Yes, it is. A New Year. And my wife and I are going to have another baby. A little bit of a shock but not all that unexpected when you have unprotected sex. Just wish we could have had a little more sex before the big bang. But those are trials of life.
Enough about me, I'm a shrink and it should always be about you, not me. Self disclosure should rarely be used in any professional therapy. Oh what the hell, let me tell you about this one ...

I have a pain in my neck. This you may be surprised to find out is not one of my patients. It actually is a pain in the neck. A huge lump of muscle the size of a golf ball is imbedded in the muscle at the back of my neck and it is .... I know you women out there are going to call this a "man flu" syndrome, but it is KILLING ME! I know, I know, men never have colds they have the "flu" and little lumps are always "cancer" and "I'm going to die" invariable means I'm going to live a very long time. Some people think just to annoy my partner... BUT it has been there for the last 2 days.

These 2 days have significantly been the 2 days I have been back at work. That tells you everything.
God, I need another holiday. Some of my patients believe that they can talk directly to him, so if any of you who are not taking your medication at the moment can actually talk and hear GOD then please give him that message from me and then TAKE THE DAMN TABLETS....

Blog

20/09/05

I have been found out. Well, I think they are on to me and it is the reason I have not been able to post anything for a while. Paranoia, I have some insight into that in other people, but with me this could be true. I can't get access to the site from work anymore. They have one of these "net nanny" things on the main server now and my access to the web site is blocked. Bastards. Who would have thought that the damn IT department would know a little about the system to do this to me. They can't seem to get anything else working at the hospital, why pick on me. The truth must out and people should see why my life sucks. Now they take that away from me. Hell, blogging is therapy. Call it the best form of free association I know. Freud would be pleased but the powers that be. They are messing with my mental health.
I am having my revenge. I am sitting here, in a book shop coffee bar looking out the window, whatching my subject material walking down below, absorbed in their lives. Drinking a double, medium size Americano with milk - call it a plain cup of coffee, that really isn’t that good and you have an idea of the thing. I am supposed to be at work, but I am not. I saw patients this morning and now I am taking my revenge. I have work to do but I don't do it when I am there so why do it now. Have coffee. Take a mental health day, I say.

I do have a story to tell, but I heard it from a college, so it is second hand but I know the source and they are too dim to make this up. A patient of his has a son with learning difficulties. He has to attend a particular school to meet the demands of his special needs. Well, the school, small and personal and with a very good reputation in the field, took some of the pupils to a game park, a glorified zoo really. Well, they "lost" this young man at some point in the day and they had a hard time finding him. When they did find him he was wet, head to toe and holding onto his backpack for dear life. He didn’t seem to ruffled by what ever had happened but what ever it was he wasn't talking to anyone. He wouldn't let go of the rucksack and in order not to make any issue out of it, for fear of creating a scene that may have turned difficult the staff put a blanket around him or a towel come to think of it. They took him back home and left things like that. He proceeded to go to the bathroom and locked himeself in it. Obviously, after 2 hours in the bathroom, his mother was becoming increasingly concerned and because of his psychiatric needs and history she called for help in order to get into the bathroom to get to her son. The only way in was to remove the door hinges, which a neighbour arranged. You can see the level of concern that was now generated by these events. Never a dull day in psychiaty!

Once the door was removed, who was more surprised by what they saw next, the mother.... The young wet boy, or the penguin in the bath. Boy and Penguin looked around at the same time with better comic timing then anyone could have planned. He had managed to steal a penguin from a zoo? Without any body realising it? What genius is that? To top it all off, when the zoo was contacted to tell them that there was a penguin missing and that it was currently taking a bath, in the upstairs bathroom of a victorian terrace. They didn't believe it. "All our pengiuns are tagged, madam, and its impossible to get into the enclosure let alone take one."
Tell that to the pengiun in the bath.
All ended well.The boy realised he had made a mistake after the first hour in the bath but once there what was he supposed to do. Poor fellow. The pengiun had his own tail to tell, no doubt, but what pengiun would believe him?

There is a song with those lyrics in it somewhere. "Happy or not, here I come" by some group I don't know and can't name. Or is that my suffering mind putting words into lyrics that are not there really. Oh, the power of negative thoughts! I think the song is actually something like, "READY or not, here I come". It doesn't make a difference, so little does in this profession. The fact is the sentiment is the same. I live with madness and today is just as telling as yesterday.

I have sat in a clinic room wondering how I could make a fortune doing something else. Six patients in 2 days decided not to come to their appointments. The endless, "I need help doctor, but I'll be damned if I'm going to do anything about it" syndrome that afflicts so many with mental illness, was proving yet again its effectiveness at wasting everybodies time.

Today something happened that makes my reality even more absurd.

I arrived at the clinic, expecting more no shows, to see the nurse in charge looking apprehensively in my direction. Finally coming to me to plant her best blow to my brain, she said in nursy tones;
"Ah, doctor, your 9:30 is here and ..."
AND is a nemesis. It makes you hold your breath and think of bad things.
" ... and your 9:30 for tomorrow is here as well."
Clearing her throat, she then added, "AND .... those two policeman are with him AND he is in chains, don't you know." Nurses always smile when they know you are in the deep end of the pool of sh_t and they won't help you. Smile and walk away. They learn that within the first week.

It doesn't happen if you are an anaethatist.
"Oh doctor, please put this patient out so we can do a bypass and by the way, the police are here with another man who they want you to put to sleep so that can retrieve their bludgeon from his large intestine. How it got there, nobody knows? But could you do it at the same time as the other man. Just to see how you manage the impossible".

Everything has a solution and I managed a way around this. Ask the police to wait with the chained man. After all, he isn't going anywhere. Re-shedule everybody. Nobody will be happy, but so what! None of them were happy in the first place.

That should certainly be enough problems for a Wednesday morning, 9:45am.
No.
I'm looking for notes for the chained man back in my department. To be hunted down by a clerk, shouting ...
(Non medics always get excited about trivia like this. What is it? Clerical staff whatch too much ER, Hobly City, St ELSEWHERE and any other medical trash on the television and think your life is glamorous.)
"Doctor, an urgent phone call. The liason team are trying to find you"
"Great," I think. I don't work for the liason team. I have nothing to do with the liaison team at the hospital, except a casual, "Hello how are you." The type where you really do not want to hear the reply to. I can't spell liaison without thnking very hard.
They are looking for me? On top of the disaster that is already my day? Are they crazy? "Things could only get better?" pops into my mind, laced with poison. Hell, lyrics are coming think and fast today?

"I am very busy at the moment sorting out my clinic, did they say what they wanted?" Questions like this, I have come to know, are always retorical in a hospital. In a culture where "turfing" a patient to the next speciality is a must-know skill. Nobody ever answers questions like this. If they did, they would know to much and that would make it their problem. So nobody ever knows anything. If you don't know anything really, what can you do about it? So, no ... the clerk had no clue. I am just being sought by a phantom liaison service for something that nobody knows anything about but it is urgent. It always is. A phone is thrust into my hand and the next thing I am talking to the voice of liaison. I will paraphrase the conversation as such;
"Doctor? So and so is on leave today and we don't know who is covering for him so we thought - you are having a great day so we want to make your life better. Hold you head under that pool of sh_t we can already smell you are in. The police have brought a man up to the accident and emergency department on a Section 136. (That is, the police have decided someone is crazy and want you to tell them they got it right .... not wrong .... right .... you see; the police know the art of turfing too. Being right, means the man isn't their problem anymore. Doughnuts calling.)He needs to be assessed, you can do it?"
Why?
It doesn't make any sense. Would you go up to a postman and say, look, don't deliver letters today. Here is a shuttle, be an engineer and fix these tiles. Yes, the black ones - the ones that heat up to thousands of degrees and are pivitol to the lives of those on board. Not you job? Does that matter? Post, tiles, tiles or post .... close enough, you can manage. See you later."
SO why should I do something I am not employed to do?
Oh. I'm a doctor. Walk over me. Here, have my blood, I don't need it. I'm in a caring profession, you come first. Take this chainsaw and use it on me, three pieces? Yes, that will do. Three pieces of me, doing three things all at the same time.
And my wife thinks I cannot multitask.
I was as polite as I could be. I was really polite. Pol-lite, with a capital P.

They say that you should start the day as you mean to go on. Happy or not.
I'm telling you, they are crazy. I know. I am a professional.

Why do I do this job. What would make a person get up in the morning and want to listen to everyone complain. Over and over again about why their lives are so far worse then yours, when you know you had to get up that morning to listen to them in the first place - what could be worse then that!

Not having anything to listen to. Yes. I am a shrink and at this moment I don't even have anyone to listen to. So I talk to myself. Does that make sense? You see, I do have things I am supposed to be doing. I have many things that I am supposed to be applying myself to.
Deadlines. I have them.
Concerns, I have many.
Am I doing anything about it.
No.
Would I advise my patients to be doing what I am doing now.
No.
But I want to tell you what it is like being me. Not that you would care, but I am going to tell you anyway just so that you can get a good look at the rubbish I have to listen to.
What you will read will be unedited. Just as I would hear things from my patients. Raw, straight out of the mouth and most importantly no spell checker in site. If you can't make a word out, hell, it should at least sound like the word I am trying to get at. Use your imagination, but keep with the topic.
If you have questions, ask them. Expect answers - I'll see how I feel. I am not grumpy all of the time just most of the time and sometimes I feel intellectual. That can be stimulating, for me a least.

So far I have I said nothing but I hope you are getting an idea of where I am coming from. I have some time on my hands when "they" don't pitch up for their appointments. Yes, the first irony in psychiatry. Everyone wants you to help them but they do not want to be stigmatised for coming to see a shrink. Wastes my time and does nothing for their condition. But, it gives me time to tell you what I am thinking and a little about them - in all confidence of course. No names, no places and no knowing who the hell I am.

Another day in the life has just presented itself, like this,

There was an anonymous phone call received by the Police from a call box in * (not on * grounds) to the effect that there were 'several bombs at **** Hospital'. The Police assessment of the situation is that this is a hoax call.
It is emphasised that there is no direct reference to ** Hospital. Thus this information should NOT be allowed to disrupt the normal working life of the Hospital and anyone on 'standby' can 'stand down'. The Police and security have checked the grounds.
However, everyone should continue to be sensibly vigilant.

This isn't the first. Yes, people needing help of the mental kind tend to do stupid things. The other weekend, we had the following scenario play itself out. Imagine this.

The entrnace to the psychiatric hospital is guarded by switchboard. As every psychiatric hospital should be, you would think. Yes, a £178 million pound hospital is guarded by one man, or woman who also happens to manage the switchboard. One day, the switchboard operator, stoke security guard is saying prayer, pointing to Mecca and doing the head bowing thing in the general direction of Mecca, is approached by a man requesting something along the lines of, "Hi there, I see you are paying, can I pray with you. On the other side of the gate, of course, we could pray so much better."
"Naturally, two prayers must be better then one, so come come on in!", replies the security/ telecommunications operative.
At the point of opening the gate, our humble guard is threatened with a machette and runs away. Well, I would run to. Who wouldn't. But who can you call now? Even if you were to have witnessed this scene, you couldn't make a phone call from the hospital becuase nobody is on the switchboard to put your call though? Mobile phones are a blessing but are not payed for by the NHS!? The police were called and the grounds searched for the machette wielding man. Our sprinting guard managed to hide and avoid certain injury. The man was found and taken away by the police but the weapon could not be found so he was ultimately released.
Now you would think that was enough for one day. You would be so wrong. Remeber this is my world, the world of psychiatry we are dealing with and nothing ever makes sense.
Later that day the man managed to make his way back to the hospital and managed to regain entry to the property. Where was the switchy-guard this time. Nobody knows. The man found his way to the two oxygen tanks that supply the hospital and start a fire underneath them. In broad day light in a psychiatric hospital, the man set fire to a pile of things he collected, under massive tanks of liquid oxygen. A prelude to a massive disaster. Overted by another mobile phone call to the police and fire department who spend 4 hours dosing the tanks with water to cool them down. Because of the threat to life and limb, sections of the hospital has to be evacuated to the cost of thousands and the inconvenience of everyone. And do you know what. Patients complained. I would have expected them to be upset about the disruption caused. No, the complained that their meals were not warmed up that night because elecricity had been cut during the incident and the kitchens couldn't warm up their food.

Just another weekend.

It is all true. It makes no sense.

Welcome to psychiatry.

We are in for one very peculiar ride.