‘Dimag ka doctor’ can make your life better!

After a great deal of inner conflict, it was on a sunlit Sunday that I finally mustered the courage and energy to visit a relative residing in the city to which I had migrated in the recent past. This relative is a 38-year-old gentleman, PhD guy and a scientist by profession. At the outset, I would like to elucidate his educational background, the purpose of which would become evident in the following paragraphs. He has been scientifically inclined since childhood, has read widely and has a praise worthy command of language, which I used to envy as a child. He has been a ‘practising’ atheist, feminist and a Marxist as long as I can remember, even from a time when these terms sounded Greek and Latin to me! His education was completed in the West and purely for ‘serving his country’, he returned back to India. In short, he was someone whom I adored since my childhood and worshipped as the epitome of knowledge and scientific temper.

As a response to my question on why his face looked dull, he started to give an account of his medical history. I know most of the doctors can relate to this experience of mine, being subjected to an obligatory session of listening to people’s medical history. Personally I enjoy such sessions because it serves as an exercise in compassionate comprehension of another person’s thoughts and beliefs. So even though my specialty training was in a different field, I listened to his issues with an open mind. His problem was debilitating fatigue; one of the kind that confines you to bed in the morning, keeps you low throughout the day and prevents you from playing with your bubbly two year old. He has seen renowned neurologists and endocrinologists in the city, and none of them even with collective effort was able to find a cause for his fatigue. He read on Google about ‘myasthenia gravis’ (It is a celebrated name for one of those muscle disorders which makes your muscles weak) and was excessively worried whether his neurologist had missed the diagnosis completely. I gathered more information about his symptoms, did a mini neurological examination and went through his test reports. It was glaringly evident that his problems were not due to any underlying organic disorder. I suggested that depression could be a differential diagnosis in his case, which would explain all his symptoms. Before I completed my sentence he became enraged and hostile. Palpable tension began mounting up in the room.

He retorted, “Depression?!I don’t have any reason to be depressed!”

I replied, “Depression need not be always due to an external factor. There is something called endogenous depression. The rate in our population is pretty high. So even without any precipitating factor you can be depressed!’

He retaliated, “This is why I don’t trust ‘English medicine people’ [He meant doctors who advocate modern medicine]. You people have a vicious pleasure in branding a normal person mad!” I explained calmly that I did not want to belittle his symptoms and I was trying to find a plausible explanation for his physical symptoms. He was not ready to accept, became vehemently defensive and stopped talking to me altogether. Though the situation became a bit awkward, I felt contented, as I could finally bell the cat!

Though I knew my words were falling on deaf ears, I narrated the experience of my close friend from MBBS class. She developed twitching of all the possible muscles in her body and had exaggerated tendon reflexes. With her half knowledge, suspecting a progressive neurological illness, the one that Stephen Hawkins had, while she went ‘doctor-shopping’, she dragged me along. None of them could identify an organic disorder in her. Finally a wise senior physician suggested that she should consult a psychiatrist. After three months of therapy, which included medicines and counseling sessions, she was totally free of all her symptoms. Of paramount importance was the change in her persona, whereby she emerged to be more cheerful and peaceful. I recounted another example of a 12-year-old girl who was admitted in our ward for difficulty in walking and a peculiar gait. She adamantly remained confined to bed for a week while undergoing various tests which failed to identify any physical disease responsible for her symptom. Simultaneously we got her evaluated by a Child psychiatrist who rightly ascertained that her religious teacher terrified her by imposing an idea of a God who would punish if she danced. This girl who was a good dancer, got perplexed and could not tell this to her school teacher ,as a reason for non-participation in a dance competition. The only way her mind could resolve the conflict in that situation was by commanding the nervous system to stop functioning. That young girl reasoned if she refrained from walking, no one would compel her to dance! After a few counseling sessions, the girl resumed walking.

I thought enumerating these examples would bring a change in his perspective about a sick mind being capable of causing physical symptoms. I was proven wrong when he said, “Why are you in denial that I have a neurological problem? I will never visit a psychiatrist in my life.” At that moment, I waved good bye, realising that the only option I had was, to leave  him to wage his own war .

A bit infuriated and irritated, wondering how an educated and scientifically oriented person like him can have an altered view of depression, on my way back home, I headed straight to a movie hall to watch ‘Dear Zindagi’. I was astonished when I heard Shahrukh Khan delivering an almost identical script that was being played in my mind. The movie, I feel, is a novel attempt because it emphasizes the need for a counselor or therapist at some point in everybody’s life. Lot many times people need support to accept who they are and grow comfortable in their own skin. Learning to adjust with oneself is perhaps an arduous skill to assimilate. Taking the help of a counselor can make that task easier.

As Shahrukh Khan vocalizes, many a times, mental suffering unlike broken bones, does not end up producing a convincing effect for the onlookers to see and empathize. Psychiatry as a science and psychiatrists have been pictured and portrayed in movies and media with so much of negative connotation that people simply refuse to acknowledge the need for a ‘Dimag Ka Doctor’ to make them feel better. To pacify such people and enlighten them, it requires a Shahrukh Khan or an Alia Bhatt. People, who do not recognize the existence of mind as a distinct entity that can fall sick any time, are sadly the ones who need assistance the most. As the movie ended, I called that relative of mine to find out whether he had any botheration in visiting a movie hall instead of a psychiatrist’s office and sent him the tickets for ‘Dear Zindagi’, hoping that Sharukh Khan and Aliya Bhatt would win where I failed miserably.