O paged me - "got one for ya." He's so cool. I love doing things for O because he never gets psycho. Even when he was berating the night shift for not drawing cardiac enzymes, he never raised his voice, just explained things in a this-is-ridiculous tone of voice, words carefully chosen and very fast. I wish I were like that.
Met him in the shock room in front of a mountain of flesh. The man is nearly 2 Hoosier Units - that's almost 400 pounds, for those of you not from the Midwest - and he smells bad. And he's on oxygen, staring blankly into space. We try to get a history. He's not cooperative, other than giving us his mother's name - doesn't tell us anything useful. It's not that he refuses to answer questions, it's that he doesn't. Just keeps talking about nothing.
I keep going, O calls mom. He told me a huge run-on story, with highlights like the following:
- He used to be a police cadet before he got whacked and spent a long time in a coma.
- When he was working, he used to mark where his truck was parked, and someone moved it every day. That same someone (he had names for all this, but I don't remember them) got a spare key to his house and beat him up and took all his money because he called the drug house over on (some street) in to the police.
- He faxed the info to the Feds in Waco that let them bust the place.
- Someone stole his van and chased him all over town with it.
- The reason he's in the hospital is because (name) right over there (here he points to the ER nurse), who stole one of his police cadet uniforms and used it to pretend to be a cop, knew that he knew that he wasn't really a cop and found him on top of his mom's house and shot him. But our patient, being a canny fellow, had a camera on a pole to watch the roof of his mama's house and it's wired to a TV downtown, right to the Federal Government, and they sent the police.
O gets off the phone as I'm listening. I finally escape to find out that Mama says he does cocaine, and that he gets these spells like this...and there he is, still talking as long as he thinks I'm listening. He went on and on and on. This is a mid-forties gentleman who still lives with his parents and does cocaine, obviously with some kind of delusional thinking, and we don't know when he last drank - he says some kind of liquor-store wine, I'm thinking Red Rose type, three days ago.
We're scanning his head, his heart (oh, he's in atrial fib, and he has hypertension, and he has diabetes), and his blood. Tox is negative, alcohol is negative, so our guesses are some kind of stroke, DT's, or just plain crazy. Peeked at the labs and someone's ordered a syphilis screen. It's possible...
I'd barely finished with him when O sends me over to see the next girl. I have a Mage character who's a barely-legal child of a hippie, raised on peyote and pot, hooked on X and only avoiding hard drugs because she's too vain to stomach the idea of needle tracks marring her body. This girl was Jen gone wrong.
She's early-twenties, history of having showed up at the ER once for detox with a claim of shooting up heroin 10x a day, taking percocet 60-80mg, and about 150 other pills, and walking out before the paperwork was done. She's in now because her dad picked her up from a friend's and noticed she was absofriggin'lutely nuts. We got her because her creatinine is high.
Urine tox is positive for cocaine, amphetamines, and opiates. Interview consisted of us asking questions and her talking a hundred miles a minute about somethign completely else, then apologising and giving us a few semi-lucid seconds. She told us she'd been shooting up cocaine and heroin the previous night - not together, no, sequentially. "Wouldn't they just cancel each other out?" A asked me later. "Get nothing?" He was being facetious. She probably was doing something else - the girl was completely manic, absolutely out of her mind with drugs. It was an amazing experience. I could put my hand on her shoulder - the contact seemed to give her focus; she'd look at me and keep looking at me as long as I was touching her - and talk to her, she'd pay attention to my face, nod a bit, get teary. And then I'd ask a question and she'd give me a high-velocity stream of gibberish before looking all around. She was very concerned with under the bed, and with all the other patients.
We gave her enough Ativan to put her to sleep so the nurses could get fluids in her and draw labs. She later woke up, I was told, and they had taken her out of restraints, so she was dancing half-naked around her little isolation room. When we got there she was in restraints - one hand, one foot. ER nurse said "She's gotten out twice already - walks around popping into other people's cubicles and scaring them - I just use them to slow her down a bit. I don't want to lose her."
I wonder, O Best Beloved, what she'll be like tomorrow as she starts to go into withdrawal from the heroin and amphetamines...
It's half an hour past my self-assigned bedtime. We capped around 8 or so except for the shockroom patient, I have my two admits and my H&P work is done; I've been dismissed for the night. In the morning I have three patients - one druggie, one strange man, and the sweet old lady with the stroke and the childish gestalt. Nobody in their right mind today. Is it a full moon?
Friday I see my Angel. Friday I get my car. Fridayfridayfriday.