This entry is a tribute to a non-psychotic patient referred to Psychiatry by IM for a number of symptoms that cannot be explained by normal lab results, and of course, knowing IM, a thorough history and PE.
She is a middle-aged woman, thin-looking who is conscious and has good insight why she is at the clinic. Her anamnesis struck me. She had a lot of struggles in life. She has been a waitress, a dancer, a vendor, a dishwasher, every possible work a mother can do just to bring up her seven children. I can say her children are very lucky for having her as their mother. She is very afraid to die because she does not want to leave her children at very dependent ages. She said she has prayed it to God several times, “wag Nyo po muna ako kukunin.” At different times, she would volunteer that she is “matapang” especially if it is for her family. She is one of those vendors that the MMDA is constantly pestering to leave the sidewalk. But at times, during the interview, we probably prodded her too much that tears would flow from her eyes, which she immediately wipes with her white face towel.
I can feel her. That feeling of spending laboratories just to rule out disease condition and eventually ending up in a clinic just because she is being suspected to have a condition that she is probably having a psychiatric illness.
This entry is a tribute to a man who unintentionally showed to me how it is to become a gentleman, a real man. He must be half-Filipino half-Arabian. He was tall and dark with a pointed nose. At first I thought he was a foreigner who is somewhat involve in the scene. But why would he be accompanying the patient. Later I found out he is the boyfriend of her sister. He was speaking in Tagalog. He claims he has long known her father, who is a seaman coming home every 7 or 9 months only. It turned out he is the only man who can become the father/brother-figure who cannot be around during the hard times. The mother and sister cannot come, most probably from the emotional burden that has just strike them. And so this man became that haligi, caring for his girlfriend’s sister to accompany to the police station and to the hospital. This man showed to me the opposite of what the perpetrator has done. Imagine that event that the rape victim went through. Your life is at the mercy of the perpetrator’s decision or insanity to just rape you or even kill you. Thanks to the Lord, the suspect was caught.
After some decades of inactivity in blogging, here I come back. I have just decided, writing is one diversion to do away from doing nasty things in life.
Today, we started in Psychiatry. What more interesting if it was started by Dr. Vista, one of the consultants I remember from last year. He introduced something that his resident psychiatrists are bypassing in therapeutic management of a patient diagnosed to have just a Normal Psychological Reaction to Illness. And that is something beyond Supportive Psychiatry. He claims that it is not just something he conjured. He says it has neurologic basis.
The idea is to spark the patient’s neocortex with facts thereby inhibiting the paleocortex, the realm of feelings and emotions. By talking about anything factual to the patient, we do away from the emotional reflexes, decreasing the tachycardia and restlessness of the patient. Then after some time, ask the patient’s feelings, then go back to facts again. Hence, the title of this entry.
It does not take a psychiatrist to do this, according to Dr. Vista, and, this should be done in the premise of a non-psychiatric patient.
I hope I’ll be able to do this in the coming years.