My pager went off just a little past midnight.
"Doctor! Patient emergency!! COME QUICK!"
I was fumbling for my glasses, as the nurse continued to freak out over the phone. "Your new admission is on the floor, not moving, completely unresponsive!" As she slammed the phone down, I could hear her ordering someone else to grab the reserve oxygen tank.
Shit.
I had admitted him three hours ago, and he seemed like my typical schizophrenic, refusing to talk to me, claiming that I was going to do "Pentagon experiments" on him, which was so wrong, because didn't I know that he is the Chief of ALL police?!!? Please, he had terrorists and aliens to go apprehend, and I was keeping him from performing his civic duty.
I dashed out of my call room and started running toward the ward, my past six months of neurology/internal medicine/pediatrics training in place and in gear, as I tried to figure out everything that might have gone wrong. Did he have a seizure? I gave him a smaller dose of antipsychotic because he was older, but maybe it was still too much? Did he have an allergy? What did I miss? What had I forgotten?
I got to the unit, and the moment my key turned in the lock, the nurses surrounded me, each trying to tell me what they had seen. "He said he needed to use the bathroom, and then before I knew it he was on the ground," "He said he needed to use the bathroom? He told me he was hungry and then he sat down on the ground," "Well at least that's what his sitter said..."
I made my way to his room, where my patient was lying, flat on his back and as stiff as a board, on the floor, with his arms folded across his chest, mummy-style. "Mr. Tagg, can you hear me?" He didn't respond, but he opened his right eye just a sliver, saw me looking at him, and then shut it tightly again.
The nurses swarmed into the room at that time, "DOCTOR! SEE? He's not answering! Should we call 911? Do you want the oxygen tank?!?!"
"No, don't call 911. What are his vitals? Why does he need oxygen?" I responded, as I pushed him onto his side. "Oh, we didn't do his vitals yet," the nurses told me. "Oh hm, well, let's get those first," I responded as the nurses bustled around me. I pulled out my stethoscope and was about to listen to his lungs when my patient let out the smelliest, loudest, biggest fart. "Heh heh heh" he chuckled to himself, all while still refusing to answer to his name.
"Doctor, here are his vitals: Pulse 83, blood pressure 115/78, oxygen saturation 100%."
"Yeah, we don't need to call 911. And he doesn't need that oxygen, so please, don't open that nasal cannula packet," I responded as I continued my physical exam.
Since my patient refused to respond, he was still lying on the ground, also refusing to move. So I crouched around him, as I tried to maneuver his arms off his chest so that I could listen to his heart. Then, all of a sudden, my feet were wet. And so were my knees.
And my patient started chuckling.
He had just peed all over the floor. And subsequently, had soaked my scrubs.
I jumped up instinctively, and he then jumped up as well and ran to the bathroom.
The best part? As I was leaving the unit (still urine-soaked), one of the nurses stopped me. "Doctor, do we need to call 911? Urinary incontinence -- that means he had a seizure right??"
No, that just means he's being a difficult schizophrenic patient.
3 years ago
