Sunday, March 11, 2012

17th Centruy France and 21st Century Pakistan

I recently gave a presentation on mental institutions in the 17th century. We did have an idea about what they were like because we keep studying old practices every now and then but I came across this particular description about a particular institution in France, called La Bicetre [pronounced bi-sseth], which gave me the chills. Here is the excerpt:

"a typical scene at La Bicetre, a hospital in Paris, starting with patients shackled to the wall in dark, cramped cells, iron cuffs and collars permitted just enough movement to allow patients to feed themselves, but not enough to lie down at night, so they were forced to sleep upright. Little attention was paid to the quality of food and the rooms were never cleaned. Patients had to make do with the little amount of straw to cover the cold floor and were forced to sit amongst their own waste that was also never cleaned up".

Last weekend, we went to visit the patients at Sir C.J. Institute of Psychiatry in Hyderabad, popularly known as Giddu Bandar. The whole purpose of the trip was to show us what its really like to work in a mental institution and also to show us how to communicate with patients who have severe symptoms of psychosis.

Before I get started, I must mention that I saw some neat scenery on my way to Hyderabad. The dried up lake, nice green fields. It was pretty.

Before going there, we we're given clear instructions that we will see things we dont like and as bad as the situation, we must remember, that before this hospital was built, mentally ill patients used to wander the streets and they were not accepted by their family or society. Had no place to live and no food to eat while children threw rocks at them. And now at least they have a safe place to stay. In other words, we were mentally prepared to see the worst.

There are 11 wards in the hospital. We were shown only 4 of them.
The first ward we visited was of patients with mild to moderate symptoms of schizophrenia. The moment I walked in the ward, I was taken over with fear because the beds of the patients were too close together, leaving a very small space for us to walk. I couldnt help but think that one of them will have a fit and get out of control. It was especially pathetic of me to think that because of all the people I should know these patients, like any other, are sick people and not animals.

Anyway, the fear was gone when I started noticing the room and people in it. The walls were of dull gray and white color [that had gone yellow from filth]. There was no ventilation in the room because all the windows were covered with net, with piles of dirt caught in between. And then I noticed the bed of patient right next to me. He was staring at us with amusement, lying in his own vomit and piss which I could tell hadn't been cleaned for a couple of days. That's where the stench was coming from. Suddenly I had a feeling that I've visited this place before or seen it...then I realized that I was actually inside the the image I had in my mind when I first read the description of Le Bicetre.

The second ward we visited had only one patient suffering from psychosis. He was narcissistic with a sense of grandiosity. Keeping all my emotions and empathy aside, I found him to be the most interesting of them all mainly because he also suffered from neologism. Neologism is the use of meaningless words by a person suffering from psychosis. Initially, we thought he was speaking in different languages because of his fluency, but later we were told that it wasn't a language but random words the the patient made up. We actually learned quite a few things about psychosis.

The third ward we visited was for female patients. They too had schizophrenia with some having absolutely no reality contact. The difference between the male and female ward was that the females were locked in room, giving it an appearance of a jail. Im not sure what the inside of the room was like because they dint let us in saying that the female patients were more hostile than the male patients. We stood outside and spoke to them. From what I could see, it was not as dirty as the male ward but not necessarily clean either. There was another room inside the room, with a jail like appearance for patients who made too much trouble.

The of the sad things was, that the less sick patients were responsible for taking care of patients in bad condition. There were only two caretakers outside the room who shouted orders to the patients inside..."Nudrat...Naseem baji ko ander band kardo", like Nudrat was a certified nurse. Naseem seemed to have severe symptoms of psychosis as she had no idea of who she was or where she was and kept taking off her clothes saying obscenities. I dint quite feel the pain of these patients until one of them came in front and began crying. She sat by the gate and kept repeating "main pagal horai hoon mujhe dawai de do mai bohat bemaar hoon. Mujhe theek kardo mujeh ghar jana hai"

Most of these patients were brought in by their children. Seeing us actually made them happy because they never have any visitors, including close family members.

The last ward was of suicidal patients. Most of them were asleep due to heavy medications and one of them chained to keep him from harming himself. We heard people shouting in other building but the head doctor wouldn't take us there saying it wast safe.

Almost forgot about the head doc, who is also the managing director of the place. Lets call him Dr. Josef Mengle, because he reminded me of him. Dr. Josef Mengle was one of the head doctors of the Nazi concentration camp where he conducted many experiments on humans, twin children in particular. The most popular experiments being injecting fluids in the eyes of kids to change their eye color and stitching twin together to form Siamese twins.

Of course he's not as badass as him but he sure has the tendency to get there. Rude and ignorant, he dint hesitate insulting two people of our staff members [security guards] for stepping inside the building because only people who have had some particular education and training are allowed inside the building. His favorite form of treatment was obviously ECT [Electroconvulsive Therapy] as he kept on saying that we should've arrived before 10 am because then he could show us patients receiving electric shocks.

He refused to show us around after 1.30 because his daughter was coming to pick him up. Though the morning shift doesn't end till 2:00 pm, all the doctors left before 1:30. The whole facility has over 300 patients, 5 psychiatrists and only 2 psychologist [only one available at a time]. I honestly dont know on what basis are the patients divided because it appeared that they were all randomly shoved together in a room ignoring the severity of their symptoms which can have a drastic effect on the health of the patients who only have mild symptoms.

Our teachers told us not to criticize the hospital unless we are willing to do something about it ourselves. So Im just going to shut the fuck up because I know I wont be going back there again. I dont have it in me. I couldn't even talk to the patients like the rest of them. I was too caught up with my own thoughts. It was the first time that I actually questioned my ability to become a good psychologist because honestly, I dint know how to react. I couldn't even stand the fact that I shook hands with one of the patients. Im not sure if Im more disgusted with myself or the caretakers of the institution.


quartertoinsane said...

maybe u'll be more acclimatized da nxt tym u go there...

is it true that that joseph guy tried to extract human souls?

uzme said...

extract human souls? o.O
No...he was just interested in creating his own saimese twins.

quartertoinsane said...

I am slightly disappointed he didnt... but still thats inhumane.

Bush. said...

Wow. Come to Jinnah.

Sarmad said...