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Monday, March 16, 2015

IN THE PSYCHIATRIC WARD

A sound mind in a sound body ~ Aristotle.
“Redemption song, that’s all I ever heard…the songs of freedom… redemption song” Hilda sang as she rolled a piece of paper, placed it between her lips, dragged in a breath and blew imaginary smoke making her grand kids and daughter laugh. Hilda wasn't this amusing when she was admitted, she was regularly making a rack, throwing her belongings, pouring out her drinking water, body spray, juice and just about anything she could lay her hands on, she also probably cursed, but in Kiswahili (she was Kenyan) and told the entire ward they are only good for ‘gulma’. She had to be put in the isolating room a couple of times just to ‘teach her a lesson’.  And I guess she did learn! Hilda got discharged a week before we did even though she came in a week after we did. This made me really want to slap in-sight into my sister’s head! Sometimes, Hilda would ask me for a pen and paper and she would write notes to her doctors apologizing and telling them she knows she has a medical condition and promises to stay on her medication plus how she really appreciates their efforts but she really wanted to go home. I don’t know much about psychiatry and if they can tell the truth from the lie but I think she just wanted to go home and not that she was going to carry on with her treatment but, I guess that’s really not for us to judge. Medical ethics does not allow for one to be retained after he/she has proven to respond positively to medications and is not a harm to themselves or the community, so Hilda was discharged.
Hajiya Maimuna spoke to herself; actually saying things which made sense only if you've been listening from the very beginning and even when you ask her what she’s murmuring, she tells you. She was a tad untidy with her belongings, clean, but untidy. I was frightened of her at first (I was frightened of all of them, including my sister….just saying!) Hajiya Maims was always in the bathroom, it became funny with time especially when the nurses were handing over duty, they go round the ward to each patient and explain to the one taking over the what, how and when of that patient. At Hajiya Maims’ space, you’d hear them screaming out her name “Hajiya Maimu, kina ina? Ki fito, ki gyara wajen kwanciyan ki.” And she would emerge from the toilet; I wonder why I never followed her to know what she did in there. I dunno how long she was before we came in but she was discharged 2 weeks before we were and guess what? Yep! She was brought back for being violent. Psychiatric cases are really one of the toughest and I have so much respect and admiration for the persistence of the doctors and nurses. Hajiya Maims was probably the kindest patient in the ward, she had no patient-relative with her (usually psychiatric patients hardly need them for they are physically fit) but she got visitors during visiting hours which I think cheered her up a lot. She shared whatever was brought for her and did not mind if any of her things got missing. I pray she is doing better now.
Farida just sat at the corner of her bed and said nothing to everyone all day. She only smiled a bit when the Sister teased her and when I realized she wasn’t so bad, I also began teasing her. At first she would look at me and just keep staring, it was unnerving but finally she relaxed and would smile at me too. I heard she never spoke to her doctors during ward rounds, many of the patients hardly do, they seem to not like them and feel they have been brought there as a form of punishment.  Her mother was staying with her; she was really very prayerful and kind. Farida, I was told, has had bipolar for a very long time, about 13 years after the birth of her last kid. Post-partum depression, like Amina, and like Amina, she keeps going on and off her medications. Apparently Farida would get violent and she had to be tied up, very sad. But Alhamdulillah her mother, whom we called Goggo, also believes orthodox medicine is a remedy for diseases.
Maman Abba had the tiniest baby (only second to my Oosha) I had ever seen, I think she came in for post-partum depression. But I heard (everybody talks about everybody to everybody in the psychiatric ward) when she was brought in, she didn’t want to hold her son and she would scream so loud (I didn’t get to ask what she screamed out). Anyways, by the time we came in, she was calm and was even backing her seriously-too-tiny-to-be-backed-baby! She was also quiet but not like Farida. I think she’s an introvert. Her husband came to visit daily and so did other relatives oh, her mother stayed with her since she was a ‘mai-jego’. I was just glad the husband didn't abandon her with the way many of our men and general African people treat psychiatric cases, you’d think it was a deadly contagious disease! May Allah open our eyes and hearts to accept and seek help for those we know suffer it.
There was Hajara, Maman Aisha, Sadiya who got better was discharged and then returned because she was harassing everyone and being violent (probably stopped taking her meds or it got mixed up or something). Blessing was discharged about three days after we were admitted. I don’t know why she was in there but physically, she looked so malnourished, she was weak and just skin on bones. She had intravenous fluid which most of the time was not fixed and even when the nurse came to fix it, she complained of being tired and wanting to rest…talk about having a choice!!!
And now, the reason why we came to the female psychiatric ward; Amina. She gave quite a tough time before she agreed to be admitted. The entire nursing students and staff, including the security guards had to be called into the room for her to realize she needed to be there because she needed help and urgently as well. Amina had a severe case of bipolar disorder (Mania and Depression). She was in a very bad place when I brought her in but today, Alhamdulillah, she is so much better. But till date, Amina does not agree she has a psychological problem, which in the medical world is called in-sight and due to the entire absence of this in-sight, we stayed about 6 weeks in the hospital. She was discharged because NARD was embarking on a strike, the one that got them all fired! (seriously LMAO) *clears throat* okay, back to Amina.
All the nurses seemed to really like my sister, we are a very likable family *polishes invisible The Most Likable Family medal* she didn't give them trouble at all, she took her meds when it was brought without complaining or excuses, she attended OT, occupational therapy which was a room filled with stuff to keep them physically and mentally busy considering they do nothing all day long. The room has computers, tread mills, sewing machines, a table tennis board and a television set, so when it Is opened, patients go in and pick an activity of their choice to engage in, my sister is a television lover and she engaged herself watching all the Arabic stations which I think maybe annoyed the rest of them who wanted to watch Hausa movies or something else. She was a good patient who obeyed not because she believed she had any problem but because she is just a good person who does things for the sake of peace.
Amina does not like Dr. A who is my favorite psychiatrist in the world! For he was the one who had her admitted like I mentioned earlier, he called in all the staff and students; his aim was to let her see it was not just my imagination or his wanting to admit her but that she actually had a problem everyone except her could see. I cried explaining to her why I lied about where I was taking her to and my reason, “Amina your shame is my shame and when people point and laugh at you, they’re pointing and laughing at me. And yes, you do not think anything’s wrong with you but I do and so does everyone else and I had to bring you here. I am so sorry.” She stared at me with daggers in her eyes I think if there were not enough people around, she would have hit me. She still carries the hurt of deception plus her paranoia and all what not but, Alhamdulillah, I did what had to be done.
Lights-out was by 22:00 hours and then we were locked in from outside. I could hardly sleep, the mattresses were solid hard, I was hot and there were mosquitoes. I remember preparing for my first semester exams so I came in with my books and read by the light of my handset when I couldn't sleep. Would wake by 03:00hrs have my bath and do the needful, by 06:00hrs the nurses would wake everyone up to prepare for the day, those who needed hot water to have their baths and then drink tea, take their meds and wait for the team whose day it was to have ward round. Psychiatric ward rounds differ entirely from other ward rounds, they have a room which has a couple of chairs for the doctors, the nurse, patient and patient-relative arranged in a semi-circle manner. The patient to be seen is called in by the nurse and if the patient-relative is around, she/he is also invited and “the interview” begins. First with the nurse, she/he tells the doctors on the attitude of the patient from the day they arrived till present day, the improvements, still-there and unchangeable character of the patient, what they feel might be done to help the patient then, the patient-relative is also asked questions, if he/she feels there is any improvement in the patient and if there are other areas that they could render their assistance to; psychiatry is a very personal and thorough unit, everything is investigated; parents, childhood, teenage hood, relatives and if possible, life after death *wipes sweat*. Then finally the patient is placed under the microscope, they ask and write (what are they writing? Can I see? I want to see *tears welling up in eyes*) and from this they draw their conclusion on whether the patient will remain or be discharged. I gathered they try to find out if the patient has started having in-sight into their problem, for; the having of in-sight is the beginning of healing in psychiatry.