Favorite Chief Complaint
Started by kugel
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Dude, I have a patient whose primary delusion is that there are 15 Michael Jacksons (no man can change that much! you can't make a black man white!), and since she doesn't know the one who died, she isn't worried about him. She is close with 5 of them, and the "one who was friends with Diana Ross" is supposed to be coming any day now to take her away from our hospital to a hospital in DC where she can get a major abdominal surgery that she has been refusing since March. Her father is the Ayatollah Khomeini, she has two sons who play for the Orlando Magic, and she speaks daily with Joe Biden through the TV. She is planning to send me and the attending each a few million dollars from the proceeds of her TV show (according to her, VERY popular in the "communist countries") once MJ whisks her away.
These delusions have been stable for months.
That's fantastic
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"I lost my apartment"
Three times in two weeks.
Three times in two weeks.
Regn... like that car... what kind of car is that?
Funniest CC was a patient s/p cabg delirium/ etoh withdrawal...
Me: How's it going? Do you know where you are?
Patient: Yes...uhh... somewhere in this galaxy... close to earth i think...
Me: Do you think you might be on earth?
Patient: Yes, I think I'm on earth?
Me: Where is earth?
Patient: Uh...it's somewhere in this galaxy somewhere...
Me: Where do you think earth is?
Patient: (Trying to organize his thoughts) Yes, I know where I am... I'm on earth... it's a really f*** up place somewhere between mars and venus... that's where I am...
We had quite a chuckle for a few minutes after that...
Funniest CC was a patient s/p cabg delirium/ etoh withdrawal...
Me: How's it going? Do you know where you are?
Patient: Yes...uhh... somewhere in this galaxy... close to earth i think...
Me: Do you think you might be on earth?
Patient: Yes, I think I'm on earth?
Me: Where is earth?
Patient: Uh...it's somewhere in this galaxy somewhere...
Me: Where do you think earth is?
Patient: (Trying to organize his thoughts) Yes, I know where I am... I'm on earth... it's a really f*** up place somewhere between mars and venus... that's where I am...
We had quite a chuckle for a few minutes after that...
Zenvo ST1, a new super car developed in Denmark. But price for each of the 15 cars is $4.8 mill at current exhange rate (DKR 16 mill). Competitor to the Swedish Koenigsegg and the Italians
What a bargain! McClaren is rumored to be developing a new car within three years... And it should be much less than 4.8 mill... 🙂
"I am the new Jesus... Only better!"
"I am on the wavelength with Bethoven and Mozart. My music talent is endless.... My rythem is amazing" - Manic 19 year old with no rythem or musical talent whatsoever. He started humming and waving his arms like he was the leader of an orchestra... It was hard not to LOL...
Pt. broke out through window. Before he left he told the nightshift nurse "I'm leaving now"... The nurse said "ok" and laughed since everything was locked... But to his suprise when he went to the pt. room later he had un-screwed the window and carried into the bathroom. A dinner fork was left by the window...
The Pt. later came back and the nurse asked him "How the hell did you manage to un-screw the window with a fork"... The pt. looked at him smiles, and said "well, the fork was just to mess with your heads. I had a Leatherman in my pocket the whole time" LOL
Sadest thing: Pt. escaped one night and had planned to commit suicide. But it was dark, so she coulden't finde the rope she had hidden in the woods, so she went to a friend who drove her back to the hospital.. I was there the next morning when she called her mom.. "Hi mom! I escaped yeasterday. I was going to hang myself, but I coulden't finde the rope.... I can't take it anymore...." ... I had to swallow hard not to shead a tear 🙁
Old women sitting across me while eating breakfast:
Her: "Do you have a wife?"
Me: "No"
Her: "A girlfriend?"
Me: "No"¨
Her: "Do you have any girls around?"
Me: "Hmm, yeah I guess I have that"
Her: So you two are whoring around!!!
Me: *Chokes on food*
"I am on the wavelength with Bethoven and Mozart. My music talent is endless.... My rythem is amazing" - Manic 19 year old with no rythem or musical talent whatsoever. He started humming and waving his arms like he was the leader of an orchestra... It was hard not to LOL...
Pt. broke out through window. Before he left he told the nightshift nurse "I'm leaving now"... The nurse said "ok" and laughed since everything was locked... But to his suprise when he went to the pt. room later he had un-screwed the window and carried into the bathroom. A dinner fork was left by the window...
The Pt. later came back and the nurse asked him "How the hell did you manage to un-screw the window with a fork"... The pt. looked at him smiles, and said "well, the fork was just to mess with your heads. I had a Leatherman in my pocket the whole time" LOL
Sadest thing: Pt. escaped one night and had planned to commit suicide. But it was dark, so she coulden't finde the rope she had hidden in the woods, so she went to a friend who drove her back to the hospital.. I was there the next morning when she called her mom.. "Hi mom! I escaped yeasterday. I was going to hang myself, but I coulden't finde the rope.... I can't take it anymore...." ... I had to swallow hard not to shead a tear 🙁
Old women sitting across me while eating breakfast:
Her: "Do you have a wife?"
Me: "No"
Her: "A girlfriend?"
Me: "No"¨
Her: "Do you have any girls around?"
Me: "Hmm, yeah I guess I have that"
Her: So you two are whoring around!!!
Me: *Chokes on food*
LOL, that's epic
Epic FIRED for the NA who was supposed to check for such items coming onto the floor in our hospital...😱
Indeed. An escape is pretty much the best (least bad) thing that could have happened at least 😛 One of our patients managed to get to a patient in restraints and attempted to pull his eyes out; imagine if he had a leatherman!
I know things are not supposed to get past the searches (some of which I do myself) and the wand, but sometimes things do get through. We don't do cavity searches, and even those aren't perfect. Rather than rely on the search, we have to be vigilant about pt behavior. Still, nothing is perfect.
From The Houston Chronicle, Aug 6, 2009
www.chron.com/disp/story.mpl/metropolitan/6562918.html
A felony suspect who tipped the scale at more than 500 pounds carried an unloaded 9mm pistol into city and county jails beneath flabs of his skin even though law enforcement officers repeatedly searched him, authorities said Thursday....
Police spokesman Victor Senties said Vera was searched three times by police personnel: once at the scene, again, more thoroughly, when he arrived at the city jail, and a final time before he was transferred to the Harris County Jail. Vera was subjected to an additional search at the county lockup. City and county law enforcement spokespeople said inmates at both the city and county jails are not required to pass through a metal detector or undergo wand searches. Vera's possession of the firearm came to light Monday when he approached a county guard during a shower break and admitted having smuggled the weapon, authorities said.
Yeah stuff like that happens... And if they dont get it in through the security check they might get it from persons outside the hospital that can deliver it to them through openings in the windows (they open maybe 5 inches or leave stuff on the hospital area where the patiens can pick it up when they are outside walking... Its a hospital, not a jail, so we dont check people after they have been walking outside if for a short time.
A patient who has been in and out for over 30 years told me that many years ago him and some other patients where smoking weed in the smoking room every day for two weeks which a guy from the outside gave them through the window in the smoking room. The nurses and assistants usually dont sit in the smoking rooms with the patients and it has air conditioning so they didnt smell it or notice it before after 2 weeks.
There is a Norwegian saying that translated into english says: If there is a wish, there is a way... Meaning that if people want something bad enough, they will always finde a way to get it/do it, e.g hurting themself.
A patient who has been in and out for over 30 years told me that many years ago him and some other patients where smoking weed in the smoking room every day for two weeks which a guy from the outside gave them through the window in the smoking room. The nurses and assistants usually dont sit in the smoking rooms with the patients and it has air conditioning so they didnt smell it or notice it before after 2 weeks.
There is a Norwegian saying that translated into english says: If there is a wish, there is a way... Meaning that if people want something bad enough, they will always finde a way to get it/do it, e.g hurting themself.
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On another note: I just came home from a afternoon shift, and I must say it really was a madhouse there today. At one point we had:
- One 65 year old women with a beard singing "Puff the magic dragon" on repeat.
- One 25 year old women laying in her bed slamming her head to the sides into the matrass while making weirds noises "uuuhuuuuhuuuhuuuuhuuh"
- 48 year old male talking about how all of us working there would be punished by God after he left and that he spoke to him several times that day. (coming from a guy wearing a blazer jacket, shorts, sweatpants and pants at the same time 🙄
This was all at the same time
- One 65 year old women with a beard singing "Puff the magic dragon" on repeat.
- One 25 year old women laying in her bed slamming her head to the sides into the matrass while making weirds noises "uuuhuuuuhuuuhuuuuhuuh"
- 48 year old male talking about how all of us working there would be punished by God after he left and that he spoke to him several times that day. (coming from a guy wearing a blazer jacket, shorts, sweatpants and pants at the same time 🙄
This was all at the same time
Why Joe Biden in particular, do you think?
I had this really disheveled, edentulous, malodorous patient a few weeks ago, whose speech was so garbled and dysarthric I could barely make out a word. The one thing he made very clear was his absolute insistence that he was a favorite TV guest of Barbara Walters.
Greetings,
I am new to this forum and from Montréal.
When i was a medical student, we had a referred case to the psych emerg with the CC being "auditive hallucinations" without much details.
The gentlement described a metallic clicking and repetitive sounds.
On his past medical hsitory (which hadn't been asked by the ER doc), he underwent a mitral valve replacement a few weeks ago and he admitted that the hallucinations started few days after the surgery...
Yet, the physical exam from the ER doc said: Cardiac auscultation normal, no abnormal sounds.
Fun times in PESU 😀
I am new to this forum and from Montréal.
When i was a medical student, we had a referred case to the psych emerg with the CC being "auditive hallucinations" without much details.
The gentlement described a metallic clicking and repetitive sounds.
On his past medical hsitory (which hadn't been asked by the ER doc), he underwent a mitral valve replacement a few weeks ago and he admitted that the hallucinations started few days after the surgery...
Yet, the physical exam from the ER doc said: Cardiac auscultation normal, no abnormal sounds.
Fun times in PESU 😀
Meds will do their darnest to dump patients on psychiatry if there is even hint of a hint of a past psych dx on the chart.
Mentor of mine got a referral on C/L with "Auditory Hallucinations."
Very nice man in early elderly years sitting in hosp bed answering all questions completely normally except for a "whooshing sound in my head," pointing to top of his crown. "I know it sounds weird and that no one believes me, but I swear it's real and the whooshing sound every second is really bothering me." Psychiatrist said, "Well, let's take a listen," and placed his stethoscope on the man's head. To his surprise, he heard a very regular whooshing sound, and sure enough it correlated perfectly with his radial pulse.
Imaging showed an AVM at the top of his head.
Very nice man in early elderly years sitting in hosp bed answering all questions completely normally except for a "whooshing sound in my head," pointing to top of his crown. "I know it sounds weird and that no one believes me, but I swear it's real and the whooshing sound every second is really bothering me." Psychiatrist said, "Well, let's take a listen," and placed his stethoscope on the man's head. To his surprise, he heard a very regular whooshing sound, and sure enough it correlated perfectly with his radial pulse.
Imaging showed an AVM at the top of his head.
attending: so youre vietnamese?
vietnamese patient: no, im white
attending: really? you look like youre vietnamese.
patient: im an angel. i fell from heaven and landed in vietnam and thats why i have a vietnam accent.
patient's cc: will you kill me or revise me? (pulls out list of 50 problems including that her large intestine was too long)
vietnamese patient: no, im white
attending: really? you look like youre vietnamese.
patient: im an angel. i fell from heaven and landed in vietnam and thats why i have a vietnam accent.
patient's cc: will you kill me or revise me? (pulls out list of 50 problems including that her large intestine was too long)
These are great! Some of my experiences:
1. CT C+ on a patient with recent onset of auditory hallucinations, cleared by medicine, CT read as normal... A co-resident and I didn't think it fit the clinical picture, so we pulled up the CT to glance at it. We called the radiologist back to ask what the 3cm opacity was in the R frontal lobe.
2. ER - Patient is acting "weird," we want a consult and would like you to admit him. Me - (glancing at the labs on the computer)... Perhaps you'd want to correct his hyponatremia and maybe look into his leukocytosis...and while you're at it, maybe you might want to start him on anti-bx for that nice looking chest x ray? Do you guys have any ICU beds?
Many more stories like the ones above, and this shouldn't happen. However, things do slip by people from time to time. We make our fair share of mistakes in Psychiatry also.
Told to me by a very pleasant, goofy, and happy manic patient today:
"I got angry with my brother and father. So I made myself take a huge dump. It was hard. I had to push (which he demonstrates by grunting, screwing up his face and valsalvaing), then I picked it up with gloves, put it in two bowls, and put it in their faces and said "eat it damn you! Eat ITTT!!!" "And thhey woouldn't!?!?!?!" "My dad said that was completely unacceptable amd then drove me to the hospital"
"I got angry with my brother and father. So I made myself take a huge dump. It was hard. I had to push (which he demonstrates by grunting, screwing up his face and valsalvaing), then I picked it up with gloves, put it in two bowls, and put it in their faces and said "eat it damn you! Eat ITTT!!!" "And thhey woouldn't!?!?!?!" "My dad said that was completely unacceptable amd then drove me to the hospital"
"I went to the clinic and got a prescription for Haldol and Cogentin, but I can't afford to buy it (only $4 each), so I wanted to come to the emergency room. The last time I called 911, they billed me for the ambulance ride. So I figured that if I walked in the highway, I'd get the attention of a cop, so that's what I did, and he drove me here. Can you give me the medications for free? And while you're at it, can I have Adderall?"
last nights call: "the gangbangers put fish oil in my drinks, so that's why my organ's all swollen. where's my vicodin?"
and
doc: "so you walked for miles in the hot sun until you passed out...tell me more about what happened before that"
Pt: "well, yeah, I can't never find the right car to fit my body, you know, and so I ran out for pepsi."
and
doc: "so you walked for miles in the hot sun until you passed out...tell me more about what happened before that"
Pt: "well, yeah, I can't never find the right car to fit my body, you know, and so I ran out for pepsi."
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I had a pt say in our unit's morning pt meeting: "I have these thoughts about being bored all the time. I'm so bored that it makes me want to kill myself(begins to cry)."
After we walked off the unit my co-res turns says with a straight face, "OMG he was literally bored to tears."
After we walked off the unit my co-res turns says with a straight face, "OMG he was literally bored to tears."
I was doing a web-search and found this forum. I don't find any of these responses funny. When I read them I think about the internal pain the people had who felt them. I would have thought psychiatrists of all people would have felt that too. I was disgusted to see doctors making fun of the most vulnerable of all types of patients behind their backs. I registered just to say that and that you all should think about what you are doing and whether you are really intending to help the people you work with. Their symptoms are not for your amusement, and if you are childish enough to find them funny I hope you are never a doctor of any relative of mine who needs mental health support. The symptoms sound distressing and are MEDICAL symptoms, not jokes. I think even a young child wouldn't poke fun at people in distress saying the things you have revealed your patients said. I just had to register to say my peace when I saw this. Don't worry, I won't be back.
Fly-by, then.
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On the psych unit where I did residency we once had 3 Jesus Christs. They didn't take kindly to seeing two others that claimed to be Jesus. All 3 princes of peace became violent with each other. A similar incident occurred on the Howard Stern show. They got a few mentally ill people who all thought they were Jesus, and they supposedly got violent with each other.
One of my patients with PTSD had an incident occur 2 months ago where 3 bounty hunters tackled him for an arrest warrant that turned out to be an error. They pointed their guns at him, kicked, him, tackled him, and then handcuffed him. The police cleared up the problem only after he spent about 10 hrs in jail.
Bottom line--his PTSD flared up bigtime.
If you ask me, those bounty hunters ought to be arrested for what they did to the guy.
Humor is the most mature defense mechanism. We can't be expected to sublimate and suppress human emotion 24 hours a day, can we?
In this field, one learns to laugh occasionally about otherwise sad events and be able to stay around long enough to help some folks, or one burns out - and then leaves the job to you, whenever your family member or neighbor is psychotic, suicidal, or homicidal.
If you do have a doctor without a sense of humor, I'm sorry for you, and him.
Humor in medicine is such a delicate thing... you never want to mock a patient, but sometimes in this job, all you can do to make it through is find something funny to laugh about. It really does make things easier. I think a lot of times it's one of those things where you can't really understand the humor of it all unless you've been there.
I have a few favorites. One was a schizophrenic patient in clinic who had recently been placed on a new anti-arrhythmic by her pcp and had noticed some unpleasant side effects when she took the new drug with her anti-psychotic. Her pcp insisted that she continue the heart drug, so in an effort to be compliant with his wishes she had quit taking her anti-psychotic about 2 months before her psych appointment and was having a gradual decline of function from her usual relative stability. Well about one week before I saw her Michael Jackson died, which was a big deal for a lot of my patients here. She was absolutely convinced that he had died because she wasn't taking all of her medicines, and it was heartbreaking! She was terrified that more people would die if she didn't get back on her meds, but she really was having side effects from the new drug combo. That was the first person I saw sob about Michael Jackson's death, but not the last.
I had another patient in the hospital who was convinced that he was not actually black and that he'd joined the Crow Indian Nation back in the 1980s. He refused to interact with anyone african american, and said that he was allergic to white people. He was okay with our attending, I think because the attending was Chinese and the patient didn't quite know how to classify him. But it wasn't until two weeks into the service that I realized the attending didn't know that the patient was talking about an american indian tribe, not birds! We had a lot of confusing conversations during those two weeks.
And of course we all have had this patient:
Doctor: What brings you to the hospital?
Patient: Well sir, I need a job, a place to stay, a car and some benzos.
Doctor: ...
[Two days later]
Patient: Well, the mechanic just called and my truck is all fixed up! Looks like I'm good to go. So about the benzos...
I have a few favorites. One was a schizophrenic patient in clinic who had recently been placed on a new anti-arrhythmic by her pcp and had noticed some unpleasant side effects when she took the new drug with her anti-psychotic. Her pcp insisted that she continue the heart drug, so in an effort to be compliant with his wishes she had quit taking her anti-psychotic about 2 months before her psych appointment and was having a gradual decline of function from her usual relative stability. Well about one week before I saw her Michael Jackson died, which was a big deal for a lot of my patients here. She was absolutely convinced that he had died because she wasn't taking all of her medicines, and it was heartbreaking! She was terrified that more people would die if she didn't get back on her meds, but she really was having side effects from the new drug combo. That was the first person I saw sob about Michael Jackson's death, but not the last.
I had another patient in the hospital who was convinced that he was not actually black and that he'd joined the Crow Indian Nation back in the 1980s. He refused to interact with anyone african american, and said that he was allergic to white people. He was okay with our attending, I think because the attending was Chinese and the patient didn't quite know how to classify him. But it wasn't until two weeks into the service that I realized the attending didn't know that the patient was talking about an american indian tribe, not birds! We had a lot of confusing conversations during those two weeks.
And of course we all have had this patient:
Doctor: What brings you to the hospital?
Patient: Well sir, I need a job, a place to stay, a car and some benzos.
Doctor: ...
[Two days later]
Patient: Well, the mechanic just called and my truck is all fixed up! Looks like I'm good to go. So about the benzos...
I know I'm stating the obvious for most of you. I am writing this just in case a person like Outraged happens upon this forum.
Most of the people here saying the patient's complaints in jest are doing so because we can tell the person is faking their symptoms for a free hospital stay (all paid by by the taxpayer at a cost of about $1000 a night), or because they want drugs of abuse.
There are a few occasional real complaints (e.g. my guy who was tackled by the bounty hunters).
Someone coming in and wanting a medication of abuse simply to abuse it is a common occurrence in our field. E.g. someone comes in and claims to be depressed (even though they do not have any objective signs of depression) and then demands a medication that does not treat depression. ("No the only thing that helps my depression is valium!"). Its something like a child claiming the dog ate their homework. We're just venting some stress.
Most of the people here saying the patient's complaints in jest are doing so because we can tell the person is faking their symptoms for a free hospital stay (all paid by by the taxpayer at a cost of about $1000 a night), or because they want drugs of abuse.
There are a few occasional real complaints (e.g. my guy who was tackled by the bounty hunters).
Someone coming in and wanting a medication of abuse simply to abuse it is a common occurrence in our field. E.g. someone comes in and claims to be depressed (even though they do not have any objective signs of depression) and then demands a medication that does not treat depression. ("No the only thing that helps my depression is valium!"). Its something like a child claiming the dog ate their homework. We're just venting some stress.
If you ignore the fact that something is funny, you are missing out on an important part of your countertransference. You will be a poor diagnostician. If someone makes you feel like laughing, makes you feel irritable, makes you feel confused, this is reflective of their presentation, and helps you focus an interview.
Don't be ashamed of humor in psychiatry. There is a large difference between mocking someone and simply acknowleding that, within all of the buckets of suffering we see in our patients every day, there are some wonderful glimmers of humor.
Don't be ashamed of humor in psychiatry. There is a large difference between mocking someone and simply acknowleding that, within all of the buckets of suffering we see in our patients every day, there are some wonderful glimmers of humor.
Yep.
I'm not talking Boba Fett or Bossk, or IG-88, I'm talking about a bounty hunter like Dog the Bounty Hunter.
They exist alright.
My patient who was attacked by bounty hunters mentioned that he was a former sherriff. So while he was in jail, the police officers there made his stay very uncomfortable. He mentioned its a type of hazing that cops do to each other because if a cop ends up in jail, they usually were a crooked cop. The police running the jail do not like crooked cops, so they'll treat them with the extra special treatment if you know what I mean.
My patient of course is not a crooked cop. It was all a misunderstanding, however he got treated like he was a criminal. Thankfully his PTSD only flared up for a month, and we got it back under control.
Doc- So, what brings you to the hospital?
Patient- "I am here because I am a democrat"
Doc- Do you have any allergies?
Patient- "Police Officers."
Patient- "I am here because I am a democrat"
Doc- Do you have any allergies?
Patient- "Police Officers."
D
deleted276313
I don't see what's so funny about a patient's delusion, no matter how bizarre it is. It's not like they can help it.
So if one is being captured by bounty hunters, how does one know they are "real" bounty hunters and not just some dudes trying to kidnap a person? Is there some sort of official bounty hunter badge? A certificate? Are they allowed to shoot you if you run? This is all news to me. 😱
Whether you believe it or not, we're generally not making fun of the patient, just the words used to convey their complaint. Their suffering is completely real and we are very serious about that. Sometimes the words used are, in fact, very funny.
In those few cases that someone is very obviously attempting to abuse/use us, and the system, to gain services or medicines to which they have no valid claim - then, yes, we are making fun of them. But that's very different from how we feel about very seriously ill patients who just happen to say funny things.
Proctologists and gynecologists police officers and plumbers and electricians and auto mechanics all have their own versions of a list of funny complaints from clients. It doesn't mean that we take the work any less seriously. And plumbers and mechanics and electricians do, indeed, come across life threatening situations - that are just darned funny. I saw a list of photos recently on AOL of stupid and life threatening home repairs that a home inspector has found in his years.
But you'll decide for yourself whether you ever believe that we're laughing at the complaint - not the person. I don't really expect to change your mind.
It's all very real and more than a bit scary at times.
What tiny bit I know suggests you can't tell who is a "real" bounty hunter b/c in many states there is no qualification necessary to act as a bounty hunter. "Bail Enforcement" vests, raid jackets, badges are essentially meaningless. Anyone acting to return a bail jumper (whether professionally employed or not) can break into your home and detain you (handcuff) in order to return you to the jurisdiction from whence they believe you fled. No warrant is necessary and mistaken identity has, indeed, happened - including breaking into homes and threatening the residents at gunpoint - despite the fact that the bail jumper no longer lives there. All completely legal if they can convince the local authorities that they had good reason to believe their fugitive was in the residence.
http://money.howstuffworks.com/bounty-hunting.htm
http://www.wikihow.com/Become-a-Bounty-Hunter
http://www.nacdl.org/MEDIA/pr000090.htm
http://money.howstuffworks.com/bounty-hunting4.htm
http://bountyhunteremployment.com/
Already answered above.
I'm a doctor dammit, not a bounty hunter expert. My experience with bounty hunters is 90% seeing Boba Fett taking in Han Solo from Cloud City.
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Well said! mocking is different from humor! Finding humor even in tragedy is as someone already said, a mature defense mechanism. It is a healthy, and it doesn't mean we do not feel compassion for our patients! imagine if we just sit and cry all day because of the things we hear, without humor it would be very hard to be a psychiatrist!
"A well-developed sense of humor is the pole that adds balance to your steps as you walk the tightrope of life."
William Arthur Ward
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From a disorganized schizophrenic:
"I'm being bombarded...I got energy comin' outta my butt."
"I'm being bombarded...I got energy comin' outta my butt."
"the ambulance brought me here... it's a happy place."
"the bipolar bear is too big now and I want to kill it."
"I want to kill myself by going up into the mountains where there are mountain lions. I'll cut my arms a few times so that I'm bleeding and then pour steak sauce all over myself."
"the bipolar bear is too big now and I want to kill it."
"I want to kill myself by going up into the mountains where there are mountain lions. I'll cut my arms a few times so that I'm bleeding and then pour steak sauce all over myself."
Bounty hunters do exist, looked into it once durring undergrad because the summer job market was scarce. The pay stinks and is not guaranteed. If you are going after a person you have to be highly inconspicuous while trying to track them down (this makes getting collateral info in psych look like a walk in the park).
So you spend days trying to track them down then you have to try and detain them usually in their own home, where they have their own guns and pitbulls and buddies to ward you off. If you do bring them in then the bail bondsman is the one who pays you and we all know how honest, upright and altruistic those folks are.
In any event, this is not a chief complaint but a funny statement I heard second hand from a psych resident, patient had some pretty loose associations going on:
"People fight too much about religion...I like chinese food...I think I am going to start my own church, the church of the fortune cookies you just open up a fortune cookie every sunday and then live by what it says inside"
So you spend days trying to track them down then you have to try and detain them usually in their own home, where they have their own guns and pitbulls and buddies to ward you off. If you do bring them in then the bail bondsman is the one who pays you and we all know how honest, upright and altruistic those folks are.
In any event, this is not a chief complaint but a funny statement I heard second hand from a psych resident, patient had some pretty loose associations going on:
"People fight too much about religion...I like chinese food...I think I am going to start my own church, the church of the fortune cookies you just open up a fortune cookie every sunday and then live by what it says inside"
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