“Mummy, mummy, mummmmeeeee……..”, 02.33 the clock flashes, mocking in the knowledge I had gone to bed at ridiculous o’clock to try to shift my lethargy. “Mummy?” now Big Son’s vocabulary is fast expanding and knowing he has been able to say “Daddy” for many months I am waiting, well praying, hoping, willing really that he may screech this word several decibels louder to render me clearly incapable of accepting the task. “Mummy, mummmmmeeeee”, and so the deal is done, third strike and you’re out policy being such that it is – I get up begrudgingly to see what could possibly be necessitating a night time visit. Admittedly it has been several months since his last nocturnal wakening. And whilst I am eternally grateful to have been blessed with 2 good sleepers it’s still nigh on impossible to get out of my bed. I am a 9 hour sleep girl through and through.
As I push open his bedroom door I am met with the most putrid, but instantly recognisable, smell. “Sick” declares Big Son. Very good little guy in correctly identifying the smucking of your muck. You will go far. As I turn on the light to survey the damage I can feel the heat radiating from his little face and yet still his arms go up with a smile “mummy cuggle”. In an instant all is forgiven.
And this is how my day began, the washing machine full by 4am and a little more sleep deprived than is ideal to a conducive days work.
So I stumble into work with seconds to spare and relieve the night shift of the on-call page, he looks decidedly better than I do but I’m not sure refusing to take the page on those grounds would go too well. Like the hot potato that the bleep can be it goes off instantly and I’m summoned to see a new admission. “Do you take sugar?” is the parting question from the summons. It’s my ward, they know me well, without that caffeine kick first thing I’m going to be good to man nor beast. And I’m quite accepting of bribery too.
“It’s always the heart isn’t it?” asks the 18 year old boy in oversize ‘phat’ pants and a hoodie. “Well, yes, I suppose it is” I reply, help! Where’s the nurse, don’t let me see this one on my own! I had merely been explaining the nuances of what a ‘physical’ involved, listening to the heart, checking the breathing, asking questions as I go regarding physical health and so on and so forth. I’d the easy job, I didn’t even need to touch on mental health issues. This has been done, the questions had been asked, the paperwork completed, the i’s dotted and the t’s crossed. So please let’s just deal with concrete here, abstract is a little beyond me today.
As we manoeuvre him with some difficulty into the treatment room we wait patiently for him to sit down. Turning his very much idle iPod over and over in his hands, looking simultaneously bemused and irritated by it. As he finally plonks himself into the chair I ask what his favourite band is, clearly he loves music and this may ensure we stay off other topics which no one is going to thank me for asking. I catch sight of the nurse behind him violently shaking his head and drawing his fingers across his throat in a “kill it” gesture. It’s too late the damage has been done. I’d riled a bull with the unintentional waving of a red flag.
I had clearly brought this upon myself misjudging the situation very badly indeed. The warning shot had been given, and duly received by myself, so why did I feel the need for chit-chat. The patient was clearly experiencing thought block so would have had little interest in my filling of the silence if it hadn’t been quite so antagonistic to him.
There’s a quote that comes to mind here, ‘Any man can make mistakes, but only an idiot persists in his error’. I like to talk, so shoot me. Admittedly tiredness makes this worse but still I talk a lot. In fact talking got me to where I am now, I am under no illusion that it is my communication skills which carried me through med school rather than my ability to remember the trillion and one different causes of pancreatitis. But psychiatry is a specialty which demands a different skill set, one of those skills is knowing when to keep stum. I am clearly not there yet.
And so another lesson is learnt. Silence really is golden.