Saturday, December 24, 2005

A leading med-blogger, Medpundit, writes:
This time of year, I always see a sharp increase in patients who are suffering emotionally. Whatever it is - too much togetherness, too many unmet expectations, financial stress, temporal stress - the week before Christmas my practice sees an influx of depression and anxiety. And always - always - the final office day before Christmas, someone comes in threatening suicide. Do you know how hard it is to find a psychiatrist on the last day of the week before Christmas? As hard as it is to convince a suicidal patient to go to the emergency room for a psychiatric evaluation and admission.
Interesting comments regarding suicide, as well, from inteuri:
Psychiatry residents need reminders that suicide is not normal. We frequently talk to people who have attempted suicide and after a while, we become cavalier about the whole affair. We forget about all of the potential pain and uncomfortable emotions that formed the foundations of the attempts and instead, crank through these suicide evaluations as if we were running through a checklist of things to pack on a trip. It becomes an “us” versus “them” issue. And we start to feel annoyed that yet another person had tried to overdose on some medication….
I worry more about the people who hurt themselves and then deny suicidal ideation in the ER. I mean, come on, if you really want to kill yourself and you know that telling the ER doc that's what you want to do will get you locked away, wouldn't you say, "No, Doc, I don't want to die. I just did this for attention. The knife just slipped."

When I was working at Mercy Hospital in San Diego on the trauma team, I had a patient who had jumped of an overpass onto a very busy street. Miraculously, the fall didn't kill her and none of the cars hit her. She did suffer multiple spinal compression fractures, fractures of both femurs and calcanei and assorted other injuries. One morning I walked into the neurosurgical ICU (on the 10th floor) and saw her with her eyes deviated up and to the left. I was worried about a bleed and called her name. She rolled her eyes toward me and said good morning. Relieved, I asked her what she was doing. She answered that she was looking at a window, wondering if it would open. This was SERIOUS suicidal intent. Even with her level of injury, she was still trying to find a way to die.

I pray for her and others like her.