This afternoon had a beautifully comedic moment, but it was a weird situation so bear with me as I set the stage.
Throughout the day, the patients have activities that they can participate in like music therapy, art expression, board games, etc. I had finished my duties for the day, so to take a break from studying, I decided to sit in on the session and observe the patient's in this setting. The moment I walked into the room, something seemed off.
This afternoon's activity leader was a man I had never met and who, at first, I seriously thought must have been a newly admitted patient. His topic of choice seemed to be poorly informed geopolitical theory and the inevitability of nuclear war - topics I expect from the schizophrenic patients, not the people helping treat them. I love me some good ol' geopolitical debates, but talking about the coming nuclear apocalypse and World War III in a room with paranoid veterans who already have similar delusions just seems like a bad idea. Perhaps he was redirecting an inappropriate comment by a patient, I thought. A few minute of listening to the conversation quickly showed that the more coherent patients where actually giving more level-headed opinions and attempting to steer the topic back to a happier place. Some of them had surprisingly reasonable points.
There are several nurses in the area as well and we were all silently making eye contact conveying something to the effect of, This is weird, right? One nurse valiantly tried to turn the conversation into something more appropriate. "The idea," she said, "that we as a country might want to take care of our own needs before worrying about others', reminds me of our own personal basic needs. I need to take care of myself before I can take care of anyone else. What other basic needs do we have?" It was superb, but futile. A few minutes later the guest activity leader was once again talking about Iran already having a nuke and how we should have bombed China in WWII. A second nurse eventually pulled the man out of the room for a moment to talk with him about the topic, but he came back with the same enthusiasm.
The people that finally put an end to this bizarre situation were actually the worst-off patients in the room. One patient wandered over to where the man was sitting and started to talk over him to us about absolute gibberish. Another offered up his opinion about Iran by talking about eating pizza with a friend. It was beautiful. It was like when a small child says something totally right, but completely inappropriate - like yelling "Mommy, that man smells really bad!" when walking past a smoker. It's inappropriate, but you almost want to laugh and give the kid a high-five, even though they have no idea why what they did was wrong or why you enjoyed it so much.
I wanted laugh and continue the pizza topic, but instead quietly smiled as the activity leader got flustered and decided he was done for the day. Good job guys. I'm proud of you.
TIL: Research has hinted that a large proportion of the patients with comorbid schizophrenia and obsessive-compulsive symptoms may have developed the OC symptoms as a side effect of treatment with the particularly nasty antipsychotic drug, clozapine.
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