Doctor Paul Goodman POV
I opened the door and walked towards the chair, I was sure was about as old as I was. Monique and David were still sitting in the same spot looking as confused as I was. I sighed internally from the headache that would come from dealing with the state and with Max. He had gotten to know max, spent more time with the kid then other providers here. This wasn't his typical behavior.
The original diagnosis was officially post traumatic stress disorder(PTSD), with lingering TBI. However, the lab work came back completely normal. The boy`s body hadn't experienced any signs of injury, trauma or hell even damage. Which didn't correlate with what the onset EMT had reported into their notes. Now the EMT could have been mistaken, which wouldn't have been the first time it had happened. However, Paul thought it was different, so did some of his colleagues.
Paul thought the boy was strange, he would sometimes talk and act like an adult, and then other times switch to acting like a child his age. Paul, along with the other staff members tried to understand what Max`s possible diagnose could be. The boy didn't meet any of the criteria for PTSD, he showed no symptoms other than the panic attack when they first met. Since the first day he got here you wouldn't even know he why he was in the ward. And, the only real reason they even diagnosed him with PTSD was because they had to diagnose him with something to get him sent to inpatient.
He had no reason to be placed here inpatient. He had no suicidal or homicidal ideations, he didn't have a serious mental illness wasn't on any medication {he had refused all medication that was prescribed to him]. They only officially kept him for his onetime panic attack which staff associated with his PTSD diagnoses, and even that had been a stretch to through upper management.
The State had taken two days to decide on where to send max, and now that he is refusing I could feel myself starting to get a tension headache from stress. The upper management would be mad at me for wasting a room and money, the state would be upset about the child decision and would most likely send him to Playcare regardless of what Max wanted.
Maybe I could talk him down into going. He seemed excited to go, which lead to his possible actual diagnose was, I did an internal mental illness check list all list on what the boy had. Possible split personality, no he didn't meet the DSM checks for it.
Maybe, taking a moment to think to himself that I should send Max`s medical report to one of his friends out of state. I had already sent Max`s medical report to Playcare, and was half way to completing his discharge paperwork ready, when the whole refusal thing happened.
I came back to my senses, sat on down on my chair which I really should ask maintenance staff to either replace or fix. I decided to get back to the matter at hand and said.
"He stated he didn't want to go, he also threatened to use physically violence if we try to move him."
Monique looked noticeable concern, while David just sighed before saying.
"As much as he doesn't want to go, the State has already made the decision. There aren't any foster homes open right now, and not only that but Playcare is the only orphanage in this district. He doesn't have a choice, did you try explaining that to him doctor?"
"Yes, I did inform him of that yesterday multiple times before patient bedtime"
"Well that is that, he can threaten and get violent all he wants. It is not a matter of him wanting to go, it is a matter of he needs to go. He can't stay here."
"I know that, and like I said I explain that to him yesterday. He seemed perfectly fine yesterday and this morning. Maybe he is afraid or scared of the toys. I honestly don't know."
Monique took that moment to say
"It could be related to his trauma. I mean maybe he is, like Dr. Goodman was saying he is scared of the toys? Most kids when I explain where they are going fall in love with it. This is honestly my first time dealing with a situation like this. David, Dr.Goodman how do you think we should approach this situation?"
"We explain that he doesn't really have a choose. His discharge paperwork says he is cleared to leave. If he gets violent then we call security or police. We might have to sedate him."
I replied saying
"I don't think it will have to come to that. Max has been cooperative, and a fantastic patient since he has been here with us. This might just be a onetime thing and seems completely random on his part. It could also be entirely possible that he has come to the conclusion that this place is a safe zone. However, I cannot be too sure of that."
"Doc, look I know the kid is having a bad time right now and all that jazz but me and Monique have other things that need to be done today. We really do not have time to deal with a kid having a 'meltdown', or a 'fit' or whatever he is having right now. There are several other cases that need our attention today. So, please go do whatever you need to do to get the discharged paperwork completed. Monique and I will get Max"
It made sense, I cant imagine how many cases there might be. Things appear to be more dangerous lately.
"Alright, I will leave you to it."
With nothing left to discuss they both got up and left my office. It didn't take long for me to finish the discharge paperwork, with it completed I could print it out. Give it to Monique, after that I would have to fax the rest of it to Playcare, and then hav-
"NO! FUCK YOU I WONT GO. ON GOD, THE HOLY SPIRIT AND WHATEVER FUCKING GOD IS OUT THERE IF YOU TOUCH ME I WILL USE VIOLENCE MOTHERFUCKER"
I could hear Monique`s voice trying to calm Max down, but that only seemed to make the situation worse. As I made my way to Max`s room I noticed the nurses and staff members giving me the "its going to be one of those days" look. This wasn't the first time that a patient didn't want to do something that was in the betterment of themselves.
For a brief moment I remembered a time when one of our patients a 15 year old girl believed that the sun was evil and that going outside would kill her. This was proven to be false, of course. She didn't die or get any injuries from the sun. In fact, the last time I had checked on her, and her family she was going quite well.
This is probably another headache situation just like that patient, for what reason max didn't want to go, I could say nor did I know. When I finally got to Max`s room I saw max backed into a corner looking like a wild animal ready to attack. There was fear, and hatred in his eyes that I had seen before in some combative patients. It hurt me to see that look on someone so young, but it couldn't be helped. Max had to leave one way or another.
He began to speak
"Max..look the state det-"
"THE STATE CAN GO SUCK MY DICK! You touch me or try to make me leave then..then I-I will use this cup on you!"
He grabbed a paper cup that was near his bed, and pointed it at us as if it were a weapon.
"Max"
"Don't 'max' me you piece of shit you are working for them aren't you. Arent you! I should have seen it. Piece of shit"
David took that moment to get closer to Max and said
"Look kid, I don't know what is going on inside that head of yours and honestly right now I don't care. You have two options either you come with me and my partner, or we will have to use for-"
David stopped right there because max had spit straight on his face and said
"I chose violence nigga, run it!"
"You little shit"
David tried grabbing Max, but max throw the cup he was holding at him. It happened so fast but before anyone could do anything Max proceeded to hit David in the testicles as hard as possible based on what I saw.
"Omph" David held his hands between his legs and nearly toppled over, before Max hit him in the face.
"MAX!" Monique yelled. She looked at her partner who was on the ground injured before looking at Max and saying
"We are just trying to help you"
"Help me? Bitch do I look like I need help. I Told that fuck fat over there that if you tried to remove me from this location I was going to get violent, and I told that sorry excuse for a motherfucker TO RUN. I AINT playing with y'all"
I motioned for the nurse to call security; we might have to sedate him I thought to myself. I decided to try to at least calm the situation down before it became more violent. Patients who have episodes like this tend to get even more violent if they feel like they are back behind a corner. The best course of action right now was to try to get Max to calm down, and either restrain him or sedate him.
"Max" I said "We aren't your enemies. You need to understand that we are doing the best we can for you. You can`t stay here, and there are no foster homes available right now. Please understand that it must seem scary right now, but you have to go with them."
"FUCK YOU! I aint doing shit. I don't need nothing. I can survive perfectly fine on my own."
"Max we legally cant do that. I am sure once you get there it wont be that bad"
"BULLSHIT! Do you even know what that company does. If I go to that place I will either die…or worse. Read my lips, motherfucker. I. AINT.GOING.NOWHERE'
Security had came running into the room the moment Max had finished his sentence. I looked at them and signaled for them to be stand next to the door. I looked at Max before saying
"Look Max I know you are scared but we either have to do this the easy or har-"
"I choose the I aint going way"
Looking at the security guards by the room I instructed them to try restraining Max before sedating him. I knew that upper management wouldn't take too kindly to me using sedation on someone so young as a first step, but there hadn't been any clinical evidence to suggest that it was harmful to combative or aggressive patients.
Security inched closer to Max like he was some kind of crazy person. Monique and I both looked at each other before leaving. We knew that us being there wasn't going to do anything. I had to get the medication ready and needed to add this incident to Max`s medical report and discharge notes.
When I got back to my office the first thing I did was order the sedation medication for Max just in case. I had instructed the nurse to have it on stand-by, just in case. I hoped that we didn't need to use it, but after working in this field for as long as I have it was better to be safe than sorry.
I didn't know what happened in the room but all I heard was screaming, yelling, and cursing from both the security personnel that had been called and Max.
A nurse had come running into my office breathing heavy before saying "Doctor. Come quickly"
With that I left my office once more, this was going to turn into a very long and difficult day.
When I finally got to the room, I saw absolute chaos. One of the guards was holding his bloody arm screaming, while David and the other guard kept trying to hold Max down. Yelling at each other to hold him steady. Max meanwhile was screaming at the top of his lungs shutting "No" "I don't want to go" and "I don't want to die". Looking at the chaos unfolding in front of me, I quickly spoke to the nurse who led me saying.
"Nurse quick the sedation that I ordered, it should still be at pharmacy"
When David who was holding Max`s arm saw me, he gave me a look of brief relief.
"DOC, tell me you got something for this demon child"
"Christ, what happened?"
"No time Doc just- god damnit hold his legs"
"NO! FUCK YOU" Max said while kicking his legs trying to break free of their hold on him
"Yes, it is on the way" I told David
"Good"
It didn't take long for the nurse to come back with the medication. Taking it from her I unclipped the needle. Looking at David and the guard I stated
"Hold him steady for me"
"Yeah, no shit doc. What the fuck do you think we have been doing!?!?!"
It was about five minutes after injecting Max with the medication that it started to show signs of working. Max was noticeable coming in and out of conscious. Just to be safe though neither David nor the guard let go of Max until we were sure of it working.
Once it was confirmed that Max was sleeping, I turned to David and asked
"What the in the blazes happened here."
"Oh. Yeah you are going to love this. That [David stated while pointing at the unconscious Max] devil child not only punched me the fucking nuts but also decided to bite josh in the God damn arm. He then after doing that clawed at Tim over there and when I say clawed, I mean clawed like a fucking demon, it was like a fucking possession manic. He also punched me in the face. It was only when Tim and me were able to recover did we get hold of that demon child. Holy fuck doc that kid is strong and fucking crazy."
Monique walked in the room towards David and said
"Are you okay David"
"Okay? That kid punched me in the balls and gave me what I think…a black eye. Do I look okay to you?" David said while touching his injured eye, it did look like it was starting to bruise. I choose that moment to add my opinion on the matter.
"Monique, David I don't think Max should go. After this incident, I am not sure how he would respond to being sent to Playcare."
I couldn't imagine how Max would react to the staff, or the other kids there and it worried me. David replied saying
"You know I normally don't say this but honestly that kid can go where every he damn well pleases. At this point I don't fucking care."
Monique looked at David, sighed, and then said
"I wish I could agree with you two but, unfortunately the state has already given their final verdict. Not only that but the paperwork has already been sent to the office. Plus Playcare is expecting us sometime today."
"Well..damn. I don't know if you have any restraints or something like that doc. But, if you do, we should probably use it on him. I don't want to be anywhere near that boy when he wakes up unless he is tied up. Also how long will he be sleep for?"
"Yes, the nurse here can provide some restraints to help with transport. For how long he will be unconscious it honestly depends. He could be out for about 3-6 hours. Its only 10:20 now, so we should have time to get everything ready for transport"