Today went much like yesterday. It was even harder to get up at 4:00am than it was yesterday. I got home and I am bone tired. I have no idea how the doctor arrives everyday at 3:30am. But it went fast.
There were some very interesting cases. I have a few good stories to tell that will help you understand the typical cases and interesting people.
A typical girl
She is around 15 and covered in circle scars on her face and arms. They are 'bug bites' that she 'picks' at. Her parents say she gets mad and scratches herself until she bleeds. She also had several episodes where she snapped tweezers in half and used them to cut her arms. Her parents were completely bewildered about what to do. She often threatened suicide and meds don't help. She says she's "not worried about scars." The doctor said to make her wear a thick rubber band on her wrist to replace the cutting. She still gets the pain and the parents get to keep their daughter with less permanent damage.
Mighty Mouse
She is as tall as me, weighs 94 pounds with red curly hair and acne. She is dainty, mousy and timid with crooked teeth. Her parents come in with her and they are overweight and stocky. Her mother has breasts below her elbows although her belly is not as proportional and very quiet. She is a new patient who has recently been hospitalized because she was "mad." The father goes into stories about how the daughter gets raving mad and beats him with a broom handle. When asked what happens after that, he says he tries to walk away but she follows him. He is convinced that this must be bipolar disorder to such an extreme point that he spends a huge amount of time trying to talk to doctor into it. The doctor immediately cuts him off and says no. The doctor explains there is a difference between blind bipolar rage and directed controlled rage. He says she acts out at home because its safe and she knows her parents won't do anything about it. He says that she is in complete control of her anger and she chooses what she does. He got her to admit it by asking if she acts out in front of her friends or at school to which she immediately replied, "I don't get mad in public, that's just stupid- I don't wanna go to jail." When the doctor suggested her parents call the police the next time she does it she gets upset and says "I"m not going to jail, I know what I need to do." which she keeps repeating. She gets very upset and threatens her father that he cannot even say that word to her or she will "get very upset." She begins to warn doctor he is making her upset. She begins to cry and the father begins to quaver. Yes, quaver as in shake in his chair and he asks the doctor to stop saying the word. The doctor actually laughs. He then yells at the father and says he should be ashamed for letting a little brat threaten him and get away with it. He yells and exchanges so many words he finally gets the father to freely admit he spoils her and wants to. He gets so frustrated that he just admitted it he goes silent for the rest of the lecture. Then when asked to return the daughter replies "if i'm still here."
The Asperger's boys
Two college aged boys came in with their parents. Both were overweight and wore glasses. It was they way they walked maybe, or the way they fought over who was going to weigh more that I knew something about them was off. Not delayed, just socially not quite there. It was hyper rational, the kind you see on TV. The eldest was a little more lower functioning as far as intellegence went and he was more well behaved. But he kept saying "that's it I'm cut it out" without explaining the it. The younger boy was so intellegent that his parents had put him in college. He had a very high IQ but he came back with a 2.0 GPA because he was "surprisingly social." Through the course of the interview, the younger kept rationalizing all his mistakes and admitting he had "complete lack of self control" as well as going off on a tangent about how he was "spoiled" by his mother, who also admitted it. It was discovered that she gave him $200/week spending money so he could have fun in college. Even though the importance of studying was discussed with everyone in agreement, the mother abashedly admitted that she couldn't stop giving him the spending money. She knew she shouldn't but she didn't want him to stop hanging out with his friends (who were probably only hanging out with him for the money). It became chaotic when the mother keeps talking and admitting she's a guilty parent for birthing two asperger's boys, while the dad is trying to comfort her, while the youngest is rationalizing over everyone, while the eldest puts his hands in his ears and rocks back and forth saying "everyone's crazy." It was a new experience because these boys were true asperger's and truely smarter than me. It was an odd feeling to have to think that this disease is simply a social inadequacy rather than one of the mind. It also convinced me that a certain pathology teacher of mine doesn't have true asperger's.
more cases later...
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