Danger to Self by Linde Paul

Author:Linde, Paul
Language: eng
Format: epub
Publisher: University of California Press
Published: 2010-04-05T04:00:00+00:00

“If it’s okay with you, Maureen, I’m going to go interview Mr. Demerit with the new intern here, and then she’s going to write up the case.”

“Sounds good to me, Dr. Linde. One less case for the nurses.”

Maureen finishes taking Rick’s vital signs—heart rate and blood pressure are a bit up, which is nothing that a touch of Ativan can’t cure. We’ve got time before he starts to withdraw from the alcohol. He’s still got a fair amount of happy juice on board, so the Ativan can wait until after the interview. I introduce the intern and myself to Mr. Demerit and instruct him to follow us to the interview room, where we take our respective seats. He does so wordlessly, which I find curious since he was so loquacious with Maureen and the cops.

I start, as I do with most patients, with an open-ended approach. “As I mentioned before, my name is Dr. Linde, and I’m one of the attending psychiatrists here. I wanted to talk to you to see if we could come up with some kind of plan to help you out.”

“Yeah, right,” he mumbles.

“So, what’s been going on in your life lately?”

“You mean, why am I suicidal?” Mr. Demerit sneers.

“That’s one way of putting it,” I say.

“My life sucks. I’m depressed. I need help.” He pauses. “I need to be in the hospital for at least those three days, if not a week or two.”

I sense his irritability, lack of candor, and laser vision for getting admitted to the hospital. I continue with the open-ended approach. “What is making you depressed these days, do you think?”

“Are you listening or what? I told you. My life sucks. I’m depressed.”

“It might help to talk a little bit about what’s actually going on in your life. For example, how are things going in your relationship?”

“Don’t patronize me, doc. My life sucks. I’m depressed and I’m suicidal. I need to be in the hospital.”

I decide on switching to a more closed-end approach because of Mr. Demerit’s repetitions, which only make him seem vague and evasive. “Is it true what the police officer is saying? Have you been thinking about hurting yourself?”

“Oh, yes, sir, I’m a danger to myself and others.”

“Have you ever been a patient here?”

“I don’t believe so.”

“Are you on psych meds?”

“What, you don’t think I’m crazy, do you?”

“Never said you were. Never said you were.”

“I’m not crazy,” he says. “I’m suicidal. I came here for my three days—it’s a seventy-two-hour hold, isn’t it?”

“Yes, the 5150 hold is for up to seventy-two hours, but that doesn’t mean you’ll be staying here that long. We’re only supposed to hold people for twenty-four hours here. If you still need to be here after twenty-four hours, then you might get admitted to the psych ward.”

“You think I can get admitted? That would be great.” His eyes brighten. “Doctor, I’m very suicidal. I’m sure I’ll need to be admitted.”

“We’ll see,” I say. “We’ll do a formal evaluation and then observe you over a period of time.

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