Hollywood

On this lazy day in Building 10, I met W.H. I don't think he is an immediate danger to himself or others, but that doesn't mean he is ready to be discharged. W.H. believes drugs, namely, meth and cocaine were inserted into his brain through the removal of his skull. W.H. is also convinced a device was placed inside his brain. This "device" allegedly kept him awake for 50 days straight and allowed him to "go to heaven." He is paranoid about the battery and what will happen to him once the device is void of life. W.H. is taking lithium, fluphenazine hydrochloride, Risperdal Consta, and paliperidone, which is the active metabolite of risperidone. W.H. is young and, unfortunately, fairly stupid. Alcohol, to him, is a healthy coping mechanism. So is marijuana. His diagnosis: paranoid schizophrenia.

For group therapy today, Laura introduced a board game similar to Scrabble. Sitting to my left was Joshua, a patient with schizoaffective disorder, bipolar type. Joshua threatened to slit his mother's throat in front of the rest of his family. Joshua's mood varies from euthymic to irritable, and he has a blunted affect, according to his chart. Part of Joshua's problem are tactile hallucinations, which affect his sense of touch, creating a false perception of pressure on his skin. He might, for instance, feel bugs crawling on him. Tactile hallucinations are often associated with the prolonged use of cocaine and/or amphetamine. Joshua is taking Depakote and Invega Sustenna.

R is a new patient. His diagnosis is alcohol dependence, not currently active in a controlled setting. Sadly, R is homeless. He came out of the bathroom of a Village Inn naked from the waist down, threatening to commit suicide. Before the episode at Village Inn, R had tried unsuccessfully to commit suicide, overdosing on some kind of substance on one occasion, poisoning himself with carbon monoxide on another occasion, hanging himself, and waiting in the middle of the prairie for a train to hit him.

Rumor has it A.Y. got a haircut and shaved his beard. Laura told me the story.