Earlier this week, I gave my usual lecture to the medical students about delirium and major neurocognitive disorder (the new name per DSM-5 for dementia). It’s similar to the one at this link.
Only 4 students showed up.
Oh well. I’ve taken to emphasizing my own experience with delirium many years ago, in the context of my colonoscopy (happy 50th birthday!). I don’t remember much about it, which conforms to the usual fragmented recall of the experience by most patients.
That could have been due to the Demerol and Versed.
Usually the patient is awake for the entire procedure. My wife was for hers. I gather from collateral sources that I was pretty funny–a departure from the usual experience for most patients and their families. Delirium is usually a harrowing experience, as a nurse describes in the video below from the Confusion in Hospitalized Older Persons (CHOPs) website:
The physician who performed my colonoscopy didn’t explain why I got delirious or why the particular medication combination of Demerol and Versed was selected for sedation. All I know is that the last thing I remember before sort of waking up in the recovery bay was lying on my side on the gurney waiting for the procedure to begin after receiving my medication.
I think the students paid attention to my little first-person account of a doctor with delirium. Their eyes got a little wider and, because only 4 students were there, I could easily tell that none of them fell asleep.
I also told them about a recently published open-access paper about a new bedside test for delirium that anyone, even a doctor, could perform quickly and easily.
It turns out that it could be as easy as asking patients, especially the elderly (like I’m getting to be), to repeat the months of the year backward (MOTYB).
I also pointed out that the article was specially labeled as “Patient Choice.” This emphasizes a very desirable feature of some open access medical literature–patients can highlight articles to the physicians who read them that this is something they need to know in order to treat them right.
Thank you; thank you very much.