A mandarin orange

CGC is a divorcee in her late thirties. She has bipolar mood disorder type 1 and end-stage renal failure, needing haemodyliasis 3 times a week. She ran a course of relapsing and remitting mood episodes over the years, mostly mania at its worst form which landed her from the most basic psychiatry services in a small town to the state mental institution. She was well-known among psychiatrists serving in the southern region of the country, mainly because of the difficulties in bringing her illness into remission and ironing out her psychosocial problems.

When I was still a service medical officer in the state general hospital, she gave me hell with her full blown mania. We loaded her with sedatives and antipsychotics and mood stabilizers up to off-label doses and yet failed to bring her back to a balance. She damaged all physical restraints that we ever had (we had to resort to physical restraint when chemical restraint at high doses didn’t help). We had to run electroconvulsive therapy on her up to 12 times in a full cycle. And when she’s better, nobody wanted her. Her family rejected her. Her husband divorced her. Her children kept a distance from her. Several psychiatric nursing homes in the city refused to accept her. She was a havoc.

She finally ended up as a long-stay patient in the state mental institution, much to the dissatisfaction of the psychiatrists because they were trying hard to treat mentally ill patients in the community instead of the old-fashioned, unyielding way of institutionalizing them.

On the days when she was well, she would tell me how she failed as a wife, mother and human being. She teared talking about her children and how they had to grow up without a mother figure. She spoke with contempt how her husband abandoned her. She considered running away from the institution but later gave the idea up saying, “I guess this is my home”.

Last Chinese New Year when she was pining for her family, the hospital’s social worker arranged to escort her back to her hometown which is 2 hours’ drive away so that she could visit her children at her mother-in-law’s house. We took a picture of her flanked by her 2 children, printed it on an A4 size paper and kept it in her files so that she can look at it anytime she wants to. Although she’s better for the past year and the psychiatric social welfare team made several home visits with the hope of sending her home, her family refused to accept her back into their lives. Her only visitors for the past 2 years were volunteers from Christian based groups and she had learned to seek solace singing Christian songs. She is most probably right. The institution will be her home till she breathes her last.

Forgiveness must have been one of the most difficult things in this world.

I spent my first 6 weeks of specialization training in CGC’s ward and I observed how she lives in this place she was forced to call “home”. I must say that we have given her the best we could. I pray that one day, her children would grow into empathic adults and give her a second chance, a real home.

Today is my last day of this first rotation. CGC came to me and sheepishly handed me a mandarin orange. “Happy Chinese New Year” she said with a smile. I returned the greetings and asked her how she got the orange. A visitor came earlier and donated a crate of mandarin oranges for the patients. Each patient was handed one mandarin orange.

“If you give me your orange, you will have none” I pointed out.

“It’s okay. You are leaving and I have nothing to give you”

I put the orange back into her hand and assured her that she doesn’t have to give me anything. I acknowledged her gratitude. Her gesture was the sweetest non-verbal form of thank-you that I have ever received.

“Although I will be posted in another ward, I’m still working in this same hospital and I promise you I will come back to visit you” I told her.

She smiled. “I will wait for you”

My patient has gotten herself a second visitor. As for me, I bring home with me another valuable lesson about mankind that’s never been taught in any textbook…

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Explore posts in the same categories: Nutcase, Strictly Medical

3 Comments on “A mandarin orange”

  1. jellio Says:

    Your patient is so sweet. Sometimes a little kindness goes a long way. Hope her family will accept her back some day..

  2. sin Says:

    Your post made me cry at work! :_(

  3. Xiao_zhai Says:

    I must say a job well done. Keep up the good work :)


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