Nude Psychiatry

April 28, 2009
Shirt and shorts required.

Shirt and shorts required.

I had this patient come in for a fall this weekend – seems like everyone was falling for some reason. He was in his sixties and had recently lost his job as a marital counselor because the foundation he worked for lost 1.5 million dollars in the Bernie Madoff scandal. Till that point, he had been sober for eight years, but the news was too much for him. So he went to the bar and got hammered.

Came home totally stinking drunk, and freshly unemployed to boot, so his wife said she had enough of him and told him to get out. So the marriage counselor was having marriage problems and not approaching them in the way that he probably advised others to do (at least I hope not).

Since this poor soul had fallen while drunk, the nurse asked him to get into a gown so that I could check him for injuries from the fall. I walk in and find a pleasant gentleman sitting on one of the chairs in the room. As we get into the physical exam, he tells me about some bruises and abrasions he suffered from the fall and proceeds to lift up the gown to show me his abdomen.

He didn’t tell me though that under that gown, he was totally naked. Just naked and casually sitting on a chair reading a magazine. Personally, I don’t prefer that any of my skin touches anything in an ER patient room.  But he, on the other hand, didn’t seem to mind plopping his naked genitals (i.e., free-birding) right down on that cloth lined (read absorbent) chair that others before him had bled, vomited, urinated and God knows what else on before. Either that or he really trusts generic hospital brand Lysol.

This reminded me of a patient we had a few months back in our psych room. She was about 50 and depressed. One of my colleagues went in to see her and being that it is the psych room, it is monitored on CC TV. As he was interviewing her, I noticed from my peripheral vision that she was successively taking off her clothes. Right down until she was totally naked and just sitting there answering his questions. It was a most unusual site to behold.

I mentioned this encounter to one of my other colleagues who is a serious triathlete. He told me that this was nothing compared to the guy that visually tortured him for months when he used to go swimming at the YMCA. This guy used to strip down to nothing but his socks and shoes and spend a good half hour riding the air-dyne (fan bike) in full view of all to behold. Not a nice image.

So, all-in-all, not sure if these are just nudists who happened to need to come in to the ER or what? But there is no doubt that we sometimes get to see way more of our patients than we ever intended to – and in most of these cases, have to live with the nightmares.