Throughout professional practice, many healthcare professionals come across some of the most curious cases, especially if they are specialists in the area of Psychiatry. For this reason, a doctor from this branch wanted to share on Twitter some of the stories you have lived in a didactic wayto serve as an example of some of the disorders he has had to face.
As explained by Daniel, a young man who did his residency in Psychiatry but who has decided to repeat the MIRwanted to take advantage of the knowledge acquired during these years to “draw attention to the different situations that a psychiatrist sees in reality of their clinical practice.
Likewise, he wanted to emphasize that all the cases dealt with are “always a consequence of the suffering y our job as health workers is to understand them as such, knowing that behind each clinical case there is a person who suffers and who needs help”.
On my last shift as a psychiatrist I wanted to remember some of the most curious calls I have received during my career:
1. I’m calling you from Uro. A patient is coming by helicopter from Albacete to reimplant the penis that has self-mutilated. Do we do it or not?
– DaniMIR_ (@DaniMIR_) May 24, 2022
Manic episodes: From stealing hydrogels to causing hyperglycemia in other patients
One of the disorders that he observed most during his residency were manic episodes, which ranged from a call to the ER because a patient had given Kit-Kats to all the patients who were waiting and had caused hyperglycemia, to a conversation with a patient who invited him to come to her bed or a man who took all the hydroalcoholic gels from the plant and hid them under his bed.
The professional advises that, in these cases, patients tend to incur large expenses that can cause financial problems, likewise, invites the patient to seek comfort by providing a quiet place, with few stimuli and, if necessary, remove the mobile to prevent it from sending compromised content.
2. I’m calling you from the ER. Look, we’ve seen that all the patients in Ward 1 suddenly have sky-high blood sugars because the guy you’re looking to assess has given them Kit-kats that he bought from the machine in the waiting room.
– DaniMIR_ (@DaniMIR_) May 24, 2022
“The manic paintings may have organic causes that should be kept in mind. The most common are corticosteroids, but especially in young people with no history of mental health and with marked blockade, anti-NMDA encephalitis must be ruled out,” he explained.
Schizophrenia and Delirium, other of the most common disorders
“I’m calling you from Uro. A patient is coming by helicopter from Albacete to reimplant the penis that has self-mutilated. Do we do it or not?” Was one of the calls received by the resident about a patient suffering from schizophrenia. In this case, he explained that, apart from the diagnosis, “no mental disorder contraindicates urgent surgery“.
Other similar cases were those of a 72-year-old woman who believed she was pregnant and who was diagnosed with pseudocyesis framed in schizophrenia or that of a patient who, before being discharged, claimed that his newborn child was a bird. In the latter case, the psychiatrist says that an appropriate diagnosis could not be made but that social services were notified to assess the family situation and the need for external help.
3. [3:30 am] I’m calling you because a patient comes by train from Galicia to be treated at Gine, because she says that this is the best hospital in Spain.
– [yo] And why do you call me?
– Because he is 72 years old– DaniMIR_ (@DaniMIR_) May 24, 2022
The doctor also shared some cases of Delirum. “I’m calling you because a hospitalized woman says that, during the intervention for aortic stenosis, she has become pregnant by Marc Márquez and now it haunts him at night. She, however, stands on the bed of other patients watching them sleep.”, It was one of the cases of a patient with this diagnosis in which she points out that the important thing is to focus on the causeusually a urine infection, and withdraw antipsychotics as soon as possible
Another was the case of a patient who wanted to report the emergency room staff because “he says he doesn’t think it’s serious that at night we’ve put on a circus with elephants and clowns in the corridor, that he’s seen it all.” this time delirium was caused by alcohol withdrawalsince its maximum severity appears a week after stopping consumption and that it has to be prevented with benzodiazepines.
Mental disorders affecting all ages
The doctor also had to deal with cases such as that of a person with Obsessive Compulsive Disorder (OCD) who did not want to pee despite the fact that he really wanted to, or that of another patient who dedicated himself to complimenting him instead of answering his questions and who suffered from histrionic disorder, whose behaviors are often exacerbated when people are distressed the sad.
“Look, since you are here, this woman who comes for a UTI says that she has been married to Arturo Valls for 20 years and that she has told him that tomorrow she will become pregnant with him,” a colleague told him about a patient, to whom he ended for diagnosing Erotomania framed in a chronic delusional disorder. “This woman, due to her social situation, felt very lonely, so her delusion has a defensive function: feeling accompanied. With the help of social work we try to improve their situation and expand their circle of contacts”, explained the doctor.
9. Sorry, I really want to continue answering your questions, but you’re so handsome that I can’t concentrate
– DaniMIR_ (@DaniMIR_) May 24, 2022
The former resident of Psychiatry has shared cases that show that psychological disorders affect people of all ageslike an old woman with dementia who, when asked who the president of the government was, pointed to the doctor himself and, clarifying that it was not him, indicated that it was her roommate.
Finally, the case of a 14-year-old boy who “says that at times he is a cat. He walks like a cat, meows and eats like a cat (he shows me videos), then he acts like a normal child.” This time he faced a dissociative disorder that is usually produced as a method of escape from difficult situationsfor which he points out that in childhood it is “essential to carry out good coordination with the school, social work and, if necessary, the police”.
11. [yo] Who is the president of the government?
– Mmmm… ¿tú?
– No ma’am, I’m the doctor
– (Pointing to her roommate) Her?– DaniMIR_ (@DaniMIR_) May 24, 2022
The medical professional, who has changed the key data to be able to share the cases, has recalled that “the more unusual the presentation of the mental disorder, the more suffering it generatesthe more difficult it is to ask for help and the more necessary it is to understand and see the person behind” and has concluded that his patients have always been his “greatest teachers”.
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