A patient came into the ER for chest pain. He was uncomfortable and a bit anxious but otherwise normal. The guy was a military officer and very athletic. I go in to draw his blood and get some background information, we're chatting as I get my supplies ready, and as I'm putting the needle in his arm he says "you're from the government." in a very cold voice. I look up and his face has completely changed. He's furious and looks like a cornered animal. Before I can ask "what?", he screams it again and rips the needle out of his arm. He kicked me backward and then stood up while screaming "you're from the government" repeatedly. I get to my feet and he charges, easily twice my size and probably trained to kill. I run to the far end of the ward, he keeps running after me, and the only thing that saved me was having my paramedic boots on. I managed to get one good kick with the steel toe into his shin and brought him down after which I got him into a restraint position and the doc sedated him. I had never seen psychosis suddenly come on like that from a completely neurotypical presentation. A switch flipped mid-conversation and he was determined to kill me without any ability to perceive pain or limit the strength of his muscles. I broke his leg and he was unaffected, still trying to get up and attack me again.
Pretty much. What got me is that he was an aviation officer with a pretty high rank. They have extremely strict entry requirements, regular psychological screenings, constant checks by flight surgeons. He was around 20 years beyond when a lot of psychiatric illnesses start presenting and as far as I know we never established an etiology for it. The only trigger I could ever think of was the needle piercing him but until that moment he showed absolutely no anxiety about the blood draw and I thoroughly explained why we were drawing two separate chest panels over the next few hours. One moment he fully understood what was happening and was discussing it, the next it was chaos. After really fine-tuning my sense of shit about to kick off from that line of work, I had zero indication anything was off about the situation.
A patient came into the ER for chest pain. He was uncomfortable and a bit anxious but otherwise normal. The guy was a military officer and very athletic. I go in to draw his blood and get some background information, we're chatting as I get my supplies ready, and as I'm putting the needle in his arm he says "you're from the government." in a very cold voice. I look up and his face has completely changed. He's furious and looks like a cornered animal. Before I can ask "what?", he screams it again and rips the needle out of his arm. He kicked me backward and then stood up while screaming "you're from the government" repeatedly. I get to my feet and he charges, easily twice my size and probably trained to kill. I run to the far end of the ward, he keeps running after me, and the only thing that saved me was having my paramedic boots on. I managed to get one good kick with the steel toe into his shin and brought him down after which I got him into a restraint position and the doc sedated him. I had never seen psychosis suddenly come on like that from a completely neurotypical presentation. A switch flipped mid-conversation and he was determined to kill me without any ability to perceive pain or limit the strength of his muscles. I broke his leg and he was unaffected, still trying to get up and attack me again.
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Pretty much. What got me is that he was an aviation officer with a pretty high rank. They have extremely strict entry requirements, regular psychological screenings, constant checks by flight surgeons. He was around 20 years beyond when a lot of psychiatric illnesses start presenting and as far as I know we never established an etiology for it. The only trigger I could ever think of was the needle piercing him but until that moment he showed absolutely no anxiety about the blood draw and I thoroughly explained why we were drawing two separate chest panels over the next few hours. One moment he fully understood what was happening and was discussing it, the next it was chaos. After really fine-tuning my sense of shit about to kick off from that line of work, I had zero indication anything was off about the situation.
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