So I had TLC's Untold ER Emergencies (or whatever it's called) going in the background while I cleaned the house yesterday. The case patient had occasional episodes of catatonia and paralysis of a limb. It was a different limb each time. The patient's husband was a super-seekrit military pilot who went away on missions for weeks at a time and he had no contact with his family.

Immediately, sez I, "CONVERSION DISORDER"

25 minutes later, after all the exciting build-up of symptoms and escalating drama...

Yup, it was conversion disorder.

Here I thought I forgot everything from Mental Health!

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Speaking of mental health, I summoned every ounce of courage I had and volunteered to do the admission for someone who was suicidal the other day. It was optional for me but one of the nurses encouraged me to go for it.

Even in my Psych rotation I never asked anyone if they were suicidal.

It truly wasn't the difficult conversation I thought it would be. Patient was an older lady, landed immigrant, here for 30 years, her only family was her husband and children. She missed her extended family, missed "back home".

I just kind of winged it but I asked her lots of questions about her mood lability and got her to rate her emotional intensity. Then I asked if she ever thought of hurting herself or anyone else when she felt like her emotions were out of control. She answered in the negative and we moved on in the assessment.

If she'd have answered yes, my next question would have been "do you have a plan?" and we would proceed from there.

Honestly, the hardest part about the question of Are you suicidal? is asking it.