Wednesday, June 14, 2006

Gone Postal

Just so you don't think that being a therapydoc is all about manipulation, glamour, and a little heart to heart, I'm going to tell you a story.

This one's about a guy, a new patient who had walked into my office a few years ago and SCARED THE LIVING (sic)DEATH out of me. All of the details have been changed to protect his identity, but I think you'll get the idea.

He wasn't tall, but he was brawny and tattooed, sweaty (it was summer) and unshaven. He wore torn cut-offs and a wife-beater tee-shirt. He had a piece of gauze taped over his wrist, and I knew what that meant. He sat for a few minutes with his head in his hands, staring at his shoes. His head was large and his hair greasy. I chilled.

After what felt like forever he looked up at me and said, "My wife's leaving me so I want to die. Just this morning I tried to kill myself., Want to see?" Uh, no, that's okay, I'm thinking, but I don't answer.

Then he proceeds to unwrap the gauze (thanks) and show me a wound so deep and ugly and, yes, fresh, that I got sick (not literally and I didn't show it, but still feel the nausea when I think about it).

I go, "Uh, there's a hospital down the street. You need to have that stitched up." He tells me he's not seeing any more medical doctors. He's already tried the anti-depressants and he's been in hospitals and he's finished with all that crap. He's just plain finished.

Now you have to understand. This is a guy who had a referral to see me from either an insurance company or a doctor, so he had some program running that worked. And he'd filled out all of his patient information before sitting down in the modest digs I call an office. So how sick was he?

Turned out his wife was angry at him for losing his job (or whatever, remember, I'm changing all the details, he could be a woman, a transvestite, anything).

I got the impression this patient showed some poor anger management at work and was worried his spouse didn't love him anymore, or some such thing, because of a suspension. What matters is that he/she threatened to go postal, to go back to work and shoot them all up.

This wasn't my first patient who had talked about going postal, in detail, describing the who, what, when, how, and why. I don't exactly give homicidal maniacs, or suicidal patients, much room to do it. Not on my watch, says I.

All right, am I making this up, you wonder? I've changed a lot, but the anecdote is pretty much as it happened. Parables, fables, Bible stories—all nice, but stories that smack of reality pack more punch.

At the time, even as I was working like mad to figure out how to get the police to my office while he was sitting there looking very scary, I thought, Who needs this crap? It's why cops are always drinking on television after work, literally hurrying off to the bar.

You want to know what happened? Sure you do.

Somehow I convinced him to let the police come and take him to a hospital. He really did fit a bi-polar disorder profile, which is why the anti-depressants he'd been on hadn't worked for him.

I arranged an admission at a psych hospital using his insurance. He said, "Give me a couple of hours. I'll go home, shower, change, kiss my wife and kids, and then the cops can come and get me. Give me two hours."

I said, "As soon as you leave my office, I'm calling the police. I'll tell them to give you time. They will, I know they will." (I was sure they wouldn't.)

He was fine with that. I called the police, then called his wife, but no one answered. Oh expletive, I thought. He's changed his mind, gone postal. (what would you think). I talked to the police a few more times. They were out looking for him. I even got paranoid, afraid he'd be looking for me.

After work, as soon as I got home (this was before cell phones) I tried calling his home again. A non-English speaking female answered. I asked for him. She said no, not home. Great.

How do you sleep after that? Not easy. Lucky I'm pretty tired by one.

Anyway, next day I called that hospital and sure enough, he was there. I consulted with the docs and told them his history—Give him lithium, dudes, please don't futz around.

Finally a nurse on the floor got the patient on the phone. He said he'd gone to his cousin's house after he left me. They had some dinner, he changed clothes. His cousin drove him to the hospital. He'd been afraid to go home. She kicked him out, after all. He wasn't going to disrespect her.

He said he'd give me a call when he got out of the hospital.

But he never did.

Copyright Therapy Doc, 2006


Alice said...

"Going postal" means going into work and shooting everybody? Wow. I don't think we have a specific expression for that over here...

I am reading all your archives bit by bit :-)

Anonymous said...

"Going postal" is used when

1.someone loses self-control and acts violently towards another person or people
2.Over-reacts to something that someone said or did. (This is how I usually hear it being used)

therapydoc said...

Thanks Anon