Psychotic Adventures

We see many different types of patients in the Emergency Department.  One large group of people are those being seen for psychotic and mental illnesses.  I had 2 adventures within a week that were amusing and quite entertaining.

One afternoon, there was a young lady in her 60s brought in by ambulance screaming that she was in labor.   She kept screaming "Get it out!!!  Get it out!!!"  By the time that I got in to see her about a minute after her arrival, she had taken all of her clothes off and was lying buck naked on the cot.  Not only this, but she had her legs pulled back in the birthing position and was actively trying to push the baby out that she was sure was inside of her.  She did not believe me at all when I told her that there was no baby coming out of her and that I was pretty sure that she was not pregnant.  When she finally calmed down enough for me to examine her she made me push on her belly to feel the baby.  As I palpated her lower abdomen her response was, "Oh!  That feels really good!!"  Needless to say, the abdominal examination was terminated at that point.  Testing did indeed confirm that she was not pregnant.

A couple of days after that incident, I had another lady coming in reporting that she was also in labor.  She, like the other woman, did not appear to be 9 months pregnant as she claimed.  She told me that she had had sex nine months previously and so she had to be pregnant and was ready to have the baby.  I told her that I did not think that she was pregnant and that she certainly was not in labor.  I told her that I would run some tests to find out for sure if she was pregnant. Unfortunately, she was placed in a bed just across from my work station.  I could hear her making phone calls to all of her friends and family telling them that she was in the hospital and was going to have a baby.   She would also frequently call out to me when she saw me and tell me that she needed to have her cervix checked to see if she was dilated or not.  She did not appreciate the fact that I would not check her "dilation progress".  Her testing also came back that she was not pregnant.  She of course did not believe me when I told her this and demanded an ultrasound, which was denied.  She was sent to see a psychiatrist to get treatment for her psychosis and unborn child.

Now, I have never had a psychotic break myself (that I know of).  But I wonder if I would think that I was pregnant and ready to have a child as well.  Women appear very uncomfortable during child birth.  It is interesting that the mind would choose something like that during an acute psychotic event.  It is probably best for all of society that these adventures were not actual pregnancies.  I would feel really bad for the babies having to go into a situation like that.