Who Did You Murder?

This is terribly belated because I couldn't deal with it for a long time.  It wasn't funny because it was too goddamned terrible.  Now it's still terrible, but full of absurdist this-can't-possibly-be-my-real-life humor.

Imagine for just a moment that you're a psychiatrist in an inpatient psychiatric facility.  You see people everyday who are quite ill and having a difficult time in their lives.  It's your job to try and help these people, both with counseling and medications.  A lot of your patients have dealt with situations so traumatic as to be inconceivable. You can't even imagine how bad things were for them.  But still, you try.  You offer support and a safe space and most of all you listen.  But maybe you've done this too long.  You've heard too many stories.  You know too much.  You become inured to human tragedy and dignity and are at this point just going through the motions.

Now that you've gotten yourself into that headspace allow me to tell you a little story.

Plenty of our patients were victims of terrible things, but plenty of them had also done terrible things.  It doesn't matter.  Everyone gets treated the same, but it's still important to know a patient's back-story.  It is important both for his or her treatment, but also in many cases for the safety of those around the patient.  

Safety of staff and patients is of utmost importance at a psychiatric facility.  The doors all lock automatically.  There isn't anything sharp on the wards.  The bathrooms for the patients don't have locks so they can't barricade themselves in there and hurt themself.  As students we aren't allowed to wear our nametags that pin to our jackets because the pins could be used as weapons.  Anything you can imagine that could be used for harm and some things that you can't imagine are all gone.  The windows don't even open.  Safety has been considered from pretty much every angle and all the staff are really serious about enforcing it.

There was this one patient, he had a teardrop tattoo on his face.  He was a gentle-spirited man who was highly medicated for his psychiatric illnesses. He was on the most "advanced" of the units in the hospital.  Each day when we spoke to him he seemed sweet, but confused (probably because of the heavy tranquilizers he was getting).  I've never met/seen anyone with a teardrop tattoo, but I've heard of them so we asked our attending whether or not he had murdered someone.  She didn't answer and didn't seem concerned, so I didn't think anything else about it.  The next day when we interview the patient she calmly looks him in the eye and in her best/most perky/sounds like Elle Woods from Legally Blonde voice asks him "Who did you muuuurrrrddddddeeeeerrrr?" He doesn't really flinch and mutters someone's name.  She asks a follow up of "Whhhhhyyyyyy did you muuuurrrrrddddeeeerrrrrr him?" to which he replies "because he was talking smack."  This was a tiny bit terrifying and pretty much where she ended that day's interview with the patient.

The next day this same patient says he can't sleep at night because his thoughts are racing.  This is not an unusual complaint.  The attending suggests he might find it helpful to draw out his thoughts.  He says that he doesn't know how to draw.  Okay- that should have been it.  The guy can't draw; we should think of something else.  No.  She did not think of something else.  She looks at one of the students and says "Teach him to draw Jaaaaaaaammmmmeeeeesss" (This is still in the weird perky Elle Woods voice that I never heard her use with any other patient).  So James asks him what he would like to draw and he says a fish.  James draws a basic fish and says something along the lines of "there you go.  That's how you'd draw a fish."  And the attending says "Nooooooooooo.  Teach him, James.  Teach him."  She makes the student drag his chair within 6 inches of this patient and give him a pen and paper to draw with.   All I can think is OH GOD OH GOD THIS GUY'S GONNA NEED ANOTHER TEARDROP! WHY DID WE HAVE TO GIVE HIM A PEN? A PEN MAKES A REALLY GOOD WEAPON! OH GOD OH GOD WHAT DO I DO WHEN HE STABS JAMES????

He didn't stab him, but he also didn't learn to draw.

There's no moral to this story.  Just maybe don't make your students give known murderers weapons and then sit really close to them.

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