A life as me ... shrink.

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.