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    The Gym Unit

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    steave iglesias
    The author, a psychiatric resident, describes evaluating patients in a gymnasium that has been converted into a forensic psychiatric quarantine unit due to COVID-19. The large, open space has padded walls and makeshift patient rooms separated by curtains. One patient, wearing an orange jumpsuit, is suspicious and fearful due to his inability to see the author's smile through her mask. He expresses concern that he has been brought to a hospital by mistake. The author realizes the mask creates a communication barrier and that the unusual setting could be confusing. She takes care to use gestures and eye contact to evaluate the patient's psychosis and offer treatment, explaining her goal is to help him live safely in the community.

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    The Gym Unit

    Uploaded by

    steave iglesias
    11 views1 page
    The author, a psychiatric resident, describes evaluating patients in a gymnasium that has been converted into a forensic psychiatric quarantine unit due to COVID-19. The large, open space has padded walls and makeshift patient rooms separated by curtains. One patient, wearing an orange jumpsuit, is suspicious and fearful due to his inability to see the author's smile through her mask. He expresses concern that he has been brought to a hospital by mistake. The author realizes the mask creates a communication barrier and that the unusual setting could be confusing. She takes care to use gestures and eye contact to evaluate the patient's psychosis and offer treatment, explaining her goal is to help him live safely in the community.

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    The author, a psychiatric resident, describes evaluating patients in a gymnasium that has been converted into a forensic psychiatric quarantine unit due to COVID-19. The large, open space has padded walls and makeshift patient rooms separated by curtains. One patient, wearing an orange jumpsuit, is suspicious and fearful due to his inability to see the author's smile through her mask. He expresses concern that he has been brought to a hospital by mistake. The author realizes the mask creates a communication barrier and that the unusual setting could be confusing. She takes care to use gestures and eye contact to evaluate the patient's psychosis and offer treatment, explaining her goal is to help him live safely in the community.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Download as pdf or txt
    11 views1 page

    The Gym Unit

    Uploaded by

    steave iglesias
    The author, a psychiatric resident, describes evaluating patients in a gymnasium that has been converted into a forensic psychiatric quarantine unit due to COVID-19. The large, open space has padded walls and makeshift patient rooms separated by curtains. One patient, wearing an orange jumpsuit, is suspicious and fearful due to his inability to see the author's smile through her mask. He expresses concern that he has been brought to a hospital by mistake. The author realizes the mask creates a communication barrier and that the unusual setting could be confusing. She takes care to use gestures and eye contact to evaluate the patient's psychosis and offer treatment, explaining her goal is to help him live safely in the community.

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    © All Rights Reserved
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    of 1

    COMMENTARY

    The Gym Unit


    Apurva Bhatt, M.D.

    I swiped my badge before entering the done its best to make our gym look and
    hospital’s gymnasium, which had been
    The surgical mask feel like a psychiatric unit, but some el-
    transformed into an inpatient forensic creates a barrier ements could not be disguised. I smiled
    psychiatric quarantine unit. The high and explained that this was indeed a
    ceiling and glossy wooden floor did not for nonverbal hospital and showed him the hospital
    disguise the thick black lines of the bas- logo on my badge. He nodded, but his
    ketball court. Blue padded mats lined communication that eyes narrowed as though he did not fully
    the walls. The basketball hoops had been believe me.
    raised, and their nets hung lifelessly. The
    previously didn’t exist. COVID-19 has changed how I connect
    gym was large and airy, and everything with my patients. The surgical mask cre-
    echoed. On my right stood a folding table and looked over his shoulder, presum- ates a barrier for nonverbal communi-
    with paper charts, a box of gloves, and ably responding to internal stimuli. cation that previously didn’t exist. I tell
    hand sanitizer. On my left were make- As I entered the flow of my interview, all my patients, “I’m here to help you in
    shift patient rooms. Wooden beds sat 6 I quickly realized how much my style any way I can. My goal is for you to live
    feet apart, each separated by metal poles relied on my facial expressions: the way a happy and healthy life in the commu-
    that held up white cloth dividers. Plastic my lips creased open when I smiled or nity.” This statement communicates my
    bins intended for belongings rested near the way my brow furrowed with con- intention, and it is usually well received.
    each bed. In the middle was a television cern. I began to pay close attention to my With its high ceiling and open space, our
    set with chairs set up around it: a make- gestures and level of eye contact, hoping gym unit allows for the furniture to be
    shift milieu. that it would help. rearranged to adapt to specific patient
    I skimmed over my patient’s foren- He pointed to his head and said, needs. It has also provided a space for
    sic pretrial report, with its familiar “Something is wrong up here.” He pro- me to be more mindful of the subtleties
    order (incompetent to proceed). I then ceeded to give a history consistent with of psychiatric interviewing. Working on
    looked up at him across the gym. He was a first episode of psychosis, which wors- this unit has helped me develop flexibil-
    wearing a soiled orange jumpsuit. His ened while he was in jail. I explained to ity and appreciate subtle communication
    hair was disheveled, and he was mum- him the usual steps of care and offered styles, which I believe will help me be-
    bling and laughing to himself. I smiled treatment options. He looked at me cu- come a better psychiatrist. I believe that
    as I approached him, but he appeared riously; then, his eyes darting around if the gym unit can adapt, so can I.
    fearful of me. This was surprising, as I the room, he whispered, “Is this really a
    am a small-statured Indian woman. I hospital? I just want to go home. I think
    At the time this commentary was accepted
    quickly realized that he could not see my there’s been a misunderstanding.” for publication, Dr. Bhatt was a resident in
    smile through my surgical mask. I gen- Then it hit me. Imagine being in jail, adult psychiatry at the University of Mis-
    tly pulled a chair next to his bed, 6 feet experiencing odd perceptual distur- souri, Kansas City; she is currently a first-
    away. He was guarded and suspicious bances, sitting in solitary confinement, year child and adolescent psychiatry fellow
    of me and had rambling, disorganized and suddenly being brought to this at the University of California, Davis, Medi-
    speech. At times, he mumbled to himself strange gymnasium. Our hospital had cal Center, Sacramento, Calif.

    The American Journal of Psychiatry Residents’ Journal  |  September 2021 6

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