Hard to tell

P4_HardToTell_title

Hard to tell what’s true anymore.
I’m a good person.
I mean well and care about others.
I’m a doctor because I want to help people.
I don’t have a problem.
I’m really sorry you’re having such a terrible experience.
Coming into the hospital is the right thing to do.
This could be the thing that changes this patient’s life.

Miracles happen every day.

Patient is at highly elevated risk of harm to self or others.
Patient agitated on arrival and required immediate restraints and IM medications.
There was nothing I could do about it.
Patient definitely does not need to be involuntarily committed.
Patient strongly denies suicidal ideation and is at low risk of imminent self-harm.
You came to the wrong place.
Patient appears highly motivated for sobriety.
She could turn it around this time.
Patient offered drug treatment and refused.
He’ll never get clean.
Yeah, I’m with you…fuck that patient.

Patient refused evaluation.
Malingerer.
I know this person.
Borderline.
Call to patient’s family for collateral went straight to voicemail.
Addict.
You’ll only get better by engaging in outpatient care.
Liar.
Listen, your insurance won’t approve anything.
She’ll be fine.

You look so much better!
You look terrible.
I look terrible.
It’ll all be worth it.
It’s a broken system.
It’s like this for a reason.

People get admitted to get better.
You never know!
Maybe she can hear all of this.
There is a small chance she could wake up and be the same.
If you put your mind to it you can lose that weight.
You could still have a long and happy life. The meds work.
It could be worse. It’s going to be OK.

We’re totally slammed.
The ICU is a crime against humanity.
I’m the worst. I can’t do anything right.
Why bother?
The hospital is where people come to die.
You’ll never get off dialysis.
Your prognosis is less than 6 months.
The chances of you returning to normal life are so small it’s basically impossible.
Meds are pointless.

No, I find this interesting!
I’m so sorry, thanks for reminding me!
I’m doing OK, thanks for asking.
No, I didn’t get your messages.
My alarm didn’t go off for some reason.
The consult phone … just stopped working.

I’m committed to this.
My life is fucked.
They’re screwing me.
Maybe I would be happier as a teacher.
Or dead.

I’m not stressed.
I’m not angry.
I’m getting fat.
I’m not hungry.
I’m still young.
I’ll try harder next time.
I’ll still have my friends at the end of this.
I’m a terrible person.
My parents understand when I don’t call them.
I’m OK with this.

I’m still OK with this.

Ayyappan Venkatraman is a second year psychiatry resident at the University of Pennsylvania and a musician.

Heavy trash_Behdad Bozorgnia“Heavy,” photo by Behdad Bozorgnia, MD

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