Resident's Notes: Chief Complaint—1
a.m.
“America” (no identification at admission/no insurance)
presents with night sweats, insomnia, chest pains,
tinnitus, acute shortness of breath, and a large muscular tear
in the pectoralis minor. Patient claims symptoms
have been present for 18 months. Upon examination,
the patient exhibits tympanic membrane inflammation,
crackles in the lungs, muscular atrophy and hemorrhaging
in the upper right quadrant of the limb.
(The tadpole's head, so less invasive
than the digging sperm, than the plunging
mandible of the worker bee, than the sharp thrust
of the electric plug, than the Gothic transept spire
reaching prayers for victory up to God.)
The patient is intubated, and resting but disoriented;
whispers: Dear God, make me strong,
help me smite the wicked, guide
my hand with surgical precision
let the bombs fall exactly
where I have planned.
Help me to show that democracy
is the cure for the world’s ills. Amen;
extremities neurovascularly intact;
Folstein’s mental status exam:
score of 11—modified stupor.
Differential diagnosis: paranoid schizophrenia
manifesting in delusions of grandeur;
delusions of persecution bear further investigation—
possible connection to severe post-traumatic
stress disorder, partially self-inflicted wounds.
Psych consult.
"Resident's Notes" first appeared on the Poets
Against the War web site
February 2003
Copyright 2003: J. Elizabeth Clark |
