15 DAYS OF AWE

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Volume 8 Issue 11 November, 2018

“There are two kinds of people in this world, the binary blue and the non-binary pink. I belong to the former. And in being so I invented the most complex operating system – Android. With numbers flowing from my head into a cube and getting power from the source, the cube became the design for Android.”

On a rather regular Monday, I found myself sitting across a young lady who, had it not been for the D4 psychiatric wards of my hospital, I would have assumed had quite an idiosyncratic imagination. This lady however was convinced beyond doubt and evidence otherwise, of every word she said. It was this conviction that led to the ICD-10 classification of her mental condition as Schizophrenia. Set apart from the usual bustling world outside, I witnessed a realm of the human mind, which wasn’t only complex, but also outstanding in ways I had failed to fathom before. At one end was a middle-aged lady with a peculiar dressing sense for her age, speculative and suspicious about every act of her care providers. While the other end had a young lad, whose intelligence could any day outscore the highest for any IQ test but failed to score enough for sanity. While all these men and women seemed like the other stranger riding on the same bus at first look, their brain’s chemistry and wirings had been altered so much that they ceased to have a normal life.

And so here I was, an Intern, trying to grasp the psychopathology of the delusive, paranoid, combative minds in practice.

Each of the interns was assigned a department mentor right from the first day of our brief 15 days posting. While at first it seemed rather frivolous, the idea struck a chord as the days passed. Shadowing our mentor and post graduates through busy out patient days, arduous ward rounds, everlasting CLP, working with the Psychiatric social work team in faraway telemetric camps, attending late night emergency calls brought a sense of responsibility. It gave an opportunity to look closely at what goes into the making of a team that deals with the human mind in all its colors and flavors day in and day out.

Hours of self-learning, patience, perseverance, compassion, empathy even when the tongue is running dry eliciting details of every life event dating back to birth and the ears going numb at times from the continuous chatter, is not just self-less but also brave and noble. And the most challenging part, as I saw it, was in convincing the family of the psychological nature of the illness, especially in a social environment where mental illness is seen as a stigma. Assuring 17 year olds’ parents that their kid is having a pseudo-seizure due to life stressors and will get better with cognitive therapy or elucidating to an old uneducated man from a traditional family that his worry about his only son’s health is a psychosis, doesn’t happen easily, certainly.

These 15 days made me realize that while reading about disorders of obsession and compulsion, personality, mood could be thrilling in terms of the spectrum, living and treating the same is far from it. It’s tough at every level of being. Unentangling this web of complex thoughts and emotions and replacing with reason and process is what makes an able psychiatrist.

Dr Khushboo Agarwal, Intern, KMC Manipal

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