Room Number 6, Purani Dilli — The First Encounter
An uncensored account of her first clinical visit at Daryaganj, Damini shares her observations from her internship and leaves us with some important questions.
In the first week of my internship at Mind Piper, I was learning about their model and services as well as various engagements at community and college level, but the part I was most curious about was the clinical work. On a fine Sunday morning, I was finally getting ready for my first clinic visit. As someone who has done her clinical training in South India, it was going to be my first encounter to the clinical cases and work being carried out in the capital region.
Located at one of the busiest corners of Purani Dilli is one of the clinics through which Mind Piper reaches out to people of this community. On my way to the clinic, I observed many faces and the different emotions that they held — happiness, agitation, indifference, annoyance and anger to name a few. I wondered what stories and mysteries were behind these faces and with this thought I continued to find my way to the clinic. Guided by the people from the local shops and GPS, I finally reached the hospital. Upon enquiring for the psychiatrist, the receptionist pointed towards one corner of the space — Room Number 6, the small chamber of a small hospital where many people come to relieve their not-so-visible pain and suffering.
As I walked inside the psychiatrist’s room, a family was ready to take adieu. Just when we started the introductory conversation, another family came to see him and this course continued one after the other; a course where families were changing continuously but the complaints, maybe not so much. As someone who was observing these stories from a distance and interacting occasionally, I saw many commonalities between the reported problems and doctor’s approach to them. For nearly all the clients, the psychiatrist would start with routine check-up such as blood pressure (BP), anemia and pulse rate. Blood pressure was routinely checked for young clients and even for those having no history of BP.
Across several families, I observed that nearly all clients and families were referring to only physiological difficulties, with little or no mention of the psychological difficulties they are or might be facing. It is understandable that talking about physiological difficulties like pain, indigestion, headache, fainting, nausea etc might be easier to describe than anxiety, sadness, grief or crying spells. As a society, we believe in silence and the only acceptable form of expression is visible pain, and therefore it legitimises the care as well. I noticed how even the deliberate attempts at understanding their initial complaints, significant life events, relationships and emotional health could grasp only very little attention by the clients. The questions would either be diverted or responded with very little information. A conversation with the doctor about the conerns that are most frequent, I realized that indeed the first visit was generally concerned with physiological discomforts. For a person who has been trained in psychopathology and its classification from Day One, it was also surprising from me to see that how many clients were not even aware of the diagnosis and severity of the illness they were suffering from. But even in this darkness, many of them were regular to the psychiatrist, probably because the treatment was working out for them, but for what and how — this part we, both the clients and I, were yet to explore.
This few hours of clinical observation with variety of clients and listening to anecodotes from the life of an experienced psychiatrist, the whole experience left me perplexed considering ground realities of psychological illness in India; the resistance and stigma towards it and the long way we have to go in order to change this situation for better. As many clients were unaware of their diagnosis, it is worth thinking if being unaware is intentional or unintentional? Is being ignorant a way to run away from accepting one’s psychological need? Could being treated in dark a better choice for clients than accepting their psychological needs and being stigmatized by self and society? In a particular instance, a client forced the psychiatrist to check her blood pressure, probably because the sense of being attended was still not there. It makes me wonder if using medical tools for all clients, a way to reinforce the idea of being checked properly? Would they still be happy if the doctor would only talk to them about their life and not carry out any physical examination? Will they ever come if there were no medicines given?
I would like to believe that probably things will be better in follow up sessions and that a better rapport would make clients more open to talk about their psychological difficulties and probably someday will come when it is not a stethoscope and blood pressure gauge that would make their clinical visits complete, rather an open conversation about their emotional health and well-being will. Probably… someday… maybe!
About the author:
Damini is a toddler in this vast world of learning and knowledge. Constantly under evolution and identifies as feminist, foodie (read momo-addict) and cat lover. Psychology helped her untangle herself and is driven to smoothen the path for others trying to do the same. Very open to feedback and she would love to hear back from you.
