Volume 3 Issue 9 September, 2013
The confused patient who convinced me!
This incident happened sometime in early part of 1980’s, after I started working in
Manipal. When I left the OPD after the day’s work there was this gentleman waiting outside the OP
whom I had seen as patient that day. When I looked at him questioningly he just nodded to mean
nothing. After I started to go to my quarters I found him coming behind me. I could see him following
me till I reached my quarters and wondered if he is stalking me. After few minutes of entering my
house there was a bell at the door and when I opened the door there he stood with a nervous smile.
“Just I want to know the diagnosis you have made in my case.” I could recall it and said “Depression.”
He immediately asked “Neurotic or endogenous?” I knew this person has read about depression
somewhere and come prepared to ask me questions. Those were the days we spoke of neurotic and
endogenous distinction, the former being ‘dysthymia’ and the latter ‘major depression’ in current
classification. In fact I thought he would be happy to know that he has neurotic depression, the benign
form. To my surprise he looked horrified and said in a sinking tone “Are you sure?” I was bit puzzled
and said “What is the matter? Why are you so worried? After all what you have is a minor form of
depression.” For that he replied in a quivering tone “That means I will have to suffer whole my life with
this depression. The endogenous one clears completely in few months. I would prefer to have that”, as
though I could do him a favour by just changing the diagnosis. With difficulty I controlled myself from
bursting into laughter and told him to come next day to discuss about the issue. He left with the
disappointment on his large face. I told myself with amusement, “He ultimately has proved that my
diagnosis was indeed correct.”
Professor at KMC, Manipal.
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