A story from my training time as a psychiatrist in Kerala, India, and I was a very reluctant shrink at that time.
One day one of those social workers (who do unpaid voluntary work) brought a youngish looking gentleman (later I knew he was in his late thirties) to the mental health centre where I worked as a trainee. His body odour was horrible and was relentlessly muttering in a low tone and it was unable to decipher.
He said, “This man is mentally deranged, he is drinking water from the sewage and we have been trying to help him. Took him to our shelter and fed him, but if he gets a chance he will abscond and go into the street. We don’t know his name, he just mutters, inaudibly and we call him Shiva Kumar (made up this name for anonymity)…”
I was skeptical as I had seen a lot of people getting dumped in hospital, so demanded, there should be someone with him always…
The social worker looked helpless.
Then my professor and mentor said, “Anil, admit him and you look after him.”
I was reluctant but took on the challenge
With the help of an attender (HSW), I got him bathed, dewormed him, and started him on Trifluoperazine. As days passed, there was no improvement. I tried Haloperidol and even Pimozide (at that time it was used in resistant schizophrenia)
He continued his routine- drinking toilet water and relentless muttering.
I was feeling helpless and asked my professor, could I give him ECT. Professor agreed to the plan.
And I started him on ECT.
After the third session, there was an improvement, he stopped running to the toilet to drink water. He complied with baths and smelt better.
The next week, his muttering was becoming clearer and I noticed suddenly that he was talking in Hindi…
I was surprised and started my communication with him in minimal Hindi I knew
“Nam kya hai (What is your name) ?”
He looked at me but he did not answer
I tried to communicate with him every day and spent hours trying to get some words out of him. I started writing my questions on a piece of paper and tried to get some answers (Those papers I still have).
Then one day he uttered his name
“D T ( Anonymised )”
And that was a start.
I tried to find details of his home, father, mother, and sibs. Suddenly I noticed, he wrote something he saw on the floor ( A piece of paper with Halidol written on it)
He wrote Haldol (Commercial name for Haloperidol), without spelling mistakes. I realised that he might know English and from then on my questions were in English
I wrote the questions and the answers he gave on a paper and asked him whether they were right. If he nodded his head in agreement then I took them as correct
He gave the details
His father name was V T (Anonymised). He was from Bara Shankar, Patahi, East Chambaran, Bihar. I had heard about Chambaran in relation to India’s freedom struggle and Mahatma Gandhi
Patahi was over 2500 kilometers north of Trivandrum !!!
A poor tormented and distressed soul covering all that distance alone was unthinkable for me.
I decided to write to the postmaster of Bara Shankar post office
A few weeks later I got a letter from his father. It was very much Shakespearian English, philosophical…
“Thank you for being there for my son, who I lost five years ago…. Thank you for looking after my long lost son….and letting the blood to meet blood again…”
DT had run away from their home about five years ago and landed in
I wrote to him asking him to bring details of DT’s identity etc.
I used to collect clothes and give that to him. I had collected some sample medicines and even a small amount of money, as a back up when DT went home with his father.
I told my professor about what I had done, so far. Professor looked at me and I could see he was blessing me.
That journey taught me about compassionate care, beyond conventional frameworks
As part of our training I had to go to NIMHANS (Premier institute in India for psychiatry training) for a month’s training. When I was at NIMHANS, DT’s father came to our mental health centre.
An old innocent, illiterate, villager from Bihar in tattered clothes.
He had not written the letter to us. It was someone else who wrote it for him. But I am sure he would have written the same emotions into words, had he known English.
My professor gave him all that I had collected for DT and in my absence, DT accompanied his father and left the mental health centre.
When I returned from NIMHANS, my professor told me what happened and said.
“They left, both son and father were ecstatic… you should have been here… you know something, he did not ask anything about you but was constantly looking at that empty chair, where you used to sit and talked to him for hours.”
As I was walking towards the ward, my mentor asked me from behind.
“Anil, do you know, what you did for a helpless, human being and his family?
I turned around and said, “I did, what I was supposed to do…and would do that again.”
He said, “Maybe…But you helped someone to get back his identity, that he had lost a few years ago”
The ward was only a few steps away.
From being a reluctant shrink, I embraced a discipline, where cure is a dream, but healing is the reality. I continue that with passion
I hope that man probably in his mid-thirties at that time, whose face I still remember clearly continues his journey in life with whatever ups and downs life poses.
PS:
I have written this as a story in Malayalam in this Blog a few years ago.
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