Shrink's Views

ramblings of an unknown psychiatrist

“Can you please give me some poison?”

Posted by Dheeraj Kattula on March 7, 2010

She came closer and asked in a soft voice, “Can you please give me some poison?”

I tried masking my shocked spirit with a layer of professionalism. I enquired “Why?”. I avoided her eyes, so as to not threaten her with my piercing look. I conviniently flipped through the medical records. The records belonged to a man who was in his late thirties. She had come proxy for the patient. She was in her late sixties.

She had been coming like this for the past 6 years. She took medicines and gave them to her ‘son’, whenever it was possible. She reported that he liked injections! Thank God for it. Every two weeks, he got a shot of Injection Fluphenazine Decanoate, a long acting drug which controls mental illness. I heard her sob. She was in tears. Why on earth would she need poison?

She was a widow. Her husband had passed away when she was relatively young. She has a son. He is married and settled. He lived less than a kilometer away from her, but did not care for her. She lives with her ‘son’, who was in fact a nephew, son of her sister. She too was a widow. When she was on her dealth-bed, she took a promise from this lady.The promise was that as long as she was alive she had to take care of her son. Truly, she kept her word. Every time the clinical notes were written, it said “Proxy- Mother”.

The old lady was bent with age and was getting weak. She is afraid that she might die at any time. She felt that if she were not alive, her ‘son’ get stoned to death in the community because of his behaviors. His behaviors were abnormal as his disease was not controlled.  His disease was not well controlled because of non-compliance. He was non-compliant, because he was severely psychotic. He was still severely psychotic, because his treatment was not complete. To break this cycle, he required a hospital admission. That could make him slightly better. If he became slightly better, his compliance could improve furthur and then his outcome could improve even more.

Why is he not admitted then? He hated to come to the hospital. This old lady cannot force him to come by herself. Her own son is not bothered about her or her ‘son’. How could she bring the patient? She therefore reasoned that it was better to poison him painlessly rather than leave him alive to the fate of a difficult life.

I did not know what to say. I held her trembling hand. She sobbed harder. I asked her if could visit her village and help her bring her ‘son’ for an admission. She agreed. I took her address. I feel the pressure now. It is uncomfortable to be the only earthly hope for someone. It is that discomfort that leads us to put in extra effort. It is that extra effort that makes the world a better place.

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12 Responses to ““Can you please give me some poison?””

  1. Really shocking tale anna!! Sad how peoples ignorance and intolerance drive people to suicides. When are you going to go to the village? Will keep praying for you..

  2. it is a very difficult but it is reality.I have to accept this.

  3. Kannan said

    Is there any possiblity of getting help from the community to bring him to the hospital? If I remember the mental health act…if complained to the police they can take that person to hospital..

    • Dheeraj Kattula said

      You are right.Police can be asked for help in bringing mentally ill to institutions. It is usually not acceptable to families especially the ones with less power.By the way I did visit their village.It was abot 35 km from Oddanchatram. He was not bad enough to require an emergency admission. He was not good enough to be treated without him visiting the hospital. I could not bring them over to Odc because of leave arrangements of his aunt. I assured him of my presence and support, if he were to come to hospital on his appointment day. I also gave the Inj FFD which was due. He was thrilled to see a doctor come to his hut. He dropped me off in the village bus-stop. We got drenched on our way in the summer rain. The visit did not result in what I had planned for, but it was worth all the effort.

      • Krishnan said

        If one looks at the community as a whole, not less than 20% suffer from psychological imbalance. Many live in the dream world. Mungeri Lal ke hasin sapne makes them feel comfortablefor an hour atleast, under narcotics. But a deeper look makes us realize that these people do not want to face realities in life. Inconsistent and incomplete efforts drive them to failure and those lead them to penury. Had you given the lady a bottle of paediatric vitamin drops, she would have consumed it and died also. The so called son would not have felt her loss also. You will find such sons,cousins etc in hundreds. I may be misconstrued, if I dare say that your effort is waste of energy, time and money, for you did not have anything to learn from it.

  4. Krishnan said

    I think, identifying yourself as a part of that family itself was wrong. None can be the only hope to any one. The world is neither born with you nor is it going to end with you, is a nice saying. If the psychologically disturbed person is made to think “idhuvum kadandhu Pogum” – this situation also will pass by – that is successful therapy.

    • Dheeraj Kattula said

      Thanks for visiting the blog and also writing the comments.I hope you come back to the blog in future.
      BTW Are you Dr Krishnan, F/o Ananth and Nivi?

      Reply:
      I have never felt being a part of their family. There is always a therapist-client distance. I only transcended that distance and took the role of a voluntary social worker to help them access in-patient care. I agree with you that it is presumptuous of me to think I was their only hope. I agree that the world is neither born with us nor is it going to end with us. It is also true that once we are here in this world, we have a role in its running. It is good to aspire to make things better in this world. Though I am tempted, I do not want to resign just because going is tough.
      “This situation also pass by” is a mature understanding of the wise in cosmic scheme of things. It is understandable in minor stresses we go through. In real life we see many things don’t just go away. There is a time to face reality head-on and not repress/suppress it with psychological theory and spiritual jargon.

  5. Isaac geke said

    Some of this looks like my experience. But i will move carefully
    thanks

    • Dheeraj Kattula said

      Thanks Isaac for visiting the blog and taking time to comment. Sorry for the delay in approving it.I have been busy with work and therefore I have not visited/updated the blog for qite sometime.
      Can you please tell how it resembles your experience. Please also share what you mean by being moving carefully.I would like to learn from you.
      Thanks again.

  6. Ron said

    The definition of patient can be derived from the verse ‘Lord, the one you love is sick’ (Dr. KV)
    Jesus always got emotionally involved with His clients. Since the master Physician is our role model, we should have no hesitation to get closer to the patients and their relatives and this requires breaking the outer shell of professionalism, even though we might have to place certain limitations depending on the circumstances.
    Mary and Martha went to their master physician. A word about Jesus and the comfort He can provide or a little prayer with the patient will go a long way in helping this old lady. It might become a sin of omission for you if you don’t, I believe.
    I recently wrote in FB about a man who I saw in casualty. This guy had become a parapegic some 20 years ago. CMC had done excellent work rehabilitating him financially, socially. He remained a paraplegic but did well in agriculture and got all his 3 children married. The last son about 20 years old and married recently was standing next to the father who was admitted in casualty after taking OP because he could not put up with his half paralysed body anymore. The complete worth of a man is realised only in Christ Jesus.
    Not possible in all cases. However we can a difference in the ones with whom we share. This too becomes better with practice.

    • Dheeraj Kattula said

      That is a sad story indeed. Care is an ongoing process. It is not a project which has an end. We must realize this when we treat people with no ‘cure’. I hope this person made it.

  7. […] “Can you please give me some poison?” […]

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