Tuesday, September 20, 2011

Of Butterflies and Roaches

Every once in a while, I check back into a more comfortable reality, as if the realer-than-real life that I have been living in the ER has been a farce. The darkness of humanity will seem to be only a nightmare that dissipates with the morning light of the waking world.

I was pulled from my section to sit for a college freshman who had ingested 20-60 liquid advil in an attempt to harm herself. Oh boy... I've seen enough disturbing cases of these to be totally on my guard.  Young, "alternative", wearing black lace tights, and thick dark eyeliner, she commanded an adult appearance way beyond her years.  Yet, she surprised me. Polite, meek, apologetic, it was as if she got caught in high school for skipping class and was in detention.  She didn't even object to having a "sitter." She took it as her due.  It made me wonder about all the combative, abusive, spitting, terrible people I have sat with hitherto, and how little effort it took to sit with Ms. Advil.  She did everything we asked and more, even replacing the blood pressure cuff herself when she came back to the bed.

Instinct told me to reach out to her- she was a little overwhelmed and completely new to the hospital environment and asked me what "butterflies" were.  The more I talked to her, the easier it was to look through the smeared make-up at the very young soul in front of me. It became more and more apparent just how young she was, with baby fat still lightly gracing her jowls. She hadn't succumbed yet to the college-girl quest for angular chins and improbable diets.

"So what happened that brought you in here?"
"Well, I was going out with this guy Nick, and I was mean to him, but I didn't think I'd push him away. So when he told me he wanted a break, I got mad and lost my temper."
"Did you want to hurt yourself?"
"Yeah, but not anymore. I just love him so much."

I let her babble on about Nick and she thanked me for listening, for it made her feel better.  She was curious about the charcoal we had her drink to deactivate as much of the drug as we could. She didn't mind when her mother and grandparents came in to sit and stay with her.  I've had young patients fight tooth and nail to avoid their parents, but they were apparently a very loving, supportive family.

They had raised a good girl, albeit a little spoiled and impulsive.  They were also very protective, asking for every little detail, whether this IV should be hurting or if the bag should be changed, or if she could have ice chips and a toothbrush/toothpaste to brush her teeth, etc etc...

Sitting with them made me feel safe- removed somehow from the adult world of lies, manipulations, agendas, gambles, real psychiatric problems.  She was just being a pouty kid.

I heard a scream down the hallway from the PCP-ingestion that was heading my way. In stark contrast, this young girl was a brash young hellion with emotional problems and the will to harm.

My few hours of peaceful counsel with the Advil girl was ended by the arrival of the ugly character of the new patient next door, who brought me swiftly back to my adult reality as she started spitting at us. Sigh, just another day in the life.


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