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Clinical Note Part 1, Addendum

In Clinical Note Part 1, I wrote: “Being mentally ill and being an asshole are two different things.

I made this statement in response to repeatedly witnessing toxically abusive, completely unnecessary behavior in the ER. I feel compelled to note at the onset of this post that I am extremely sensitive to the needs of the mentally ill, and I try to be a strong advocate for this poorly served patient population. Having said that, there are things that are simply unacceptable regardless of the patient’s state of mental health.

Warning – in a blog filled with graphic profanity, I am about to use language I would never engage in to illustrate my point. Don’t read further if you are easily offended

It is never acceptable to call your doctor, nurse, or other healthcare professional a cunt, faggot, or nigger. You may be an unmedicated paranoid schizophrenic, but there is a limit to what these good people should be expected to endure in the interest of caring for you.

Your personality disorder does not give you a license to hit, threaten, or intimidate your doctor, nurse, or other healthcare professional when they are trying to help you.

Being bipolar does not excuse spitting at or urinating on your doctor, nurse, or other healthcare professional.

Your drug use or current state of detox does not give you the right to shit on the floor or throw your feces in the direction of your doctor, nurse, or other healthcare professional.

Engaging in any of these behaviors will result in summoning security, and in my ER, I will not hesitate to do so if your conduct endangers the health and safety of either yourself, your providers, or other patients and their families.

I have an extremely thick skin and a huge reservoir of compassion, but I have to look at the big picture. My goal is to care for you and everyone else in my ER, but I do not expect my colleagues to have the same degree of tolerance I do. Your “acting out” is preventing you from getting the care you need and traumatizing the people who are attempting to do so.

Unless you are having a complete psychotic break from reality, you still have the ability to understand your abusive behavior towards other humans. You have lived in a society around other people since you were born, and you understand, however vaguely, the consequences of your actions towards others.

The difference in the ER and the rest of the world for you is this: We deal with people exhibiting the most extreme behavior on a daily basis, and we know how to handle it, no matter how unpleasant it may be. We WILL care for you; we can just do it the easy way, or the hard way. It’s your choice.