without realizing that the person is mentally ill. Unfortunately, that is a term that our society looks upon as something that is caused by someone being weak, spineless, cowardly, and worthless. Not true. There isn't anyone I know Who hasn't manifested some symptoms of mental illness in their lives and most overcome it. lt has been said With some truth that we are all "crazy" to some extent, it is just a question of degree.
paranoid delusions, I remember her saying several times that my grandmother was always trying to poison her food. For this reason, in most cases she would only eat food when she had personally observed the preparation and cooking of it. My grandmother was the caretaker of my great-grandmother in her last years and truly there wasn't much love lost between them. In reality, my grandmother easily conceded that she hated her mother due to the abuse she had suffered as a child. In spite of this, I never had any doubt that my grandmother didn't hate her enough to try to kill her. A humorous (though some would question that label)event occurred at one of our family gatherings one Saturday afternoon when I was a teenager. As usual at these functions, dishes
very fast). In her progress toward her trailer, she walked past me. As she passed me, she stopped, grabbed me by my arm, and said in her normal barely audible voice, "Boy, don't eat anything on that table, those people will poison you!" I was intrigued about What had transpired between my uncle and her and, a short time later, I found out What he had said to her. He was telling the rest of the family about it and told them he had said to her, "Ma'am, that's an excellent choice of meat. That is the best armadillo meat on the face of the earth!" Then I understood her reaction since she would not eat anything except beef or pork and considered all Other meats vite. I have to explain that for years, the armadillo, an animal brought to Florida from Texas and accidentally released to proliferate greatly, was thought to be a worthless animal until someone tried eating them, only to find out that they are indeed good to eat in spite of their lack of appeal in appearance. The meat that my great-grandmother was serving herself was in fact roast beef, but With her paranoia, she fell for my uncle's joke. The next really interesting Story about a psychiatric patient occurred when I was in my first two years of medical school. In those years, we had very little interaction With patients since we were Learning basic sciences. But we had several Lectures by psychiatrists and psychologists about some of the things we might see in this realm of medicine. A told us a story about an ER patient seen in the hospital attached to the medical school. This occurred late at night (l have always been intrigued by the fact that
The next really interesting story about a psychiatric patient occurred when I was in my first two years of medical school. In those years, we had very Little interaction With patients since we were learning basic sciences. But we had several Lectures by psychiatrists and psychologists about some of the things we might see in this realm of medicine. A told us a story about an ER patient seen in the hospital attached to the medical school. This occurred late at night (l have always been intrigued by the fact that these weird types of problems always seem to occur late at night or very early in the morning) and the psychiatrist was called because apparently an ambulance had brought in a patient found on the street Who appeared to be overdosed on drugs and largely unresponsive. However, as the Story went, White the ER staff were assessing the patient and trying to figure out how to treat him, (he was
(he was young man in his early twenties)the patient suddenly awoke out of his previous mental State, and began screaming wild obscenities and words without meaning to the ER staff. He tore the IV line out of his arm, jumped off of the gurney, and began grabbing anything he could get hold of and throwing it at the ER staff. He then began tearing apart anything in the room he could get his hands on. Realizing that discretion is indeed the better part of valor, the ER staff quickly evacuated the room, and shut and locked the door. This was the point when they called the aforementioned psychiatrist, inquiring as to What to do about this situation. I will mention here that psychiatrists have a unique perspective on the
human psyche and sometimes come up With strange but creative solutions for such problems. That certainly is What occurred here. The psychiatrist told the ER doctor to find the smallest, most frail- appearing female resident doctor and send her into the room. As the Story goes, the female resident edged her way into the room and stood With her back against the nearest wall, certainly terrified as to What might happen. As soon as he saw her, the patient crouched Iow and began advancing on her With his arms stretched out and hands shaped like claws, definitely a fearsome sight. He was also growling like an animal. As he got Close to her, she Said, "You know, you are scaring the out of me!" His reaction to this statement was apparently What the psychiatrist planned, because the patient immediately stopped his animalistic growling and approach to the resident. He calmly said to her, "I am?" He then calmed down and accept
and accepted the medical care that he so obviously needed. The psychiatrist finished his Lecture by explaining his rationale for this truly creative approach to a patient from hell. People on drugs Who are reacting violently like this do not have their higher brain centers functioning but are functioning With primitive brain centers that direct life-protecting activities. (One of my med school professors said this part of the brain controls only three activities, referred to as the three F's. The three F's are feeding, fighting, and fornicating.) Some people on psychoactive drugs (particularly drugs such as cocaine, I SD, PCP, and methamphetamines) react by basically shutting down the higher levels of the brain that give us the good sense to use those activities wisely, and using only that primitive part of the brain, without any filtering by societal disciplines we have learned as we grow. When a doctor Who was not threatening in appearance or behavior was sent in, the patient was able to quell the fearful thoughts in his own mind. As you can see, medicine is not a profession that you can practice With a "cookbook" approach. My next significant experiences in the realm of psychiatry occurred when I was a third-year medical school student. My first psychiatric rotation was in the psychiatric ward of the local Veterans Administration (VA) hospital. This was a locked ward because many of the patients were a danger to society or to themselves and had to be locked up until they were no longer dangerous. Locking them up also gave them a sense of security since they had many fears (unrealistic fears, thus psychotic fears) about the world. lt sounds cruel and seems to go against the greatest benefit of our society, freedom to live our lives as we wish, but it was actually therapeutic for them. Within days of being locked up, many of their psychotic symptoms were lessened. Our psychiatry professor told us that this effect was not due to the powerful sedating medicines they received, but due to the sense of security they received in that locked environment. In fact, there was a long waiting list of people waiting to get a place in there. The patients in the VA psych unit Were by far the sickest mentally ill patients I have ever Seen. I have often theorized about Why that might be the case. Having been in the military, I have some insight about this. In the military, people are sometimes put in life-threatening situations that are too horrible for most people to contemplate and, while most soldiers or sailors get through these situations without prolonged after-effects, sorne are not able to maintain their mental health after these episodes. Truly, battle is probably the most stressful situation that anyone can endure. Some great philosopher once said, "War is hell." But I don't believe that is the only cause of mental illness among veterans. The Vietnam War, With all of its contradictions and lack of appropriate direction, led many people
into psychotic "breaks" away from reality. lt also led many young GIS into drug addiction and alcoholism. I know that for much of the time I was in the military, heavy drinking of alcohol was virtually a norm. lt was considered to be part of the hard swearing, hard drinking, smoking, womanizing behavior considered appropriate for the aggressive lifestyle that is military life. The armed services have begun to realize that in the modern world, GIS must use their higher brain centers and fight and live smarter than the warriors of old time-s. In people that have some predisposition to mental illness (Some figures say up to 9 percent Of the population) these behaviors combined With the stress of war send them over the edge. Most never recover completely. Additionally, the sexually transmitted diseases of inappropriate sexual behavior can lead to mental illness (syphilis in particular). awayto
One case that I was involved With concerned a man Who went away to Wortd War 11 at the age of eighteen or nineteen. He had grown up in an abusive home and had come from a long line of generations that were abusive to their children and spouses. He was very intelligent and had many talents, With Skills in music and many other areas. He went through basic training, which was pretty rudimentary at that point in history. The first military assignment for him was to land on Normandy Beach as one of the first wave of GIS invading Nazi-occupied France. This was probably the most deadly area of the most deadly battle of World War 11. Ninety-five percent of his unit was killed in those first few hours, though he survived without a scratch. Sometimes that in itself can give someone a tremendous sense of guilt for not having died With their Gl "brothers." He stated that he did not steep for the first two weeks after Landing on the French coast. Lack Of steep is a well- known trigger for psychotic behavior, and one of my psychiatry
professors said that most people that go forty-eight hours without steep Show signs Of psychotic behavior. Additionally, for the first two weeks after the invasion, I was told that they did not take prisoners. White it is true that the Geneva Convention dictates that if an enemy soldier surrenders, you must not harm hirn, the reality Of war is that sometimes the Geneva Convention is overlooked due to circumstances. The reality was that, in the heat of battle those first few weeks, they had no facilities or personnel to look after prisoners, so anyone that surrendered got shot anyway. That sort of behavior makes war very dehumanizing. About two weeks after the invasion, the Gl in this Story Said that they began taking prisoners into captivity and holding them. They had apparently captured some Germans and were herding them into a group in a French town. They had also not adequately searched the prisoners. One of the prisoners suddenly pulled out a pistol and began shooting at the American soldiers (the Germans also had their share of psychotic behavior). The patient in this Story pulled out his .45 caliber pistol (a big gun!) and began shooting at not only the Germans but the French and Americans, too. In the process, he shot and killed the German With his gun, but also a French woman. The fact that he was shooting at everyone is clear evidence of a paranoid psychotic break away from reality. He was subsequently subdued by Other Americans and shipped back to the U.S. I was told that he used no alcohol before the war, but afterward began daily consumption of large amounts of this drug (it is a drug!). I was told that before the war, he was kind, sensitive, and caring. Afterward, he was hardened and showed great cruelty to his family. He consistently showed paranoid behavior for the rest of his life and had chronic delusions that people were out to get him. He always carried a Loaded gun With him and threatened to kill people at times. He
had a family history of mental illness and it is apparent that he inherited some tendency toward this along With the alcoholism. Mentally ill patients also frequently "self-medicate" With alcohol to quell the "demons" within them.
paranoid delusions, I remember her saying several times that my grandmother was always trying to poison her food. For this reason, in most cases she would only eat food when she had personally observed the preparation and cooking of it. My grandmother was the caretaker of my great-grandmother in her last years and truly there wasn't much love lost between them. In reality, my grandmother easily conceded that she hated her mother due to the abuse she had suffered as a child. In spite of this, I never had any doubt that my grandmother didn't hate her enough to try to kill her. A humorous (though some would question that label)event occurred at one of our family gatherings one Saturday afternoon when I was a teenager. As usual at these functions, dishes
very fast). In her progress toward her trailer, she walked past me. As she passed me, she stopped, grabbed me by my arm, and said in her normal barely audible voice, "Boy, don't eat anything on that table, those people will poison you!" I was intrigued about What had transpired between my uncle and her and, a short time later, I found out What he had said to her. He was telling the rest of the family about it and told them he had said to her, "Ma'am, that's an excellent choice of meat. That is the best armadillo meat on the face of the earth!" Then I understood her reaction since she would not eat anything except beef or pork and considered all Other meats vite. I have to explain that for years, the armadillo, an animal brought to Florida from Texas and accidentally released to proliferate greatly, was thought to be a worthless animal until someone tried eating them, only to find out that they are indeed good to eat in spite of their lack of appeal in appearance. The meat that my great-grandmother was serving herself was in fact roast beef, but With her paranoia, she fell for my uncle's joke. The next really interesting Story about a psychiatric patient occurred when I was in my first two years of medical school. In those years, we had very little interaction With patients since we were Learning basic sciences. But we had several Lectures by psychiatrists and psychologists about some of the things we might see in this realm of medicine. A told us a story about an ER patient seen in the hospital attached to the medical school. This occurred late at night (l have always been intrigued by the fact that
The next really interesting story about a psychiatric patient occurred when I was in my first two years of medical school. In those years, we had very Little interaction With patients since we were learning basic sciences. But we had several Lectures by psychiatrists and psychologists about some of the things we might see in this realm of medicine. A told us a story about an ER patient seen in the hospital attached to the medical school. This occurred late at night (l have always been intrigued by the fact that these weird types of problems always seem to occur late at night or very early in the morning) and the psychiatrist was called because apparently an ambulance had brought in a patient found on the street Who appeared to be overdosed on drugs and largely unresponsive. However, as the Story went, White the ER staff were assessing the patient and trying to figure out how to treat him, (he was
(he was young man in his early twenties)the patient suddenly awoke out of his previous mental State, and began screaming wild obscenities and words without meaning to the ER staff. He tore the IV line out of his arm, jumped off of the gurney, and began grabbing anything he could get hold of and throwing it at the ER staff. He then began tearing apart anything in the room he could get his hands on. Realizing that discretion is indeed the better part of valor, the ER staff quickly evacuated the room, and shut and locked the door. This was the point when they called the aforementioned psychiatrist, inquiring as to What to do about this situation. I will mention here that psychiatrists have a unique perspective on the
human psyche and sometimes come up With strange but creative solutions for such problems. That certainly is What occurred here. The psychiatrist told the ER doctor to find the smallest, most frail- appearing female resident doctor and send her into the room. As the Story goes, the female resident edged her way into the room and stood With her back against the nearest wall, certainly terrified as to What might happen. As soon as he saw her, the patient crouched Iow and began advancing on her With his arms stretched out and hands shaped like claws, definitely a fearsome sight. He was also growling like an animal. As he got Close to her, she Said, "You know, you are scaring the out of me!" His reaction to this statement was apparently What the psychiatrist planned, because the patient immediately stopped his animalistic growling and approach to the resident. He calmly said to her, "I am?" He then calmed down and accept
and accepted the medical care that he so obviously needed. The psychiatrist finished his Lecture by explaining his rationale for this truly creative approach to a patient from hell. People on drugs Who are reacting violently like this do not have their higher brain centers functioning but are functioning With primitive brain centers that direct life-protecting activities. (One of my med school professors said this part of the brain controls only three activities, referred to as the three F's. The three F's are feeding, fighting, and fornicating.) Some people on psychoactive drugs (particularly drugs such as cocaine, I SD, PCP, and methamphetamines) react by basically shutting down the higher levels of the brain that give us the good sense to use those activities wisely, and using only that primitive part of the brain, without any filtering by societal disciplines we have learned as we grow. When a doctor Who was not threatening in appearance or behavior was sent in, the patient was able to quell the fearful thoughts in his own mind. As you can see, medicine is not a profession that you can practice With a "cookbook" approach. My next significant experiences in the realm of psychiatry occurred when I was a third-year medical school student. My first psychiatric rotation was in the psychiatric ward of the local Veterans Administration (VA) hospital. This was a locked ward because many of the patients were a danger to society or to themselves and had to be locked up until they were no longer dangerous. Locking them up also gave them a sense of security since they had many fears (unrealistic fears, thus psychotic fears) about the world. lt sounds cruel and seems to go against the greatest benefit of our society, freedom to live our lives as we wish, but it was actually therapeutic for them. Within days of being locked up, many of their psychotic symptoms were lessened. Our psychiatry professor told us that this effect was not due to the powerful sedating medicines they received, but due to the sense of security they received in that locked environment. In fact, there was a long waiting list of people waiting to get a place in there. The patients in the VA psych unit Were by far the sickest mentally ill patients I have ever Seen. I have often theorized about Why that might be the case. Having been in the military, I have some insight about this. In the military, people are sometimes put in life-threatening situations that are too horrible for most people to contemplate and, while most soldiers or sailors get through these situations without prolonged after-effects, sorne are not able to maintain their mental health after these episodes. Truly, battle is probably the most stressful situation that anyone can endure. Some great philosopher once said, "War is hell." But I don't believe that is the only cause of mental illness among veterans. The Vietnam War, With all of its contradictions and lack of appropriate direction, led many people
into psychotic "breaks" away from reality. lt also led many young GIS into drug addiction and alcoholism. I know that for much of the time I was in the military, heavy drinking of alcohol was virtually a norm. lt was considered to be part of the hard swearing, hard drinking, smoking, womanizing behavior considered appropriate for the aggressive lifestyle that is military life. The armed services have begun to realize that in the modern world, GIS must use their higher brain centers and fight and live smarter than the warriors of old time-s. In people that have some predisposition to mental illness (Some figures say up to 9 percent Of the population) these behaviors combined With the stress of war send them over the edge. Most never recover completely. Additionally, the sexually transmitted diseases of inappropriate sexual behavior can lead to mental illness (syphilis in particular). awayto
One case that I was involved With concerned a man Who went away to Wortd War 11 at the age of eighteen or nineteen. He had grown up in an abusive home and had come from a long line of generations that were abusive to their children and spouses. He was very intelligent and had many talents, With Skills in music and many other areas. He went through basic training, which was pretty rudimentary at that point in history. The first military assignment for him was to land on Normandy Beach as one of the first wave of GIS invading Nazi-occupied France. This was probably the most deadly area of the most deadly battle of World War 11. Ninety-five percent of his unit was killed in those first few hours, though he survived without a scratch. Sometimes that in itself can give someone a tremendous sense of guilt for not having died With their Gl "brothers." He stated that he did not steep for the first two weeks after Landing on the French coast. Lack Of steep is a well- known trigger for psychotic behavior, and one of my psychiatry
professors said that most people that go forty-eight hours without steep Show signs Of psychotic behavior. Additionally, for the first two weeks after the invasion, I was told that they did not take prisoners. White it is true that the Geneva Convention dictates that if an enemy soldier surrenders, you must not harm hirn, the reality Of war is that sometimes the Geneva Convention is overlooked due to circumstances. The reality was that, in the heat of battle those first few weeks, they had no facilities or personnel to look after prisoners, so anyone that surrendered got shot anyway. That sort of behavior makes war very dehumanizing. About two weeks after the invasion, the Gl in this Story Said that they began taking prisoners into captivity and holding them. They had apparently captured some Germans and were herding them into a group in a French town. They had also not adequately searched the prisoners. One of the prisoners suddenly pulled out a pistol and began shooting at the American soldiers (the Germans also had their share of psychotic behavior). The patient in this Story pulled out his .45 caliber pistol (a big gun!) and began shooting at not only the Germans but the French and Americans, too. In the process, he shot and killed the German With his gun, but also a French woman. The fact that he was shooting at everyone is clear evidence of a paranoid psychotic break away from reality. He was subsequently subdued by Other Americans and shipped back to the U.S. I was told that he used no alcohol before the war, but afterward began daily consumption of large amounts of this drug (it is a drug!). I was told that before the war, he was kind, sensitive, and caring. Afterward, he was hardened and showed great cruelty to his family. He consistently showed paranoid behavior for the rest of his life and had chronic delusions that people were out to get him. He always carried a Loaded gun With him and threatened to kill people at times. He
had a family history of mental illness and it is apparent that he inherited some tendency toward this along With the alcoholism. Mentally ill patients also frequently "self-medicate" With alcohol to quell the "demons" within them.
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