Anxiolytic Calls

"I've got a suicidal patient on the line, would you mind if I merged the call?"

Yeup. I was to manage a suicidal call into the hospital. Compared to the fake Code Green of earlier today, I must say that my heart rate went astronomical. How was I, a novice intern on his first night of call, going to talk someone out of lethal action and get them to the hospital? Huh. Quite the formidible challenge. Thankfully, again for training call, I had my now favorite Atlantan by my side to coach me through with rapidly written questions on some loose leaf.

We'll call the guy Mr. Sad.

"Mr. Sad this is Dr. Webster, can you tell me what's going on right now? Alot of people are worried about you."
"Well. I just want to end it all. Its too much."

Thus began our talk. I clearly donned my most calming, empathetic voice and prayed my anxiety would not bleed through the line. Think, midnight slow jams DJs on R&B stations.

Mr. Sad talked of his recent failure out of college, his loss of a job, loss of financial security, and the threat of being kicked out of the house by his mother. Apparently, he had been experiencing a debilitating depression since his December despite taking his medications.

"I just feel like everything makes me snap...I just...feel low and stuck."

Well, as for the latter half of his sentence I must admit that he was not the only one that felt a bit low and stuck. All I could think about is just keeping the guy on the phone and trying to organize a way for him to get to the hospital.

We spent about 20 minutes chatting while we (the nurse on the phone and I) located his brother to get him to our ER (he declined an ambulance or police officer ride). He seemed to finally be letting off some of his steam and simmering down a bit. Similarly the newness of the situation melted off a bit and I found a warm compassionate place to come from. It worried me that there were firearms in the home (as so many vets have), but I was comforted by the arrival of his brother to his house and hearing his mother in the background.

"Alright. Its absolutely important that you come to the ER as soon as possible. We'll all waiting for you so we can help you through this difficult time. I'll be waiting for you at the ER."

Those were a long 30 minutes. Mr. Sad lived far from the city and although my sense was he would definitely be arriving there is always that fear. We eventually saw in the ER and admitted him to the ward. He seemed deeply thankful for our visit. The nature of psychiatry is such that you never really have control. It becomes painfully more clear when your twiddling your thumb on the cord as you stare at a computer screen tens of miles away from a very acute situation.

My Atlantan training wheels put my mind to ease and congratulated me on a fine job.

"Your voice. You'd be a great psychotherapist. Its just so relaxing. It just makes me want to go to sleep."

Let's hope so. Speaking of which I hope I can pack in some sleep. The blood pressures on the floor have cropping up again. Let's hope the night staff is resilient and my drug choices adequate.

One life saved.