I couldn't breathe, my stomach was cramping, and my heart was pounding so quickly, there were no longer individual beats, but rather just one long systole-diastole hybrid. I was getting more exercise than I had for the past five months combined, and yet there I was. Still running. Still running as fast as I could.
See, I was running after my patient.
My patient, who had seemed so calm and cooperative, who had suddenly bolted from the exam room as I waited for a nurse to accompany him to the unit.
And now he was fleeing, running away, weaving through traffic and between businesses, and the nurse and I were the only people running after him.
Through the lovely streets of East LA.
As part of my psych ER rotation, I get to evaluate people who walk in to the outpatient psych clinic and ask to be seen without an appointment. Usually it's pretty easy, I just have to talk to them for a bit to see if they're suicidal, homicidal, or unable to take care of themselves. If they are, then I take them over to our unit, and if not - I set them up with some follow-up care and I can return to my other duties.
We usually let them wait, because they're pretty low priority. And it's pretty unlikely that a patient gets admitted.
Yesterday, it was especially busy in the ER, and so my patient ended up having to wait five hours for me to evaluate him.
I talked to him, determined that he was endorsing a lot of passive suicidal ideation, so I wrote up his 72 hour hold and got him ready for admission. He sat and waited in one of the exam rooms while I quickly assessed the two other patients who were waiting for me (who did not meet admission or hold criteria), and then we were ready to go.
Except, he suddenly stood up and asked to use the bathroom. As I directed him towards the on-unit bathroom, he twisted away from me and started running.
Shit.
Shit shit shit.
I started running too, all while yelling at the charge nurse -- "Call a code! Eloping patient on hold!! CODE GREEN!!!! DO IT! DO IT NOW!!!"
I had no time to tell if she understood me, because he was sprinting through the hallways, and I was on close pursuit. And then security came.
Or so I thought.
A security guard was returning to his post, opened the door, saw the patient running towards him, also saw me running after him, and what does he do?
He holds the door open for the patient.
Shoot me now.
So the patient got out of the clinic, and here we were, running down the streets of East LA, as I tried pleading with him from 20 meters behind, pleading with him to come back, to stop, to slow down, to just let me talk to him for a bit. Because I had just put him on a involuntary hold because he said he wanted to sleep and never wake up, that he wanted to accidentally get hit by a bus...and what was he doing? Running through the streets, where the possibility of getting hit by a car or bus - accidentally or not - is astronomically high.
Thankfully, just as my body was about to collapse, three sheriff cars came tearing through the streets, screeching to a halt in a U-formation, blocking my patient's escape route.
The good: they caught my patient.
The bad: they couldn't apprehend him unless I had the hold in my hand -- which of course I had thought to grab as I was chasing my patient in the hospital. Except I didn't. So what do the sheriffs make me do? Run back to the clinic, grab the hold, and then run back to their location so that they could finally escort him over to our unit.
And that, my friends, was my first day back at work after an especially fun and lovely week of vacation. I love my job.
3 years ago
