First Time in T&R

"Day 2 of Week 2.  I missed yesterday because I pretty much had a massive panic attack in the am because I was so bloated that my brand new pants didn't fit.  Talk about depressing upon depression.  My excuse to them, I had a massive migraine.  Thankfully, the bloating is gone and I can be on my merry way.

At the prison, only one door is allowed to be opened at one time in any area with more than one door.  (I guess the latter of that sentence was a given, eh?)  Anyway, I can't see how you can ever get accustomed to waiting as someone buzzes you in through a door.  This is especially true when you're in an area with inmates just staring at you because well they have nothing else do to!  

It's my second week and I'm a little more at ease with the signing in and showing my badge to the guards upon entering.  To avoid any awkwardness I say good morning to everyone that I pass.  I know what you're think, "Oh em gee, she is voluntarily saying good morning to STRANGERS??" But to be frank, these people that work here are different.  They're not your everyday strangers!!

So I had a 3 hr break between my stranger comment and now.  I saw 3 inmates in the transfer and receiving area (T&R).  You know how some people just look crazy, or there's something significantly off about them.  Ladies and gentlemen, meet Rodnee.  (The name has been changed of course).  Well, Rodnee is a schizophrenic that sees sparkly silver shineys and hears voices talking to him inside his head.  They don't tell him what to do nor do they criticize.  Matter of fact they help him play cards! Go freaking figure.  Anyway, I mention Rodnee because there was something so "off" about him and I just couldn't pinpoint it out.  Then I realized, he was a child in a grown man's body.  He has been puppy pathetic eyes and looks at you like a terrified kid who's about to get his ass whooped on.  I kid you not, I was hypnotized.  Not in a fatal attraction hypnotized.  More of a I'm sorry life handed you these circumstances type of hypnotized.  If nothing else, I have a rekindled want to work in child psychiatry and get them before they end up like Rodnee.  By the way, because I know you're curious, he is serving time for throwing a rock at a window. It's considered shooting a deadly missile. Yeah I know.

The Turtle Suit Cure and "Tad"

Suicide Protection Gown and Blanket

When an inmate is suicidal, they are admitted into the Y-dorms aka Self Harm Observation Section (SHOS).  They are further stripped of their own identity and made so wear a dark green shroud.  Maybe shroud is the wrong word.  Imagine a dark green hospital gown without sleeves and is somehow padded.  In order to wear it, the turtle suit must be attached by velcro.  (See picture). To add to the comfort of an inmates new living quarters they are given a matching padded blankets and twin sized plastic mattress on the floor.  Like they're not depressed already.  Forget meds, these guys are acutely suicidal.  One inmate was admited to the Y dorms last night and miraculously after one night in that turtle hell he was cured.  When asked how he was feeling, he was just fine and ready to return to general population.  I'm telling you, all you need is a night in a turtle suit to cure you of suicidal tendencies!  His neighboring inmate was not as blessed.

We had two follow ups and an admit today.  I'll tell you about the more interesting case that also let me show off some skills on my psychotropic knowledge.  Let's call him Tad (don't ask, I like the name and it suits him).
It wasn't until his first visit to a juvenile detention center, at age 8, that it was discovered that he was schizophrenic.  He's been in and out of facilities since then.  He presented to us today for severe akathisia, which is a movement disorder side effect of his antipsychotic medication.  He was on such a low dose of antipsychotics because of his movement disorder that he was having active audio visual hallucinations while being interviewed.  I genuinely felt bad for him.  I have no clue what he did to arrive at the prison, nor do I really care.  I did care however that the residents were contemplating on giving him a new medication to control his movements not realizing that a side effect of it was to cause or worsen psychosis!  So yes, I said something to that effect.  One resident immediately got out his Synopsis of Psychiatry to look it up for himself and low and behold there it was in black and white.  One point med student.  I continued by making mention of another (cheap formulary) medication that was used to treat the movement disorder that had minimal side effects, a beta blocker.  And yes, it felt great that when they were on the computer googling it they found recommendations stating that a trial a beta blockers be done for akathisia. Two points.

Needless to say, besides flat out falling asleep at my chair this morning even after having coffee, it felt good to show that I knew something and am more than just an observing student.  Also, I look forward to following Tad's case.  Interesting doesn't even scratch the surface on this guy.

Get Out of Jail Free Card

So today was my official first day at the prison. It was full of informational information like, don't get manipulated by someone that's drug seeking aka someone that says that they're a bipolar schizophrenic.  They indeed have instead FOS syndrome -_-.  Though I only observed two inmate/patient encounters, it was not a day without its memorable moments.  Like when one of the attendings asked the Jewish resident about details in the book of Revelations.  The response, "The Jew doesn't know."  That was only one of that many one liner jokes thrown out there today.  I wrote some down, if I remember I'll post them later.

Needless to say, it was quite uncomfortable when I went to get my ID badge.  Having to wait in a large room full of a myriad of convicts in varying degrees of dress (naked to assigned blues) was quite an unnerving experience. Especially when you KNOW they are staring at you and you obviously are walking around like a bumbling idiot because you're so nervous about the place you are in.

Apparently during morning report, we were informed that it's no big deal if you don't remember the inmates that go to the names that you're talking about because afterall "we're in the business of processing human units."  Yes, since this is a reception center (inmates come here from their original destination to their new location) and this is a state prison, were I have learned you lose all sense of self and have all human rights removed.  You are degraded by being yelled at and told when to eat sleep and shit.

The state prison is no joke, and the inmates know this.  You would think that with this much traffic there would be hell broken loose at the drop of a hat.  It's surprisingly organized.  Through the chaos of corrections officers telling inmate to hurry the fuck up and get their shit together, intakers yelling out inmate names as though she were calling cattle to the slaughter, there's a system that works.

As far as the people I'll be working with, well, they are what high school nerds grow up to be.  I mean who works 20 years as an ophthalmologist, retires, goes to law school and then goes into a psych residency? One of the residents, that's who.  The other isn't any better.  He worked as an assistant district attorney, retired and went to med school.  He has children my age.  They are quirky though awkward and they do help the down time go bye.  Can't really complain since they let me bullshit on the computer when I'm bored.

All in all not the worst of first days, but I'm hoping to report back on more excitement.   

Makeup in Prison

So I am contemplating on whether wering makeup to the prison is a bad idea or not. I mean is it vain of me to think that wearing it will really make a difference? Is it not bad enough that I am of the few females already there? This is, if nothing else, definitely a unique experience.
Yesterday, I couldnt help but notice that most of the female staff had something strange about them. Was it a requirement? Or, did their work make them that way? I wish I could give an example, but I cant. It was just that something was a little off about them.

On another note, I actually had a nightmare about my test scores. And some exercise for me to not be afraid of my ex and all the things he could do to hurt me. 337 came up twice in a row in said dream-mare. Also, something w a 4, and fractions like 1/10. Weird.

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