Psychiatry – Day 17

I got to see a lot of interesting psychiatric pathology today. One of our patients is very well known for cussing people out as soon as the get into the room. I had the good fortune one being able to come in the room during round. He kept repeating himself and wasn’t responding to questions. Everyone once in a while something would get through and he would respond in his own uncooperative way, often with a bunch of F-bombs thrown in. At one point he mentioned how he just wanted to watch Harry Potter which was playing on the TV. My attending attempted to latch on to that and asked which Harry Potter movie it was and he goes, “It’s Harry Potter and the Fuck You.”

The next guy we saw had some pretty severe Korsakoff syndrome, way beyond the guy I saw at the LA county hospital when I was on IM. He was just nearly talking is word salad, almost completely incomprehensible except for a few brief moments of linguistic clarity, though he has pretty consistent intention. I actually wanna say there is something else going on besides Korsakoff because as far as I know, though I could be wrong, while both Wernicke and Korsakoff can present with confusion and amnesia, word salad is not super characteristic of these. I never saw the chart so maybe there is some addition diagnosis that was not mentioned to me.

I still miss doing physical exams and looking at labs and asking where it hurts.

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