you up with a psychiatrist.”
“That’s fine,” she said to him. She covered her face after a sob, “I just need to talk to somebody. What I’ve been through is horrible.”
“We’ll get someone for you to talk to,” he said to her and moved to begin conducting an exam.
She halted him by raising her hand. “When I was in California,” she started. I thought, oh boy, here it comes. I was interested actually. She made me curious. “When I was in California, Homeland Security came into my house…” she paused as her voice began to shake. I was mentally shouting for joy. The crazy gods had smiled down upon us for she is dragging the government into this! “…they ripped me from my house and took me away…” Again, she had to pause. Yes, yes! Go on! “They threw me into some hospital and drugged me with sodium penthol.” Government and hospitals and drugs, oh my! This is turning out to be a great story time! Everyone in the room was absolutely still. We figured she was about to snap and we didn’t want any vibrations from our movement to cause her to finally let go.
She let such atrocities sink into us before continuing. “And after that, they returned me to my house like nothing happened.” She wore a mock expression of amazement. We were all also amazed. This was the perfect crazy person story. And all she needed to do was snap.

“Okay,” the doctor said. …and snap! I could almost hear it.

The snap manifested on her red face. “No! Don’t tell me it’s ‘okay’! Don’t dismiss me passively!” She pointed to him and shouted, “What if it was your mother, your daughter, your brother, your grandmother, your aunt, your uncle, your wife!” For a while, I didn’t think she’d stop and I wondered if she would include me into her rant, but she didn’t.  My self esteem took another blow.  “Don’t take that passive…” she was so flustered she couldn’t finish and flapped her hand at him. “Just, get out! I don’t want to talk to you anymore! You can just send in your little social worker!”

She wanted a rise out of him. Or maybe she wanted him to drop to his knees and beg her to let him stay. But not this doc. He would gladly leave. He would even grab himself by the back of his scrubs and fling himself out.
“Okay, we’ll send in the social worker,” he said. I could almost hear the joy in his tone.
We left. I looked to him and said, “I didn’t see a tinfoil hat on her head. Do you think it’s in her pocket or is it invisible so Homeland Security can’t detect it?”
He chuckled. He made a space of about an inch between his thumb and index finger and said, “She’s just a little delusional.”
“But you got out of there fast,” I said to him.
“I appreciate that.”

Later I looked at her shoulder x-ray. What do ya know…she had a screw loose.