This month was a bit of a roller coaster.
Exams.
Census.
The perpetual chart battles in the Only-in-PGH Emergency Department (you try not to be a part of it, but your name just keeps popping up every now and then).
And a whole salad bowl of intense emotions that needed to be sorted out.
But July is here.
And with it comes a new batch of brewing bitter vegetables that we need to swallow down for our own good.
I come from the point of view that nothing could be as bad as it seems. I'm in training because I chose to be. If this is not my calling after all, I'm still already a doctor and I will always have a home.
I've been in the psychiatry department for half a year now, only a speck in the hourglass if you compare it to the greater scheme of things, but the chronicles I hold in my head are more than enough substitutes for what other people consider as their daily need for their prime time soaps.
I'm off to the province tomorrow for my brother's ordination and my dad's birthday, bringing along my 3 month old infant, her favorite stuffed animal, Peewee, and her nanny. Just for the weekend, the feel of salty sea breeze, the tang of lime and soy sauce for the smorgasbord of shellfish and oysters and grilled squid stuffed with onions and tomatoes, and the pleasant atmosphere of a smog-free small town, and the company of family, is an itinerary worth an adventure.
Home is something to be thankful for. I can't imagine myself sitting in front of my patients and listening to their woes if I didn't have someplace like Roxas City to fly to when I need to run away and regenerate.
You see, Schizophrenia... it's a downward drift. Not just for the patients but for their families as well. I see a mother hyper-vigilantly arguing with the nurses about her mentally ill child and sometimes I get drained. Drained from the seemingly endless broken record I feel like becoming when I try to reason with them. Drained from the strength I know I must muster to keep my own defenses up. Drained also from the strength I must try to give to other families who seem to have lost hope.
What do you do for patients who have nothing? A drawer full of free samples can only go a long way.
There are others who are intellectually and physically able to provide for themselves, and then society spits them back out into the whirlpool of their psychosis the moment their mental illnesses are discovered. Never mind that he has a masters degree or is currently working on a doctorate. Never mind that he can do complicated equations without a calculator. Never mind that he could have an IQ greater than yours and mine combined...
Never mind.
Never mind.
Never mind.
He has a mental illness.
That one.
They mind...
How do I protect my patient from such prejudice?
And who am I to judge his employers for protecting their own interests?
And what of love? Are the mentally ill capable of a love that is true? By law, psychological incapacity is a ground for the dissolution of a marriage. But who are we to say that there was no love? And what of "till death do us part, in sickness and in health?" Is not mental illness nothing more than another sickness to which there are treatments? And where do we draw the line between our social responsibility and the trampling all over of another person's right to love or to bear children? I wrote last February about a patient known to have a chronic mental illness who came to my ER, anxious about getting married. She was the one who met her fiance in the psychiatry ward when they were both admitted. Now they're married and now she's pregnant. She had the insight to stop taking her medications because she new there could be adverse effects to the baby in her womb, but the cessation of medications brought back her psychosis with a vengeance. He watches over her like a mother hen over a chick. For that is what she seemed to have become. Regressed and childlike with eyes that seem to watch the world from someplace distant. Someplace far. Not here. Not here. Not in this very judgmental, very unhelpful world we call "normal." Slowly, gently her doctor pulls her back, a milligram of Olanzapine at a time. Because no matter how unjust reality seems to be, it is still where we belong. It is where her child will be born and more likely than not, some future psychiatrist will have to be that child's secret chronicler.
It's also quite timely that I when I was feeling this woe-begot about my patients and how desolate they seem to be that I passed by Alikabook, (the best bangketa bookstore along Padre Faura Street).
Books...
Better than bouquets...
They make me happy.
So, Needless to say I bought a paperback, hoping to get a little high.
Nectar in Sieve, by Kamala Markandaya.
From a poem by Samuel Coleridge: "Work without hope draws nectar in a sieve..."
And it was such a sad, sad book. Not the kind I needed at the time. But beautiful, none the less. Only a strong woman like Rukmani could have endured without complaint the ordeals that Markandaya made her go through. Extreme poverty, also a disease that breeds more hopelessness. And the resigned acceptance of one day's tragedies in perpetual hope that tomorrow will get better. Tomorrow is always better. It was a heavy feeling. Rukmani is a heroine without triumph. Only the promise of "later." Only the virtue of extreme patience in accepting all the blows.
Haist!
I knew it was time for me to take a moment and put myself back together when a mother asked me, "lifetime na ba ito talaga doc?" and I felt my heart break because I knew I must say yes. I shouldn't be too involved. There's a chink in my wall and I must repair it.
So, thank you Johnny for the invitation to come home... and just in time.
Woes begone!
And Promise will be with me. Her first airplane ride and she won't even remember it. The way Nanay ring will ball her up in a jacket and more than one layer of wrap. The way she will squirm in my arms when she's hungry or in need of a diaper change in the most inconvenient of places. The way daddy's eyes will smile the moment he'll see her. The way mom will hold her in her arms in a manner which will probably remind her of how I was when I was at that age. No, Promise won't remember any of that.
Although I will.
In that respect, I can understand Rukmani with all my heart.
As a mother and how mothers remember...
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