Thursday, 7 June 2018

My first patient

Day 1 of the Journal

My first contact, he held my hand as I steppd into the dark, twisted world of rampant inner demons, or better said, dragged me in by the wrist. He was soft and mild mannered. My first patient.

My first memory of him begins as I walk through the turquoise corridors on my second day of employment alongside a more experienced delver of psyches, 6 weeks in the ward she had gathered so far. A slight man with greying hair hanging ruffled over a stern forehead, and a slightly jutting jaw which granted him a stubborn air. He bares a thick brass ring with a skull and snakes acid-etched on its surface. He has no time for introductions in his accelerated state.
He commences his ferocious assault by spraying the air with strings of words and mucus: "How am I supposed to contact anyone if I'm only allowed to call twice a day? What if I accidentally type the wrong number? Or the other person is calling or there's a network error and the electricity flows backwards and..." My chaperone barely listens, feet speeding up and head only slightly turned towards him as her irritated, bored eyes sear him. He sprays on imperviously "and I'll let you know I know my rights and I am no dummy to be kept in the dark, to be kept quiet and locked away be-"

"Unforunately there are only two phone calls a day." she attempts to interject. She is picket fence against flood; he spews on but we reach the door and slip into a future favoured sanctuary of mine, where I would retreat to during lunch breaks when overwhelmed or to escape fatal hyperthermia after my 15 kilometer morning bicycle commute and layers of mandatory livery in the summer hell, and bask like a penguin on ice, and his voice abruptly subsides.

The following days I spoke to him and keenly tried to pick out any semblance of logic from his scattered, manic mind. He no longer wanted to be called Mr.: it was an affront, an allusion to the eras of slavery where the lords of old ruled over the plebs, he wanted to have a specific section of his intestine replaced by a functional female reproductive organ, as his wife had become infertile after several failed IVF attempts, yes doctor, I know it might be hard, but I have faith that a prodigious surgeon could do the job. Space-time talks to him, and if he were as powerful as Putin it wouldnt be only this room communicating to him, instead he could install large antennas on his head and communicate even with Mars!

I tended to him when others ignored his incessant silly string trails of demands and objections - for days he pleaded for a circumcision, providing a cornucopia of explanations as to why: he suffered from phymosis, a narrowing of the foreskin causing pain and infection, he wanted to become a Jew, and many more which my brain fails to grasp. So pervasive was this idea of getting circumcised amongst his other more fickle fixations that I decided to examine him - indeed there were some signs of mechanical trauma, most likely explained by the cocktail of antipsychotic pharmacopoeia leading to the inability to ejaculate, leading to literal hours of manic masturbation without an end in sight. I prescribed him a salve - he wouldnt remember but someone had to care for those ostracized - and the next day his grand obsession of snipping and foreskins receded.

Over the following days, I prompted him and listened to his responses, carefully, and inexpertly attempted to fit his mind into a grid, deconstruct the jumbled tangle into something medically acceptable. Sleep last night: 2-3 hours, Appetite: low. Perceived need for sleep: none. Insight into condition: lacking. And so on and so forth.

Just over a fortnight past, my first patient lay motionless in bed, unusual for a
the manically derailed to be able to sleep. As I woke him, he reported how startled he was. How much furor and wrath welled up inside him. I could tell his bottomless energy was reaching its bottom. The reality of his situation had sunk in - his wife had divorced him, and he was now homeless. I'm to this day still unsure whether he truly understood it yet, but his emotions seemed to.

Three days later, with reductions in his medicine, he was gone, to be kept in a less intensive station. He was like a brief gale that had knocked me off my feet and disappeared without a trace, leaving me a little confounded, yet awed at the force in him. I decided to investigate and inform myself of his storry via electronic records.

First manic episode at age 19, he was now 52. Exceptional grades, he was a gifted student. Since then he had accumulated several suicide attempts. The mundate details of his biography in conjunction with the severity with which his affliction permeated his life sobered me, left me contemplative. How fragile sanity was, I pondered, and vowed to never become jaded.

Today I saw him once more. As I entered the airlock, his eyes fixed onto mine as he trundled towards me. They lit up in recognition as we had a brief exchange of pleasantries, his usual tangential speech swinging around in wide, barely coherent arcs. Maybe his mind had been flushed into outer space, but his body language suggested that he remembered my kindness. In a profession mostly devoid of gratitude, his eagerness to greet me melted my heart.

Today was the best day ever.

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