Of Textbooks and Other Works of Fiction

“I will kill you!” the man screamed.

He paced up and down the narrow room. A nurse could see me through a window on the wall. I tried to appear calm.

It was my first week as a psychiatry trainee, and I wanted to prove that I knew what I was doing. Be cool, I said. You can deal with this.

The man looked at me, studying me with narrowed eyes. “You worship elephants, don’t you?”

How to answer the question?

“No,” I said without much inflection.

This was not the answer he was looking for. He screamed, “Do you worship birds?” He took a step towards me and screamed again, “I am asking you – Do you worship birds?”

He was wound tight, muscles bunched, energy waiting to explode.

I remembered advice from my psychiatry textbook: “The clinician can often disarm the aggressive and agitated patient by reflecting the effect that the patient is having on the clinician. For example, one might say, ‘Your behavior is making me worried’”

I took a deep breath. “Samuel,” I said gently. “Your behavior is intimidating me.”

“You f$^$%^%^ p#*$*&&!” he screamed. “You scared f(@*#(&$ p)&(&$(&! I will cut off your head, you f(U#&&(# elephant worshiping f###%!”

Note to Self: Do not believe everything you read in textbooks

July 12, 2008 | 9:15 am | By Dr Shyam Bhat