Thursday, March 15, 2012

Thought Disorder

(I introduce myself and ask what's wrong.)
Can I have coffee?
My mother likes coffee.
I can't be having those people coming and sleeping at my mother's house.
All I got is this cup and my mother.
I got an infection of my hands.
I'm holding somethin' wif nuffin'.
They built in a school.
(I ask the patient to go urinate in the cup. Patient goes to the bathroom and comes out a minute later.)
I can't urinate I'm sorry.
I don't have no brothers and sisters.
(I have the patient sit back down and ask how the patient's mood has been lately.)
I can't be happy after what they did to me (shows me an old scar, I inquire about timing and event).
They did it to me the same night I got shot.
I'm not superman.
I'm not gonna keep doin' this for ya'all to tear me to pieces.
My mother's still there, what we gonna do with her.
My mother, she needs to lie down.
Ain't no computer out there for her.
She wants to see the world.
I don't understand why.
That's why I go to the club, cuz when we together we argue.
They got destruction going on at the club.
(I ask: construction?)
No, destruction.
I ain't gonna give no piss like that to the doctor.
I got a house trying to sell out to a school.
I'd rather have a purpose then destruction.
Saving everybody, not one against another.
I got to find these people.
(I ask: Do you do drugs?)
(Response): I don't supposed to.
I drink Pepsi, I drink coffee.
I take pills.
I keep hair out my nose.
I got tired of cutting my hair everyday.
This is the only way I can talk to a woman, if I come to the hospital.

This post is written as an illustration of thought disorder. It is the exact dialogue between myself and a patient. Here we have flight of ideas and loosening of associations. The patient is actually not anywhere as ill as many others I've cared for. Sadly schizophrenia can be devistatingly disabling. The most disabling feature is not exactly the symptoms but the absense of insight. Nearly all patient's who suffer from schizophrenia do not believe they are sick. It's like their mind's wiring of reality is so distorted that they cannot comprehend the mind they used to have. They do not realize they are sick because the sick mind is the new mind. It is the only mind. But the person there is still the same person. And that is what has been one of the greatest challenges and rewards of what I do, connecting to and helping that person lost within the ill mind.

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