Documenting my journey through the mental health system

I have a catatonic patient. He hasn’t moved much in days, other than spontaneous leg movements and occasionally opening his eyes. He has late onset schizophrenia and is a veteran like me.

I experienced catatonia myself. On the roller coaster ride that is bipolar, a downward plunge with no rebound pushes me deeper and deeper into depression. Sometimes I lose ability to move or speak at all. I lay there, fully aware, pissing myself, unable to do anything about it.

I was open with a few of my new coworkers about this. I told them I too have been catatonic and that our patient is fully aware of everything going on around him. They had all kinds of questions. How did I get out of it? What causes this? Can he really hear us?

I told them about my experience, and how Ativan is used to bring a patient out of catatonia, most of the time. Our patient is under a DCR hold for aggressive treatment with ECT – electroconvulsive therapy – in addition to the regularly dosed Ativan. The ethics committee and palliative care are involved.

Tonight, I was getting vitals on his roommate, and I heard rustling, so I looked on the other side of the curtain and the patient was half sitting up, eyes wide open. I immediately turned my attention to him. He laid back, eyes closed again. I asked him to open his eyes and look at me. And he did.

I asked how he was feeling. His voice was really soft, but he said “good.” I asked if he was in pain. He said no. I told him we were very happy to hear him talking and that I was now going to reposition him. He said thank you.

His eyes remained closed, so I washed his face and rolled him over and changed his brief. He didn’t talk any more after that, but I didn’t push him either. He may very well have gone back to the dream place, not the same as regular dreaming. On an MRI, they are totally different brain waves. It’s an in between state, a type of dreamlike stupor. I’ve been there before.

I told the others when I came out of the room that I’d had a short conversation with him. They were shocked. I am now basking in the glow of being the first of any staff he’s talked to over the past couple weeks.