My Very First Psych Patient

*Disclaimer - Identifying patient information has been changed to comply with HIPAA*

    The other day, I had to say a very bittersweet goodbye to my very first psych patient.  Let's call her "H" for the purposes of this post.  One of the first days I started on the inpatient psych ward, I took H on as my first patient.  H was a great patient to start on, because she was euphoric, expansive, and delusional... which translates to fun, not scary, and entertaining, in my opinion.  H was a textbook example of mania, complete with grandiose delusions that she was a doctor, oceanographer, pilot in the army, etc.  H would pace the halls, and every time I would encounter her, she would get all excited, smile and start rapidly indulging in one of her many delusions.  On several occasions, H told me she was born blind at birth, all the while making super intense eye-contact with me.  Each day she would decide she was a different race; that's something you can just pick and choose, right?!  

   H took a special liking to me, if I do say so myself, and would tell me she loved me every day.  She also told me that she was getting married (not true), and excitedly invited me to the wedding, however told another staff member who made her mad that they were uninvited.  One day, H told me that she was Lady Diana, and that I could have her inheritance (how generous!).  The last couple of days of working with her, she kept insisting that I should get more diamond earrings, and even said she was "going to the diamond store when she got out, to check if I got them."  

   When the resident and I spoke with H on her last day, she told us, "You two are my favorite doctors, and you take real good care of me.  Can I take you with me?"  She said she would never forget me, and left me with a very special parting gift (see picture below).  Her very last words to me were, "Wait, can I tell you something? Merry Christmas, and a happy new year!" and then she burst into laughter.

     

"Fire away that is you best shot"
When I asked what it meant, she said, "it means I love you."

   Even if most of her shenanigans were the mania talking, I still grew very fond of her.  As much as I was glad to see her doing better and moving on with her life, I was sad to see her go.  I am going to miss her contagious smile and laughter, listening to her wild imaginative delusions, and watching her dance and sing like nobody was watching out in the courtyard.  I don't think I'll ever forget H either.  My first patient of third year.