I had a strange one a few shifts ago. I was called to a house along with the HART (Hazardous Area Response Team) team to a young man who believed he had been the victim of a chemical incident. He had received a package that was ordered from a mail order company by post which contained a small computer part. When he opened the package he apparently suddenly suffered a myriad of seemingly unconnected symptoms simultaneously. The man immediately called the emergency services. As he was suggesting that the contents of the package were to blame the HART team were dispatched to investigate.
Once on scene, HART used their specialist training and equipment to assess the situation. Deeming that the scene, the package and its contents were completely safe and uncontaminated, I was allowed to go and see the patient. He was intelligent and calm and told me in detail about a range of symptoms which had started at the precise moment of opening the package.
The subjective symptoms he reported included watering eyes, headache, sickness, neck pain, pains shooting up and down his back and legs, and weakness and itching – amongst others. These had all but resolved by the time I was assessing him. There were no objective signs of any abnormality and all his observations were completely normal.
What was strange about it was this – here was a bright and seemingly sensible young man with no mental health history. He had a mortgage and a good career, and yet he held the firm belief that this extensive and strange concoction of ailments could have been brought about by contact with a new small part for his computer; even when he was told that this was not possible. Further to this, he had a huge number of emergency services blocking the road outside his house and even when he was told that the package wasn’t contaminated and couldn’t have caused even one of his symptoms he wasn’t even a bit embarrassed at the level of over-response his call had generated from the emergency services. Most genuine people apologise profusely if they feel they have wasted our time and this all seemed a bit odd to me; it just didn’t add up. I wasn’t sure if this was a first presentation of a paranoid episode in a mental illness because there certainly seemed to be no discernible physical signs.
I’ll never know what lay behind all this. I referred the man on to his General Practitioner for follow-up and unfortunately we rarely get feedback. It reminded me of the Kurt Cobain quote: “Just because you are paranoid doesn’t mean they aren’t out to get you” although I’m not sure which would be the most tricky outcome for him; that there was a “they” who were out to get him or that he was actually having a mental health crisis.