Jerry agrees. It is often instantly obvious; we notice right away when someone is “off” or “not right”.
Instead of investigating further, we shy away from anything that hints of death, dying or disability. We don’t want to know, because it is too awful to contemplate somehow, especially in children or young adults. All that needs to be done is to check minute volume and the other basic vital signs. Hypercapnia is easy to miss and is very treatable. [see other posts].
Jerry was 21 and was graduating from university with honours when he became delirious. He hardly remembers the police taking him to the hospital [he was combative in his delirium- he was terrified in the delirium- he was delusional in the delirium ]. No one checked his breathing or his other vitals. His interpreter [his mind] was gone, he was completely disabled and we all know how disabled people are treated. Jerry’s parents “knew” he was very sick; they knew his entire medical history, he had a history of breathing problems, urinating problems, he had been in frail health for much of his childhood. No one asked about his paediatric or birth history; they only thought of psychiatric stereotypes and psychiatric bias, they completely ignored his physical health. I bet that they did not even think to take his temperature. Delirium is that scary…..especially if it becomes stereotypic [quiet, mixed manic locomotor types of delirium] and the patient becomes too disabled to communicate. Then the patient becomes a blank slate for doctors to paint and decorate with bold psychological colours. They missed the boat with Jerry. His parents could do nothing against the mighty pseudo medico-psychiatric mumbo jumbo protected by secrecy [known as confidentiality]. His parents never gave up on him. They knew that he was very very sick. They knew it had nothing to do with psychology or psychiatry. They were exceptionally wise but powerless and they were not given a voice to protect their son.
Paula “knew” that everyone would get it wrong, she knew no one would imagine that she’d lost her mind overnight. And she “knew” she was sick. As frantic as she was, she realized she looked like a slumped zombie, she had no words. Other people saw her – they knew something was ” off”, yet they also had no words. All the outward signs were general, non specific. The outward signs were ambiguous, easy to misinterpret without an interpreter. And Paula’s interpreter [her mind] was absent, she could not explain what was wrong, she couldn’t even remember what was wrong for more that a few seconds. It was such a nightmare. She knew they would think she was depressed. And she knew that she’d become suddenly intellectually disabled and needed to have her vitals checked.
OK she didn’t know that yet, and even if she had known that- she would have forgotten it, given how ill she was.