[Doctor:] I want to know whether you have been taking any drugs.
[Addict:] I don't, I don't, I don't take drugs.
No.
I don't take drugs.
No.
No.
[Person on gurney is wheeled into emergency room]
[Nurse:] Do you remember what time you took the pills?
[Nurse 2:] How are you feeling?
[Nurse 3:] What did you take?
[Nurse 2:] How many bags are you on?
How many bags of heroin are you on?
[Patient:] Umm.
[Physician:] Just what did you take today, then?
What did you take today?
[Music]
[Addict:] You don't, you don't, you don't, you never took, did you,
did you ever take acid?
[Physician:] No.
[Addict:] All right so then how are you gonna, what do you know about it?
[Physician:] Well, you can tell me.
[Addict:] I can't tell you, you don't, you can't, you can't explain what's going on
in your brain.
You can't tell somebody how, what's happening, what's going on in your mind.
[Physician:] Why don't you just try?
[Music]
[Narrator:] Every physician recognizes the feeling of satisfaction that comes
with the successful handling of a life-threatening emergency.
Among the most difficult and yet most frequently encountered today is the drug abuse emergency.
Often the situation is complicated by histories that are notoriously unreliable
and by conflicting signs and symptoms brought on by unknown combinations of drugs.
Proper diagnostic techniques, coupled with appropriate emergency measures
invariably produce rewarding results.
[Nurse:] Right here!
[Doctor:] Well you put it on, it's on my space. Okay okay.
[Narrator:] One of the drug emergencies seen with increasing frequency is the heroin overdose.
Heroin overdose and barbiturate intoxication sometimes present a similar clinical picture.
There are, however, several distinguishing signs.
With heroin the pupils are pinpoint,
whereas only minor constriction or none at all occurs in barbiturate intoxication.
And in the habitual heroin user, a permanent set of tracks is usually visible.
Nalline is a specific antagonist for heroin.
[Muffled speech.]
[Doctor:] We need to get a reading.
[The patient is injected with Nalline and begins to scream.]
[Narrator:] While response to Nalline is usually both rapid and dramatic,
patients do not always react aggressively.
Precise diagnosis is essential.
Should the heroin overdose be complicated by barbiturate intake, Nalline may add to
the patient's already depressed respiration.
Narcan, another heroin antagonist, does not depress respiration even when barbiturates
have been taken at the same time.
[Nurse:] It won't stick.
[Doctor:] Huh?
[Nurse:] Hey!
[Sounds of struggle]
[Nurse 2:] Do we have a name on her?
[Everyone in unison:] Jane Jones!
[Patient screams and nurses talk rapidly]
[Nurse:] There we go.
[Sounds of activity in the ER, patient groaning and protesting.]
[Doctor:] Who is Tony?
Get me Tony. Get me Tony.
Como tu te llama.
[Mary begins screaming again and tries to force herself up.]
[The doctor and nurses speak to one another while restraining the screaming patient.]
[Narrator:] Despite the dramatic recovery, the patient is not discharged immediately.
Vital signs must be checked every half hour for at least two to three hours.
If the patient relapses, Nalline or Narcan is administered again and the vital signs
checked over the next three to six hours.
Quick action is important in both diagnosis and treatment, since respiratory failure
is an ever-present danger in all central nervous system depressant abuse.
Immediate resuscitative measures should be available,
ranging from simple mouth-to-mouth resuscitation where the situation precludes
any other possibility,
to the more sophisticated means of support such as endotracheal intubation and tracheostomy.
Changing the unresponsive patient's position periodically prevents the development
of hypostatic pneumonia.
[Barbiturates, Idiot Pills, GBS, Bluebirds, Nemmies, Downs, Goofballs, Tooies]
[Music]
Some characteristics of barbiturate intoxication are confusion, staggering gait, drowsiness,
drunken behavior, slurred speech, fogged memory, and irritability.
Depressant effects are heightened significantly when the drug is taken in combination
with alcohol.
Multiple drug abuse presents a more complicated picture.
A marked set of needle tracks in the barbiturate abuser may indicate heroin addiction as well.
[Doctor:] Listen!
You hear me? Huh?
Did you take any heroin today?
[Woman:] No.
[Doctor:] You sure about it?
[Nurse:] What else did you take today?
Mary Lou, what did you take today?
[Mary Lou:] Three spoons.
[Nurse:] Three Tuinals, you just took 'em?
[Mary Lou:] Yeah.
[Nurse:] What else?
That's all?
What did you take this morning?
[Mary Lou mumbles while the doctor examines her arm for heroin tracks.]
[Doors open and close, ER staff move around, and the patient mumbles]
Mary Lou, what else did you take besides the three Tuinals?
Mary Lou.
What time did you take the Tuinals?
[Mary Lou:] An hour ago.
[Nurse:] An hour ago?
What else did you take with them?
[Mary Lou:] Ummhmm
[Nurse:] That's all?
[Mary Lou:] Honest.
[Nurse:] Honestly, okay.
[Narrator:] The patient's veins are often collapsed because of repeated heroin injections,
necessitating a cutdown for the administration of fluids and medications or for blood samples.
When there is some doubt as to how the drugs were taken, a gastric lavage is done.
[Doctor:] Okay, listen.
You feel it back there?
Swallow.
[Nurse:] Swallow, Mary Lou.
Swallow.
[Doctor:] Hold your breath.
[Nurse:] Mary Lou, listen, hold your breath.
[Doctor:] Hold it. [Nurse:] Hold it.
[Doctor:] Hold it.
[Mary Lou coughs.]
[Doctor:] Open your mouth.
Ahhh.
Open your mouth.
[The physicians try to push the tube down into patient's stomach.]
[Nurse:] Now keep your hands down there.
[Fluid is pumped into the tubes in her nostril.]
[Doctor:] The needle is over here girls.
Keep... no open that syringe.
[Doctors locate a vein in Mary Lou's arm for injection.]
[Medical staff talking to one another.]
[Narrator:] Sodium amytal is used to control and prevent convulsions in the
chronic barbiturate abuser.
Other anticonvulsants such as Dilantin are ineffective for this purpose.
[Sounds of medical activity.]
[A needle is inserted into Mary Lou's groin and blood is drawn.
[Continued conversation among medical staff.]
Regardless of how near death they may appear, an overwhelming percentage of drug abuse
patients respond to effective emergency treatment.
When the emergency is over, a withdrawal schedule with elixir of Nembutal or Seconal
is set up for the chronic barbiturate abuser.
[Another patient is brought in on a stretcher.]
[Nurse:] Do you remember what time you took the pills?
[Nurse:] How many did you take?
[Patient:] Whatever was in the bottle, I think it was about 24.
[Narrator:] In other cases of barbiturate intoxication, for example the kind seen
after a single overdose, somewhat different problems arise.
[Nurse:] 188 over 120.
What's your name?
[Patient:] Janice.
[Doctor:] B-u-n lights.
Barbs.
CBC.
[Nurse:] Janice, I'm going to have to put this tube down.
And I need you to help me.
It doesn't hurt but it's uncomfortable.
All right take it easy.
When I tell you to, I want you to swallow, okay?
Take it easy.
Take a couple deep breaths.
That a girl.
Now get ready to swallow.
Swallow.
Swallow.
Swallow, hon.
All right, all right, all right, all right.
Sit up.
Take a couple deep breaths.
Can I have a little bit of water for her?
All right, give her a...
take it easy, take it easy you're okay.
All right don't swallow.
Now swallow.
[Nurse:] Okay, okay that's good.
Okay that's it.
[Patient makes gagging noises.]
[Doctor:] Okay...here now.
You want to take that tube...
Did you eat anything purple?
[Janice retches.]
[Nurse:] You're not vomiting anymore, just take it easy.
[Doctor:] It's coming out through the tube.
It's purple on your lips.
[Nurse 2:] Yeah I noticed that too.
I asked her, she said she didn't have anything else but the food.
[Doctor:] How long does it take to get [?]
[Nurse:] Self-inflicted...
I'm going to take it out, I think we're through with that now.
[Narrator:] The possibility of suicide is a principle concern even when the patient
denies any thought or intention of self-destruction.
[Psychiatrist:] You want to tell me again what happened to your hands?
[Janice:] There was... a fire in the restaurant.
[Psychiatrist:] When was this?
[Janice:] Night before last.
[Psychiatrist:] Night before last.
And what happened?
[Janice:] I went to get the back window open to let the smoke out.
[Psychiatrist:] Was there anybody with you?
[Janice:] [?] came.
[Psychiatrist:] You didn't see a doctor about your wrists?
[Janice:] No I, it just happened the night before last.
[Psychiatrist:] Was it a bad fire?
[Janice:] No, we put it out right away.
[Psychiatrist:] Put it out right away.
[Janice:] Yes.
[Psychiatrist:] And did you, you broke the glass in the window?
[Janice:] Yes, in the back.
[Psychiatrist:] Well, how did you get your wrists then?
[Janice:] I just did it myself.
[Janice:] So I just got disgusted.
Did you ever do this before?
[Janice:] Never.
[Psychiatrist:] Were your wrists bandaged up?
[Janice:] We had a fire in the restaurant the other night.
[Psychiatrist:] What were you thinking about when you took the pills?
[Janice:] Just disgusted, you know, just uh very depressed.
[Psychiatrist:] Was anybody in the house when you took them?
[Janice:] I took them at the restaurant.
The restaurant is, it's closed.
[Psychiatrist:] Was there anybody around?
Or did you take them by yourself?
[Janice:] I took them by myself.
This just, the past two weeks because of all the problems and the drinking.
My husband went over to the, to take a steam bath.
[Narrator:] In many cases, no signs of suicidal intent are apparent.
Nevertheless, the depressant drug abuser should always be submitted for a psychiatric evaluation.
[Janice:] I felt like I was fading away.
[Psychiatrist:] Fading away?
Did you lose consciousness at any time?
[Janice:] No I almost, but I didn't.
[Psychiatrist:] How did you get in touch with somebody?
How did they find out you took the pills.
[Janice:] I called my parents because my husband wouldn't send for an ambulance.
I got panicky at the last minute and I asked him to call the ambulance and he wouldn't,
he just sat there and laughed.
[Psychiatrist:] Your husband?
[Janice:] Yes.
[Psychiatrist:] Did he believe you had taken the pills?
[Narrator:] If inadequately treated, barbiturate abuse might result in psychosis,
depression of the respiratory center, convulsions, and in some instances, death.
[Amphetamines, Bennies, Jolly Beans, Ups, Dexies, Pep Pills, Speed]
[Doctor:] Sit down.
Now you sit down Peter.
Here.
[Narrator:] The amphetamine abuser generally presents a picture of verbosity, hyper-motility,
euphoria, aggressiveness, and paranoid ideation.
[Doctor:] Are you feeling just the way you usually do?
[Peter:] Yeah, yeah.
I feel great, I feel like you know, on the moon here.
Welcome Fred and Lemuel Munchkin, hey over the moon.
[Doctor:] Yeah, well you seem to be quite excited. [Peter:] No.
[Doctor:] Are you usually very excited?
[Peter:] Well I feel good that's all.
I feel good.
[Doctor:] Has anything been happening to you recently.
[Peter:] No.
Nothing.
No.
Where did you get all these, did you buy these?
Or did they give them to you here.
[Doctor:] Do you...[Peter:] Did they give this to you?
[Doctor:] No I, I bought them.
Just sit down Peter.
[Peter:] This collection is fantastic.
[Doctor:] Tell me, do you have a headache?
[Peter:] No, I...where'd you get that?
That looks like a Chagall, that one.
That's a Chagall.
[Doctor:] Well it is...
Now sit down.
[Peter:] I have no heart disease.
[Doctor:] I'm happy to hear that.
Tell me why you are here.
[Peter:] I don't know.
I don't know, my grandmother brought me here for no reason.
[Doctor:] Do you feel any palpitations in the chest?
[Peter:] No.
No, I feel good.
[Doctor:] And you're not dizzy?
[Peter:] No.
Uhhumm.
[Doctor:] Are you uh, do you feel nervous?
[Peter:] No.
No.
[Doctor:] Do you always jump around this way?
[Peter:] I'm not jumping around.
[Doctor:] Yes you are jumping around.
Now all I'm going to do is to ask you a few questions and uh, I'd like to examine you briefly.
Now, you feel exactly the way you always do?
[Peter:] Yeah, yeah you want some gum?
[Doctor:] Now grandma, what made you bring him in.
[Grandmother:] He just came to the house, he rang the bell...
[Doctor:] Peter, Peter I want you to sit down here.
[Peter:] What is this?
[Doctor:] I want to examine you that's what we do.
[Peter:] I, no wait a minute, wait no.
What is this?
What's with the doors?
I want to go.
[Nurse:] I'll leave it open.
[Peter:] I would prefer it open.
[Grandmother:] We're going to go home together.
[Doctor:] Things are quite all right.
[Grandmother:] Not right now, not right now.
We'll go home together.
Believe me.
[Doctor:] I want you to sit down there and I'll make...
I'll ask you a couple of questions.
I want to take your blood pressure and make you feel better.
All right, now just take your jacket off.
And I'm going to take your blood pressure.
[Peter:] Umm, can I have, do you have water?
[Nurse:] I'll get you some.
[Grandmother:] I'll have your coat.
[Peter:] Thank you.
[Doctor:] Would you sit down, roll your sleeve up,
I'd like to take your blood pressure.
Have you been taking any uh drugs or any medicine?
[Peter:] What?
I don't do that kind of stuff.
[Doctor:] Have you ever taken speed?
[Peter:] No.
[Doctor:] How about dexies?
[Peter:] No.
[Doctor:] Ups? [Peter:] No.
[Doctor:] You haven't done that?.
All right.
[Peter:] Listerine is as far as I go
Did you ever smoke pot?
[Peter:] Uh no.
[Doctor:] Very good.
[Peter:] Come on.
[Narrator:] Elevated blood pressure, tachycardia, increased respiratory rate, and fever
are frequently found in amphetamine abuse emergencies.
[Peter:] Come on, come on, come on.
[Narrator:] Some users however, develop a tolerance to the drug, and these symptoms
may not be present.
[Peter:] Will you please...
[Doctor:] Now just wait a minute.
All right, that's all.
[Peter:] Good, well.
[Doctor:] Now I need to look at your eye.
[Grandma:] When he says you're all right...[Doctor:] There sit down.
Let me look at your eyes, Peter and then we'll...
[Peter:] Look see here, see?
You happy?
[Doctor:] Now just hold your, hold your head still and look right at my nose.
Look at my nose now.
[Peter:] Okay.
You see? [Doctor:] Okay.
[Peter:] You giving me road chipper?
[Doctor:] I want to give him an injection of Valium.
Ten milligrams.
[Peter:] Nah this is..
[Doctor:] Intermuscular injection, did you bring it in?
[Grandma:] You've got to stay. [Doctor:] All right now look.
You're going to feel a lot better.
We're trying to help you.
[Peter:] I feel good!
What do you want!
[Doctor:] But you're not, you're not good.
And you need...
[Peter:] You're not stabbing me okay? I feel good.
[Doctor:] Just sit down.
Well maybe, maybe you think you feel good but you are not good.
[Grandma:] ...we're going to go home too.
[Peter:] Well let's go then.
There's nothing keeping us here.
[Doctor:] As soon as, you'll go home in a few minutes, after you get the injection.
Now sit down.
[Peter:] Umm.
Can I take a look at...
[Grandma:] Peter.
[Narrator:] In most cases medication is unnecessary.
Where indicated however, the drug of choice is Valium.
[Doctor:] Hold still.
Now I want you to stay still.
[Grandma:] I'm right here.
[Nurse:] She's right here.
[Grandma:] I'm right here, it won't.
It won't hurt.
[Doctor:] Now if you rest for a minute, you're going to feel a great deal better.
[Peter:] Is there a bathroom around here, I really got to go.
[Doctor:] We're going to let you go to the bathroom in a few minutes.
[Peter:] Well, I wanna go right...can we just...
[Doctor:] Now just sit down and tell me.
[Peter:] Can't be, I'm pouring my heart out I don't give a...come on!
[Grandma:] Come on.
[Doctor:] Are you sure you haven't been taking any tablets of any kind?
[Peter:] No, I don't take tablets.
Aspirin, Excedrin, that's it.
[Doctor:] Did you ever hear of speed?
[Peter:] No.
No.
I don't know what speed is.
[Doctor:] Have you ever hear of pot?[Peter:] No.
[Doctor:] You're not telling me the truth Peter.
[Peter:] I'm telling you the truth.
[Doctor:] I don't want you to lie to me, you're not supposed to lie.
[Peter:] I know what it is.
I don't use it.
I don't use it.
Okay.
[Doctor:] Then you do know what speed is.
Did you use it at all, did you take, did you ever take it?
[Peter:] I don't take stuff, what did I tell ya?
[Doctor:] Have you taken it...
[Peter:] Grandma, I don't take stuff.
[Doctor:] Sit down Peter.
Have you taken a single dose for the first time, recently?
[Peter:] Um.
[Doctor:] At a party.
Were you at a party?
[Grandma:] Peter tell him.
[Peter:] All right, all right, I was at a party, so?
I was at a party.
[Doctor:] Did you uh, smoke anything?
[Peter:] No.
[Doctor:] Did you take any tablet.
[Peter:] No, no.
[Doctor:] Any liquids. [Peter:] Uh no.
[Doctor:] I think you're lying to me.
Did you take anything at all.
[Peter:] Well uh there was this, they had this water.
Then there was, some kids were shooting up, but uh...
[Doctor:] How about you?
[Peter shakes his head no.]
Are you feeling a little better now?
[Peter:] Uh yeah.
[Grandma:] No.
[Peter:] Okay.
[Doctor:] All right, we'd like to umm have you sit here for a little bit and uh, if you have
any unusual sensations, if you feel your heart jumping around.
[Peter:] What around...
[Doctor:] Do you have a headache at all?
[Peter:] No, no I..
[Doctor:] Do you feel better now than you did when you came in?
[Peter:] I'm a little more at ease with you, yes.
[Doctor:] Were you very afraid of something a little while ago when you came in?
[Peter:] No I just wanted to know what going on, that's all.
[Doctor:] Well you've been to the doctor before.
[Narrator:] Recovery after an amphetamine binge can be misleading.
The patient's apparent improvement may be in fact a mask for underlying depression
and suicidal ideation.
Therefore psychiatric consultation is indicated.
[Doctor:] Now what you need to do now is to go home and rest.
And then I'd like to see you in the morning.
And examine you again and see if there are any after-effects of this medicine.
Come in with Grandma and uh it won't take much time and I think uh,
it will be good for you.
[Peter:] Wonderful.
[Hallucinogens, Buttons, LSD, Acid, Peyote, Mescaline, Purple Flats, Cube]
[Psychedelic music]
[Two patients stumble into the emergency room.
[Young man mumbling]
[Donald:] We came to get some...downers or something, umm.
[Nurse:] What's your name?
You don't know your name?
Could you get up here so the doctor could see?
Miss Cohen?
[Narrator:] The most dangerous hallucinogen is LSD.
Other substances whose abuse results in similar emergencies are mescaline, DMT, STP, and THC,
or more potent forms of cannabis.
[Doctor:] Doctor Kowalski.
What happened?
[Nurse:] We just want to get you up here so you can talk to the doctor.
[Doctor:] What happened?
[Carol:] He got sick and uh he's uh...
[Doctor:] When?
[Carol:] Tonight?
I guess, uh...
[Nurse:] I'm just, I'm just holding your hand.
[Doctor:] What did he take?
[Carol:] Uh, I don't know.
I don't know what he took, you know, but it just made him sick.
[Doctor:] Has he been taking anything?
Any kind of drug?
[Carol:] Taking uh, um, have you been taking any drugs?
[Doctor:] Have you?
Look it, what's your name?
Huh?
Do you know your name?
[Donald:] Yeah, of course I know my name.
[Doctor:] What is it?
[Donald:] It's Donald.
[Doctor:] Do you know where you are, Donald?
[Donald:] I'm in the hospital, we came to the hospital.
[Doctor:] Which one?
Which one, do you know?
You have to help us out and let us know what, what happened.
[Carol:] Which hospital, you need to know that?
[Doctor:] We want to know what he took.
What did you take, Donald?
[Donald:] Just the usual, you know, what everybody takes.
[Nurse:] Let me just have your arm straight up.
[Doctor:] You take LSD too?
[Donald:] Huh?
[Doctor:] LSD.
[Donald:] Sometimes.
[Doctor:] How about today?
[Donald:] It won't hurt me, will it?
[Nurse:] No it won't hurt.
[Doctor:] Just relax. [Nurse:] It's just pressure, Donald.
[Doctor:] Just, what did you take today Donald?
[Donald chuckles.]
[Donald:] Just, no, just get this fucking thing off me.
[Doctor:] Watch your language.
[Nurse:] You don't want me to take your blood pressure.
It won't, I just want to see what it is.
[Doctor:] What did you take today?
[Donald:] Today?
[Doctor:] Yeah.
What did you take before you came over here?
[Sounds of blood pressure cuff being pumped up.]
[Donald:] Umm...
[Doctor:] Why did you, why did you come?
[Donald:] Because...
[Doctor:] Why did you come to the emergency room?
[Donald:] I don't know. [Doctor:] Yeah why...
[Donald:] It was a mistake. [Doctor:] You know why?
[Carol:] Because he said he didn't feel good and he got really sick.
[Doctor:] Does he often feel like this?
[Carol:] Um, no.
He doesn't often feel like that.
[Doctor:] Well, why did you come into the emergency room this time?
[Donald:] I came, I came into the fucking emergency room because I took some acid
and I don't, and it's not working right.
[Doctor:] Okay fine.
[Donald:] And this isn't going, it's not going good, it's not going well.
[Doctor:] We want to help you out then.
[Narrator:] There are many similarities between the LSD bad trip
and the amphetamine abuse emergency,
but there is one major difference.
Speed overdose is usually characterized by paranoid behavior, while the LSD bad trip
produces visual hallucinations, which may be frightening to the patient.
[Doctor:] How do you feel now?
[Donald:] Just uh, the back of my neck.
[Doctor:] What's the matter with the back of your neck?
[Donald:] It's running down.
[Doctor:] What's running down there?
[Donald:] Hot fluid.
A lot of it.
[Doctor:] Is the best part over?
[Donald:] There was no best.
[Carol:] It wasn't a very good trip.
[Donald:] That's what I said.
That's why I'm here.
If it was nice I wouldn't, I don't know.
[Doctor:] This the only bad trip you've had?
[Carol:] Watch him.
He was getting crazy.
[Doctor:] Yeah, that's what I want to find out.
[Carol:] So watch him.
[Doctor:] Yeah.
What happened after you took it?
Donald, I'm not a policeman, I'm a physician and I have to find out what you took.
[Donald:] So you wanna know how I feel? [Doctor:] How do you feel?
[Donald:] What happened?
[Doctor:] Right.
You wanna lie back and feel more comfortable?
[Donald:] I'm just going to go for a walk. [Doctor:] Sure.
[Nurse:] Maybe at this point we could put him in a wheelchair.
[Donald:] But why?
[Nurse:] You have to speak to someone.
[Donald:] Oh.
[Nurse:] You have to talk to someone in a place that's a little nicer-looking
than this.
You know, without all this medical stuff.
[Carol:] It's okay, you know?
[Nurse:] You know?
[Carol:] It's all right.
[Nurse:] I'm gonna go get the wheelchair.
[Doctor:] How do you feel about that, Donald?
You feel okay?
It'll be more comfortable.
[Nurse:] Yeah, it's a nicer room.
And it's quieter and it doesn't have all this medical equipment around.
And you can just sit and talk to someone.
[Psychiatrist:] Donald.
Donald, I want to talk with you alone, okay?
[Donald:] Excuse me...all right.
You stay right here...
[Woman:] I'm going to stay.
[Psychiatrist:] You don't have to, I can't help him if you stay.
[Carol:] But you can't do it if I don't.
[Nurse:] You'll be together soon.
You'll be together soon.
[Psychiatrist:] All right.
[Nurse:] A few minutes.
[Psychiatrist:] There you go.
Come on.
Come on.
I want you to sit down over here.
[Donald coughs loudly.]
Okay.
That's good.
[Donald:] Um, was..
[Psychiatrist:] That's good.
Sit down there.
[Donald:] Where did uh, where's Carol?
[Psychiatrist:] She's with a very nice lady and everything's gonna be okay.
[Narrator:] As a rule, the treatment consists of talking the patient down.
In rare instances, a tranquilizer such as Valium may be useful.
[Donald:] I'm flying this kite.
I flew this kite.
I was walking on a hill, I was on this hill and uh, and I picked it up and ran down the hill.
And it got off so the next week I went and I bought a Japanese beetle type and put it together.
And uh...
[Narrator:] There are no hard and fast rules for talking a patient down.
But several points should be kept in mind.
It works best in a warm, friendly atmosphere.
Physical contact is important,
as well as the physician's manner of talking, listening, and relating to the patient.
[Psychiatrist:] What's, what's your overall feeling?
[Donald:] My overall sensation?
[Psychiatrist:] Yeah.
Feeling.
Inside.
[Donald:] And then, you know, I keep thinking about the same fucking thing
keeps driving into my brain and it keeps coming back, you know?
And the thing that keeps coming back is that I want to get out of here...
[Psychiatrist:] No.
Stay, stay and let's..
[Donald:] And get away from you.
[Psychiatrist:] Let's talk a little bit more though.
[Donald:] It's really hard.
It's really hard.
When it flashes, when blood is...
coming through.
My fucking blood!
It's going through oh...
[Psychiatrist:] Is it pleasant or unpleasant?
[Donald:] It's different, I'll say that.
I don't know.
Um, can't uh...
[Psychiatrist:] What else are you thinking about?
[Donald:] I can't get around it.
[Psychiatrist:] What does it feel like?
[Donald:] It feels good.
It feels better up here than it does down there.
[Psychiatrist:] Colors?
[Donald:] Ultraviolet.
[Psychiatrist:] Pleasant, unpleasant?
[Donald:] Nah it feels good.
[Psychiatrist:] Feels good, what does it feel like?
[Donald:] Fuck you man!
Just fuck you, that's all!
[Psychiatrist:] Maybe you'd be more comfortable if you sit down.
You're still a little wobbly.
You're up a little bit high.
[Donald makes noises in his throat.]
Donald, what do you feel like?
[Donald:] Uhhhhhhhhhhhaay.
[Psychiatrist:] Do you know what that means?
[Donald:] My mother.
[Psychiatrist:] You feel better when you say it?
Hmm, when you make noises like that do you...
[Donald mumbles.]
[Donald:] Because it's the only time that I can straighten anything out.
[Psychiatrist:] How would you straighten anything out...
[Donald:] All alone.
All alone by myself.
With nobody talking, nobody hassling.
Nobody...just being, just being that's all, just existing.
Just fucking being, that's all.
[Psychiatrist:] Alone?
[Donald:] Just fucking being, that's just feeling the energy that's in my body
because I know what I'm doing.
I take a fucking drug and it's just affecting me this way because I don't even,
I can just tell myself what's happening.
[Psychiatrist:] You see.
[Donald:] It doesn't really, it doesn't really mean, ahh.
[Psychiatrist:] Donald, it looks like you've leveled off considerably.
How do you feel now?
[Donald:] I feel drained.
Drained.
[Psychiatrist:] It was a pretty, pretty bad scene.
And why, why would you want to go through something like that?
Was that pleasant or...
This isn't the first time.
[Donald:] No, but it never happened like that before.
[Psychiatrist:] You've dropped acid before but you never had a bum trip.
[Donald:] No.
I never, never had anything like that ever happen to me.
Not quite like that.
[Psychiatrist:] Do you know what flashbacks are?
[Donald:] Yeah.
[Psychiatrist:] Does that ever worry you?
That you might have one?
[Donald:] I, I, you know it's, I've thought about it but...
[Psychiatrist:] It doesn't stop you from using.
[Donald:] Um, no, it hasn't so far.
[Psychiatrist:] The girl you came in with, you were tripping together?
[Donald:] Umhmm.
Yeah.
[Psychiatrist:] What do you think the future has for you?
What do you want to do for yourself?
[Music]
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