“Psychiatry consult, returning a page,” she said, cradling the phone between her left ear and left shoulder. Digging around in her pockets, she eventually pulled out a half-sheet of paper that wasn’t already covered in barely legible writing and boxes marked with Xs. Her right hand clicked the pen and prepared to write.
“Hi, this is Cardiology,” the male voice on the phone said. Doctors tend to lose their names when they are calling consults. “Thanks for calling back. I could use your help.”
“Okay,” Psychiatry said.
“The patient’s name is Montgomery Ward,” Cardiology said. “He’s a 47 year old guy with a past history of high blood pressure, high cholesterol, and diabetes. He was admitted yesterday with a chief complaint of chest pain. We’re treating him in the coronary care unit for a heart attack.”
“Uh huh,” Psychiatry murmured, scribbling notes onto the scrap paper.
Cardiology took a breath and then said, “He didn’t sleep at all last night and won’t stop talking. He keeps asking to leave and says something about having to end the war overseas, that he’s the only person who can do it. I think he’s manic.”
“Huh,” Psychiatry said.
Cardiology asked for help with diagnosis and treatment. Psychiatry said she would see the patient within half an hour.
“Great,” Cardiology said. “Here’s my pager number, but I’ll probably be at the nurses station, charting.”
Psychiatry walked into the unit and immediately heard a man talking loudly. She guessed that this was Mr. Ward.
“If I don’t go there the war will never end I know the generals I taught them everything they know They will listen to me and stop They all know who I am The President will get upset if the hospital doesn’t let me go No one wants to make the President upset The President once gave me a golden heart—”
A nurse, recognizing Psychiatry, pointed at the talking man and commented, “He’s yours.”
Before Psychiatry could respond, a man in a long white coat and blue scrubs said, “Hey, are you Psychiatry?”
Psychiatry nodded.
“Hi, I’m Scott, the coronary care unit resident,” Cardiology said.
“Jennifer,” Psychiatry said, waving hello. “I’m guessing that’s Mr. Ward?”
“Yeah,” Scott said. “He’s been talking like that ever since he got here. He might have slept for an hour last night—if that. Let me introduce you.”
Scott led Jennifer into the room. He rolled a stool from the corner and sat down.
“Mr. Ward—”
“Dr. Scott, the President will be upset if you—”
“—I want to introduce you to Dr. Jennifer, who is a psychiatrist—”
“—don’t let me do my job The military is counting on me to be there and I have the secret codes—”
“Mr. Ward—”
“—and without the secret—”
“Mr. Ward!” Dr. Scott said loudly… and calmly. He waved his right hand in the air.
Mr. Ward stopped for a moment.
“I know you’re concerned about the war and your dedication is admirable,” Dr. Scott continued. “But I want you to meet Dr. Jennifer—”
“I once met a woman named Jennifer who said that she would help me get messages to and from the battlefields and she—”
“Mr. Ward,” Dr. Scott cut in, smiling. “Let me finish, please.”
“Sorry I just have so much to do—”
Dr. Jennifer watched the conversation and smiled to herself. Though he couldn’t finish a sentence, Dr. Scott was gracious with Mr. Ward. The patient was noticeably not put off with Dr. Scott’s interruptions. She was impressed. Not all doctors she had worked with in the past demonstrated this level of skill with patients—particularly those that were difficult to steer, for whatever reason.
“—so I hope you’ll talk with her so we can all help you get better soon,” Dr. Scott finished.
“Okay Dr. Scott whatever you say but the military needs me—”
“Hello, Mr. Ward,” Jennifer said, taking her cue. Scott stood up and Jennifer took his seat.
“… so that’s what I would recommend for you and your staff. Hopefully, that will help keep him here so he can get proper treatment,” Jennifer said to Scott. “I’ll put all of that in my note.”
“Thanks.”
“By the way,” Jennifer said, “you did an excellent job in there with Mr. Ward. Given his current state, it’s not easy to interview him. Nice work.”
Scott chuckled and looked down. “Thanks,” he said. “When I was in medical school, someone taught me how to talk to manic patients.”
“Oh, really?” Jennifer asked.
“Yeah. I was on my psychiatry rotation and the chief resident gave a talk on interviewing techniques. It was really useful.”
“And that’s why all medical students should go through a psychiatry rotation,” Jennifer said, smiling.
Maria Yang is a psychiatrist who blogs at In White Ink.
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