psyche evaluation

this is the chief complaint for more people than you would think. a patient hardly ever admits they need a pysche evaluation, but when they answer the 'what are you coming in for today?' question with statements such as 'im hearing voices', an assessment of their mental status is usually in order.

unfortunately for the docs but fortunately for the bums, when there is no obvious medical concern for a homeless man, these three words equal a golden ticket to a brand new bed to rest their mangled head on. it is my personal belief that these bums had a meeting many years ago, and discussed the ways to get into the ER. apparently saying you're insane was the rivaled winner. coming in second is 'possible frostbite', followed very closely by 'im suicidal.' also a free pass for a mental assessment.

usually when i get a nut sitting in front of me, i like to sound real concerned.

always, though, im trying to hide some sort of 'great, another psychopath' expression.

one particular night comes to mind. the usual 'i'm hearing voices' thing came unexpectedly, i mean the guy was well dressed, spoke normal, and was in his mid twenties. i get him to the back, he pulls me aside and says 'hey, can i ask you something? off the record?'

'sure,' i said.

'what would you say if i told you it was beyonce that keeps talking to me?'

jesus.

'i dont know, i guess i'd say you're pretty lucky. could be worse.' i learned then that telling an ER patient, especially one in for a pysche evaluation, that it could be worse is usually the wrong thing to do.

'she's telling me i should kill myself,' he says. 'after i kill everyone i know.'

christ.