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.
With every physical, there is a 12-point Review of Systems. In order to get paid, you must include at least 12 systems. 11 and you don't get paid, and with good reason. One of those systems in Psych. This particular patient was smiling and answering no to all of the other systems, even the one involving chronic muscle or joint point. Usually that gets most people over the age of 40. Everybody has some ache or former injury that causes some discomfort. But not this one. It wasn't until the psych questions came that a pregnant pause occurred. It was not their psyche that was the cause of concern. It was one of the children. They had begun to have their first psychotic break. The parents never saw it coming.
My heart began to break and I had a choice. Do I begin to connect those rooms with corridors? Do I let my own pain help others? But how do you do that without making it about you? Then I heard what the medications were being used. The prescribing physician was either 80 years old and hadn't read a new journal in over 40 years, or a complete and lazy asshole who just wanted to snow the kid. In other words, turn them into a stupefied zombie so they're not causing any trouble. They're also hardly conscious. My decision flew out the window. None of that crap seemed to matter anymore. Without even thinking, I began, "In my personal experience......"
I encouraged the patient to stick with the child. They will need someone steady. I warned them at the first onset of mental illness, it can take upwards of a full year to get the right diagnosis and more importantly, the right combination of medications that works well for them. I warned them this will NOT be easy. I warned it may take multiple opinions to get to that right combination of medications. And then I again reassured them to take heart, to not give up, to love your child. And before I even realized it, I said this all in front of the attending. I had never done such a thing before. They did not correct me or interrupt me. Instead, after exiting the room, he asked about my son in a heartfelt way. As I said in my last post, something is shifting.