Vertigo and bad thoughts of a SI patient

This one patient was admitted to ER with a complaint of "I feel dizzy, I have bad thoughts about myself." Actually, he only verbally mentioned that he felt dizzy. Apparently this man was a homeless man as he described afterwards that all that belonged to him in this world was in that small bag that he brought in. Also his odor was that of a man who didn't take a shower for more than a week. One psychiatrist told me that people who are admitted to ER for SI are not really treated but they are monitored and transferred to a rehab program. Some hospitals have separate ERs for mental cases. Unfortunately, my hospital's ER does not have a mental ER so all mental cases are treated as well. This does not suit well as all that doctors here (who are mostly internal medicine) could do are to do some IV and monitor them to make sure they don't harm themselves, and to offer food and advise. The only plausible symptom that most SI patients could come up with is dizziness, or vertigo(as told by some doctor, but apparently this definition is wrong as shown below).

Vertigo, sometimes called a headrush, is the sensation of spinning while the body is stationary. With the eyes shut there will be a sensation that the body is in movement; if the eyes are open the surrounding will appear to move past the field of vision.

The effects may be slight; may cause nausea; or, if severe, may give rise to difficulty with standing and walking. Vertigo is usually associated with a problem in the inner ear balance mechanisms (vestibular system), with a problem in the brain, or with the nerve connections between these two organs. The most common cause is benign positional vertigo, which self-resolves.

• Vertigo should not be confused with dizziness. Dizziness is an unpleasant feeling of light-headedness, giddiness or fuzziness often accompanied by nausea.
• Vertigo is often used, incorrectly, to describe a fear of heights.
• Vertigo is often experienced when breathing helium, as a result of helium flow instead of oxygen to the brain.

Wow, these sound like what I feel all the time. Note that many SI patients come here after they smoke a dope or two. If not, they come after they stop doing crack. No wonder there are so many SI patients everyday.

This one man who came here for SI stressed the fact, when I talked to him, that he was born with a silver spoon in his mouth and that his father owned some major corporation. Now he said he had nowhere to go. I was surprised to see at least one patient a day who had SI. I think today there were at least 3. Most of the time they just slept or chilled in their beds eyeballing female doctors or nurses. Oh yea, they also kept bugging me for free food (that ER provides to its patients).