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Duly noted, good sir, but in my particular case I didn't have to even sleep with them for one to take a very good shot at ruining my life. That one was the ex of my own best friend at the time (and I ended up catching his schizophrenia in med school myself).
23 yo M med student, final year. No comorbidities is a mild exaggeration, since he had borderline hypertension. His dad was a captain in the Merchant Marine, out at sea when this all went down, but just a week prior, had gotten his son a full checkup, including a then highly unnecessary NCCT brain. All squeaky clean.
Kid was slightly obese, we had some issues getting a line in the EJ.
Anyway, he was in between his written exams and OSCEs, when he was at home with his mom and developed a splitting headache. Got taken to a GP, who told him not to think so much about exams or women, and to sleep it off with a paracetamol.
Face started drooping shortly after, was brought to the ER convulsing, immediately sedated and intubated, rolled into the ICU, then SICU, bleed considered too small for neurosurgery at the time.
I counseled his family, or rather his mom, his friends, most of them from non-medical backgrounds barring the girl, who wouldn't know what a pontine hemorrhage was if it
hit her in the headThe senior consultant, the rest of the hangers on, none of them could convince his mom who was having a fully justified meltdown to go home. She wanted to spend the entire night shivering on a bench (no separate accomodations for the family of an ICU patient). I spent about two hours coaxing, cajoling, arguing, bribing and finally convincing the poor lady to go home after everyone else failed.
The dude was actually improving for the first week, with spontaneous eye opening, some degree of following of commands. Then he had said rebleed, shunt placement didn't help, his GCS dropped to 2T, I got chewed out by a neurosurgeon for asking if he was brain dead, and said brain death was informally relayed two days later, and formally declared a week later when his dad was airlifted off Taiwan and brought to say goodbye.
Funnily enough, no AVM found on multiple kinds of imaging, including an MR angiogram. No kidney disease either. As far as anyone could tell, it was just bad luck. And as far as I can tell, the stereotypes about neurosurgeon ego are entirely justified and universal.
Autism really is my best guess. Zero interpersonal skills, extremely blunt, genuinely curious about how men think about women and what they consider as red flags or worthy of avoidance, with absolutely no insight into her own behavior. The last bit isn't genuinely bad, just an example of how she really seemed clueless. Sure, she could definitely have asked someone far worse at answering that question, but if you need to ask. Shame Aspergers has been deprecated, it was a useful one. Plus she had the same, nigh inevitable, descent into undifferentiated insanity I've seen in every gyno resident, barring the men, who seem to be rather sane. Is she actually mentally ill? I have no idea, but she was off.
Absolutely genius. She's fucked up her sleep cycle enough as is, I can pass it off as a dangerous, controlled sleeping med.
Fuck.
Also OB/GYN is traumagenic. Complicates the psychiatric formulation.
On a more serious note it's worth thinking about the way autism has become a catch all for poor socialization, that isn't to say that these people don't have some form of autism spectrum, just that it's worth being a bit more cautious with it since it's becoming an over diagnosed thing (at least in the U.S., thanks TikTok!).
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