Originally posted on May 14, 2014 at Dr M’s Notes (www.thehealthquotient.com)
It’s easy to dismiss the patient with mental health issues.
When they pop up in our Emergency Departments, on our wards or in our clinics, there’s a common urge to handball responsibility to another party. They’re not my problem. They’re already sick. What help can I be to them, anyway?
The very practice of psychiatry is full of labels and names. Schizophrenia. Manic depression. Borderline. Dependent. Schizotypal. Involuntary. When one of these terms pops up on the admission notes, it’s easy to let the person fade behind the jargon. Especially when we’ve got fifteen other patients to look after; patients who are more relatable, more help-able.
Since February of this year I’ve been working in a community psychiatry clinic. It’s an experience I’m thoroughly enjoying. The diversity of patients constantly astounds me. There are people from families like mine, and families completely removed from anything I know. There are people from rural Victoria. There are middle-aged women living alone in boarding houses, young men on the streets, older men in their family homes. There are refugees from Vietnam, Somalia, India, Cambodia. I’ve used interpreters for many different languages.
Sometimes, when you meet a person who is suffering from a mental illness, you look into their eyes and you’re not sure if you’re reaching anything there. Sometimes they feel as vacant as an abandoned house. You wonder, how did they ever get to this stage? What happened to them to bring them to this point?
Over time I’ve seen some patients improve and others deteriorate. But what I’ve noticed this job growing in me is an ability to empathise with people from various walks of life. And I’m delighted that I’m becoming more genuine, rather than more jaded.
I’m learning to pause, to really listen. I’m trying not to simply search for the answers I’m expecting, but to absorb the sense of who a person was before they became unwell. And some of the best moments with my patients are when they crack a joke—usually a wry, half-true joke, but a joke nonetheless—and they look over at me to see if we’re on the same page. And for a split second, the interview transforms, and we’re just two people sharing a laugh.
It’s funny how simple and effective a joke can be. It’s prompted me to realise that we’re all made from the same dust. We’re not really different from the people we treat, at all, and we shouldn’t go down the path of thinking we are. If not for a different set of life circumstances—a different set of genes, a different childhood—you or I could so easily be the one with the label.