The Crusader of Mental Health

Dr. Harish and his Demons

He was sitting on the bench outside the OT. He had been sitting there it seemed for a long time, holding his head in his hands.

“You are going to make a mistake, the patient will die.” It was Mr. Ramkumar’s voice, his anatomy teacher in college, who was always hypercritical.

“You are unfit to do surgery. You will bring a bad name to your professor,” said an unknown male voice.
He looked around, but no one was around; it seemed like the voices were coming from inside his head. They sounded real, and were insistent, repeating their commands, over and over. He looked around for escape, but he felt powerless, and was in the grip of someone.

He saw Prof. Gopalswamy coming towards him, in his quick stride.
Harish* rose to greet him. Professor nodded at him with a quick smile. “Ready? Let’s go in”.
Harish ran behind him in panic. “Sir, I am not feeling well.”

The professor stopped and turned to him.
“Sir, I am having a migraine since morning. I may not be able to concentrate during the operation. Can someone else take my place today”.

The words had come out in rush.

“Okay, ask Bhaskar to take your place.”

Harish could not register what was being said. He looked blankly at him and said, “Pardon, Sir?”
That was the first time it had happened. Harish went home and locked himself up in his room. He told his parents that he was not well, and needed rest.

Things were normal for a few weeks after that. One morning, he parked his bike and walked towards the hospital. He was reviewing in his mind the case notes of the patient they were going to operate a little later.
“Stop! go back”, he heard someone call out. Even before he turned to look back, he knew with dread that there was no one behind him. “I am ordering you not to operate. If you disobey, something terrible will happen”.
Harish felt that he was absolutely under the control of the voices. He called up his teacher, excused himself from assisting him in the operation, and left for home. He felt depressed for days after that. He had to hide what was happening to him from everyone in the hospital. He avoided going out with fellow students and kept his interactions to the minimum.

His father was surprised to see him come back. Harish took his father to his own room and told him about the voices. His father was disturbed and questioned him, asking him to explain the episodes.
Both could not figure out what was happening. Harish felt it was a supernatural thing. His father suggested that he see a psychiatrist. Harish did not want to see anyone in the hospital or the word would get out. His remembered reading articles by Dr. CRC, and about Samadhana.

He took Harish to Samadhana. It was the year 2011.

CRC heard him out and said that these were hallucinations brought on by schizophrenia. Harish then recalled dimly being taught about it in MBBS. But he could not accept that he was affected by the illness. He feared that it was untreatable and that his career as a surgeon would be finished. He argued with CRC that it was only an acute psychotic episode, not schizophrenia. CRC understood Harish’s concerns, and told him that while labels did not matter, he needed medication.

He agreed to be put on medication. The voices disappeared and he could complete his MS without further episodes occurring. He joined a nursing home. Later his parents persuaded him to start seeing prospective girls for marriage. Radha was the first girl they met. Harish asked for meeting alone with her. They met a few days later in a coffee shop.

“I need to tell you something”. Harish told her about his illness. He told her quietly, without emotion, looking intently at the table. Then he looked up at her. “Just tell me in one word if you are not ready for this. I will understand”.

She nodded at him silently, not trusting herself to speak. He continued. “I was afraid I was going mad. I was terrified that my colleagues and patients would find out and avoid me. I was afraid of living alone after my parents. But my doctor has given me confidence that I can manage. It is not the end of everything for me”.
They stared at each other, caught in the confusion of choices one has to make in life and the unknown consequences. They sat without speaking for some time. Slowly she felt her fears being replaced with a hope. After all, this man had confided his deepest fears to her. He needed her.

She took her time to reply. “I need some time to think, but I think I can handle it”.

They met several times after that, talking without awkwardness or artifice about everything that mattered to them. They eventually married, and life flowed smoothly for a year.

Over time, Harish came to believe that he did not need the medication anymore. He reduced the dosage, worried about their side affects like trembling of hands, which would stop him from performing surgery. He started behaving strangely on some days. He had a sense of being controlled by someone. He would not go his clinic on such days and seclude himself.

Harish’s mother was not been told about his illness. His colleagues and patients never seemed to notice anything strange in his behavior. Whenever Harish felt the symptoms coming on, he did not report for work that day, or if they appeared while he was in the nursing home, he took leave and went home.
Radha took him to see CRC. Harish confessed that he had reduced the dosage. CRC told him that despite the risk of side effects, which was low, he needed to take the medication, as otherwise the consequences would be worse. Harish agreed reluctantly. He was prescribed Risperidone tablets.

But some time later, the symptoms reappeared. His wife found out that he had stopped taking the medication. He refused to listen to her, declaring that he was alright.

His wife went to CRC alone. He prescribed Risperidone syrup and asked her to mix it with his food or coffee. She followed his advice and Harish improved. These episodes of stopping or reducing medication seem to keep reoccurring with Harish. His wife is supportive and tries to help him manage his condition.

Harish joined a new hospital in Hassan, for better pay and prospects. During his recent visit, in 2015, Harish told CRC that he had established a good reputation for himself in Hassan, having successfully performed many difficult surgeries. Patients like him for his empathy and caring nature.