A loud American

She screamed at me. She screamed at everyone. "I am a loud American! And he, he, he is the one who has done the things that she does not like, she being her, her being the one whom he who is him has harmed. I, I, I am not at fault. How am I going to do my homework? Is my homework not due in the morning of this night of which I am trapped in this nightMARE being caused by you, you you, are the authority figures, you four men and one woman who are here to silence me, a loud American!"

The nurse on duty tonight has been working in this ER for decades, her soft voice and compassionate approach are lost on this patient "Here, this will help you relax and sleep for the ride." says the nurse as she slips the needle into the woman's flesh in the hopes that the sedative will make the 40 minute trip to the psych facility easier for everyone.

"Ow! How could you do that to me your fellow woman?" she screams as she begins to sob "We are women, we are women and they are men. They are 'the man' the authority but now you are one of them, you are no longer woman you are a man now because you are just like them you are. You have a penis now" she says very matter of factly before she begins to cry; her thoughts and statements nothing more than a series of babbling run-on sentences.

She remains indignant, the medication not touching her and so we wait. We watch the camera monitors as she sits on the edge of the bed talking to people who we cannot see. Is there someone there with her? Who does she talk to? She has been here in the ER for a couple of hours now and after being evaluated by the ER doc, the crisis clinician and finally the psychologist she has been "blue papered." A judge has decided that it is in the best interest of her safety and society for her to be involuntarily committed. I had been sitting in the ER for most of this time and when she was deemed ready for transport I went back over to the base next door to the hospital and picked up my partner. Rather than my regular partner I picked up the probie. My regular partner had just returned from maternity leave and was looking forward to what could potentially be the longest nap she has had since the baby was born. I offerred the trip to the probie and he readily accepted. He accepted before this fiasco in the ER and so now that she has been medicated it is my job to tend to her for this transport. She does not go quietly. The fact is she goes violently; kicking, screaming, digging me with her fingernails. She is having an acute psychotic episode and she honestly has no idea of what she is doing. I have never met her before but I know that this is not the person who she is on a daily basis. She is a college student, brought in by the college police after becoming disruptive and out of control during a meeting on campus.

We give her another dose of Haldol and some Ativan and it still does nothing to her and so it is decided taht we will transport her in restraints. She struggles, she cries but she eventually submits. She is restrained and she is pissed off. The transport is uneventful, she stares at me every now and then and attempts to bore holes through my head with here eyes. I know that this is not her, I do not let it bother me. We arrive at our destination and wheel her inside. We arrive at her floor and begin to remove her restraints, she stands, she paces, she sits on the edge of the bed she tries to walk to the door which is blocked by the police officer who accompanied us and the staff at the hospital. We explain that she cannot go back to school right now that she must stay here, she asks to use the bathroom and so the staff let her in to a bathroom adjacent to the small locked room which she will occupy for the night. She sobs uncontrollably in the bathroom as we leave the floor and as we step in to the elevator the probie looks at me wide eyed and amazed and simply utters "wow."

As the doors close I simply turn to him and say "Welcome to mental health."