Thursday, March 19, 2015

psychogenic polydipsia

Recently, I overheard a nephrologist, a resident, and a med student discussing a psych/med patient with hyponatremia from psychogenic polydipsia. The nephrologist was arguing that a patient couldn't maintain that significant degree of hyponatremia just from drinking lots of water.

Nephrologist: "Hey, we have a third year med student... we can experiment on her."

Med student: "Huh?"

Nephrologist: "So she would have to drink about a liter and a half of water every single hour, right? Actually, she's small, so maybe only a liter. She'd have to drink a liter an hour every hour, 24/7."

Med student: "I think I'd get tired..."

Nephrologist: "What do you think? Could she keep it up?"

Resident: "I don't know. Is she a psych patient?"

Nephrologist: "Well, she seems like a pretty nice girl. Also I don't think they let psych patients into medical school. So is it possible?"

Resident: "I think it's possible."

Nephrologist: "She'd have to keep drinking while she was peeing."

Resident: "You mean you don't do that?"

Nephrologist: "Yes, but I thought I was the exception."


  1. Hehe poor student. At least she was involved in the discussion!

  2. Wow.
    No wonder med students and residents won't get treated for mental illness. Who wants to be labeled a "psych patient" after being in on a few of these conversations? Not someone who thinks of herself as nice and worthy of medical school admission.

  3. I know you folks know much more than I do, but is the patient taking any psychotropic meds? If so, can the anti-cholinergic effects of the meds
    be causing the dry mouth leading to the polydipisa?
    - Paul

  4. You all eat your own like this? How would you treat us? Seriously, I know this isn't you Fizzy but its people like this that cause a lot of issues between patients and doctors. I fail to understand why the medical profession doesn't dump them, as just because someone spent a lot of money for a degree, no other profession keeps them in working just for that.

    1. In his defense, I think he was trying to be funny.

  5. Yes, sometimes what's said tongue-in-cheek can come across as mean spirited.
    I like the fact, though, that bullying is not tolerated on this blog. In fact, even the suggestion of it is met head on. Thank you PGYx! You set the tone, Dr. Fizzy,
    and I thank you for it.
    - Paul