Thursday, March 26, 2009

Who Are You?

The DOC badge said his name was John X. Doe and that he was born on 1/1/81. The medical information system said his name was John Y. Doe and that he was born on 2/4/84. The legal information system said that John Y. Doe plead guilty to misdemeanor theft and was given six months. John X. Doe has an open robbery charge. John Y. Doe has been through the system three times and has always screened negatively for mental health issues and never needed psychiatric services. John X. Doe was in our forensic hospital for six months being restored to competency. The patient insists he's John X. Doe in spite of both information systems that link him through his DOC number.

I've never treated either of these guys before, have no old records of my own and have no way of knowing if they're actually one and the same person who just lies about different things at different times. Someone just shoot me now.

So is John Doe someone with no previous psychiatric history who is malingering now because he's facing a serious felony charge? Or is he a chronically mentally ill person who is going to relapse if I don't put him on meds? (And relapse in a big way if it required a six month hospitalization.)

Oh yeah, one more thing---he won't answer any questions other than to confirm his middle name and birthdate (which may be a lie). When I try to do a mental status examination he sits there and stares at me.

Gawd, ya gotta love this work.

Any suggestions?