Bipolar Expeditions by Emily Martin Page B

at a lot of jobs, at times five at once. He has been in jail, once for a number of years, and he is a college student. His personal history: he was born by Csection, drank bleach at eight months of age and was hospitalized then. Life was poor and chaotic, but he stood out. He was outgoing like all the kids, but he was sensitive, and he would stay inside and study. Assiduous and studious, he did very well at school. But he did get into fights, from age fourteen on, and was jailed for fighting several times. Two years ago he was admitted to State College, in the business program. He kept very busy, often staying up until 2 a.m., during his first year. Now he is home for the summer and has a summer job as an intern at an investment bank, the first job of any substance he has ever had.
    One week before admission, he had a dose of Angel Dust [PCP]: unknown to him it was in the marijuana he smoked. In college for the first two years he was on the dean’s list. Then there was a downturn because he felt his family didn’t visit him and therefore must not love him. After that he only got Cs. He has also been anxious and overactive. He would try to do ten things at once.
    Last Tuesday, his family saw an abrupt change. He was very tearful, very labile, and paranoid. He thought the neighbors were going to kill him so he bought a pistol and kept it nearby. (As an aside: this is part of his reality—people do get killed in his neighborhood.) The family called him crazy. He came to Baltimore to see a friend, and at that point he bought another gun. Frightened, he called 911 himself. He came into the Riverside emergency room out of control. At one point he ran out naked, and he was then put into the seclusion room. He showed rapid speech, tangential speech; he was labile, tearful, and grandiose. He talked about how he would be rich, a famous rap star. He heard God’s voice.
    On admission here, I saw someone who was clearly manic. I assessed him as a twenty-year-old with underlying illness who had become floridly manic with all these stressors. Complaining of pain, he was examined and diagnosed with severe testicular torsion, and so he had to have a testicle removed. Now he is close to normal, but he is still intrusive—you can’t interrupt him. The reason we brought him in here is to get help with whether his condition is PCP-induced or caused by an underlying illness.
    Mr. Burton came in, accompanied by his mother and grandmother. As he entered the room, he looked around at all the people sitting there in white coats, and said, “Hello, I am Keith Burton.” Sitting down, mother on one side and grandmother on the other, he said, “I’m a twenty-year-old college student with a 3.75 GPA and I am not crazy.” Without missing a beat, Dr. Paulson began the interview.
    Dr. Paulson: How are you feeling today?
    Mr. Burton: Great.
    Dr. Paulson: How did it happen that you called 911?
    Mr. Burton: I loved my family and I missed them in Florida, so I came back north. After I got here, my grandmother kicked me out. She said I was crazy to drop out of college, so I told her next time you speak to me I will be calling from a mental institution.
    Dr. Paulson: Do you remember the question I just asked you?
    Mr. Burton: I came to Baltimore, saw my friend, and called 911 emergency. They took me to Riverside Hospital where they injected me with three needles, because they said I had to be calmed down, but I was terrified, I didn’t know what it was.
    Dr. Paulson: Were you scared?
    Mr. Burton: No, it was really that I was terrified. I wanted to call my mother, because no one even knew where I was, and I didn’t know what the needle was. Now I have needle marks all over and I don’t even shoot drugs. After the fourth needle, I again wanted to call my mother and father, but they wouldn’t let me, so I ran. I was terrified. They called security on me, restrained me. But I still got shot. Now I am back to my