Volume 8 Issue 8 August, 2017
Psychiatry at good old school
When we go down the memory lane many things come to our mind and when asked to write to a journal I had hard time choosing something which will be of interest to all the readers. A non academic subject or the pranks we played with fellow P.Gs will be out of place here.
About more than 40 years back in 1972 to be precise when I had to present the first case conference as a DPM student way back in NIMHANS which was being called then as All India Institute of mental Health and Neuro sciences (AIIMH & NS). I was nervous as that was my first case conference and very senior psychiatrists, teachers, PGs, Psychologists; social workers were present in the audience. DSM 2 was being followed those days particularly those who were reading Kaplan’s CTP and ICD were known only to a few. I thought it would be nice to present a case of Manic Psychosis which was also being called manic depressive insanity, manic depressive Psychosis-mania and now being called BPAD-Mania.
The present day cases of BPAD are different, they are more irritable now and hardly have we come across the real grandiose variety, the reason could be co morbid substance use which is more a rule than exception. I thought choosing such a case will entertain all those who attend the case conference and it will be definitely a good learning experience also. There is another reason why I selected such a case was that my Professor of Psychiatry used to say some times, during ward rounds if at all we get mental illness, we should get Mania as we feel we are rich, enjoy so much and entertain people around us. I selected one patient by name Ganapathy (name changed) who was the attraction and centre of attention in the ward (It may be considered unethical mentioning a patient by name while writing a case report, but even if I mention the name, I do not think this patient under mention can be identified now). Mr G was never quarrelsome or irritable had no drug history he used to dress himself in the most grotesque way and had an un interrupted talk, he used to move around the ward shouting “Newspaper is the mirror of the world and “student life is golden life”, I particularly remember when it was time to interview the patient as was the custom during case conferences, Mr. G appeared with a white turban round his head and tucked two hibiscus flowers on either side of the turban and he was of all energy and effervescence during his short questioning session. When asked why he donned a turban which he never used to do during his stay in the ward, he said since the chairman was a Sardarji I thought I should appear like him. At the end of the session people did not notice my nervousness as Ganapathy’s energy was all pervading and it was nice and I was lucky selecting such case.
The case conference at that time was chaired by our Professor and Head of the department of psychiatry late Prof. Dr. A.S Mahal who was a kind hearted person who was an Ex army doctor was very strict and was also very supportive to his students. Some of my classmates and contemporaries may remember what a nice person was Prof. Mahal, whose interest was psychotherapy (probably because there was not this much invasion of pharmaceuticals and magic bullets into Psychiatry) and he was insisting that all his students should learn and practice psychotherapy. He used to take individual sessions with all his students. That could be the reason why psychiatrists of my times give lots of importance to evaluation of a case than insisting on treatment and outcome which were appreciated by the patients. Always good evaluation forms the strong basis and foundation to successful treatment. Ganapathy was a regular visitor to the mental hospital every year and he remembered my name and asked me whether I cleared my exams or not and what he will do when I finish and go to my place. I do not know where Ganapathy is, whether he is there or not in this world I fondly remember him for his contributions to my learning psychiatry.
Dr. K. Krishnamurthy Prof & HOD Psychiatry College of Medical sciences Bharatpur Chitwan, Nepal
