Tag Archives: mental status exams

Don’t act so angry when I pass your tests.

Standard

I had to deal with another professional trying to drag me to the hospital yesterday, insisting since I was weak enough to fall someone had to look at me. When I told him that my doctor had already looked at me, and that my doctor did not want me in the hospital, he wanted me right where I’m at (staying with a friend to make sure I don’t fall, and resting, which I can’t do in an emergency room), he was not at all pleased, and tried to convince me he was going to do it anyway unless I could sit up straight (which I couldn’t, but still insisted I wasn’t going).

I did not know this, but it’s illegal around here to force someone into medical treatment unless they can be proven disoriented. Which explains what happened next.

Normally, people describe me as oriented times three (to person, place, and time) even when I’m not, they don’t even bother doing the normal test of this. It’s the sort of thing most people just assume about you, unless they’re given serious reason not to. If they do ask, they generally ask you if you know who you are, where you are, what situation you’re in, and what day it is.

In this case, he didn’t just ask those things.

He wanted to know not only the date (something I normally have trouble with, but luckily knew yesterday), but the exact time of day, which is something most people don’t know without looking at a clock. Fortunately, my staff person had left shortly before that, so I said “after five”. He checked his watch (he didn’t even know the answer to the question!) and grudgingly admitted that it was just after five.

He went through a similar rigamarole when asking me where I was. He wasn’t satisfied with my description of where I was (a friend’s place, naming the friend) until I gave him the exact street address, something else that most people don’t memorize when they go to visit friends.

The thing about all this is, with orientation to time, they usually ask the year, the season, the month, and the day of the week, sometimes also the name of the president. I have been excused for not knowing the precise day of the week before if I was otherwise coherent, or for saying something like “I think it’s either Monday or Tuesday”. Knowing the time of day is above and beyond anything I’ve ever been asked, or heard other people asked in busy emergency rooms. Being expected to know the time of day when the examiner doesn’t know it is absurd.

With orientation to place, I’ve seen people passed or partially passed on these exams for simply knowing they were in a hospital, without knowing the specific name of it. (This would be like me saying “a house”.) I’ve never seen people asked anything beyond the specific name of the hospital. (This would be like me saying “Jim’s house”.) I’ve never, ever seen anyone asked a complete street address before.

And I’ve rarely seen a professional so angry as this guy was when I proved to be anything but disoriented.

Hint: If I’m able to coherently and rationally discuss, at fairly great length, while under pressure, despite total and obvious exhaustion, precisely what doctor I saw earlier today, his status among doctors around here, the problems I am having, the problems I am not having, and my doctor’s orders that I remain staying with this friend and not in the hospital where I would be put at risk of catching more diseases that could combine with this to make me really require hospitalization, then maybe I am alert and oriented enough to make my own medical decisions. If I have not injured myself, and am proven to be alert and oriented even beyond what is normally expected of a person, and have told you in detail about my visit to a doctor (since you seem to want me to undergo all the tests I’ve already undergone), you should be happy, not angry that you can’t force me to do what you want me to do.

I’ve already discussed it with my friend: Next time I fall, whatever people are around can make me as comfortable as possible on the floor and wait there until I’m strong enough to get up. I know I apparently look pretty awful, but I’m sick of people telling me to go to the hospital, especially after my doctor and I already came to the conclusion that this would be bad for my health unless I was actually seriously injured in a fall or any of the other usual things that would warrant this. Simply having trouble sitting or walking and “looking bad” isn’t enough.