One of the many pluses of being a psychiatrist that is rarely discussed is that we hear fascinating stories, stories that are moving, stories of bravery, of cowardice, of stupidity and of grandest of spirit. One of my peer review group members recently spoke movingly about a particular case he was involved in many years ago and it struck me that all of us have stories that have stayed with us. It may have been because the story was so unusual, the suffering so extreme, the bravery was so extraordinary or because we stuffed up. One stuff up occurred when I was a neurology registrar and saw a woman in her 60s who had developed some limb weakness that was finally diagnosed as one of those rare neurological disorders, the excitement being the diagnosis as no treatment is available. Anyway this woman, I’ll call her Jane was very distressed. The consultant asked me to speak to her. She told me a story of loveless marriage with a husband who had recently retired and was driving her mad with her only solace being golf three times a week. She had no insight at first but then realised she was terrified that her limb weakness would force her to have to stay home and spend time with the husband. She ventilated freely with many tears, I congratulated myself on a job well done….. We did a ward round the next day and the consultant asked Jane how she was feeling. She said, and I can remember it as if it was yesterday “I was fine until that young man came to talk to me and I’ve been feeling terrible ever since!” Well, I was enraged, here was I exercising my therapeutic acumen, teasing out a difficult situation, giving her insight and she was blaming me! It was not fair. My consultant was not happy and made his displeasure widely known. It was a good lesson in leaving well enough alone.
The second memorable case was also a woman, she was called Pip. Pip and her husband had a cottage in the country and went there frequently with their children. She was walking home at dusk with her daughter on a winding country road, a utility drove past with a piece of timber projecting forward at an angle that struck her on the right side of her head causing a significant skull fracture. I saw her two years later with regard to her claim. She had totally lost her memory for recent events. Every day she had to learn anew who she was, where she was, who her family were, how to do even the simplest of activities. At some level she was aware of what she was lost and was quite devastated. It was a very isolated lesion, she was cognitively intact with no real changes in personality and no problems with mobility.
The third memorable case was a 26 year old electrician called Harry who was married with two young children. During the course of his work he had suffered a devastating electrocution leading to the destruction of both arms. Of course he was not able to return to work as an electrician. I saw him with regard to his claim and was surprised to see that he had not, in fact refused, to see a psychiatrist or psychologist or counsellor. His explanation was memorable, he said, “I feel like I’m circling a black hole. I have to keep looking away from it because if I look into I’m a gonner. I know that if I see anybody they will make me look into it and I won’t survive. My only way of keeping going is to try and not think about it and just get on with things.
I know that you must have similar stories. I would love to hear them. I would love to hear what you learned from them.
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