Psych ER: Psychiatric Patients Come to the Emergency Room [NOOK Book]

Overview

Drawing on the experience of evaluating over 2000 emergency room patients, René Muller explores the important role of psychiatry in emergency room medicine. He discusses some of his most challenging cases, showing how psychiatry comes to the aid of medicine in managing the crises - real, imagined, and contrived - that are the everyday fare of clinicians who work in the ER. We are introduced to a world in which lies are exposed, manipulations ...
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Psych ER: Psychiatric Patients Come to the Emergency Room

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Overview

Drawing on the experience of evaluating over 2000 emergency room patients, René Muller explores the important role of psychiatry in emergency room medicine. He discusses some of his most challenging cases, showing how psychiatry comes to the aid of medicine in managing the crises - real, imagined, and contrived - that are the everyday fare of clinicians who work in the ER. We are introduced to a world in which lies are exposed, manipulations revealed, diagnoses made, medications adjusted, and even very brief psychotherapy attempted.

Muller begins with patient narratives rooted in the mental disorders most commonly encountered in the ER: Depression, panic disorder, drug dependence, bipolar depression, bipolar mania, schizophrenia, and Alzheimer's dementia. These stories pave the way for more puzzling ER cases, which Muller gathers into sections of "Veiled and Bizarre Stories" and "Stories with a Medical Component." He introduces us to the meanings of ER malingering and offers hard-won insights into managing "dumps" (when patients are dumped into the ER by families, police, doctors) and "stumbles" (when patients' bizarre behavior lands them in the ER).

The stories patients tell - and the questions these stories raise - drive Muller's text. A young man has seriously overdosed, but with what? Why has a successfully medicated schizophrenic suddenly begun hearing voices again?  And what are we to make of a patient who is willing to risk death attempting to "drown" his hiccups by drinking up to 12 liters of fluid a day? For these and equally fascinating questions, Muller is a sure-handed guide, working his way through one ER challenge after another with psychiatric acumen and a balanced appreciation of the medical, custodial, socioeconomic, and legal dimensions of ER work. An intriguing account of the competing agendas that enter into the handling of emergencies, Psych ER is also a compilation of evocative patient stories about the subjective experience of being ill.
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Product Details

  • ISBN-13: 9781135060725
  • Publisher: Taylor & Francis
  • Publication date: 6/17/2013
  • Sold by: Barnes & Noble
  • Format: eBook
  • Pages: 224
  • File size: 6 MB

Table of Contents

Preface
Acknowledgments
Pt. I Straightforward Stories 1
1 Depression: The World Pushing Down 3
2 Panic: The World Coming Apart 11
3 Borderline Personality: A Brittle World, a Labile Mood 15
4 Multiple Personality: Taking on the World with More Than One Identity 25
5 Alcohol: Chemically Altering One's World by Mouth 33
6 Drugs: Chemically Altering One's World by Nose and Vein 37
7 Bipolar Depression: The World Too Low Down 47
8 Bipolar Mania: The World Too High Up 53
9 Schizophrenia: Being Unable to Share a World with Others 59
10 Alzheimer's Dementia: The World Dissolves as the Glue of Memory Cracks 63
Pt. II Complex Stories 67
11 Panic Disorder Fed by Emotional Dependence 69
12 Histrionics Mistaken for Schizophrenia 77
Pt. III Veiled and Bizarre Stories 89
13 Malingerers and Manipulators 91
14 The "Dump" 99
15 The "Stumble" 105
16 Murder and Mayhem, Maybe 109
Pt. IV Stories with a Medical Component 113
17 Why Is This Schizophrenic Patient Hearing Voices? 115
18 How a Stomachache Turned a Head 119
19 A Serious Overdose, But of What? 121
20 A Closed Head Injury Leads to Paranoid Psychosis 127
21 A Patient Who Risked Death Trying to Drown His Hiccups 135
22 Delirium Missed as the Reason for Psychotic Symptoms 145
Pt. V How Patients' Stories Lead to a Psychiatric Diagnosis 157
23 The Narrative in Psychiatric Diagnosis: It's the Story, Stupid! 159
24 Alexithymia: When There Is No Story to Tell 167
25 Renegotiating the "Contract for Safety" 175
26 Jean-Paul Sartre in the ER 181
Suggested Reading 189
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