The last few days i have observed behaviour in the Emergency Department that i hope are misunderstandings on my part. Today security guards were called to deal with a psych patient. A patient who was depressed and who wanted to just go home. A patient that the psychiatrist deemed not safe to be discharged. They called in the bouncers of the hospital. Predictably, the patient panicked, grew more agitated and went beserk. She started shrieking. They dragged her off into an isolation room where they would restrain and chemically calm her down. I saw the nurse prepare the injections and medications.
I was upset. When i spoke to that patient, she was calm and very much in control. Now she isn’t. She does not speak English, could not convey herself properly. The members of the guard team were all English speakers. They did not understand what she was saying, and i do not think they tried very hard. They spoke to her like she was a drunk or a drug addict, using condescending soothing tones as though she was a child. I wondered why they did not call me. I could have interpreted. I can understand if the doctors did not call me. They just came on the shift so they were probably not aware that i had been doing the translating. But the nurse in charge of the patient knew. But he did not bother. In fact, in the middle of the Code, i stopped him as he was wheeling his bloody arsenal of chemical weapons into the isolation room.
I asked if they would like me to talk to the patient. Perhaps she would be able to calm down. I saw her gave me a stricken look as the guards dragged her away. She was weeping. I merely stood to a side, not sure what i was supposed to do. On one hand, i had a medical obligation and i understood certain regulations need to be followed. On the other, we hail from the same culture, and i too understood why the patient was acting the way she was. Yet somehow, i am not able to connect the both, and make people from both sides comprehend. Everything just swept past me, like a massive undertow. I was helpless.
The nurse said the patient was probably too agitated to be spoken to. He was more concerned about my safety. After all, i am only a medical student. But a part of me wondered, isn’t that the whole purpose of me talking to the patient? So that she could calm down, and we do not have to resort to restraining and sedating her?
I left at the end of the shift, her screams emanating from the isolation roon, following me. I was and am upset. Did medical school not teach us that communication was first and foremost, and that different cultures have different practices? How is it that the majority of healthcare professionals seem not to put that into practice?
I am still appalled. And just a little angry. I wish i could do more, but i am not sure what i would do could help.