Curiosity definitely helps folks ask that second question in all sorts of situations. Sometimes patients say such cliffhangers you have to wonder why a clinician *isn’t* compelled to ask that second question.
I'm a pre-nursing student. I try to spend more time outside of academia reading fitness / clinically relevant articles so I can be better prepared in the future (currently reading Peter Attia's new book and some weight training textbooks).I just found your Substack today and just wanted to say thank you! Take my subscribe!
Given everything about the patient, the context, and prior conversation, it would have been totally implausible for his statement to have a rational meaning. Also, even later on he wasn’t able to explain it. We definitely asked follow up questions.
I found this a curious statement: "For others, the uninterrupted space to talk may be all that's needed for their manic symptoms to kick into high gear or decide that now is a good time to clue me in on the CIA’s recent and extensive wiretapping of their home. "
I do not know about the CIA specifically, and I trust the obvious fact that the clinical psychiatrist has a lot of context, but I ask, "Has the good author here not read of the surveillance state being effected by means of public-private fusions and technocracy in the hands of an angry god of technocracy?"
Frankly, I am concerned about my neighbors who do not engage in pattern detection regarding surveillance, especially since we have evidence of algorithmic trolling of digital communications for keywords and even semantic structure.
And, again deprived on the real experience, along with Mxtpik, my first thought merely accessing this story through an epistemological peephole, was that your patient may have have thought he was being clever, as well as trying to establish rapport with your two. Knowing that you two were at least medically educated if not more, and he -- I presume -- not, possibly he was doing a play on words: "rango" and wrangle.
I try to interact with lots of kinds of men in my area, young men whose lives may be positively impacted. They are severely lacking in vocabulary almost to a one. I frequently am astonished when I get a glimpse at their lack of understanding of simple terms and idioms. When they reach for a word, often they get it mixed up a bit --- not in anyway that I can describe as different from that element of verbalization in your rango-wrangle story. These are hard-knocks guys.
(B.t.w., I buy used dictionaries, and if and when the timing in a relationship seems to suggest itself, I give one to what might be a good candidate. One fellow just went back to college after some time off cleaning up some alcohol abuse: he got a dictionary from me. A long conversation a week ago revealed to me a crisis of America's destructive educational system, and less so the localization of the heavy burden of problems on individuals, per se, though I cede the point that indubitably every institution is nothing more than individuals behaviorally-ordered according to various political and philosophical conceptual and bureaucratic artifacts.)
As a writer, or a wannabe writer (and not a psychiatrist), I am intrigued by this word play and OUR wrangle involving, "tango with rango." Maybe we would do better if I ceded the pint instead, and we discussed this over a beer. (Or do you not drink beer, even Socratic beer?)
Curiosity definitely helps folks ask that second question in all sorts of situations. Sometimes patients say such cliffhangers you have to wonder why a clinician *isn’t* compelled to ask that second question.
I'm a pre-nursing student. I try to spend more time outside of academia reading fitness / clinically relevant articles so I can be better prepared in the future (currently reading Peter Attia's new book and some weight training textbooks).I just found your Substack today and just wanted to say thank you! Take my subscribe!
Thank you, and best of luck in your studies!
Excellent example of assessing a patient for psychosis. Thanks for posting.
Thank you. I hope more Psychiatrists will read your blog.
Couldn’t his statement have had a rational meaning? Maybe Rango is a person and he had learned not to get in a fight with him?
As for rhyming, non-psychotic people do this plenty when expressing themselves, especially in vernacular/street cultures.
Not saying you were wrong - you saw his affect in person - but not sure why you saw this statement as so determinative
Given everything about the patient, the context, and prior conversation, it would have been totally implausible for his statement to have a rational meaning. Also, even later on he wasn’t able to explain it. We definitely asked follow up questions.
I found this a curious statement: "For others, the uninterrupted space to talk may be all that's needed for their manic symptoms to kick into high gear or decide that now is a good time to clue me in on the CIA’s recent and extensive wiretapping of their home. "
I do not know about the CIA specifically, and I trust the obvious fact that the clinical psychiatrist has a lot of context, but I ask, "Has the good author here not read of the surveillance state being effected by means of public-private fusions and technocracy in the hands of an angry god of technocracy?"
Frankly, I am concerned about my neighbors who do not engage in pattern detection regarding surveillance, especially since we have evidence of algorithmic trolling of digital communications for keywords and even semantic structure.
And, again deprived on the real experience, along with Mxtpik, my first thought merely accessing this story through an epistemological peephole, was that your patient may have have thought he was being clever, as well as trying to establish rapport with your two. Knowing that you two were at least medically educated if not more, and he -- I presume -- not, possibly he was doing a play on words: "rango" and wrangle.
I try to interact with lots of kinds of men in my area, young men whose lives may be positively impacted. They are severely lacking in vocabulary almost to a one. I frequently am astonished when I get a glimpse at their lack of understanding of simple terms and idioms. When they reach for a word, often they get it mixed up a bit --- not in anyway that I can describe as different from that element of verbalization in your rango-wrangle story. These are hard-knocks guys.
(B.t.w., I buy used dictionaries, and if and when the timing in a relationship seems to suggest itself, I give one to what might be a good candidate. One fellow just went back to college after some time off cleaning up some alcohol abuse: he got a dictionary from me. A long conversation a week ago revealed to me a crisis of America's destructive educational system, and less so the localization of the heavy burden of problems on individuals, per se, though I cede the point that indubitably every institution is nothing more than individuals behaviorally-ordered according to various political and philosophical conceptual and bureaucratic artifacts.)
As a writer, or a wannabe writer (and not a psychiatrist), I am intrigued by this word play and OUR wrangle involving, "tango with rango." Maybe we would do better if I ceded the pint instead, and we discussed this over a beer. (Or do you not drink beer, even Socratic beer?)