Occasionally, as a doctor, I am asked to see a patient in the emergency department who is completely mute. They sit motionless, staring around the room. I lift up their arm and it stays in that position. Someone takes a blood test and they don't even
Questions start running through your mind. What's wrong with them? Would they respond to someone else? Do they have a brain injury? Are they putting it on? And – hardest of all – how am I to know what's going on if they can't tell me?, a severe form of mental illness where people have problems with movement and speech.
One question comes up more than any other: what are people with catatonia thinking? Are they even thinking? Some described experiencing overwhelming fear. Some were aware of the pain of staying rigid for so long, but, nonetheless, seemed unable to move. What we found most interesting, though, were those people who had – on one level – a rational explanation for the catatonia. One patient's notes read:
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