NERVOUS BREAKDOWNS. Classic “I know it when I see it” stuff. Here’s two stories from attendings I work with, and two from me:
- A 3rd year resident who “just snapped” one day. In the middle of a busy work day, she took out every single patient chart and simply wrote an order to “D/C home”. 3 hours s/p CABG? D/C home. Hematocrit of 4? D/C home. Still on a ventilator? D/C home, damnit.
- A surgical intern who left a case, started yelling nonsensically in a hallway and then locked himself in the team room. They had to call security to make sure he was still alive, but when they unlocked the door, he was just sitting there, chilling. (He allegedly was leaning back in a chair and drinking a soda, but I don’t know if I can buy that part – no matter how awesome the mental image is.)
- A patient who sent her kids off to school, packed her husband a lunch for work, kissed him goodbye, and got in a car and drove to a totally random city 5 hours away with no plan. Found lying on a park bench, memory totally intact, tox screen negative.
- One of my classmates, before our first anatomy exam. (I don’t feel like I even need to supply details because it’s surprisingly easy for most medical people to imagine the kind of crazy things someone might do in this situation.)
The point is, nervous breakdowns are a thing. People who are under a lot of stress occasionally “just lose it” and act like a crazy person, and can never properly pinpiont why afterwards. And these are people without histories of psychosis – and they usually never have another episode.
And it would be sincerely, 100% helpful to me and probably the medical profession at large if I could use it as a diagnosis.