Mental health emergencies, the 988 Suicide & Crisis Lifeline, mobile crisis teams, dual diagnosis, trauma and PTSD — care for the moments when waiting isn’t an option.
Robert, a 61-year-old retired electrician in Cleveland, walked into the emergency department with crushing chest pain, a troponin level off the chart, and a clear command from his cardiologist that he needed immediate cardiac catheterization to prevent a fatal infarction. He refused. Not in a confused, mumbling way, but firmly, with eye contact, telling the … Read more
Rosa had been stable on lithium for eleven years. She lived in Sacramento, taught middle-school art, married a patient man named Joseph, and had not been hospitalized since her early twenties. When she and Joseph began trying for a baby, her OB suggested she stop lithium quickly, citing concerns about Ebstein’s anomaly that, while real, … Read more
Hannah, a thirty-one-year-old paralegal in Boston, kept a small spiral notebook on her nightstand. For nine months she had been tracking the days. The pattern was unmistakable. Eight to ten days before each period, the world would tilt: a kind of hopelessness that arrived without warning, intrusive thoughts about not waking up, sudden rage at … Read more
Maya was twenty-three when she walked into a Phoenix emergency department at 4 a.m., still wearing the cardigan from the night before. She did not know whether she wanted to file a report. She did not know whether to call her mother. She knew only that she was cold, that something inside her had gone … Read more
Wendell, a fifty-two-year-old high school principal in Cleveland, had been in psychiatric care for three years when his second psychiatrist asked him a question the first never had: how do you sleep? Wendell laughed. He slept the way everybody his age slept, he said, badly, and he had been told for as long as he … Read more
Daniel arrived at a Nashville hospital with a blood alcohol concentration of 0.42, a tremor that rattled the gurney rails, and a CIWA-Ar score climbing past twenty within an hour of admission. He was forty-six, a contractor who had been drinking around a fifth of vodka a day for nine years, and he had been … Read more
Trevor, a 34-year-old software engineer in Sacramento, had been on bupropion for treatment-resistant depression for nine months when he was found unresponsive at his desk by a coworker who initially thought he was sleeping. The convulsions started while paramedics were loading him into the ambulance and continued through the emergency department triage area, prompting immediate … Read more
Marcus, a 64-year-old retired postal worker in Tucson, had been taking haloperidol for paranoid schizophrenia for nearly two decades when his daughter noticed something strange during a Sunday dinner. His tongue darted in and out of his mouth between bites, his lips puckered and smacked involuntarily, and his fingers played invisible piano scales on the … Read more
Hannah, a 22-year-old graduate student in Boston, started her first semester of a neuroscience PhD program in good health and ended it on a locked psychiatric ward, then a neurology floor, then a neurocritical care unit, with a diagnosis no one in her family had ever heard of. The first symptoms were flu-like and unremarkable: … Read more
Diego, a 41-year-old construction supervisor in Albuquerque, was started on a six-week taper of high-dose prednisone for severe poison oak dermatitis after a hiking trip. By the second week he was sleeping three hours a night, talking faster than his wife had ever heard, planning to refinance the house to fund a side business in … Read more