The Man Who Mistook His Wife for a Hat!

‘The Man Who Mistook His Wife for a Hat’ 

is a case study of a teacher in the School of Music. He is named as Dr. P in this book. He failed to see faces and even worse he saw faces when there were no faces to see. No one ever thought that it was a serious impairment until he is diagnosed with diabetes and being referred to a ophthalmologist (as diabetes correlates highly with visibility). 

    It was then his ophthalmologist referred him to Dr. Sacks’ clinic. Dr. Sack’s first impression on Dr. P was that he is absolutely normal. He has no dementia, good sense of humor and imagination.        However, series of bizarreness were being discovered as he make futher tests. The first thing that struck Dr. Sacks was when Dr. P faces his ear towards Dr. Sacks while talking to him, with his eyes looking at Dr. Sacks’s features; his chin, nose, right ear. Secondly, was when Dr. P couldn’t distinguish his foot with his shoe. Later, Dr. P showed him the picture of Sahara dunes and asked him to describe the picture. He specifically said that he saw a river, little guesthouse with its terrace on the water. 

   He also said that he saw some colored parasols. The agenda just gets more interesting when he reached out his hand and took his wife’s head, trying to lift it off and put it on, thinking that it was his hat. A further checkup on Dr.P was done at his own home. He recognized Platonic solids and cartoon characters with no difficulties. However, when pictures of his families were shown to him, he did not recognize most of them. He only identifies those with ‘obvious markers’, for example, a person with a square jaw and big teeth. He was told then to describe a rose. He described it as being 6 inches in length, convoluted red form and linear green attachment. Dr. P could speak about things but failed to see them face-to-face. 

  He was said to be like a computer, recognize things by means of their key features and schematic. His imagination was also found to be on the right side of him only. He was thought to have internal agnosia as well, as he is lacked sensorial, imaginal and emotional reality. 

  Dr. P was later diagnosed with a massive tumor or degenerative process in the visual part of his brain. Hence, it can be concluded that not just classifying and categorizing is important in our life, but also continuous judging and feeling. If this is missing, then we will be like a computer just like Dr. P.

My Report in Doctor's meeting...

The first thing I learnt when I entered the meeting is how organized it is. Not only doctors are present in the meeting room, there are also hospital social worker and a person that is in-charge with Day Care hospital. Social workers are also essential members of interdisciplinary hospital teams. They help patients and their families understand a particular illness, work through the emotions of a diagnosis, and provide counseling about the decisions that need to be made. Working in concert with doctors, nurses, and allied health professionals, social workers sensitize other health care providers to the social and emotional aspects of a patient’s illness. Hospital social workers use case management skills to help patients and their families address and resolve the social, financial and psychological problems related to their health condition. This is exactly what can be seen in the room. They discussed all of these aspects of the patients, one by one. If any of the doctors in the room have any problem, they can straight ask for the social worker help.

   As the doctors were progressing with the meeting, I realized that quite a number of patients that are referred to the Hospital Day Care. I made some research and what I found out was remarkable. Day care center offer structured support to patients with long-term severe mental disorders (mainly schizophrenia), who would otherwise be treated in the outpatient clinic. However, I had come across a study that shows there was no evidence that day care centers were better or worse than outpatient care on any clinical or social outcome variable.

   Moving on to my main focus at the meeting was on the cases that the doctors layout. There are wide varieties of cases that were being discussed in the room. I realized that the world doesn’t always look the same for other people as it is for you. My world was covered with classes, assignments and books. For other people, like the patients, their life is not as lucky. Some have problems that are beyond my imaginations; others are delusional and even suicidal.

   One of the cases that were being laid out concerning a pregnant woman named Karen. She was diagnosed with bipolar disorder. She is said to be ‘borderline’ this week. Her psychiatrist had few sessions with her and what found out that she has a very bad relationship with her husband. The doctor also had an opportunity to talk to her husband and he mentioned that he couldn’t cooperate with her sickness anymore and thinking of filing a divorce. All of the doctors in the room seem very concern about the news. They then talk through the potential outcome of the husband’s decision and impact it will bring to the Karen. It is surprising to find out that Karen is actually carrying her third child with her husband. A woman that is pregnant, has 2 small children and is currently unemployed with a bipolar disorder would not certainly need an addition of stress with a divorce. However, the doctors keep on constructing strategies to handle the situation. It is amazing to observe their reaction towards this situation. They did not interfere with the patient’s marriage, perhaps, by talk the husband out of it, instead, they converse about both probability.

  A case about a patient named Micheal caught my attention. He is delusional with olfactory syndrome. Olfactory Reference Syndrome (ORS) or Autodysomophobia is a psychiatric condition in which the affected person is excessively preoccupied by the concern that one's body odor is foul or unpleasant. This disorder is often accompanied by shame, embarrassment, significant distress, avoidance behavior, social phobia and social isolation. His psychiatrist had placed him under counseling for a long time until recently found out that Micheal had once stab himself. Micheal said that he has to distract himself and keep him busy all the time from doing something dangerous. Further evaluation and sessions needed to find out his stressors. So, the doctors made come to a decision to keep him on further counseling.

  There are even cases about schoolgirls. A girl named Megan has a borderline personality of bipolar disorder. She was raped when she was 16 years old. The doctors compliment about her intelligence and how polite she is. However, recently she is has been avoiding her sessions in the hospital. She gave reasons like she has lab and schoolwork to do. The doctors are concern about this. After going over her case, they conclude to try to make another schedule with her, and if she missed it too, they are going to put her to the school counselor.

  The meeting got a lot more interesting when cases about delusional and suicidal patients are being analyzed. I did not catch the name of patient but what happens was that this patient tried to jump in front of the train. What happen was that the train driver managed to pull the brake just in time. The train stopped right in front of the patient, just before it hit him. Interesting as it is, his actions has brought him into the doctor’s radar but that was years ago. The patient is better now.

Talking about delusional patients, there was this patient that has also been cured, once believe that the New World Order is commencing. The term New World Order or NWO refers to the emergence of a totalitarian one-world government. He even believed that Armageddon or End of the World is happening.

   It was a great Friday. It is amazing to see how the doctors work together and accept each other’s opinion. Everyone is allowed to talk in there. Sharing patient’s and cases can be seen clearly to lighten the burden of individuals in the team. They talk almost about every aspect of the patient’s background. They go deep and really search and trying to understand the condition of the patient. They try to lighten up the burden of the patient as much as possible. Constructing a way out for other people’s problem is a really noble job.

   Professor McDonalds managed to give us one word of advice, he said, ‘Remember, the patient probably doesn’t have only one disease, they can have two or three disease at a time.’ My thought at that time was how much more difficult could it be with more than one disease!

  Before I wrap up my essay, I just want to state about a patient I met in the Psychiatric Department ward. She was around late 80s or 90s. She said to me,’ I have enough of doctors’. It certainly made me think. Doctor’s life is in the hospital. Their main concern is to treat patients. They are expected to use the perfect word, the correct expression, and the honest decisions. We aren’t robots. But one thing is for sure, we have to try to be as perfect as possible…. for the sake of our patients.  

---These are just one of my assignments---

Might as well just share it here. Enjoy. (although its quite formal) >.<

Psychiatric Ward Round

Salam people. 

Its been awhile since anyone write here. 

Anyway, I have a story to tell. I great one! MasyaAllah....

As some of you know, ktorg ade SSM (special study module here).

Sume org lain2 la... well, ade yg same. Iza punye Psychiatric Neuroimaging. So, first ktorg kne tau about the psychiatric disorders. Well,,, just sbb nak expose ktorg ... our ssm make appointments with the doc at the psychiatric department. 

Ktorg sume lain2 hari la... (long story to tell what happen). So, last minute, I just got the e-mail from my instructor to sruh g that hospital at 9am that morning. Cepatlah siap and nak prgy.

I waited in front of the Psychiatric Department. Sebab pintu die kunci. Then, lame2... dh bukak pintu tu... i tried to masuk and look for the place. ... Well, long story short...i didn't find it. Wtv....

Then, iza pon ddk balik kat depan pintu tu..tunggu Ujer.. Cause die sepatutnye ngan iza. 

Then, this Old Lady went out. Shes about 70, 80 or even 90's... i dunno. 

She said 'HI' and i replied back... with a 'hi' of course. She stand in front of me.. and said, im just gonna go and take my bag. 

Iza: Ok. That's great...where is it?

The Lady: Just in front. 

The thing is... she keeps on standing there. So, i continued our conversation....

Iza: Em, do you want me to go with you. 

The Lady: Sure, that would be nice of you. 

I was startled a bit, that she accepted my invitation. I actually have an appointment here!!!

Wtv it is.. suddenly the conversation become like our 'Professionalism'... you know... the talking with the patient and stuff. 

Ok, then we walk together. VERY SLOWLY.. (cause she's old). 

But, quite strong as I can see. Walking and bukak pintu all... OK! 

So, I asked her about the doctors here. She said that the doctors was great.. they are very kind. 

But, she said that she had enough of doctors, 'you know what i mean'. I said 'yeahh'...

The funny part just begun. Ktorg sampai at the hospital entrance. Kat c2 ade caffee. She said that she wanted a drink. And so i said, that ok,, sure..but i already have mine...(while showing my thermos with hot chocolate tu,...NUIG pnye yeee) 

Then, out of nowhere... she said..Thanks... thats very nice of you to give me your drink. Perhaps, i heard her wrongly... I think she said something about didn't bring her bag or purse with her...and that she doesn't have any money to buy a drink. 

I said to her that she can keep my cup with her. HAHAHA>>> sbenarnyee tgh mcm...ok dh lambat appointment....

SOOO<< dinda.. my NUIG thermos thingy is with her. Looks like i have to buy a new one. The story ended with her introducing herself ... 

Im thinking of visiting her one day. Waktu masuk the 'doctor's meeting'... (part of the ssm hari tu',. diorg ade bincang about their patients... and one of the patients yg diorg bincang tu,, ade diorg sebut the old lady's name. But, im not sure whether its her.

They said that she's Legendary... hahaha... Cause she take all the meds there. She tried all different kind of stuffs..

I can't be too sure that they'r talking about her. Its nice to have a walk with a patient.. It makes me feels like... I ACTUALLY WANT  to be a doctor!!!

She story didn't end there... The reflection didn't end there. Nanti kalau ade mase... iza tulis lagi... 

BYEE>>> Syira baru call ajak g town. sooo,, im out. Assalamu'alaikum.