When I met my first psychiatry patient, Samuel, he greeted me with a broad, mischievous grin and an elbow bump (COVID being at large). I started off my patient interview by asking him some general questions about his personal details, his main complaint, and his medical history.
He believed that he was the god of the moon. Besides holding this grandiose delusion, he had hardly slept for several days and felt an irresistible urge to chop as much wood as possible. This so-called manic episode caused his family to admit him to the psychiatric hospital. He mentioned often that he felt overwhelmed by pressure and judgment from his family and smoked cannabis to cope with stressors in his life. I imagined that Samuel and many other psychiatric patients over the ages must have felt that way, when their illnesses set in and they were forced to face the double-edged sword of stigma and psychosis.
Samuel was an incredibly pleasant individual who seemed to be quite intelligent (he had graduated as a chemical engineer and was fond of mathematics). He had performed well in school before he started to use marijuana and gradually developed psychotic and mood symptoms. He was responding well to treatment. I wondered about those who didn’t.
Talking to Samuel was a fascinating experience. Our conversations seemed to bring him comfort as well. He often said that he felt like he had “a lot to say,” that he was “glad to meet somebody who was willing to listen.” Despite the advances that we have made in psychiatry, a quote by Louis Nizer echoed in my mind: “Words of comfort, skillfully administered, are the oldest therapy known to man.” I felt hopeful, knowing that his treatment and my listening helped him.
When I eventually found my way out of that dusty ward, the sun shone through the dark clouds over the psychiatric hospital complex. I now associate that place with memories of hope, of helping others—people who just needed the right treatments for their illnesses, like one needs a bandage for a cut. There were no horror movies or psychological thrillers there, as Hollywood would lead us to believe.
Durban, KwaZulu-Natal, South Africa