I learned a new word today: incarceritis. It's been around for some time, I'm told. Guess I have just lived under a rock.
I heard it from the officer who brought in the individual from the courthouse after allegedly having a seizure immediately following his sentencing (note: I never want to know their offenses. Besides, it just isn't relevant. All I need to know is "violent", "grabby", or "just do what you need to do from the doorway").
I try not to be judgmental but, when all the officers and EMS people tell me that is a stone-cold case of incarceritis before the patient even hits the room, it can be difficult. Shaky Dude was rolled by (in shackles) and placed in a hallway bed. My partner eyed this dramatic scene over the top of her ever-present half-glasses as she sipped her coffee. "Incarceritis", she said knowingly. She is rarely impressed by the antics of the general population.
Paramedic Pete: "He wouldn't let me do vital signs, wouldn't let me do a fingerstick glucose because he didn't want me to cause him any pain, ditto on the IV. Couldn't get any history, allergies, or med history"
Why?
Paramedic Pete: "He has been shaking the side rails, whipping his head back and forth, and faking a seizure, while also telling me he couldn't talk to me right now because he is having….a seizure".
Officer: "Yep. A clear cut case of incarceritis if ever I saw one"
Alrighty, then.
My triage note included the patients first words to me, upon asking him what happened today
Shaky: "I need to make a phone call"
Me: "Not my decision to make, sir, this gentleman with the badge is the boss of your extra-medical activities this evening. He says no phone calls until you get to the jail".
Eventually the doc saw him and suggested the complimentary head CT for aberrant behavior along with the usual assortment of lab tests for various medical maladies (and the presence of drugs in his system), whereupon Shaky stopped shaking and became perfectly lucid. "Nope, I don't want any of that. I'm fine. I need to make a phone call, just let me make a fu*king phone call!"
Doc: "No sir, the officer has said you can do that when you get to where you are going. Are you refusing any treatment or diagnostic testing that I have determined is necessary for your seizure-like activity? Because if so I will have you sign out Against Medical Advice"
Bye. Incarceritis. Use it in a sentence today.
