Have you forgotten?

Have you forgotten how important you are? In the life of your patient? In the life of those who love your patient?[1]

May be you haven’t. You see it in their eyes, those dull pill-stricken eyes, how they light up when you enter the room. You hear it in the panic in their calls when it's midnight and the pills aren’t working and daddy is still pacing the floors and asking what they want.

You know you‘re a life-line and they’re all sinking, but as if they’re in some Greek tragedy, they don’t go down, they don’t give up, but each breath seems to bring them closer to the water line, each moment seems to take a little of their strength.

May be you have.

It can be tough being who you are. You are the monstrous other, the self that is rational. You are the representative of the pharmacopoeia, the great white hope. In many cases, your patient arrives at your clinic, sits in your waiting room and clutches a hope. “He's very good, he studied abroad and when my daughter went through a little depression, he put her right in weeks. Just a little expensive but when its health, my, you can’t count the paise,” someone has told her or him or her father or her husband or his mother. And here they are, waiting, hoping, and believing.

And sometimes you do it. You don’t know how you do it but you do it. You get it right and someone walks out of your clinic and begins to stretch towards the light, begins to reach towards wholeness. That must feel so good.

However, there are others when the prognosis is grim. It's about amelioration now, keeping the symptoms down. It's about trying to hold things together. Only, the hope is the same, the despair is the same, the love is the same. Because that's what hurts: Love. It's what leaves them baffled; it's what makes them wonder why they aren’t the families they’ve read about in Reader's Digest, the families they’ve seen in Barjatya movies. It's what makes them long to replace the person they love with a v2.0 who doesn’t have these design flaws; and it's what makes them guilty about longing to replace someone they love; and it's what makes them sad that they should even think about such a thing.

So you’re living the life of a sponge. You just have to soak it all up. No wonder some of you are such terrible holograms of yourself.

Let me tell you a story.

I’m going to call him R. He is part of my family but to protect his identity, I’m just going to say, he's R.

R had an alcohol problem for as long as I’ve known him. And after decades of drinking, he gave it up. He stopped. And he began the long slippery slide into depression. 1 day, he said he wanted to kill himself. Well-trained, my family responded by taking him to hospital, a good hospital, one of those known for its psychiatric ward. He was admitted, papers were signed and the family was asked not to come back for 3 weeks.

I didn’t think this odd. I thought it was rather nice too. It gave everyone breathing space, I thought. The family could relax and not have to take the incessant, “I’m all right, I can come home now, I promise I’ll behave.” The patient did not feel abandoned and if the family was the reason for the problem, s/he too would have some room to breathe.

However, I felt responsible for R and I felt I should simply go to the hospital and meet with his doctors. I would not meet him; no breaking protocol. I’d just meet his doctors. And when I arrived, the nurse told me he had been taken for his ECT. I asked who had signed the consent forms. I was told that they had been signed and I was shown the form. I tore it up and asked that they try other lines of treatment.

“It will take longer,” said Matron.

“That's all right,” I said.

A week later, I visited again. This time I met his psychiatrist who did not remember his name but when he was given a series of clues and hints, he remembered and said that I could see R if I wished.

“There are no latches on the toilet doors,” said R. “It's very difficult to take a shit properly.”

I knew why they were doing that. You can’t let them hurt themselves. You can’t let them take a bath in private. Or a crap. Do as you would be done by? Never mind that. You can’t let them hurt themselves, never mind what happens to their dignity.

“Does your psychiatrist visit regularly?”

“Rounds. He comes and he says, ‘How are you?’ and I say, ‘Better’ and he says, ‘Continue the pills’ and then he goes away.”

“Are you feeling better?”

“No.”

“Then why say it?”

“Because he's standing up and he's tapping his pen on the bedpost and he wants to leave. So, what to say?”

At the end of this, the psychiatrist presented his bill (It was not included in the hospital charges and would have to be paid separately) He wanted Rs. 150,000.

I think he might have forgotten.

Have you?