Like A Deer (Ass) Caught In the Headlights

We got a patient on the floor today, a transfer from another hospital who quickly ingratiated herself to the staff by complaining about how much better Brand Name Hospital was than this shit hole.

Okay, so she probably had a point, but...

She was also a crazy bitch.

A crazy bitch whose crazy husband started raving psychotically to the unit clerk about how crazy the sister was, and how if she should just call to ignore her! She's crazy! Really, Really crazy!!

Okay. We get that's she's crazy.

But if the sister is "crazy" then what would you call the following story:

Bitchy Crazy Lady starts talking about how her dog brought a deer ass carcass and put it on her bed. And she's apparently proud of this behavior, and thinks it's funny, but in a completely different way than we think it's funny, because now we really think she needs a rubber room.

I had to ask twice about the "deer ass carcass," because, dude did the nurse and tech just tell me she said "deer ass carcass"?

One of the nurses commented on the layers of irony in this story and references to pop culture, like the head's horse in the Godfather.

And we all thought: Wow, what a brilliant dog! What a way to say "I think you're an ass! And not only an ass, but a carcass of an ass!"

As I'm laughing my ass off, I'm also thinking the lady has got to be paranoid delusional, possibly schizophrenic with visual hallucinations (which she may well be, since she's on about half a dozen non-formulary pain medications and muscle relaxers) when the nurse and the tech say the husband confirms the carcass-ass-bearing-dog story.

Wow. I couldn't even remember which DSM IV psych diagnosis would be pertinent in this situation--but looked it up on a google search and found DSM-IV Diagnostic Criteria for 297.3 Shared Psychotic Disorder to be pretty close to what seemed to be going on with these folks.

I wonder what a psych consult would make of these folks.

And they aren't geriatric, either. Nor are they strangers to the psychiatric world, because the husband actually said the sister (the crazy one, remember, as if that qualifier means anything significant in this context) was dystonic and nobody without some kind of contact with psychiatric services knows that word, unless they like to read the dictionary for fun. Or maybe if you're these people, the dictionary reads to you and does a little song and dance at the end.