In our class in Psychiatry, we were required to conduct a complete psychiatric interview of a psychiatric patient confined at the PGH. We were also expected to present the diagnosis, along with a comprehensive plan of management.

Initially, I had my reservations, probably because of my limited and biased experiences. Studying various psychiatric disorders for a semester and the normal functioning of the mind the semester before that had not helped me any in preparation for dealing with real live patients. Besides, I still had 21 years of biases formed from thousands of hours of TV watching to undo.

I know that I can do a pretty comprehensive history; I've had practice from several Neurosciences ward work sessions. But this was an entirely different story. Questioning patients who you know can answer adequately is fine; interviewing patients who may have a hundred different answers to a single question or don't want to speak at all is another.

But required is required, and as with all academic requirements, it too should come to pass.

We met a young adult female patient one afternoon during a month where all academic hell had broken loose. We were determined to keep everything short and sweet; we had reports to finish for the following day and excruciatingly thick transcriptions to go through for an exam a few days after.

But alas, interviewing her was difficult; we tried to bribe her with food as our other groupmates had done so that she would agree to talk with us, but she adamantly refused it. It took a while, but she began to spontaneously talk to us after she began to be interested in the sheets of paper we carried around on our clipboards. She thought they were test papers she had to answer; to us they were but our Neuroscience Examination Sheet which guided us during a neurological examination of a patient.

She filled the check boxes, the blanks, the spaces. What she wrote was starkly different from what was asked; when prodded, her explanations were even more cryptic. When questioned, she would answer with an entirely different concept. When examining her, we had to pretend it was all a game to get her to cooperate.

Her answers might be confusing, but there were still glimpses of reality in her stories. What we thought was but a product of her mind had a connection to past events, thought the connection was often tough to elucidate. She narrates stories of trips to far-off towns where seemingly strange events would occur; she would tell us of persons who were "at war" with her. She would say that her body parts correspond to different internal organs and that rubbing alcohol was a "cure-all". She also told us of her fear with certain numbers, and why she feared it. Somehow, these still had connections with reality.

Our interviews with her and her mother led us to the conclusion that she had disorganized schizophrenia. She had hallucinations, delusions; speech content was poor; thought process was tangential.

Through that interview and through the process of making and presenting a report, I learned a hundred new things about the psychiatric interview and about schizophrenia. What I did not expect to learn from her was the realization that I had been dismissing people with psychiatric problems as inconsequential and people who are best left ignored. What I understand now, more than ever, is that all patients, and not just psychiatric patients, do not need pity, sympathetic looks or whispers; what I should do is help, which I could accomplish by simply listening to the story of a patient who has no one to talk to or being the stranger whom an anxious mother can pour out her worries about her sick child.  

I wish that I would remember this for the rest of my life, and not become preoccupied with symptoms, lab results, pathology reports, and drugs. I hope that I do not forget that people who are admitted in the hospital are not just the "person with TB meningitis" or the "person in Ward 5, Bed 14" or the "person who would not last the week". I hope I do not become as callous as that and forget that they are people with lives, experiences, and feelings outside their illnesses and that they are people who are thinking of their mortality and do not just need a biological cure but emotional and spiritual support as well.

For I know, one day in the future, I myself would be confronting my own mortality, albeit in a still unknown manner.

And I know I would want one doctor who holds my hand, comforts me, and listens to my fears rather than a hundred specialists who regard me as another interesting case to be studied.