A young intern, caring for a drunk, explained, "I feel I really do something useful about twice a day, such as when I give Valium for the D.T.'s it relieves the patients' fears. They get a squirming, crawling sensation, and they feel as if spiders and snakes were on them.
This particular patient imagined also that a little green man 
in the corner of the room as trying
to "get" him. The physician called me in to see him and to try to watch the spider which the patient perceived on the physician's coat. There is a small penciled X above each examining table and the D.T. patient usually calls this X a spider.
He asked the man with the D.T.'s, "Did she (pointing to me) come with the little green man in the corner? I looked at the man, straight in the eye, and I think he saw that I was not hostile to him. He looked back at the doctor and said slowing, &q
uot;No, she didn't come with the little green man. She's too big." (Five feet, two inches is larger than the little green man!)
It is easier to give Valium for the D.T.'s, than to change lifestyles.
The intern asked about his drinking, and the patient recited the Alcoholics Anonymous Credo. He was given a shot of Valium, and he then calmed down somewhat. He told the intern he had had a bad night last night. Bears and lions were hunting him and ha d tried to "whoop him." Actually, he hit his wife's boyfriend on the chin hard enough to knock him down the stairs, but he was not dead. He was given another smaller injection of Valium in the arm. He would be kept in the hospital for detoxifi cation.
"Why him, a terminal case?" I asked. "I mean, he would eventually die of the drinking, because the only thing to stop the D.T.'s is more drinking, and soon he wouldn't eat, and then he would have malnutrition or pneumonia. Why do you kee
p him in the hospital and not keep the 26 year old woman who ingested the twenty pills?" Checking upstairs, I had found that she had been dismissed. "Oh, she wasn't serious!"
It is a matter of human frailty; the number of patients that one doctor, one human being, can emotionally accommodate. He can offer good service when he is overwhelmed, without great caring.
Department of Emergency Medicine
