schizophrenic

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I remember my respected psychopharmacology preceptor always had a pile of a bit out of date copies of the Wall Street Journal sitting around the house.  I asked him why — about the third time I saw them sitting around his living room. He explained to me then it was the thing you really had to read to know what was going on in the pharmaceutical industry.

I remember I rolled my eyes heaven ward.  I was too busy memorizing molecular structures and trying to understand potential mechanisms of drug-drug interactions. I still do a bunch of that sort of thing.  I do it more quickly than I did at that time, but I still do it.  Oh, I will find on line pretty much anything I can in “Newsfeeds” and such, but it is more to condemn than to follow these days, from what I know and can see. Basically, my problem is that they seem to keep making better sounding drugs.  But from what I read, I don’t usually see them as a clear CLINICAL improvement over what I have seen in the past. In other words, I don’t think they are making people “more better” in terms of having more efficacy or less side effects or such.  I just can’t find it in statistics in general, and sometimes even wonder if statistics are not a tad “Gerrymandered.”

Read more on How They Plan To Sell Even More Drugs Next…

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Back in France, when I wished there were more hours in the day to study, two female Mormon missionaries showed up at my door.  They tried to get inside, wanting to assimilate me to that religion.  I had not yet developed the method of chasing Mormon missionaries that I used years later, when we lived in Palm Springs.  I took the bus and the Mormon missionaries would nail me at the bus stop.  I did not want to run away and miss the bus, so I yelled “Devil get thee behind me” in English and numerous Psalms in Hebrew.  This method worked quickly and efficiently for getting rid of many southern California Mormon missionaries.  This method has been replicated by me in numerous situations.

Back in France, I was less experienced.  I hit them with Genesis Chapter 3 verse 16; in French “Tu enfanteras avec douleur.”  I suppose I could have used the English standard version.  I basically convinced them not only that I knew my Old Testament pretty well, but that I had enough problems being female and a French medical student without being a Mormon.  The older of the two women, a preceptor guiding a young student, said the equivalent of “she knows Scripture; we better leave her alone,” and I hid my joy. Read more on Women’s Pains…

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There’s a joke about a woman whose blood pressure was 180/90.  She didn’t think she had reason to be concerned.  After all, she argued, 180/90 is the mathematical equivalent of 2/1 and that doesn’t seem so high, does it?

I once treated a young man of color, obese and sad looking, whose numbers were close to this – 170/100.  And I was not laughing.

This young man was schizophrenic for sure, but pretty harmless.  Life had beaten him down enough that his jail experiences — assault, as directed by disembodied “voices” — had him so frightened that he would never do anything the voices said. Not now, not ever, and I believed him.

As a psychiatric physician, I always managed to get “vital signs” on all patients.  That should not have been a battle, but it was. I did not understand nor relate to the medical assistants who took them.  Why?  18 months training after high school and they had not been nice to me — not at all — criticizing my lunch and the fact they did not think I worked hard enough.Exploding Heart Bursting From Chest

I was concerned when I saw a blood pressure of 170/100.  Patient said he had been on some kind of medicine.  The best I could get with one of my “naming medicines and seeing what it sounded like” was hydrochlorothiazide — maybe. And of course the relevant parts of the chart were missing, as was the case more than actually finding anything.

He said he had stopped his medications a couple of days before because they gave

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He was in his mid-fifties and seemed pretty clueless.  What’s more, he had more abnormal movements than any 20 people and looked like he was dancing with an invisible partner.

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He sat at home all day trying to get himself involved in things like doing laundry and watching television so that he could get himself tired enough to sleep, focused enough to avoid the voices. He was safe — no forced hospitalization was necessary or even possible here. He promised that he would not harm himself no matter what the voices said, but it became clear that he lived in a world where devils and demons gave him a continuous commentary on everything from why Obamacare would never help him to — the size of his wife’s behind. There may have been some exhortations to harm self or others in the distant past, but they were indeed distant.

He said he had no medicine for the past ten years.  I asked how he lived and he said his family was no help, but his woman was. He was married to someone else but this woman was the only person who knew his day-to-day life and she had brought him to the clinic, so I got a release signed and got her in there. I told her he said he had no medicines in say, the past ten years or so.  She started laughing.

“He ought to be telling you the truth.  He gets his Mama’s old Seroquel whenever he can. Makes the voices shut up so he can sleep a little. ” Read more on Taking Mama’s Pills…

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He was a new patient to a community clinic.  They warned me to be careful with this 48 year old, thinking he was “really crazy, schizophrenic or something.”  The social worker had tried to do the intake and told me he was confusing, “not your average bear.” Strangely enough, most of my female staff already had told me they were attracted to him; an unusual state of affairs.

I was struck first by his clothes and demeanor.  A little like Michael Douglas as Gordon Gekko.

This is not usually what new patients look like, schizophrenic or not, when they come in. No wonder the front desk staff already had a crush on him (“sigh!”).  We didn’t get men in designer suits in these parts. Read more on Otherwise, The Patient Was Normal…

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