2008-02-10
SCHIZOwhat?? 1st week in psychiatry dept.
Alas, while I am hoping to start the semester with some light subject, the opposite is taking place, and so I'm stuck here in the psychiatric dept for God-knows how-long.
The problem in psych cycle is that, ...you dont have to bring anything instrumental (no stethoscope, BP set, tongue depressor, thermometer) but what you need is an excellent skill to talk with patient...and while I am well-known for my verbal skill in making contact, I obviously lacking that one when we have to conduct a psych status exam in Russian!!!
of course if it is a normal patient, they might understand what I am trying to say...but here is a mental patient, they can hardly even decipher the word "cookies", and here I am sounding as mental as they are..
anyway, no picture can be included here as to protect privacy
Here are some interesting case I have seen so far:-
1. a 51-year old physic teacher acknowledge the presence of his dead grandparents before him, and hearing their voices, fortunately though, its not commanding...so the voice didnt tell him to kill other person, etc. Kidding, he is nice...so its ok. He was a physic teacher, so u can conclude that his conversation is filled with physic terms like "quantum" "velocity" and what not. Claimed that he was admitted into the hospital and receiving the treatment for "his grandparents" so that they are health (ie he was the portal through which his grandparents received the meds). He was diagnosed with "Simple Schizophrenia"
2. a 31-year old military outcast admitted for the 28th time into a psychic hospital. Earlier evaluation shows the sign of conflict in home with parents. Parents are alcoholic, and while patient didnt seem to hate his parents, he actually wish that his parents condition can be reverted. No hallucinations, but depression seems major. Avoidance to talk about "conflict" and "main issue" and the tendency to change topic. Orientation is good, though date orientation is blurred. I would have investigate more for history of physical/sexual abuse at home during childhood as patient seems reluctant to discuss about his parents, and the oversensitivity to arguments and criticism is highly visible. But the doctors already diagnosed him with "Paranoid Schizophrenia" and thus I had to agree with it :)
3. The best one. 19 year old medical college students. Was admitted for the first time. Cause of admission is due to commanding hallucination. Few weeks ago, patient suddenly take off his clothes in the middle of class, acknowledging a "voice" telling him to conduct "sexual intercourse " with the girl sitting next to him. Orientation seems good, and prior to the disease, patient doesnt seem to have any social difficulties and in learning. While patient admitted that he know the act is "immoral", but he couldnt resist the temptation to follow the commanding voice inside his head. Several days ago, visual hallucination started to appear where patient see himself making a sexual intercourse with another unidentified woman. Upon my conversation, we found out that patient had had a girlfriend with whom right now he is not in contact anymore. I would have thought that this is a classic case of "woman-o-phobic" where rejection by a women lead to impulsive projectile behaviour towards other woman. But the dr had diagnosed him with "Paranoid Schizophrenia"
cool huh???? hehe...for the next few days to come, I wait anxiously for another new interesting cases. this one actually way cooler that those typical Diabetis and Arterial Hypertension :)
warm greetings from the Schizo- world!!
The problem in psych cycle is that, ...you dont have to bring anything instrumental (no stethoscope, BP set, tongue depressor, thermometer) but what you need is an excellent skill to talk with patient...and while I am well-known for my verbal skill in making contact, I obviously lacking that one when we have to conduct a psych status exam in Russian!!!
e.g : I would like to ask "How is your relationship with your parents?"
instead it become "WHat is your tendency towards your parents"
instead it become "WHat is your tendency towards your parents"
of course if it is a normal patient, they might understand what I am trying to say...but here is a mental patient, they can hardly even decipher the word "cookies", and here I am sounding as mental as they are..
anyway, no picture can be included here as to protect privacy
Here are some interesting case I have seen so far:-
1. a 51-year old physic teacher acknowledge the presence of his dead grandparents before him, and hearing their voices, fortunately though, its not commanding...so the voice didnt tell him to kill other person, etc. Kidding, he is nice...so its ok. He was a physic teacher, so u can conclude that his conversation is filled with physic terms like "quantum" "velocity" and what not. Claimed that he was admitted into the hospital and receiving the treatment for "his grandparents" so that they are health (ie he was the portal through which his grandparents received the meds). He was diagnosed with "Simple Schizophrenia"
2. a 31-year old military outcast admitted for the 28th time into a psychic hospital. Earlier evaluation shows the sign of conflict in home with parents. Parents are alcoholic, and while patient didnt seem to hate his parents, he actually wish that his parents condition can be reverted. No hallucinations, but depression seems major. Avoidance to talk about "conflict" and "main issue" and the tendency to change topic. Orientation is good, though date orientation is blurred. I would have investigate more for history of physical/sexual abuse at home during childhood as patient seems reluctant to discuss about his parents, and the oversensitivity to arguments and criticism is highly visible. But the doctors already diagnosed him with "Paranoid Schizophrenia" and thus I had to agree with it :)
3. The best one. 19 year old medical college students. Was admitted for the first time. Cause of admission is due to commanding hallucination. Few weeks ago, patient suddenly take off his clothes in the middle of class, acknowledging a "voice" telling him to conduct "sexual intercourse " with the girl sitting next to him. Orientation seems good, and prior to the disease, patient doesnt seem to have any social difficulties and in learning. While patient admitted that he know the act is "immoral", but he couldnt resist the temptation to follow the commanding voice inside his head. Several days ago, visual hallucination started to appear where patient see himself making a sexual intercourse with another unidentified woman. Upon my conversation, we found out that patient had had a girlfriend with whom right now he is not in contact anymore. I would have thought that this is a classic case of "woman-o-phobic" where rejection by a women lead to impulsive projectile behaviour towards other woman. But the dr had diagnosed him with "Paranoid Schizophrenia"
cool huh???? hehe...for the next few days to come, I wait anxiously for another new interesting cases. this one actually way cooler that those typical Diabetis and Arterial Hypertension :)
warm greetings from the Schizo- world!!
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