THE MORBID STATE OF THE MIND PREAMBLE This is quite a long update. This post is for the people tagged at the end and, since all of them are medical students, I will use a lot of medical terms. Still, the content should be clear enough to the average reader who can consult a dictionary when necessary. I will NOT reply any comment apart from those from the individuals Im tagging, or those that are not from these individuals, but that I think deserve replies. I will try to ensure that this update does not exceed 3,000 words. INTRODUCTION Last year, as a 500 level medical student in Psychiatry posting, I went to interview (clerk) a patient on the Mental Health Ward at Wesley Guild Hospital, Ilesa. It was my first time of interacting with a psychiatric patient, and I didnt really know what to expect. To compound matters, my colleague that should have accompanied me told me he was still in Ife, so I had to do it alone. The patient was a dark, pretty lady in her 30s with a sober look. I asked her what brought her to the hospital, and she replied that she was brought in because she attacked her parents and damaged some of their properties. Why would you do that? I asked her. She then went on to tell me how her parents had hated her since she was born, that they wanted a docile child, but she was strong willed, so they decided she was not a good child. Furthermore, she said her parents capitalized on the fact that she was below average academically to punish her. I was startled. It was difficult to believe the things she was saying, but she said them with so much conviction that I had to continue listening. She thereafter told vivid tales, of how her parents had tortured her, how her mom would secretly tell guys she brought home that they should not date her, how... At the end of the interview, I was angry. How could her parents be that wicked? I eventually concluded that some people did not deserve to have children. ON INSIGHT AND PSYCHOSIS The next day, I had to present my findings to the consultant psychiatrist. Unfortunately for me, not only did the junior consultant come, a senior and experienced psychiatrist also came to listen to my presentation. I told the consultants everything the young lady told me the previous night, and concluded the case was one of physical abuse. How did you arrive at such a conclusion? asked the consultant. I replied that the patients parents had tortured her, and that, with the amount of suffering she was made to bear, it was only right that she had to react violently at a point. The consultant smiled. How sure are you that the stories she told you are true? How sure are you that the people she talked about really exist? That was the question that caught me off balance. As a new student of Psychiatry, I had not yet understood the nature of psychosis. In reality, all the stories the lady told me were cooked up in her mind. She had no intention of lying to me, but the mind that made up the stories was not functioning well, so the stories, regardless of their appeal and vividness, were false. Later, I would be taught that, until she realized that the stories she told me were unreal, and were as a result of a psychiatric disorder, she would not be discharged from the hospital. In short, she needed to regain her insight before she could be declared cured. ON ISRAEL AND PALESTINE I have often be accused of being biased when it comes to the Israeli-Palestinian conflict. People are dying on the Palestinian side, so they should be pitied. Everything should not be about defending the Israelis; the suffering Palestinians too should be helped. I agree that that is a nice way of looking at the conflict... Nice but flawed. Pitying the Palestinians will not help them, just as pitying my patient did not help her. My patients problem was an abnormal way of reasoning. It was that way of reasoning that led to the stories. Sympathising with her would not have stopped the stories: it would have increased her false beliefs that the stories were right. Eventually, she would have gone deeper and deeper into psychosis. The only way to help her would be to correct the source of the stories -- the mind. The experienced psychiatrist knew that my patient had to be made to realize that her stories were false, that she had to gain insight into her disease state. Similarly, for peace to reign in Palestine, the Arabs must be made to gain insight. The basic story the Palestinian mind is churning out is that the Israelis are occupiers. The Arabs think that the Jews are colonialists, and that armed struggle and resistance will drive the Jews away from their land, just like it drove the French from Algeria, and the Italians from Ethiopia. But this is a wrong way of reasoning. The French had their country-- they only went to Algeria for economic purposes, and when the native Algerians revolted, the French realized that the cost of staying in Algeria was more than the benefit, so they had to leave. The Jews have no other country; so, regardless of the violence the Arabs perpetrate against them, they have no choice but to continue living in Israel. Living in Israel is a life and death issue for them, unlike the French and Italians who occupied Africa on a profit and loss basis. Insight for the Palestinians means realising that the Jews have come to stay, and that accepting them is the only condition for peace in the region. Any other intervention will fail, for it cannot address the underlying issue. Therefore, as much as empathy for suffering and dead Palestinians is a good deed, it is not enough in itself, for it cannot cure the morbid state of the mind that underlies the conflict. (NB: In line with medical ethics, I have modified the story the patient told to ensure confidentiality.) CC: Adeyemo Ayoade Adeboye duchess Opeyemi Adewunmi Teslim Adedamola Hanafi Habeeb
Posted on: Sun, 18 Jan 2015 21:24:09 +0000
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