Tuesday, December 06, 2005

Go directly to Jail, Do Not Pass Go

Today we discharged a patient directly to jail, which was quite an upsetting experience for her. The probation officer and (female) bailbondsman came to pick her up, and if anything, those two were sketchier than any of our patients. I think what was most disturbing was a tattoo which was only visible because of her considerable decolletage. Of the fifteen or so people who saw her though, none were later able to identify what the tattoo was a picture of. Scary.

The patient was not excited about her destination and started screaming at the top of her lungs, banging her head on the wall, and was very near to having to be sedated and forcibly restrained when she decided to calm down. I was all set to practice my psychiatric take-down moves for the first time too.

Sadly and realistically, jail will be good for her. It is a forced detox program, and just might improve the patient's attitude. It keeps her from killing anyone, including herself. The unfortunate thing about the situation of many patients like this is that they have no insight, which to a psychiatrist means they don't understand their situation. They externalize all blame for their misfortunes and don't realize they have a problem within. Really frustrating.

Oh yeah, what is she going to jail for?

Violating her probation by disobeying a restraining order. That's minor you say? Well she violated the restraining order by chasing the subject of it down the street with a knife while high on meth.

And the subject is her husband.

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