Thursday, March 18, 2010

Possibly the weirdest therapy day ever

It's Thursday! Thursday means that tomorrow's Friday and is generally a good day. I also like my schedule on Thursdays because it's a nice mix of meetings, therapy, and hanging out on the unit (where the inmates live). It's also my chance to get everything set up for Friday, which is perfect for the Type A side of me that wants "a place for everything and everything in it's place."

Today started well. The kid slept late, which meant I didn't have to take him to school, which meant I had 10 more hours before I had to face pain-in-the-butt daycare director (who I actually told off pretty good yesterday.) I got to work on time, no crazy chaos, life is good. Then I got pulled in for my surprise final performance evaluation, six weeks early. That was on my list of "work-life balance challenges" because my probation period was going to be up while I was on leave and I wasn't sure how that would work out. Now I don't have to worry about it because I've officially been recommended for "permanant civil service." Yay!

Usually on Thursdays I run one large therapy group on the unit. This group has evolved nicely and is becoming a really good, functioning group. It's got good reviews from both staff and inmates and is fun to run. Today's group started with a lot of "you've gotten bigger!"s and "that's going to be a healthy baby!" The women are all super-interested in the baby and it's become friendlier and less awkward to share small details like "yes, bigger by the minute" and "no, definately not twins." It didn't hurt that shortly after group started one woman raised her hand to say "Dr. Chiconky, you're so pretty." Hey, I'll take it where I can get it.

So group's going. And the women are working hard to grasp a difficult concept. I'm starting to see the lightbulbs and we've got a good energy going. Then I hear it. A gasp from the second row. Then I see it. Feet, in state issued white tennis shoes, shaking underneath the first row. And in that moment I realize that one of the women in my group is having a seizure.

As an aside, I've learned over the past year and a half that pseudo-seizures (seizures without a neurological explanation) are common in this population. I've seen my share of them, and they all look different but have the same time-slowing, tightly controlled calm effect on a unit. It's really very interesting and a fascinating thing to watch.

So I pressed my alarm, the officers stepped in, and we waited. After a few minutes she stopped shaking and we were told to carry on. So I'm back to running my group, trying to recreate the energy while six officers and two nurses attend to the seizing inmate. And then I hear it. Another gasp. More white shoes shaking under the couch. This time in the third row. Another alarm. More inmates being moved. More officers.

So now there's two seizures happening. A third inmate says that she can't be near it or she'll have a seizure is gearing up in the back. And again with the tightly controlled calm. And then I hear it AGAIN. A third gasp. A third pair of shoes. This time in the fourth row. The woman with the prophetic powers is in the fetal position next to her door and I'm waiting for her to go (I'm still surprised she didn't). At this point one officer starts placing cones to identify where the seizing inmates are. The rest of the inmates (probably 20) are still sitting calmly, just as they're taught to do when there's an alarm. There's now well over 10 officers, 4 nurses, and 3 inmates spread through my group in various states of medical emergency.

All of this happened within 15 minutes. By the time the third was done, we decided to recall the unit (send everyone to their rooms) and consider the group a wash. And then I got to revel in my first experience with contagious seizures, something that I've never ever seen before. Even better, the jokes just keep coming.

I'm thinking that my business cards should say "Groups so good it'll knock 'em out of their seats."