A young woman who was brought into the Emergency Room had taken twenty pills because she thought this would show her love for her boyfriend. She was wild-eyed and had a strange accent... it wasn't American. The paramedics had tried three times to do a cut down to get the intravenous solution started, but even with two women holding the young woman, she had pulled away. The resident tested her reflexes, her heart and her eye grounds. The attendant then tied her arms and legs to the gurney. Meanwhile the boyfriend and his brother came into the cubicle and hovered over her. The boyfriend told her he felt she had attempted suicide in order to show her guilt for "what she had done to him."
She was rolled to the transportation area to be transferred to a satellite hospital because there were not enough beds upstairs, but a telephone call revealed that there was no room there either. So she was directed upstairs to Medicine. We all went by
elevator to the ward, but there was no space in the ward, so she was wheeled to a teaching auditorium.
The resident examined her in the teaching auditorium.
While the resident examined her, she called out to her boyfriend in the hall. Three paramedics were there to help the resident. They bent her head and inserted a stomach tube and injected two bags of fluid. After the lavage, she began wrestling, retchi
ng, bleeding and biting. The resident left. I asked them why such a young, thin woman was so strong? They said she didn't care if she hurt herself and therefore she strained. She was gently cleansed by the
paramedics. The doctor came back and the four men gathered around her. The resident supervised t
he paramedics who were restraining her to the bed. He said, "There isn't much chance now of her pulling the I.V. out from the elbow." She held onto his arm and asked if he was in the movies. When they all left to talk to her boyfriend in the
hall, she raised herself on her other elbow to ask me if she was in a hospital. I asked her how she felt. "Shaky," she said, "I don't want to be all right; I want to die." She looked wild-eyed. She cried and then blacked out.
Three paramedics were there to help hold her down.
I asked the resident about some psychiatric care for her. He answered, "Tomorrow a psychiatric consultant will come." "What about care for the boyfriend who is enjoying having her attempt suicide as a way to show her love for him?" "You can't force anybody to have psychiatric care. Anyhow, he is not aware that he could use some."
The boyfriend went in the room where she was and stayed with her; she didn't want to be alone. The nurse with a tired sense of reality said, "We have so many cases like this. Psychiatry decides if she is allowed to come to the clinic, but only if she volunteers. We can hold her no longer than seventy-two hours."
Department of Emergency Medicine
