Krazy

It's 1AM and I'm working on this write-up on a patient I saw over a week ago. As soon as I started talking to the guy I realized he was totally crazy. I have to appear professional and clinical in my note though . . .

What I have to write:
"Mental Status: Oriented to person, place, and time with respect to day and month – but believes the year is 2004. Maintains eye contact, except for short periods of time where he seems to close his eyes to maintain concentration when responding to an open-ended question. Changes in consciousness are noted, including waxing and waning and some confusion. Throughout the H&P the patient shows poor insight into his current condition. He shares his history lethargically yet cooperatively. At times he is dysarthritic or incoherent, with occasional bouts of blocked thought with subsequent perseverant explanations. Mood is euthymic and full affect is noted. Appropriate thought content, no suicidal ideation."

What I WISH I COULD write:
"Mental Status: The old dude is totally effing crazy. He asked me 47 times if I new his name in the first two minutes. When I'd ask him a yes/no question about a random disease he may have had, he'd answer "yes" no matter what.

Cheeler: How about any childhood illness . . . ever have rheumatic fever?
Krazy Dude: Yes

Cheeler: How about the mumps?
Krazy Dude: Yes

Cheeler: Tuberculosis?
Krazy Dude: Yes

Cheeler: Leprosy?
Krazy Dude: Yes

So totally nuts, but otherwise a nice old guy. Oh yeah, and he CRAPPED all over me when I sat him up to listen to his lungs."

Ahhh yes, medical school. I should have stayed in business school. I hear they have nice mixers.