Two on the Floor

The other night, the paramedics brought in a patient that was nervous and paranoid. He was a schizophrenic and admitted to being off of his psychiatric medications for some time. He said he was hearing voices and having thoughts of suicide. I explained someone would soon take him over to the emergency psychiatric ward for help. He agreed to wait. I did his paper work and went to see my next patient just around the corner.

She, too, was a schizophrenic, off her medicines and talking of suicide. Unlike the first gentleman, however, she had behaved so aggressively towards the police and paramedics that they had to restrain her. They did this by putting leather straps on her wrists and ankles and tying her to the gurney. We call this “four points,” meaning four points of restraint, one on each extremity.

By the time I went to see her, she was a lot calmer. I asked if she would behave if we took her restraints off. She assured me she would. As I started to release the restraints, one of the paramedics gave me a look like, “You’ll be sorry!” I released her restraints, reminded her or her agreement to cooperate and left while staff took her vital signs and got her registered.

Very soon, I heard screaming and detected agitation coming from her room. When I got there, she was face down on the floor. The nurse said she had refused to stay in bed and, as soon as she stood up, purposely went to the floor without hurting herself.

Let me help you picture what I saw as I looked down at her on the floor. She was a large woman. She had no clothes on under her hospital gown so her entire backside was visible as she lay sprawled out on the floor at the entrance to the exam room.

She pretended to be unconscious but I knew she could hear me as I told her she had violated our agreement and would now have to be put back in restraints. Hearing this, she immediately jerked herself onto her back. At the same time, she pulled the hospital gown away so her entire naked front side was now visible for the world to see. It appeared she tried to use her nakedness as some sort of a weapon when she was not happy with what was going on.

By this time, at least eight people were at the bedside including two police officers that happened to be in the department. Since the patient refused to get up, I instructed everyone to grab an arm or leg so we could safely get her back on the bed and into restraints.

That is when she really went off. She screamed at the top of her lungs and swung and kicked at us. Unable to get her arm loose from me, she grabbed my pants and tried to pinch my leg. As she flopped on the floor, she tried to pull her gown completely off.

When everyone had a secure hold of her, I called out, “One, two, three…” to coordinate lifting her back on the bed. We maintained our grip while someone went to get the restraints.

Suddenly, I looked over my shoulder to see that the first patient I told you about was now in the room. He was hollering as loudly as the lady was. Having heard her distress, he decided she was in trouble and needed his help. “I’m Federal! I’m Federal!” he repeatedly hollered as he grabbed some of those still trying to restrain the lady. “Let go of her! I’m Federal!”

Unfortunately for him, one of the people he grabbed was a police officer. In a flash, the officer released his hold on the female patient, turned, took the man down, and pinned him face down to the floor.

“Why are you doing this to me? Get your knee out of my back! Let go of me! I’m Federal!” the patient loudly protested. The police officer hollered back at him to shut up.

All of a sudden, I started to laugh. I couldn’t help it. It was too bizarre to even believe. One naked woman screaming and fighting in front of me on the gurney. One man screaming and fighting on the floor right behind me. It was just too crazy.

The woman, who now had her feet in restraints, turned to me and asked, “Why are you laughing?”

“I’m sorry, but it’s just funny,” I said.

“You are the shittiest doctor I ever had in my life,” she said as I was finally able to release her arm, which was now restrained at the wrist.

Soon, both patients were in four point leather restraints and sedated. I hope they were able to get the help they needed when they got to psychiatry.