Tag: Bipolar Disorder

It was 2 AM when the phone jarred me awake. It was a busy evening in the ER and I had gotten back to the on-call room at 1:30 and had just fallen asleep.

“Doctor Smukler,” I said, yawning, and fumbling with the phone, hoping the ER nurse made a mistake.

“Sorry to wake you. We have a 50-year-old  male physician who’s extremely agitated. Pacing, diaphoretic and saying he has to talk to a doctor.”

“Why?”

“He won’t say. He said it has to be a doctor.”

A loosely organized thought wormed its way into my overloaded brain. “What kind of doctor is he?”

“I don’t know.” The nurse sounded a little defensive.

“Please ask him.”

A minute later she came back on the line. “His name is Doctor Jeffrey. He’s an ophthalmologist.”

I seemed to recall a fellow resident mentioning something about a violent ophthalmologist. Was I remembering it right? Something about him having to be restrained…

“Does he seem violent?”

“No. Just agitated.”

How many violent ophthalmologists could be hanging around emergency rooms? “You know what. I think you should call the police.”

“The police? I really don’t think it’s necessary.”

“Maybe not, but please call them. When they get here, ring me back.”

“You’re the doctor.” Translation: what an idiot. She might be right. She probably is right. Christ, only six months into my first year of psychiatric residency and I’m going to come off like an absolute fool.

Twenty minutes later, I walked into the ER and the nurse said, “The officers are waiting outside the examining room.” The expression on her face implied that she was doing everything she could to not roll her eyes.

I started to explain why I was doing what I was doing, but then just shut my mouth. As I approached the officers, another bit of memory came back. The guy was a Karate expert.

“Hi officers,” I said, and shook each of their hands. “I may be overreacting, but this patient is a physician who has a history of violence and a blackbelt in Karate. The nurse thinks I’m being a bit, I don’t know–”

“–Don’t worry about it Doc. That’s why we’re here.”

I sighed. “Thank you. I’ll leave the door open. Could you both stay off to the side and give me a few minutes. If I holler, you know what to do.”

I walked in the room and before I could even introduce myself, Doctor Jeffrey screamed some unintelligible obscenity, leaped out of his chair, and charged towards me. Before I could even open my mouth, the officers had raced into the room, grabbed the doctor, and slammed him down on the floor. Seconds later, he was in handcuffs. Minutes later, he was strapped to a gurney and on his way to PGH, Philadelphia General Hospital, where there was a special unit for violent patients and criminals.

On the way out of the ER, the nurse came up to me and shook my hand.

“Doctor, I will never doubt you again.”

“Sometimes, you just get lucky.”

“Maybe. But if you ever decide to go to Vegas, take me with you.”

We both laughed and I dragged myself back to bed.

The next morning, I spoke to the resident who had mentioned Doctor Jeffrey in morning rounds. Doctor Jeffrey had a history of a severe Bipolar Disorder. When he stopped his medications, he went into a paranoid, manic state and often became violent.

I learned a very important lesson that night. It’s okay to be afraid.

Interestingly, it was fear that helped me to be lucky. Luckily, I remembered what my fellow resident said and erred on the side of caution. Luckily, I was too tired to care much what the nurse thought of me. And luckily, the police were really good at their job.

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