You Can Only Have So Much Patience For Patients With No Patience

I work as a doctor in a psychiatric hospital. Sometimes patients get administered to our hospital against their will because, due to their illness, they’ve become a danger to themselves or others. It’s important to know that despite this, we are a normal hospital and have no security. Since we all have extensive training and experience in de-escalation, everything usually goes peacefully, but there are a few exceptions.

This is one of my most memorable ones.

I’m on the night shift and am responsible for all inbound calls.

Caller: “Hello, this is [Prison]. I’m calling to inform you that we’re going to send you a patient in approximately thirty minutes.”

Me: “…what?”

This is not something we do. At all. While we do sometimes treat patients that have become violent, that is legally only possible if they don’t have a prison sentence. If they do, they will either be treated at a prison hospital or at a forensic psychiatric hospital. 

Caller: “Yeah, he just arrived here, and our prison doctor said he can’t examine him because he’s too violent.”

Me: “What?!”

Caller: “I know. I’m sorry.”

Me: “You’re aware that we have no security, right? “

Caller: “Yes.”

Me: “And you still want to send him here? From a prison, where you have guards and everything?”

Caller: “I’m sorry, I really am. It’s ridiculous. But that’s what our doctor says. He won’t examine him because he’s afraid the patient will harm him.”

Me: “And it’s okay if he harms me or the nurses?”

Caller: “I’d rather not answer that. Anyway, we’ll be there soon.”

While they’re on the way to our hospital, I call the senior physician on duty. There’s a bit of back and forth that ends with the conclusion that, apparently, the prison doctor can pull a few strings that make this whole thing legal.

Then, the patient arrives. Strangely enough, at first, he seems entirely peaceful. The police lead him into the examination room.

Me: “Hello, you must be [Patient]. My name is [My Name]. How are you?”

Patient: “Gimme my stuff.”

Me: “I’m sorry, I don’t have your stuff. The policemen might have brought some of your things, though.”

Patient: “No, my stuff! My drugs!”

Policeman: *Cheerily* “Yeah, we told him that since you’re also a withdrawal clinic, you would give him methadone and everything!”

Patient: “Yeah, I want [long list of addictive medications in very high doses].”

Policeman: “Well, he’s all yours now! Have a good night, everyone!”

And before I could say another word, the police were gone.

While, technically, we had everything the guy wanted, this was NOT how it worked. There was no way I could give a potentially lethal dose of drugs to an unknown patient. Instead, he’d be monitored closely and get medication according to his symptoms. This way, the withdrawal wouldn’t be pleasant but as safe as possible.

Luckily, I had the foresight not to tell him this immediately. Instead, I asked two huge male nurses to accompany me and a third one to stand by the door, just in case. From a safe distance, I informed the patient of our planned treatment. Before I could even finish, he threw a table at us. We hightailed out of there as fast as possible and the third nurse locked the door behind us.

While we called the police — seriously, I have no idea why they even left in the first place; it’s not like this wasn’t totally predictable — we could watch through a window as the patient wrecked the entire examination room. We didn’t watch for long, though, because he tried to break the window to get to us.

When the police finally arrived, they acted as if it was my fault for not just giving the guy what he wanted.

I got the last laugh, though, because they ended up having to watch the patient for the rest of the night while he received treatment as planned, and I was able to go to sleep.