Wednesday, February 16, 2011

Tales From Intern Year: The Haircut

The story I got:

Mr. Hoff (not his real name) is a 40 year old guy who woke up to go to work in the morning. The next thing he knew, it was the next day... he woke up covered in coca cola and apple juice, on the floor of his room. He's never had any incidents like this before.

I walked into the room and he was a young-looking guy with a kind of strange shaved haircut. The sides of his head were completely shaved but the top was kind of long... it actually sort of looked like a Vanilla Ice haircut. I asked him what had happened and he said he wasn't sure. Nothing like that had ever happened to him before.

"Do you have any memory at all of the last day?" I asked him.

"No, no memory at all," he said. "I just woke up... and I musta got something to drink, cuz... I woke up all covered in coke and juice. Also, I gave myself this haircut."

"You don't remember shaving your hair?"

"Nope, not at all."

"Have you ever shaved your head before?"

"No way... I didn't even think I could."

It was impossible to get a good idea of what had happened to him because he had absolutely no concept of time. He had been to the emergency room at another hospital for a brief loss of consciousness, but he wasn't sure if it had happened days ago or weeks ago. I started doing a mini-mental, but I knew it would be way too painful to do the whole thing, so I just started it....

Me: "Mr. Hoff, can you tell me what day it is?"

Him: "It's Monday, March 17."

Me: "No, actually, it's Tuesday, March 18."

Him: "No way! Really?"

Me: "Yes."

Him: "Are you sure?"

Me: "Yes, I'm sure."

Him: "I thought it was Monday. Wow, are you sure?"

Me: (starting to doubt myself a little) "Uh, yes."

Him: "Wow..."

Me: "Can you tell me what this is?" (points to my watch)

Him: "I don't have my glasses."

Me: "This thing on my wrist."

Him: "Oh. A watch."

Me: "Good. Can you tell me who the President of the US is?"

Him: "An asshole."

Me: "Uh... what's his name?"

Him: "George W. Bush."

When I asked him to spell the word WORLD backwards, he just said "D.........." then he gave up.

His urine tox was positive for a bunch of things he admitted to having taken (medications), but we still couldn't figure out what was going on. The attending didn't know what to make of it, but he sure had a lot of questions about Mr. Hoff's haircut:

Attending: "So were you thinking of giving yourself a haircut?"

Mr. Hoff: "No, not at all."

Attending: "Is this a haircut you've ever had before?"

Mr. Hoff: "Well, maybe years ago. But not in a long time."

Attending: "Is this the kind of haircut you would have wanted?"

Mr. Hoff: "No, no... not at all."

Attending: "Have you ever given yourself a haircut before?"

Dr. Hoff: "No, never. I didn't even think I could."

Attending: "It actually looks pretty professionally done... are you sure you did it yourself?"

Mr. Hoff: "Yeah, I mean... there's hair all over my bathroom."

By the end, I was seriously wondering if my attending was going to ask Mr. Hoff to do his hair too.

9 comments:

  1. "My other personality is a hairdresser. She must have done it."

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  2. Sounds like if he laquered it up he could have a rockin mohawk. Maybe he was punk rock in a past life.

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  3. Apparently that hairstyle is all the rage these days. Who'd a thunk!

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  4. Sounds like time for a psych consult to me!

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  5. I wish I could blame my current haircut on a lapse of consciousness.

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  6. Last month I had a conversation that started similarly to this one - minus the hair cut. . . Only it ended in me realising that the patient actually had a higher MMSE score than me. I was convinced it was a a different date than it was in reality. YAY sleep deprivation.

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  7. Georgina: I recently enthusiastically told a patient "RIGHT!" when he said the year was 2010.

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  8. I'm cracking up at the last part! The attending's questions were pretty funny. So (if you're allowed to tell us), what was the outcome?

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  9. Are you sure, when he said he was covered in "coke," that he meant "Coca-Cola?" Hmmmm indeed.

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