Friday, 12 April 2013

When life gives you lemons....

Some people just get more lemons than others. Whilst the old adage tells us to make lemonade sometimes it just isn't that easy. 

As a medical student I see some pretty shocking things and none more-so than during my current placement in Psychiatry. Whilst social stigma dictates the most shocking things I should be seeing are extreme acts of violence and depravity from patients with schizophrenia and personality disorders I have to say that has not been the case. The most shocking things I've seen are from ordinary people who really have been dealt the most lemons. From people addicted to drugs and alcohol, screwed over by poor childhoods, social and financial deprivation and a faulty system hindering their progress despite motivation to change, to the ordinary family man/woman whose lives have been destroyed because of one person or thing setting of a chain reaction. It's the latter that has lead to me writing this...

Yesterday I spent the day with an acute psychiatry service. Their primary goal is to assess and manage patients who come into acute medical settings (A&E or acute treatment wards) with onset of acute mental illness, or, primarily, suicidal ideation (either threatening or attempting suicide). It was a pretty standard morning - timewasters, the intoxicated, the extremely depressed, the personality disorders, the usual. By the afternoon I had gotten a pretty good indication of what the team had to deal with day-to-day. My final patient had taken a large overdose of paracetamol (around 60-70 500mg tablets) a couple of days previously and was now medically fit for discharge. He was a lovely gentleman - pleasant and friendly, polite and well-mannered, and just an all-round sweetie. But there was this underlying sadness about him that instantly made you feel a sharp pang of emotion.

We started the assessment and listened to everything that led to his suicide attempt. From the start of his life he was dealt a tough hand - single parent family in the 60s, mother a severe alcoholic who provided no support for him, an intelligent child left to under-perform at school due to bullying, leaving school with no qualifications and no friends except his beloved dog, a whirlwind romance leading to a failed marriage with 3 children who he barely sees until finally he meets the love of his life - his soulmate. He is a happy family-man - honest, extroverted, passionate, sociable, hard-working, and very content with his life. Him and his wife do everything together, talk for hours about nothing, laugh and love and live, in his own words, a "wonderful" 30 year marriage with 2 children the product. He becomes a chef, and every Sunday cooks a marvelous meal for his family including large numbers of extended relatives. Time goes on and his kids grow up and move out. his wife becomes distant. 

A year after his youngest moves out his wife turns to him and tells him she doesn't love him any more. She asks for a separation and tells him to move out as soon as he can. The only available accommodation he can afford is miles away from his job and his family. He isn't a young man any more. He has to quit his job as a chef and take a manual job near his new home. His children no longer speak to him. His family and former friends cut off from him, he is now isolated and alone. This chef doesn't cook any more because "what's the point in cooking for one"? He gets up, goes to work, comes home, sleeps. Rinse and repeat. Not long after he is diagnosed with depression. He is quiet now, introverted, rarely socialises, has no passion for anything.

Months later he learns his wife is now seeing a new man - a former family friend known for his Casanova-like behaviour. As time goes by the man sees them together and, his love for his wife still strong, worries about him breaking her heart. She has become a much more callous and vindictive person, rude and cruel towards her husband. Months later the man bumps into the wife's new man and warns him to look after her properly. This is not taken well and they begin to fight, as the man described it, like "schoolgirls"... "pathetic really". No injuries are sustained bar mild bruising and scratches. 

A few weeks later the man is woken up in the early hours by loud banging on his front door. He opens the door to be arrested by the police on suspicion of assault. He is handcuffed and loaded into the back of a police van. He is taken to a police station in another city and given no explanation as to why. He is left in a cell for hours before being questioned, charged, threatened with prison time, and released on bail. He is left in another city with no money or phone and no way of getting home. 

Thanks to the kindness of strangers, 3 hours later he makes it home. Exhausted, degraded, and upset he decides to pay his wife and her new man a visit. He goes to her house and asks to speak to them. She won't let him in and starts shouting at him through the window. He asks if they would drop the charges saying that if they did he would leave them alone forever and they could all just get on with their lives. His wife tells him she hopes he goes to prison and rots there forever. She hopes he dies and rots in hell. The man gets angry and shouts back, playing her at her own game. He goes home more upset than ever.

Over the weekend he realises that this is not the way he should have behaved. He still loves his wife and doesn't want to treat her badly. He decides he should see her to apologise. Little does he know that his wife has filed a harassment case with the police and as soon as he arrived they are called. He is calm and unaware and apologises to her through the door. He sees a police car turn the corner into the street and runs back to his car, terrified. The policeman approach his window. He tells them to please apologise to his wife on his behalf and drives off before they can say anything. 

He drives around for hours, terrified of being arrested again for an innocent act. He doesn't want to go home in case they look for him. He checks into a hotel for the night to let things die down. He sits and he thinks - what has his life become? He is alone and frightened and has no-one to talk to. Everyone he ever loved has abandoned him. He has spent his whole life a good and honest man and now he is being treated like a common criminal for doing nothing but trying to reason with the woman he loves and the man she has left him for. He is lonely, sad, and degraded. What is the point? She wants him to die, he'll give her what she wants.

He spends the evening driving to different shops collecting packet upon packet of paracetamol. He gathers around 100 tablets and a bottle of cheap white rum and returns to his room. He emails his wife telling her she has now got what she wanted. He empties all the tablet packets onto the bedside table and takes one with a sip of rum. The rum tastes awful. He can't stomach it. He abandons that idea and uses water instead. One by one he takes the tablets until he begins to choke and gag. Somewhere between 60 and 70 tablets later he can't take any more. He decides to go to sleep now in the hope he will never wake up.

He lies in bed tossing and turning. His mind is racing. His thoughts replaying the last 30 years - how did it get to this? What happened? Why did life so suddenly turn on him? He starts getting dull aches in his abdomen. He really feels like crap. Morning comes and he hasn't slept a wink. He is still breathing but he doesn't feel well at all. He suddenly realises what he's done and immediately regrets it. He gets in his car and drives himself to the nearest hospital. He is given treatment and recovers, highly regretful of his actions. Two days later we see him. He has still heard nothing from his wife.

A man with a tough beginning came through it all and led a good and happy life until out of the blue one woman destroyed it all in four words - "I don't love you".

I tell you this story because for me it highlighted something so real and so important - it doesn't matter who you are and how well things are going, life can very suddenly rain down lemons and they can weigh you all the way down. Put up your umbrella and try not to get yourself too wet. Afterwards you may not be able to make lemonade right away but with time, the right tools, and the right mentality you'll get there. In the meantime, appreciate what you have because you never know when those lemons are going to come...

Alternatively you can take advice from Cave Johnson (Portals 2 fans unite)...

Stay happy :)

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