26 April 2006

Word Salad

I know it is completely unethical to share any details from patient appointments, but I just have to. It took me a few minutes of careful redirection when determining the reason for CL’s visit today (not her real initials). A few mind-warping minutes of wondering if it was too late for my coffee or if I needed to practice focusing a bit more. I couldn't understand her (English) description of her chief complaint. She said her vagina was "sweck" and "swappy." She rolled those terms out like everyone knows them. She is not a teen. It is not some new generation thing (please correct me if I am wrong). I have been privileged to learn “dukie” (noun, shit) and “nut” (past tense of the verb to ejaculate), and a rash of other terms previously unheard by me but understood in context because I am somewhat smart (and it is my job to understand my patients).

Anyway, it took me those few minutes to realize my patient was completely nuts (not to be confused with nut). She went on to describe “you know, when you do [some reference for a drug] and get that white flowing feeling when it overflows over your underwear, when your skin is following one direction and the rest of you has gone to [a place or mental state].” Have you had this problem before? “ Well, I’ve been taking in a lot diamonds and properties and that usually makes it sweck. I shouldn’t be telling you, but I’m pulling it all together now- you know when all the parts just get in line?’ Are you sexually active? “Oh yeah, but my husband is so gorgeous and famous, he has sex for cigarettes or necessities sometimes. Women can’t resist him.”

CL had a simple yeast infection. I had a fabulous time talking with her in her unmediated state. I used to work with mentally ill adults, but never doing GYN care. It’s a whole new menu of word salad. And I love word salad. That’s where we are with Stella now. “Mama can take Baba for nana, Sweetie.” “Did you make coco? I think your diaper has uh-oh in it.” “Put down the watering can, Stella.” “Agua!”

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