The Emotionally Fragile Doctor

The Emotionally Fragile Doctor.

Thomas was a brilliant young researcher in a progressive area of medicine that would have been the envy of many doctors. Having just secured another post-graduate course, with a renowned overseas university to further his ambition, he called me for an urgent appointment. When he appeared, he looked extremely tired and depressed, and took ages to form a coherent reply to my probes. The gist of his concern was his wife of nine months, who had just walked out of their matrimonial home a week ago, and had begun divorce proceedings. He was at his wit’s end! He had not been sleeping for several days, and rather than prolong our first session, I recommended that he check-in with his family doctor and attend to his depression before our next appointment. Before he left, Thomas gave his permission for me to speak with his wife, Mary, and his mother.

Mary, a family physician, had made up her mind to go ahead with their divorce. She had reached the end of her tolerance over Thomas’ repeated attempts at manipulating her to have his own way whenever they had disagreements; either by cutting his wrists or some other part of his body, or threatening suicide by sitting at the edge of their 15th floor condominium’s bedroom window, until she gave in. Mrs Ong, whom I saw separately, painted a rather sad and bleak picture of Thomas’ relationship with his abusive father. Thomas was their only child. They are divorced, as Mr Ong had a violent temperament. Thomas was disciplined for the slightest infraction from a very young age, and her ex-husband’s belt was his main disciplinary implement. Nothing Thomas or anyone did satisfied him. Thomas’ depression first surfaced when he was in his early teens, when he began self-mutilating, but he managed to hide that from his parents. Only during his medical internship days was he told by his superiors to see a psychiatrist. He hated taking his medication. Mrs Ong, together with their family doctor, was immediately co-opted into a suicide watch programme.

Before Thomas’ second appointment, an emergency call came through at around 11.00pm one day. Thomas was at the other end and sitting at his bedroom windowsill, sobbing, and threatening to jump. We talked for what seemed like an interminable forty minutes, before he became calmer and more coherent and willing to allow his mother to approach him. I guided him to safely swing one of his legs around inside the room, and then had him hand his mobile to his mother. Noting that Mrs Ong’s best friend was also in the apartment, I instructed that her friend call their family doctor over immediately. Mrs Ong then walked over to Thomas and helped him climb back into the room, shut the window, and sat him down. I spoke to Thomas again to gauge his mental and emotional status, and we talked till his family physician arrived. He was hospitalised for a week. This was one episode that typified our walk with Thomas through his troubled journey.

Suicide ideation and attempts are not uncommon for those who struggle with major depression and other related depressive symptomologies. This incident was one of many encountered with other clients. On a few occasions, the police’s suicide squad called me to talk to a client who had threatened suicide, as they would usually be on the scene first. In more critical situations, it necessitated joining the squad to pacify an extremely distraught client, and solving the immediate triggering circumstance, before the situation was stabilized. It was not unusual for me to arrive home at 2.00am on these occasions, but saving lives make these forays absolutely worth it!