#56

This is an experience I thought of sharing. The reason why I am writing about this is because I believe that obsessive compulsive personality discorder is not a laughing matter when it could be for some. OCPD is different from OCD (Obsessive compulsive disorder) in many ways yet similar in some. In OCD, the patient would be aware of it but this is not so in OCPD.

During my posting in psychiatry, I met a patient. It is amazing by how much you can learn by just observing a person's actions and this is not something that someone would normally do unless you have a lot of free time in the world. Well, I had that free time. At first, it was a bit odd because this person also has schizophrenia and so there were stories which my friends and I heard. After awhile, I noticed that this person would ask the same question at least 2 - 3 times even though an answer was given after a few minutes each time. Everything had to be proper it seemed. Arrangement of the things brought along, sitting posture, properly structured English sentences.

Initially, a few people laughed because it was weird to ask a question over and over again after being told the answer multiple times. But then later, I noticed that it was not weird at all and this person, I felt, was actually anxious and required reassurance. And I was right, this person did have OCPD. I felt that this was an amazing experience because it is sort of like getting a diagnosis right without being told. It is sort of like being able to pick up something just by observing and not just that, by listening to what patients have to say, they make the best teachers.

This is also one of the reasons why we are advised to spend more time in the hospital than to study books because everyone comes with a different presentation. One matter can overlap with another. One matter may predispose a person to another disease/problem. I guess what I am also trying to say is that mental illnesses is not something to joke about. Sure, it can be joked about among a circle of friends but not in front of a patient or stranger because it is a sensitive issue and that does not mean these patients do not deserve the care. I feel that they are the ones who deserve more care.

I met many doctors who inspired me and taught me these lessons of caring for a patient. Child psychiatry (Autism, Down's, learning disabilities etc) and neuropsychiatry (dealing with behavioural changes in Parkinson's, Alzheimer's etc) were two fields which caught my attention. It's not that doctors in other postings do not care about their patients but I suppose it is because in psychiatry, there just had to be extra attention to the patient's wellbeing.

At this point, how many are there who actually care for the patients? Back in Phase 1, we knew nothing about empathy. We were excited over cases, not patients. The more severe, serious and rare it was, the more excited we would be. But now, it is different. Sometimes, I find it depressing. I am yet to be able to deal with death well. I cried a lot when 2 patients whom I have been following up with since their admission passed away because I got to know what went wrong, how their lives have been and the suffering at the end. And I know that crying was normal.