I sent an email to TOH's Patient Advocacy service. This is an excerpt.
This is an old story just before The Ottawa Hospital came into existence. It’s a story that takes place at the Civic and the General.
The hospital is a dangerous place behind its facade. Iatrogenic harm seeps out of its foundation and into its walls. It’s everywhere waiting to strike an unsuspecting patient via the staff who unknowingly transmit the pathogen. A patient gets infected in many ways such as procedures, IVs, medication errors, and misdiagnosis. Some die, others are temporarily affected and a large portion suffer for years at the hands of their treatment team, the ones who are supposed to heal them.
Imagine being an 18 year old female with undiagnosed autism spectrum disorder and a moderate to severe anxiety disorder that is not recognized by anyone, who has passed through the threshold of the General’s emergency department entrance. It’s her entry into hell. All the on-call psychiatrists see is the adverse reaction to a SSRI that she started 10 days previously. It suddenly caused suicidal ideation and impulsivity. The rigid and obsessive thinking and a delay in social development along with the SSRI reaction make it appear that the patient has a personality disorder, specifically Borderline – a diagnosis that is known to ostracize people and deny them treatment. After one clinician labels the patient it sticks. After that most cannot see past it and the patient is condemned.
A few months later polypharmacy is ravaging her body. She can hardly eat, is drowsy due to all the pills, is profoundly disinhibited, is hallucinating like she’s stuck in perpetual stage one sleep, is confused and disoriented, and has trouble forming memories. She is missing time and is a poor historian. Apparently she fabricated the whole entire incident. Dr. (name withheld) wrote in his discharge summary: In Emergency, it seemed that her behavior was kind of weird and there was possibly some mild disorientation at times that readily disappeared when she was proposed hospitalization and the patient and the doctor finally agreed on 1-3 day admission. – A resident noted it was either the 5mg of Haldol that they gave her or the offer of hospitalization that stopped the bizarre behaviour.
A week later she ended up at the Civic Hospital and has no recollection of it. There like at the General, her bizarre behaviour was noticed. Possible anticholinergic syndrome? Her symptoms seem to resemble it. Dilated pupils, confusion, low glucose, tremor, visual hallucinations, elevated anion gap, dehydration and a bunch of abnormal ECGs were not enough to make the psychiatry resident question his diagnosis and harsh judgement of her. Dr. (name withheld) wrote: pt states having auditory command suicidal ideation, but we are very uncertain about the authenticity of those voices. His notes are filled with opinion rather than observation. Even Dr. (name withheld) thought she was malingering.
She has no recollection of any of this. How could she have been faking? Friend and neighbours noticed her bizarre behaviour and at times incoherent speech. Even a security guard at a government office on Booth Street and Carling Avenue did when she tried to enter the building in her dishevelled and confused state.
No, she wasn't faking it. She was delirious and no one saw it except for the emergency physicians who failed to question the psychiatrists. They went along with the BPD diagnosis and interpreted the behavior as manipulative to gain hospitalization.