persevererSenior Contributor
Post Mortem on Yesterday's Psyche Consult
My heart goes out to psychiatrists. It is one of the toughest, most emotionally draining jobs in the world. It requires many years of study to do Medicine and then Psychiatry. It takes a person who is very dedicated, intelligent and grounded to be able to do it. Mental health patients do not always or even often recover. There are varying degrees of how well they can adjust to living in society. Some, with help, can live relatively normal family lives, keep a home and hold a job with intermittent periods of illness. But many others are too ill to have any semblance of normality in their lives. For psychiatrists, it must be heartbreaking to devote years of treatment to such people only to see continuously worsening illness.
That being so, how much worse is it for the poor patient. A gigantic shadow hangs over their lives. They see their friends doing things they feel they can never do. If only they could wake up each morning, see the sunshine and feel that it's great to be alive. But they don't. They wake up with a feeling of crushing and crescendoing gloom. They know their day is going to be full of painful struggle, even to do the most basic things like get out of bed and have a shower. Their minds are full of terrifying, confusing or conflicting thoughts that they cannot control. They are scared out of their wits. Sometimes the world around them feels extremely threatening - even colours are out to get them. Each step is a stammer of determination to try. But they feel defeated and hopeless every step of the way. They are a prey to addictions because even the most fleeting and momentary pleasure is a distraction from their tormenting inner turmoil. Then they hate themselves for being addicts.
For the chronically mentally ill person life is a series of crises. Their lives are chaotic and out of control. They see only too clearly how devastating their illness is on those around them. Their parents have no freedom; their siblings are neglected. The system gets sick of them, because ultimately, it does not have the answers. The mentally ill patient feels totally fed up with himself for causing all this trouble. It seems to him that the world would be better off without him. He sees no hope for his own future, just continuing torment. He becomes suicidal.
The public health system is limited. Our local hospital does not even have a resident psychiatrist. They have a psychiatric ward with enough beds for 25 patients. When my son developed catatonia some years ago and lost he ability to walk, he was not put in the psyche ward, he was put on the general ward. The psyche ward is reserved for the suicidal.
All the patients here are very ill. Most are schizophrenic, so on top of being depressed and suicidal they are also delusional and very confused and disjointed in their thinking. To voluntarily choose to go on this ward and be with these people says something about what the patient is going through. They are saying not only that unless they are restrained and observed continuously around the clock they will end their lives and break their parents' hearts, they are also saying that ONLY this environment can restrain their terrible addictions and maybe, just maybe help them on the road to recovery. So it should be seen as a big deal to any treating psychiatrist when a patient comes through the public system with a view to being admitted to the psyche ward.
With all this in mind, I need to comment on yesterday's psyche consult with Dr S. This is the doctor who said to my son last week, "What you need is a good boot up the backside." It did not surprise me to see him standing in front of my son yesterday with his hands on his hips saying, "You do realise that one day Mum and Dad won't be there and you will have to stand on your own two feet." It seems to me that this doctor feels strongly that my son OUGHT to have made a substantial recovery. Certainly he was regarding our voluntary 14 hour wait to see him as an attention seeking exercise. After ascertaining the rest of the family's mental health problems he even accused me of not giving my son enough attention and that is why he keeps wanting to come to hospital.
Dr S, there is something I would like to say to you. Remember why you became a psychiatrist in the first place. You wanted to help people. But you will never help them until you understand them. I bet you have done a lot of good for a lot of people. And if you are honest with yourself, you must admit that you have patients who never really seem to recover; they are just too ill with many complex and intertwining difficulties. But you have provided for such patients a network of support in which they feel they have someone to talk to who at least understands what they are going through. For someone like my son whose whole life is a nightmare, this is at least one last little light of comfort.
So when things seem hopeless and you feel you need to blame the patient or blame the parents, try to bury those feelings and remember that the least you can do is be compassionate. If you do nothing more than hold my son's hand and say, "Listen mate, I know you are going through hell, but we are here to care and support you in any way we can", you will at least be doing something caring and it could actually give my son a feeling of hope, that maybe suicidal ideation will be on hold for another week or two. Thank you for giving us your card and saying we can call you any time and you will come and see us in our home. THAT was the best thing you did.
That being so, how much worse is it for the poor patient. A gigantic shadow hangs over their lives. They see their friends doing things they feel they can never do. If only they could wake up each morning, see the sunshine and feel that it's great to be alive. But they don't. They wake up with a feeling of crushing and crescendoing gloom. They know their day is going to be full of painful struggle, even to do the most basic things like get out of bed and have a shower. Their minds are full of terrifying, confusing or conflicting thoughts that they cannot control. They are scared out of their wits. Sometimes the world around them feels extremely threatening - even colours are out to get them. Each step is a stammer of determination to try. But they feel defeated and hopeless every step of the way. They are a prey to addictions because even the most fleeting and momentary pleasure is a distraction from their tormenting inner turmoil. Then they hate themselves for being addicts.
For the chronically mentally ill person life is a series of crises. Their lives are chaotic and out of control. They see only too clearly how devastating their illness is on those around them. Their parents have no freedom; their siblings are neglected. The system gets sick of them, because ultimately, it does not have the answers. The mentally ill patient feels totally fed up with himself for causing all this trouble. It seems to him that the world would be better off without him. He sees no hope for his own future, just continuing torment. He becomes suicidal.
The public health system is limited. Our local hospital does not even have a resident psychiatrist. They have a psychiatric ward with enough beds for 25 patients. When my son developed catatonia some years ago and lost he ability to walk, he was not put in the psyche ward, he was put on the general ward. The psyche ward is reserved for the suicidal.
All the patients here are very ill. Most are schizophrenic, so on top of being depressed and suicidal they are also delusional and very confused and disjointed in their thinking. To voluntarily choose to go on this ward and be with these people says something about what the patient is going through. They are saying not only that unless they are restrained and observed continuously around the clock they will end their lives and break their parents' hearts, they are also saying that ONLY this environment can restrain their terrible addictions and maybe, just maybe help them on the road to recovery. So it should be seen as a big deal to any treating psychiatrist when a patient comes through the public system with a view to being admitted to the psyche ward.
With all this in mind, I need to comment on yesterday's psyche consult with Dr S. This is the doctor who said to my son last week, "What you need is a good boot up the backside." It did not surprise me to see him standing in front of my son yesterday with his hands on his hips saying, "You do realise that one day Mum and Dad won't be there and you will have to stand on your own two feet." It seems to me that this doctor feels strongly that my son OUGHT to have made a substantial recovery. Certainly he was regarding our voluntary 14 hour wait to see him as an attention seeking exercise. After ascertaining the rest of the family's mental health problems he even accused me of not giving my son enough attention and that is why he keeps wanting to come to hospital.
Dr S, there is something I would like to say to you. Remember why you became a psychiatrist in the first place. You wanted to help people. But you will never help them until you understand them. I bet you have done a lot of good for a lot of people. And if you are honest with yourself, you must admit that you have patients who never really seem to recover; they are just too ill with many complex and intertwining difficulties. But you have provided for such patients a network of support in which they feel they have someone to talk to who at least understands what they are going through. For someone like my son whose whole life is a nightmare, this is at least one last little light of comfort.
So when things seem hopeless and you feel you need to blame the patient or blame the parents, try to bury those feelings and remember that the least you can do is be compassionate. If you do nothing more than hold my son's hand and say, "Listen mate, I know you are going through hell, but we are here to care and support you in any way we can", you will at least be doing something caring and it could actually give my son a feeling of hope, that maybe suicidal ideation will be on hold for another week or two. Thank you for giving us your card and saying we can call you any time and you will come and see us in our home. THAT was the best thing you did.
