WILTIMS #312: I'll do it in a GIFfy!

I am a PRN of lorazepam! I'm taking this as a compliment from my supervising psychiatrist, but I bet it needs more explanation before most of you will see why.

My supervisor asked me to interview a new patient near the end of the day. We had heard that he was a little upset about being admitted against his will, which seems understandable. My supervisor thought I could handle him (but it would probably be best to keep around the nurse assigned to watch him). Brimming with confidence, I set out to find the patient.

About 30 seconds later, having found the nursing station abandoned, no staff members in sight, and realizing I have no idea who this patient is, what he looks like, or where to find him, my confidence returned to Toby Turtle levels. After awkwardly walking in circles enough that schizophrenic patients came over and asked if I was ok, I finally figured out that a nurse was already talking to the new patient in a private room.

Disappointed and dejected, I shuffled back to my supervisor and explained that the patient was busy talking to a nurse and was unlikely to be free or willing to talk with me in the near future. He listened and shrugged. He said (paraphrasing), "Oh, well that's ok. I was really just going to use you to calm him down a bit and if he's already isolated and talking to someone, that's probably fine. You just have such a soothing presence; you're like a PRN of lorazepam." [Translation: you're like an as-needed anti-anxiety drug] - I think this is a good thing. Also, I know that a few of my readers (e.g. my siblings) would take issue with this description of me.

TIL: The major cause of death for patients who die from complications of eating disorders is hypokalemia (low potassium).

It is important to remember that when psychiatric patients decide to stop taking their medications, they usually stop taking all of their medications. Thus it is not uncommon to see patients with decompensated diabetes, sudden hypothyroidism, or severe high blood pressure.

Though we're warned when studying for boards about the rare heart birth defect caused by lithium use during pregnancy, called Ebstein's anomaly, in real life the risk is so much lower than the risk of untreated bipolar disorder, especially with a suddenly discovered, unplanned pregnancy, that often lithium is actually the best choice for treatment.