delusions

The following is not FACTUALLY accurate. Details have been changed, things deleted, stuff made up, all to protect identity. But it is 100% absolutely true.

     While not exclusive to schizophrenia, one of the hallmarks is delusions. Delusions in the medical context refer to a belief which is either highly unlikely or flat out implausible. Aliens abducted me. My spouse is slowly poisoning me (though this one can be true in bizarre instances). I am an undercover agent for the CIA & KGB. What fascinates me is that the delusions have to come from somewhere. They usually aren't created ex nihilo. Sometimes the source of the delusion is quite clear. For instance, one patient was going to exact retribution on all unfaithful spouses of the world. Clearly it was not surprising to find a messy divorce involving infidelity in their past. Other times it seems a bit less personal as when one patient was furious with the Bush family and wished to punish them. Probably their delusional thinking was fueled from watching CNN.

But in one instance, I was at a complete loss. "Do you have any questions for me or the doc?"

In a clear, calm yet quizzical fashion the patient asked, "Just one. Why did the CIA turn me into a horny vampire?"

     Dead silence. We are trained neither to reject nor entertain a patient's broken perceptions. We are merely supposed to go along with the notion that they believe them to be true and that's all that matters. But this question stumped me, the nurse or the attending doc. They just kind of mumbled something and moved on.