Crisis & Acute Care

Priya, a 28-year-old paralegal in San Diego, had just bombed an oral argument practice when her hands began to claw inward involuntarily. Her lips went numb. Her jaw tightened. By the time her supervisor walked her to the urgent care two blocks away, she was convinced she was having a stroke. The clinician took one … Read more

Robert, a 61-year-old retired electrician in Cleveland, walked into the emergency department with crushing chest pain, a troponin level off the chart, and a clear command from his cardiologist that he needed immediate cardiac catheterization to prevent a fatal infarction. He refused. Not in a confused, mumbling way, but firmly, with eye contact, telling the … Read more

Rosa had been stable on lithium for eleven years. She lived in Sacramento, taught middle-school art, married a patient man named Joseph, and had not been hospitalized since her early twenties. When she and Joseph began trying for a baby, her OB suggested she stop lithium quickly, citing concerns about Ebstein’s anomaly that, while real, … Read more

Hannah, a thirty-one-year-old paralegal in Boston, kept a small spiral notebook on her nightstand. For nine months she had been tracking the days. The pattern was unmistakable. Eight to ten days before each period, the world would tilt: a kind of hopelessness that arrived without warning, intrusive thoughts about not waking up, sudden rage at … Read more

Maya was twenty-three when she walked into a Phoenix emergency department at 4 a.m., still wearing the cardigan from the night before. She did not know whether she wanted to file a report. She did not know whether to call her mother. She knew only that she was cold, that something inside her had gone … Read more

Wendell, a fifty-two-year-old high school principal in Cleveland, had been in psychiatric care for three years when his second psychiatrist asked him a question the first never had: how do you sleep? Wendell laughed. He slept the way everybody his age slept, he said, badly, and he had been told for as long as he … Read more

Daniel arrived at a Nashville hospital with a blood alcohol concentration of 0.42, a tremor that rattled the gurney rails, and a CIWA-Ar score climbing past twenty within an hour of admission. He was forty-six, a contractor who had been drinking around a fifth of vodka a day for nine years, and he had been … Read more

Trevor, a 34-year-old software engineer in Sacramento, had been on bupropion for treatment-resistant depression for nine months when he was found unresponsive at his desk by a coworker who initially thought he was sleeping. The convulsions started while paramedics were loading him into the ambulance and continued through the emergency department triage area, prompting immediate … Read more

Marcus, a 64-year-old retired postal worker in Tucson, had been taking haloperidol for paranoid schizophrenia for nearly two decades when his daughter noticed something strange during a Sunday dinner. His tongue darted in and out of his mouth between bites, his lips puckered and smacked involuntarily, and his fingers played invisible piano scales on the … Read more

Hannah, a 22-year-old graduate student in Boston, started her first semester of a neuroscience PhD program in good health and ended it on a locked psychiatric ward, then a neurology floor, then a neurocritical care unit, with a diagnosis no one in her family had ever heard of. The first symptoms were flu-like and unremarkable: … Read more