Thread by @docbhooshan

#psychiatry
#lifelessons
#thread

First year of psychiatry residency teaches some valuable life lessons.

Here is a real life story about fighting delusions and living with them as it applies to today.

I worked in a municipal hospital during my urban internship stint. There was once a week Psychiatry OPD started by resident medical officer Dr Shirole and visiting consultant Dr Thombare (unfortunately, both have now passed away). I had already expressed my interest in Psychiatry

So I was allowed attend this OPD.
Dr Thombare wanted me to learn about symptoms of mind so he asked to talk a patient in detail. He allocated a middle aged man as my patient.
He was on treatment for years and was considered a "stable" patient.

One afternoon, I sat down to hear his life story. As it was common those days (1994), he had suffered a few years of symptoms before receiving treatment. He had an extensive belief system supported by his hallucinations.

He firmly believed that his wife, children, other family members, neighbours and colleagues all were part of a group that kept an eye on him, stole his money, prostituted his wife and did terrible things to his children.

He experienced that his thoughts were broadcasted on a special channel on cable TV accesible to only few selected people from that group.

I listened to him all afternoon with fascination. Struggling to tell myself that it was all in HIS head.

Later when I started my psychiatry residency in govt hospital in same city, I met same gentleman again as my patient.

Once, I don't know what I was thinking, I decided to spend one more evening talking to him.

I tried to "talk him out of his delusions" as intellectual exercise and failed spectacularly as it was bound to happen.

He had is own way of interpreting everything happening around him in a way that fit into his delusion.

Even things that I considered as clear evidence that should have shattered his beliefs, were neatly mis-interpreted by his mind as evidence towards his beliefs.

After struggling with it all for an entire evening, I had convinced myself about unchangeable nature of delusions.

Over next few years, he had 2 more episodes of his illness (Paranoid Schizophrenia) and I saw his delusional system evolve to include whatever was happening around

I witnessed firsthand how his mind continued to invent past that was supportive of his beliefs.

Between episodes, he was a regular family man with a job. Just like me.

For long time I believed that such experiences were common only with those brains that were occupied by psychosis.

And then internet happened, social media happened and post-truth happened.

And I started finding regular chaps like myself getting consumed by stories and narratives. Including every new experience into their belief systems and they even have their own TV channels catering to echo and magnification of their distorted beliefs.

Now we call that belief political ideology and it is a freedom protected by law.

They all hold regular jobs but live a life of suspicion and anger and fear. Dividing the world between us and them.

No amount of convincing will do. They seem lost.

No matter what they call their ideology, they seem to be more alike than different.

Ignoring reality and relations and real needs of present.

Only an asylum seem to be a sane place now.