Please Allow Me to Introduce Myself by Dr. Rhonda Houston

They call me Houston at the hospital. Sometimes they add “ Dr.” or “Dr. Miss” before Houston, but either way, I’m still Houston. As in, “Houston, we have a problem.” I work at a behavior health facility. I said I would work the trenches for a semester about 15 years ago and I’ve never left the hospital setting. I love the clients! I promised to share some stories and quotes of the day I’ve collected over the years. I thought of this story today when this particular client returned, as she has multiple times over the years. When she is stable, she is quite interesting and intelligent. But when she is not—well, let’s just say she is never boring.

One of my very favorite stories happened years ago. Then I had an office in the outpatient setting. So the front door was always unlocked. I was coming back from lunch, sandwich in hand, and as I stepped through the door the clerk eyeballed me, motioned with her hand and whispered the familiar “Houston…we have a problem.” Coming down the hall was a fit middle aged woman wearing spandex shorts, spandex top, black leather bikers vest, and black leather boots that went up to her knees. Her hair was long and curly. Her eyes blazed as she came right up to my face and told me how lovely I looked. Oh My! I put on my most pleasant professional voice and asked how I could help. Out streamed a whole bunch of words that made no sense, stuff about the Devil and God. In between she made sexual comments about most everyone that walked by. I knew immediately she needed our help. As I was trying to gain her confidence, I was also trying to figure out how to get her to a safe place out of the milieu.

My first thought was to offer her lunch. In a surly voice she replied, “No thank you, I ate Tabasco sauce for breakfast.” I have to admit, at this moment it was almost impossible for me to keep my composure– I just wanted to burst out laughing! I offered something to drink and she chose coffee. I slipped out and over to the intake department to give them a heads up and to clear a room. I nabbed the coffee, adding some cold water, just in case it went flying. One learns these tricks early in the field of mental health. Upon return I offered the coffee. In a surly husky voice she asked “Did you put poison in this?” Her eyes narrowed to a glare. “No.” I replied, “You didn’t ask for poison, just coffee.” “Ok, I’ll drink it then.”

As she sipped her coffee, I offered to allow her to stay so she could have a warm bed for the night. She liked that idea. I was able to walk her over to the intake room where we started paperwork. First, I started the form where we asked for another contact–a relative, or perhaps a good friend, in case of emergency. After she tossed out several names she finally decided “Lucifer!” I repeated, “Lucifer?” She said, “Yes, Lucifer– you can trust him.” I wrote down Lucifer on the form and asked for a phone number. That glare came back and she hissed, “YOU know his number.” Suddenly an angel appeared, backlit by the light of the doorway. To my relief, it was an intake person who swiftly and thankfully took the client up to her room.

Miranda here–This is from my friend Rhonda, and should probably rightfully be called  ”Why I am Not a Psychiatrist #4.”

Why I Am Not a Psychiatrist #2

After that last uplifting little story, I figure I better write Part Two of “Why I Am Not A Psychiatrist”.  It’s always important to have a good laugh after a good cry!   So back to my Adventures in Psychiatry.

As I mentioned before, my psychiatry rotation was at the VA Hospital.  My attending physician was a very experienced senior psychiatrist who truly believed in the axiom  “Know Thyself!”  And therefore he had a way of helping us students toward that end.  Back in those days, it was common during a psychiatric evaluation to administer a test called the MMPI, which stands for the Minnesota Multiphasic Personality Inventory.  As I recall, the test took several hours to take and was quite maddening—the questions were repeated over and over, as if to “catch” the test taker in a lie.  It was not a fun test to take, say, like an IQ test where you arrange difficult little triangles into a square box, or a “what should you be when you grow up” test (I was strongly encouraged by that one to do musical theater, or to become an opera singer, which is quite hilarious if you’ve ever heard me sing!).  No, this was a long BORING test which had no apparent purpose. And yet, my psychiatry attending decided that ALL of his medical students were going to take the MMPI, after which we would sit around and discuss the results of our newly discovered personalities.

The day came, and there we were—six medical students, a couple of interns, a resident, and the attending.  We were handed sheets of paper with our names, on which there were scores for several different categories, which were then pictorially demonstrated by a connect- the -dots graph.  Each test taker was given scores for basic personality traits, such as empathy, obsessive compulsivity, narcicism, obstinacy, and, of all things, paranoia.  So I am looking at my scores and I am bobbing along quite nicely at the fiftieth percentile for each of the 8 or 9 different traits, thinking “nice, I am NORMAL!”.  But wait….at the very end of the list there is the category paranoia and my graph takes off like a helicopter, I mean STRAIGHT UP UP AND OVER the 100 percent line.   What was this?  WHAT WAS THIS???  I had a moment of panic, and then I settled…turned to my attending and said, “Look at THIS!  Paranoid?  I’m NOT paranoid!  You must have graded mine wrong!”

All eyes turned to me, and the little sniggles of laughter welled up into great big guffaws.  I would venture to say a few folks in the room actually wet their pants, judging by the tears of laughter in their eyes.

Okay, so I’m paranoid.  But let me tell you, I also won the Award for Student Excellence in Psychiatry.  And I never took another personality test, ever!

Why I Am Not A Psychiatrist, #1

I love psychiatrists. Besides the fact that several of my  family members have availed themselves of psychiatric services,  I have always admired the intellect and insight required to truly “see” into another person’s mind, combined with the patience to listen, even when one is bored or otherwise preoccupied—these are skills I do not have.  When I was in medical school however, I thought I might become a psychiatrist.  That is, I did until I actually did  my psychiatry rotation.  I was assigned to the locked ward at the VA hospital.  This was back in the days when truly psychotic individuals were locked up, and were not found pushing shopping carts full of their belongings around Central Park and other large city venues while searching dumpsters for food.

I took my assignment very seriously.  I knew that schizophrenia was characterized by visual and auditory hallucinations—the patients were seeing things and hearing things that actually weren’t there. I studied the books, and I practiced a calm, empathetic demeanor.  I was ready to bridge the gap between fantasy, hallucination and reality. I knew that with focus and understanding I could bring my patients back into the world of the here and now.  I was going to be a SHRINK!

My first patient was a youth who had served in Viet Nam.  He had come back a changed man, and not in a good way.  He had lost touch with reality and was diagnosed as a paranoid schizophrenic.  He had been on the ward for several weeks, and was still having hallucinations despite large doses of thorazine and Haldol.  He had been known to refuse to speak to medical students and residents, and there was even talk of violent behavior.  So I was very gratified that he agreed to grant me an interview, otherwise known as a “therapy session.”

In my best psychiatrist voice, I asked the young man what the problem seemed to be, and why he was there as an inpatient at the VA Hospital.  He said to me, “I see things.”  I resolved to delve deeper.  Casually, I said, “And how do you ‘see’ things?”   He replied, just as casually, “I have X-Ray vision.”  Now THIS was getting interesting.  I was treading a fine line here, wanting him to feel comfortable talking to me, yet not wanting to endorse or otherwise encourage his visual hallucinations.  But still…I was fascinated.  So taking a deep breath, I asked, “What do you SEE?”

He took an equally deep breath.  He took a step back.  He looked me up and down, not once, but several times.  And then, in a loud voice, he announced:  “I SEE TITTIES!!”

Okay, you can call me gullible now.