God, Lies and Thunder

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On a stormy afternoon in August, I met a man who told me he was Jesus Christ.

He’d been sitting in the crowded waiting room in the psych ER for a few hours, nibbling his free turkey sandwich and looking down at his lap, waiting his turn to see the doctors. His hoodie had holes in its sleeves, and his sneakers were worn down at the edges, so much that a sliver of bare skin peaked out through the fabric. Outside, an apocalyptic summer thunderstorm was raging, the kind that erupts after days of increasingly unbearable humidity, where the sky darkens and then fissures, drenching a previously sunny day in sheets of rain.

He wrote “I am Jesus” on the intake form, the one that asked for his chief complaint and so drew the attention of the staff more than other patients there for more typical reasons: a few people seeking drug rehab, lolling in and out of consciousness; a man who’d been found by police yelling obscenities in the park; a woman unable to cope with her depression.

A nurse spoke to him briefly, taking the preliminary history. When she returned to the workroom, she declared that he was lying.

“He’s too organized,” she said, meaning he seemed too normal and “with it” to actually believe he was the son of God. Since he was homeless, she thought he was looking for shelter from the rain and a free meal and so concocted the craziest story he could think of, figuring it would buy him a few hours indoors.

As she told us her assessment, I didn’t think she sounded jaded or cruel. Rather, she sounded like someone who, after years of trial and error, had developed a sixth sense for the thin contours that delineated the sick from the well, the helpless from the conniving, those in pain from those seeking painkillers. It was a skill that I envied, because it comes only with experience, and as a medical student exactly one week into my psychiatry rotation, experience was my most glaring deficit.

I volunteered to do his intake. We brought him into a small, airless interview room with just two chairs and a computer and started to talk. I asked him why he was there, and he looked down at his hands.

“I caused this storm,” he told me. He’d gotten angry with a friend, and as soon as he did he heard thunder roaring out of the sky, and vibrating in the sidewalk, echoing the boom of his raised voice. When the rain began to pour and lightning flickered in the distance, he realized the damage he could do and he decided it was time to seek help before someone got hurt.

He seemed disappointed in himself. He seemed frightened by his own power and ashamed of his inability to control it.

Most of all, he seemed genuine.

I suppose he could have been lying—we had no way of knowing. There was no blood test to run or x-ray to shoot to prove that he wasn’t a seasoned trickster with a knack for manipulating unwitting medical students. We could have sent him away, cast him out into the rain, betting that he wasn’t the best use of our resources.

But if Jesus were to return, what better way than as this man, malodorous and HIV-positive, sitting in a waiting room among the drugged, the delirious, and the damned, daring us to write Him off as yet another malingerer?

When I finished my interview we retreated to the workroom and presented to the attending, who asked for my assessment.

“I think he’s psychotic,” I told her.

“Why do you say that?” she asked.

I couldn’t answer. I didn’t have experience to lean on as validation of my gut feeling. I just believed him. I believed that he thought he could control the weather, that he was ill, and that he needed our help.

After a few minutes of discussion, the attending agreed. We made phone calls, set him up with outpatient mental health resources, and went back to the waiting room to tell him what to do next. He nodded in understanding, assured us he would follow up, and thanked us. Then, he gathered his things and walked out the door, with nothing but his tattered hood to protect him from the pounding rain.

Leigh Finnegan is a third year medical student at the Perelman School of Medicine of the University of Pennsylvania.

Thunderstorm_Hannah Singer.JPG“Thunderstorm” by Hannah Singer, MD

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