Mental Health

In the last week, I've seen 3 patients, 2 active duty, who would very much benefit from seeing our Combat Stress (i.e. mental health, i.e. psych) providers, but they absolutely refuse. Very resistent and, of course, these are the very people who really need the help. No they are not suicidal or homicidal. That's part of my job to figure that one out, but all have serious sleeping issues that I'm convinced are a product of their stress, frustration, PTSD, anxiety or combination of all of them. My favorite analogy to how much our minds can affect our bodies is that of the emotion of embarrassment - this very much an emotion, all in your head, but what happens to your face? You turn completely red - a physical manifestation of your emotion. I think that's a pretty good analogy, but no, didn't work on these guys. Oh they agree with the analogy, but they just don't think they are crazy enough to see psych. Now how do you convince a guy who has hypnagogic hallucinations (hallucinations occuring just before losing complete consciousness into sleep or right as you are waking up and are not that uncommon) of urinary incontinence which feels very real to him, that he is not crazy? I don't know, but you let him vent for about 30 minutes about how frustrated he is with his job and his command, using a curse word like I use "um" when I'm nervous talking. He's following up with me next week.

On another note, it was Ash Wednesday today. We had a nice little service in the hospital conference room at 1030 with dear Fr. Pat who always wears his Navy desert camo stole. Now in the gospel today, there was the bit about 'don't look like you are fasting when you are' and 'go pray in the privacy of your home' etc. Sort of ironic that we wear ashes as a very obvious symbol on this day of fasting. You are always greeted with one of two responses to the ashes from a person who does not also have ashes on their forehead. Either it is "Oh, is it really Ash Wednesday already!" or (with a very strange look) "Um, do you know you've got this big black spot on your forehead?" I will say, though, that it did bring about a nice conversation with my last patient of the day who was actually deciding whether he wanted to convert as his wife was Catholic. It was nice to do a bit of explaining in that respect.

Well, I better try to get some sleep. It has been a little restless lately and I'm just hoping I don't wake up at 0300 to run to the porta-potty because of the two cups of tea I had at the UAE compound tonight with dinner.