Shrink's Views

ramblings of an unknown psychiatrist

Important Content: a story

Posted by Dheeraj Kattula on June 12, 2011

“Don’t irritate me, even a bit more mama”, Shravan Iyer said rushing into his room. He closed the door behind his back and muttered to himself “I am sick of these females”. He lay in his bed, pillows covering his ears. The soft Carnatic music that his mother was playing in the dining room could not be heard in his room.

About a hundred kilometres away was the Azad family, a high class business family which was English speaking but had retained its traditions. They had been having trouble controlling Salma, since her teen years. Her behavioural problems never ceased even after visits to many dargas. Many holy men tried to get the ‘Jinn effect’ out of her, but all was in vain.

Sandeep went to Shravan’s room to get his ipod as he prepared to go for his evening jog. When he went in he smiled at his brother, who was in no mood for any humour. Shravan was pacing in his room, running his hand through his hair, turning to and fro, clenching his teeth and kept muttering to himself. Sandeep asked if he needed something. Shravan denied wanting anything. Just as Sandeep left the room, there was a loud noise. There was a shout “Stop it, you bitch”. Shravan had broken the desktop computer in his room with his Cricket bat.

After a lot of shopping for a magical remedy Azad’s wanted to try out medical help, after a cousin told them that Salma could be mentally ill. “I AM NOT MAD.YOU ALL ARE….”,Salma shrieked. Her neighbourhood knew her shriek. It was because the Azads had done a lot of philanthropy in the neighbourhood for two generations that people put up with the drama of their home. Otherwise it was a pain to be woken up by Salma’s shouts.

Sandeep and his mother came running into Shravan’s room. It was not acceptable to destroy a computer. It was OK if he punched or threw pillows at the wall to let his frustration. They had been thinking that he probably had a ‘love failure’. They had been very tolerant of him to get over it, but things had only been getting worse. He stopped going to work for the past two months and had been increasingly preoccupied. They had been encouraging him all the while fearing that he might harm himself, but that day’s aggression was clearly beyond the limits.

Salma was taken to a psychiatric facility. The doctors could not conclude about her illness. They wanted to clarify her diagnosis by observing her in the ward. After all her only behavioural problems were a bit of adamancy and problematic shouting to get her way through.

Shravan was evaluated in the same hospital. It was found that he had been having auditory hallucinations. The psychiatrist just asked him if the voices spoke to him or spoke among themselves regarding him or gave a running commentary on his actions. He replied that the voice abused him. The psychiatrist moved on to assess other areas in his mental status. He recorded second person auditory hallucinations in the medical records. He was admitted into the facility due to risk for property.

Salma was admitted in the same facility in room no 3. Her family had requested for room no 10, which was the last room in the corridor. It would give them some more privacy and that Salma would not be a disturbance either. The doctor insisted that treatment in all rooms would be the same and did not change her room. He wanted to avoid few extra steps he might have to make during rounds.

Salma shrieked that night in the corridor. Shravan realized that the one who had been tormenting him was near. He had been hearing a similar voice shouting at him and abusing him all this while. Salma looked at him and was shocked. His thin built, fair complexion and brown eyes reminded her of the school teacher, who abused her when she was 12 years old. She shouted even more.

Shravan could hold himself no longer. He charged towards her and caught her neck with his hands. She fell backwards and opened her room door and fell on the table. In her agitation she got a knife which was on the fruit tray. She picked it and drove it into her assaulter’s abdomen. He bent on himself. There was a gush of blood. Salma fainted.

Shravan was operated upon and he survived. The knife had nicked the spleen. It had to be removed to save his life. Iyer family did not want to pursue the legal case. Azads paid a good amount to the police and saw that FIR was not filed.

The psychiatrist was clueless about what had happened. Was he wrong in where he placed them as inpatients? He was convinced that he was following the diagnostic manuals. He had picked the phenomenology right. He was right in the diagnosis. He was following treatment guidelines and he was right in the drug treatment.

What he did not realize is that diagnosis depends on the ‘form’ of psychopathology but risks are due to the ‘content’ of the psychopathology. In his management, he should consider content as seriously as form.

Shravan and Salma continued their treatment in the facility and did well.

Dargas- A Sufi shrine built over a grave of religious figure usually frequented by Muslims.

Jinn effect- Effect of Demons

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4 Responses to “Important Content: a story”

  1. Hi brother! Good to see you back on the blogosphere! How goes the many new things in life esp PG and marriage? The length of time away from the blog show you have your priorities right! Anyway, welcome back and God Bless!

    • Dheeraj Kattula said

      Thanks bro. She had been at home for the past 3 months. She is joining M2 from the middle of the coming week.She had been away last week, visiting her parents. So got back to my pre-marital love – Internet! I do prioritize marriage above other things including work! 🙂 Pssst…This could be blasphemous in CMC 🙂
      I am yet to start reading in a structured manner.I hope once she starts working, we could work out a schedule for that.

      • Great to know you seem to be holding things in good balance! And we need more people to speak out against the present CMC work culture, I feel. (another blashphemous thought!!) God bless you and make you a blessing.

        • Dheeraj Kattula said

          🙂 I must hold myself from speaking out. I am yet to pass the final exams 🙂
          Thanks for your wishes.

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