You know you’re in trouble when…

The nurse tells you to “have fun with this one!” when you are on your way to see a patient…
I try and remain optimistic.
Her chief complaint was “having spells”. As I entered the room I noticed a normal-looking obese female sitting calmly in a wheelchair in no apparent distress so I asked her:
“how can I help you today Ms. W?”
when she failed to answer promptly her very sweet and attentive 18 year-old daughter began to give me the details. However I quickly stopped her and told her I wanted to hear from the patient first and then I would want the daughter’s version. So again...
“how can I help you today Ms.W?”
“Oooouuuuwwwwwyyyyyyoooooooouuuuaaaaaaiiiiiiiiiiiihhhhhhhhhhhhhhhaaaaaaaaaa….”
I still don’t know what the hell she was saying or trying to say, but it sounded a lot like she was attempting to speak “Whale” like the little blue fish Ellen Degeneres played in the movie, Finding Nemo. Anyway, after about 10 painfully long seconds of listening to “wwwwwaaaaahhhhhooooouuuu…” and trying to keep a straight face while watching Ms.W contort hers like silly putty as she dragged out every syllable of a word I never did figure out, the words “psych consult” popped into my head and I turned back to the daughter…
“OK, your turn. Fill me in.”
Apparently these are the spells Ms.W has been having. She would, at random times, alternate between speaking Whale (or whatever she was doing) and then speaking like an auctioneer on crack. So after I examined the patient and ascertained that nothing dangerous was going on, I reassured her daughter, stepped out of the room, ordered some basic screening labs, and called my psychiatry team to please come assess this morbidly obese female who was trying to communicate with whales.