Pejorative: Crazy

[Sneezing]

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How often, if at all, do you use the word crazy?

 

[peppy]

I never use the term to refer to mentally ill people, but I do use it to refer to situations.

 

[CaMD]

I use it constantly. Both in reference to mentally ill people as well as anyone else. I don't mean it as a pejorative.

 

[OldPsychDoc]

How often, if at all, do you use the word crazy?

We didn't use it today, but the patient did.

"He called me a 'psycho b----'! How can he say he loves me if he calls me a 'crazy, psycho b----'?"

(Chief complaint after presenting in ED after cutting up husbands clothes and threatening him with scissors....)

Oh Lord,...I would gladly become a Pharma ***** if only one of them would develop an Insight Pill.

 

[The Long Way]

Oh Lord,...I would gladly become a Pharma ***** if only one of them would develop an Insight Pill.

LOL. I love it. For better or worse, poor insight is not limited to psych...

Oh, and to OP, just a graduating M4 here, but I really don't use the term crazy when referring to a psychotic patient, but I do use it when asked to see a patient without obvious psychopathology and a ton of psychosocial pathology in the ER. 🙄

 

[Bakfiets]

To be honest I hear this word used a lot among psychiatrists, but more in reference to either "psych dx NOS" meaning they have no idea what is up with the patient, but they know it's something. OR, as a reference to a referral from another doc who couldn;t specify the need for the referral, but just knew the patient was "crazy." (That's not what the referral says - it usually drones on about some sx's here and there without ever offering much of a differential).

One third way: Among psych docs to normalize their profession to others at cocktail parties.. "See ... I'm one of you.. I can be funny, too. Please be my friend." sort of thing. Usually fails BTW.

 

[Indryd]

For better or worse, I often use this term endearingly to refer to patients in general when talking about psychiatry, as in

"I love my crazies!"

But I don't think I'd be too cool with using in front of a patient or to describe a specific patient.

 

[Sneezing]

That's kind of what I'm wondering. We know better than to say that to or infront of a patient. I've seen a primary care do it, but our specialty is a little different.

Can we still use it in social settings to describe someone's choices or to comment on their story? "Dude, you're crazy!" "Wait, your girlfriend did what?!? She's crazy!" Or does being a psychiatrist mean we should strike this word from our vocabulary because others might place more weight behind it simply being a lighthearted adjective?

More examples:
"Your mother-in-law sounds like a crazy *****. I'm sorry for you. Here, have another beer."
"You just bought a pair of $300 shoes and a $250 dollar purse? You're crazy!"

 

[sunlioness]

I tell patients "you're not crazy" fairly frequently. But otherwise it's not a word I tend to use in a professional setting. Though I would imagine I use it in other settings as much as anyone.

 

[Indryd]

Can we still use it in social settings to describe someone's choices or to comment on their story? "Dude, you're crazy!" "Wait, your girlfriend did what?!? She's crazy!" Or does being a psychiatrist mean we should strike this word from our vocabulary because others might place more weight behind it simply being a lighthearted adjective?

I still use it in this way. It hadn't occurred to me that that would not be OK. It's funny though, I have a friend or two who are always like "Dude, that's freakin' craz---Sorry man, is that word not OK to say...er??'

 

[LadyWolverine]

I spent my psychiatry rotation on a locked unit with 50 treatment-resistant schizophrenics. My 2 attendings regularly used the word "crazy" when refering to their patients. Never to their faces, mind you, but definitely when speaking with me and their staff members.

For example, "LadyWolverine, wait til you interview John later on today. Man, he's totally CRAZY."

Really? I couldn't tell that I was in a mental hospital from, you know, the bars on the windows, or the random people milling around the halls shouting at things that aren't there, or the fact that I have to go through 14 sets of locked doors to get out of here...

 

[Indryd]

I had an attending who described patients' behaviors as "nutty," even when speaking directly to them.

As in (cue Sri Lankan accent):

"I know you wandu go home, but we wandu be sure you're not goingdu step outside and immediately start acting nutty again."

 

[Messerschmitts]

Now I can't get the Maroon 5 song out of my head. "I think you're craaaazy!" 😛 But I always say (half-jokingly), "Now now, we don't use the C-word here in psychiatry!"

 

[billypilgrim37]

I had a mental health policy course during my masters year (at the school that has been #1 in health policy since they started ranking), and said the "C" word once, and I seriously thought they were going have me burned. And the class was taught by an economist, no less. A bunch of MPHs locked in a room with two MD students feel like they can finally let their hateful anti-doctor wrath be known.

Given that these people, who by and large do represent the sort of people that will be deciding our financial futures, would rather throw a dollar out the window than give it to a psychiatrist for therapy (the social workers should do it!) or meds (the PA should do it!), we should all be afraid.

 

[Shikima]

We didn't use it today, but the patient did.

"He called me a 'psycho b----'! How can he say he loves me if he calls me a 'crazy, psycho b----'?"

(Chief complaint after presenting in ED after cutting up husbands clothes and threatening him with scissors....)

Oh Lord,...I would gladly become a Pharma ***** if only one of them would develop an Insight Pill.

Too awesome! Thanks for the pick me up before night float!