The Psych Ward expansion has taken effect. The Psych Ward now occupies the entire floor. It has been renamed Psych Ward East and Psych Ward West. Psych Ward West is the expansion unit.  Both Psych Ward East and Psych Ward West will be headed by the same Director and Treatment Team Leader.

Some of the patients that are in Psych Ward East have been moved to Psych Ward West. The patients that are still left in Psych Ward East are the patients with the more colorful personalities. They are the ones who stand out and exhibit expressive behaviors that medication cannot control or suppress. Most of the time the expressive behavior is not violent; it gives a unique perspective among the patients who otherwise remain silent and do not express themselves as long as they are medicated.

One example is Dora. She is diagnosed as being borderline personality ( she does not like her fellow patients; she hates some more than others. She hates some staff members and recently she flip flopped on the new Intern ( When the new Intern first came aboard she liked him. Now she hates him. The old Intern wonders what is his status with Dora? .  However Dora interacts with the first Intern which tells him that he isn’t on her hate list. As a bonus she usually reveals the latest events that take place in the Psych Ward; at least the old Intern get to know what’s happening from a patient’s perspective.

Earlier Dora caused a ruckus because she did not want another patient that she hates sitting next to her. It was during snack time; Dawn sat at her table because all the other tables were taken. Dora objected that Dawn sat next to her but the staff told Dora that Dawn has every right so sit where she wants too. Dora took offense and screamed at the top of her lungs; then she took Dawn’s juice and threw it on the floor.

Another patient who often expresses herself in ways that medication cannot control or suppress is Kate. She also caused a ruckus; the expressive behavior that Kate exhibits is to verbalize her thoughts and feelings in a loud voice. If someone says something to her about her verbal expressions, she raises her voice even louder. However this time around Kate had a legitimate concern that she verbalized; but her delusional perspective prevailed over the legitimate complaints. Kate has the delusional idea that some members of her family were murdered. If you didn’t know Kate what she says about the murder of members of her family sounds convincing. But when you read her chart that contains documented personal history. Her chart states that there is no evidence that members of her family were murdered. The spin on this is that she started to blame Kevin (another patient) for committing the murders. Then Kate started to verbalized that Kevin is not a good person.

It is interesting how Kevin’s repetition precedes itself.  Everyone in the Psych Ward, from management, to staff, to patients say that Kevin is a shady person and cannot be trusted. Even patients and staff, who have spoken to Kevin for the first time has concluded that Kevin’s character is shady; yet, Kevin’s chart reveals that he is not a criminal; he never spent time on Rikers Island or the state penitentiary. His chart also reveals that he is promiscuous and that he has commitment issues and just cannot be trusted to follow through with anything. Kevin is perceived as being a con artist. When he plays a game with his fellow Psych Ward patients, he walks away from the game if he is losing.

The last interaction with Kevin was less then positive. The problem with him was when he  began to say negative verbal remarks that made his partner feel bad. His partner’s (Nadia), weak mental state would have led her into a depressed mood all because Kevin did not like the fact they were losing. The Intern told Kevin to stop it and if he wants to continue playing the game with the group, he has to treat his partner with respect.  Kevin stood up and he walked away like he usually does; but this time he came back later and apologized.

Lydia, the anorexic patient made her usual objections to taking the weight maintainer nutritional substance; and as usually she started to cry. However it is recognized that her behavior of crying is nothing but crocodile tears; the rants accusing the staff of trying to kill her usually follows her crying act.

Observing the expressive behaviors is comical and would make you laugh. But what is not laughing a matter is that the expressive behavior is real and the patients would either hurt themselves or others.

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