"Uh... Well, I haven't slept in 2 days and want to kill somebody." He made violent hand gestures.
"Oh, right. Ok. Err... Can I take your vital signs?"
"I just want to sleep. And if you can't make me sleep, I want to kill you too." He stared at me weirdly. I backed away from his bed.
I guess the wrong thing to say would have been, "buck up, son, two days ain't a lot. I've gone months of 2-3 hours/night." I didn't, but I wanted to. Within a safe distance, of course.