Wednesday, February 28, 2007

Lesson One: Use "Irony" Correctly In A Sentence

From the Green Acres catalog of therapeutic group offerings:

"Grammar Basics: This group is for those interested in self-improvement or wish to prepare for high school or college classes."

Tuesday, February 27, 2007

What Money Can't Buy (A Green Acres Interlude)

[Scene: Dr. Turbo walking down the hallway by the cafeteria. Another doctor’s patient approaches him:]

Patient: Dr. Turbo! I could give you this [shows wallet] and this [shows old black plastic comb]. Would that be enough to get me out of here?
Dr. Turbo [Walking on]: No, I’m afraid bribery isn’t the best way to try to get out of here.
Patient: Wait, Dr. Turbo! Wait! Don’t walk away! I also have pocket change!

Friday, February 23, 2007

Sometimes It's Hard To Know How To Respond

Patient: I have a hard time keeping track of my meds at home.
Dr. Turbo: I wonder if one of those “medi-set” pill organizers would help?
Patient: I had one, but it didn’t work. The pills didn’t fit into the holes.
Dr. Turbo: Oh-- your pills were too big?
Patient: No. The holes were too small.


Patient: They were giving me a nicotine patch before I got transferred here.
Dr. Turbo: Okay. Would you like to continue using the patch?
Patient: No. I heard that nicotine stuff is bad for you. I’m going to go back to smoking.

Thursday, February 15, 2007

Space Holder Post

I do apologize, dear reader(s), for the dearth of postings lately. Green Acres has been just buzzing with business, and I seem to have little time or energy for much else. Well, that's not entirely true-- there's also been some skiing, lately. And I spent a whole afternoon tearing apart the Subaru's dashboard, installing a new radio, then realizing that I had somehow disconnected the heat.

I've been making extra work for myself at G.A., lately, by being more "aggressive" in trying to get treatment authorized for those who can't leave the hospital without it and guardians for those who can't make adequate decisions for themselves. Many patients are convinced that this is my favorite part of the job-- that I simply live for the joy of going to court to take away peoples' rights. The truth is, I hate it, and it exhausts me. My liberal mind fights with my doctor mind, my philosopher mind fights with my pragmatist mind, and my anti-authoritarian mind fights with my compassionate mind. The only thing worse than being pitted against your patient in a courtroom is hearing on the news that your patient froze to death, or was shot by police, or killed his brother.

Also, for some reason, I am currently trying to stay in touch with a record number of moms-of-patients. Generally I have a dozen patients at a time, and it's fairly rare that more than one or two family members are interested in their plight. But just now I have seven mothers (plus a few dads) actively involved and trying to keep tabs on what's happening. For the most part this is really very good. But it takes a lot of time to answer all the voicemails...

Monday, February 12, 2007

Fecal-Oral Transmission

It’s pretty common around here for people to smear feces on the walls and furniture, and also pretty common for people to spit on the staff. But this weekend one of the guys took to spitting feces on the staff, which is rare and most unpleasant.

Friday, February 09, 2007

Motivational Posters Of Green Acres, Part IV

A sign on the wall of a Green Acres hallway reads:


Although I entirely agree with the statement, I am confused by its presentation. What do the quotation marks mean? If this is a quotation, who said it? And did he or she say only the part about contributing, not the part about mental illness? If so, who added the mental illness preamble?

Or, are the quotation marks meant to indicate that this is a “dubious” or “so-called” sort of “fact”, that is not really “true” per se?

As with so many of the mysteries of Green Acres, we “shall probably never know the meaning."


How To Interpret?

When the Mount Washington weather forecast says "highs in the low negative teens", does that mean it will be around -17 to -19, or does that mean more like -13 to -14? That is, does "low" refer to the temperature, or to the numeral?

This may seem sort of academic, but it's important, because the difference between -13 and -19 is the difference between a tolerable winter hiking day and a day that's just going to be a bit too chilly.

Wednesday, February 07, 2007

The Truth, The Whole Truth, And A Good Dose Of Weirdness

Psychiatry, as a whole, is an unusual occupation—but working at Green Acres sometimes seems a couple standard deviations beyond the norm even for shrinks.

For example, how many psychiatrists ever find themselves in a court hearing, on the stand, being cross-examined by one of their own psychotic inpatients? Such was the Twilight Zone-like experience this morning. The hospital had filed a petition to extend a patient’s involuntary hospitalization, the patient had fired his attorney and received permission from the court to represent himself, and I was a witness in the matter. In the process my patient asked me to testify on such topics as, “Don’t you think it would be a good idea not to lie so much?”, and “What do you think of this judge?”, and “Why does that attorney have such a funny nose?”

Meanwhile the patient’s (ex-)attorney was relegated to the back row of the courtroom. During my direct testimony, he once or twice verbalized reasonable “objections” on his client’s behalf, but the patient loudly exclaimed “objection to the objection!” and told his attorney to keep his mouth shut, or he’d be thrown out for contempt.

Tuesday, February 06, 2007

And What's Even More Disturbing Is That Half Of Our Children Have Below Average Intelligence

From a Smallish State Public Radio story yesterday morning:

"...The majority of Smallish State boatyards employ fewer than 50 people, and over half of them employ fewer than five."

Friday, February 02, 2007

I Was Warm, Below The Storm

Was I away? Oh yes, I suppose I was, ever so briefly, in Tropical Island Paradise Region, visiting the family. No sailing, alas, unless you count the sunfish with a cracked hull, which sank every 30 minutes. But I took Favorite And Only Nephew (age two) on a brief kayak ride. He grabbed right on to the paddle. He will be a fine paddler when he grows up.

Also very exciting, I saw an octopus while snorkeling. I have been waiting many years to see an octopus while snorkeling. He was just swimming along, and saw me about the same time. He quickly retreated to a nook under a rock, behind a sea urchin, and curled his arms around himself. I backed up a few yards and waited. Before long, his eyes came peering up over the rock, watching me. When I moved so that the urchin blocked his view, he moved and peered around the urchin. He changed colors from tan to white to blue-ish. But he would not come out and play.

Thursday, February 01, 2007


Case in point: This morning a new admission arrived at Green Acres. The staff who checked her in took away her chapstick, but let her keep her cigarettes.

Later in the day a nurse called me regarding a different patient. Apparently she (patient) had lit her hair on fire during a smoke break. She's quite disorganized and I guess her hair was just hanging in her face while she smoked. But God forbid she might have had chapstick on her lips at the same time-- it's probably quite flammable.

Things That Drive Me Bonkers, II

Fun exercise: Rank the following items in terms of their dangerousness.

- Chapstick
- Carnation Instant Breakfast
- Popsicle
- Pickles
- Watercolor paints
- Cigarettes
- Lipton Green Tea with Citrus diluted 50/50 with water.
- Stuffed bunny
- Plain gold band wedding ring

Now guess which one of these items is considered so benign that it never requires a doctor’s order, and which seven items are considered so potentially hazardous that, within the past week, nurses could not or would not give them to a patient until I wrote an order.