The day before yesterday ,a little before midnight ,a couple was brought to the casualty.They were both dead-long gone and cold by the time they were wheeled in.It was a case of deliberate self harm.Under the normal circumstances ,the doctor would have examined the patients clinically ,declared them and would have continued with her work.This time however,something made her take a long second look at the couple .They looked familiar...The doctor on call was doing a thesis on DSM and had a set of questionnairres she had to go through with each of the patients with the diagnosis.She could not put a finger to the identity so she put down the numbers mentally making a note to take the chart out the next day to see what the earlier visits had been for.
All cases of DSM ,before discharge, go through an evaluation and counselling at various grades ...starting from the doctor incharge, to the consultant and if not a staff ,the pastor.If they need help they are sent for specialist consultation.
I wondered if she had been through any of the channels.The lady ,it so happened ,had come six months earlier after consuming fifty tablets of alprazolam ,unconcious with respiratory distress.Need for ventilation had seen her going off to Dehradun the same night ...and the man had also come to the casualty on the thirtieth of the last month after consuming five alprazolam tablets at a go and had walked out of the casualty the same night against medical advice.Both the patients incidently had had no interaction with a surrogate counsellor as such.
The next thing I knew I was pushing my junior to get the addresses of all the patients she had interviewed so that we could atleast drop in a post-card and see if we could ask them to come for a follow up.
We have no psychiatrist in the hospital but we do have these steady stream of DSM patients whose number seconds only that of cardiac patients in the acute care unit admission.
It is quite distressing to note that a huge number of our lady patients who visit the out-patient when counselled and talked to,confess to suciedal intent.
This is a pandora's box for me.I have worked in Palaumu...where material poverty is so immense that it is often difficult for us to see anything beyond ...'I was hungry and you fed me ..I was naked...and you clothed me...' in the literal sense .Here in the Doon valley ,it is something much deeper...nothing short of the 'Bread of Life'will sustain the deep spiritual hunger and the emptiness I see all around..
I should like to think that my taking a little time out will make them choose life over death...I will try to do my bit in all earnestness.
you have made us for yourself,
and our hearts are restless
till they find their rest in you;
so lead us by your Spirit
that in this life we may live to your glory
and in the life to come enjoy you for ever;
through Jesus Christ our Lord
who is alive with with you and the Holy Spirit,
one God now and for ever. "-St Augustine.