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.
Not many patients scare me. Even though I was used as a human shield placed between the patient and the doc, there were not many times that I felt to be in danger. Jose, however, scared me. Schizoaffective with mania. That meant poor Jose was both schizophrenic AND manic. Nothing like taking someone who hears voices commanding him to do things and adding mania to the mix. So long as you did not say anything bad about Kelly Clarkson (they were lovers and he had special powers to talk her telepathically) he usually could be calmed back down after he got worked up.
When I first met him, he worry baggy clothes which hid his frame. Shorter than me, I wasn't too alarmed by him, despite his ability to get worked up very quickly. After all, I didn't have to be able to fight a patient. I just had to be able to keep them off the doc long enough in order for a tech to rush in and get a shot of Vitamin H into them (that's haldol). I first became a bit concerned when Jose commented that he liked to work out. He rolled his sleeves back to reveal biceps the size of softballs. Yikes. I became slightly concerned the day we brought him into the room to talk. I left the door cracked. Deliberately. As in leaving an escape route. The patient ever so politely got up to close the door. Now he was caged.
I really became concerned when the doc decided he wasn't stable enough to be released. Uh-oh. Wait. He didn't understand. The doc had a thick accent. Leaning over to me, the doc asked if I could explain to Jose that we needed to keep him longer. Ummm, seriously? I don't think this is quite the role of a med student but sure, why not? Taking a deep breath I calmly and in as non threatening a voice as I could muster, I explained it to the patient. He clearly understood me because the chair got overturned as he leapt to his feet. Tense as a wound spring, his arms flung around in agitation as confused and angry threats flew from his mouth.
Long term problem was how to manage this patient's labile mood. Immediate problem was how to avoid a scene from Fight Club. I'm not quite sure how I got the door opened and the patient out of the room without getting hit. I kinda flashed back to my wildlife days when I once came face to face with a rogue Cape buffalo. About the same level of adrenaline only no chance of getting gored. But fortunately, no harm came to him or me. Unfortunately, the doc found that I was able to handle the wild ones and was thereby cursed to deal with all dangerous ones.