Crazy For You: A Short Story Tribute to Women in Mental Healthcare

The Covid pandemic poses a threat to Mental Health, with symptoms of anxiety and depression increasing in the population.
Let’s take a look at the lives of Women in Mental Healthcare who are providing “Mental Health for All” – the 2020 theme set by World Federation for Mental Health

Disclaimer: This fiction was originally submitted as an entry to Per.empu.an Writing Competition 2018, as a tribute to Malaysian Women in Mental Healthcare. The Story was modified and published in Med.Ona, magazine of Monash University Medical School. All characters in this story are fictional but the references of location and the challenges are real.

Year: 2018
Location: Permai Hospital, Johor Bahru, South of West Malaysia

Dr Michelle stepped into the male psychiatric ward of Hospital Permai. As soon as the doctor was in, the male staff nurse bolted the grills to prevent patients from sneaking or barging out.

Tap tap tap …

Dr Michelle’s footsteps clicked against the concrete as she headed for the office. On her right, patients gathered around a plastic table for breakfast. An elderly man with intentional tremor was shaking as he lifted a bowl to his lips. An adolescent greeted Dr Michelle in shrill enthusiasm. Dr Michelle smiled and waved to him. The youth then resumed feeding his friend who had psychomotor retardation.

Dr Michelle pictured the friend lifting a spoon like the sloth in Zootopia – excruciatingly slow. Ah, Zootopia. The movie was released two years ago, and it was the last movie Dr Michelle had watched. She and her obstetrician husband, Dr Sunny, had enjoyed the show together back in their hometown of Sibu, in East Malaysia. They hope to let their future children watch it too.

Dr Michelle felt a slight movement in her tummy. Her hand traced the curve of her abdomen. Baby would be due in 10 weeks’ time. She and Dr Sunny were very much looking forward to the arrival of their first child. Her babymoon would start tomorrow.

Click! The office door opened.

A single long table occupied the room. At one end came the woosh from files being shuffled by Nurul, the pharmacist, as she peered over drug charts. On the other end of the table was Dr Saraniya, who had just passed her exams to become a registrar. Flip flip … Dr Saraniya was flipping through a Sadock Pocket Handbook of Clinical Psychiatry, preparing to substitute Dr Michelle over the next few months.

The woosh and flip paused as the two women greeted Dr Michelle warmly. The petite psychiatrist from Sarawak was cheerful, capable, and liked by everyone. Dr Michelle had excellent rapport and communicated efficiently with staff and patients alike – thanks to her fluency in four languages. She owed this to her Iban dad and Chinese mom who made her master English and Malay alongside both parents’ native tongues.

“How’s baby?” Dr Saraniya asked.

“Doing fine. It’s me that’s getting aches and pains from stretched ligaments when I roll over during sleep.”

“I’m sure Dr Sunny understands,” Nurul remarked.

“He does. Shall we call in our first patient?”

Harry was an Iban man in his early twenties, admitted involuntarily yesterday morning by the police after he tried to hit a young lady in the streets because “she looks like my wife who cheated on me”. His next of kin is a brother in Johor, whom Harry had moved in with since his divorce. The brother informed that for more than a year, Harry had been hearing a woman’s voice and seeing (literally) a woman in the house that no one else could hear and see. However, the brother refused to take Harry to see a psychiatrist for fear that Harry would be labeled “crazy”, like how their father who was diagnosed with schizophrenia was. The police had confirmed that Harry’s alcohol breath test was negative, and there were no traces of illicit drugs in Harry’s urine.

Harry was brought in by the guards and seated in front of Dr Saraniya.

“How are you, Harry?”

Harry shrugged, replying in broken English, “Sad … wife not good.”

Dr Saraniya asked a few questions to check for side effects of the 15mg oral aripiprazole they had prescribed him, by reviewing his metabolic profile and asking for gastrointestinal symptoms. Acknowledging the language barrier, Dr Michelle offered to assist. Dr Michelle sat next to Dr Saraniya, at the edge of the long table.

“How are you feeling today?” Dr Michelle asked in Iban.

“I feel surprised,” Harry replied.

“Why do you feel surprised?”

Harry paused before saying, “I’m surprised to see my wife here in this hospital.”

Dr Michelle turned to Dr Saraniya and asked in English, “Did we allow him visitors lately?” Dr Saraniya declined.

“Where in this hospital did you happen to see your wife?” Dr Michelle asked Harry in Iban.

“In this very room.” Harry tapped his index finger on the table. “She is in this room, this very moment.”

“What did he say?” Dr Saraniya queried.

Harry wore a brazen look as he slowly rose from his seat and leaned across the table. “In fact, I am looking at my wife this very moment.” His gaze was fixed on Dr Michelle.

“Michelle, what did he say …………. Wait, NOOOOOOOOOOOOOOO!”

Harry wrapped his hands around Dr Michelle’s neck, pulling her up from her seat as he tightened his grip. Nurul dashed out of the room to seek help, while Dr Saraniya struggled to pry Harry’s grip off to no avail.
Dr Saraniya may be fit and strong from years of Bharatanatyam dancing, but Harry was stocky and aggressive, a descendent of the fearless Borneo warriors. Dr Michelle’s eyes were wide, her small frame quivering as her little fingers tugged at his in vain. Colour was draining from her face.

Harry’s gaze darted to Dr Michelle’s gravid uterus. “Your lover made you pregnant,” Harry bellowed. “I want to kill both you and his baby.”

Suddenly, Harry went limp. His grip on Dr Michelle’s neck loosened. His eyes drew shut and his head hit the table with a thud. Dr Michelle sunk into her chair. Through her own panting, Dr Michelle heard Nurul say, “I got it.”

Dr Michelle pictured Nurul plunging a syringe into the deltoid of Harry’s shoulder.
Nurul the pharmacist must have given Harry the right dose of sedative.
……………………………………………………………………….
“Vital signs of mother and baby are both normal. No abnormal changes in CTG,” Dr Zila assured. Dr Zila had been called to check on Dr Michelle by her superior, Dr Sunny, who was currently in Tokyo for an antenatal symposium.

After sending Dr Zila off, Nurul and Dr Saraniya stayed with Dr Michelle in office.

“Is Harry okay?” Dr Michelle asked softly after long moment of silence.

“Dr, Harry must have thought you were his wife,” Nurul reasoned. “He wanted to take revenge on you. However, I am sure he was given adequate doses of every correct medication he should receive. I confirmed this with the nurses.”

“Is Harry okay?”

“Yes, he is,” Dr Saraniya affirmed.

“Thanks,” Dr Michelle said. “I don’t want him getting injured for something that’s not really his fault.”

We’re more concerned for the two of you, Dr Saraniya thought, eyeing Dr Michelle and her baby bump.

The workplace offers a million hazards for you when you are a woman in mental healthcare, thought Dr Saraniya. Anything could happen any moment. However, nothing would change Dr Michelle’s life more than The Event.

Dr Saraniya recalled The Event. The Event happend two years ago. It was Dr Saraniya’s first week shadowing Dr Michelle as a medical officer in Hospital Permai. They were in clinic, calling in their patient after chatting about the movie Dr Michelle recently watched with Dr Sunny. The movie had a rabbit and a fox in it … What was it called? Ah, Zootopia.

Well, small talk aside, the patient who came into the room was a young domestic helper from Medan, Indonesia, known as “Susan”. Susan was loud, excited and carried a big handbag. The employer had brought Susan to Dr Michelle out of concern that Susan had been awake for three days in a row, claiming to be the greatest cleaner of all time who can remove all the filth in the world.

Halfway during the interview, Susan took a plastic bottle out from her giant handbag to “clean out all dirt from this clinic”. The employer and Dr Saraniya were unable to control Susan from spraying the bottle’s contents on Dr Michelle’s face. Susan laughed heartily as shrieks filled the air.

The bottle had contained drain cleaner, aka lye. The sodium hydroxide ate into Dr Michelle’s skin and eyes. Plastic surgery had successfully restored much of Dr Michelle’s aesthetics, but ophthalmologic intervention could not bring back her vision. Today, Dr Michelle is one of the few practicing blind psychiatrists in the world, still holding on to her passion for mental health. Dr Sunny supported his wife in her choice of career, but he openly expressed concern for her safety. Nonetheless, over the past two years, Dr Michelle managed to convince her husband that she would be just fine, but what will he say after today’s incident?

“Michelle, I’m glad today’s your last day,” Dr Saraniya chirped. “You need a break.”

Dr Michelle turned as if looking Dr Saraniya in the eye – a hollow gaze. “Saraniya, it’s not my last day at work. It’s just that now my priority is Baby, but once I’m off from maternity leave …”

The three women playfully chimed Shakira’s “Try Everything” – theme song of Zootopia, the last movie Dr Michelle would ever watch: “I won’t give up, no I won’t give in ….”

After a round of laughter, the three female healthcare workers called in their next patient.

Resources:
1) Learn about World Mental Health Day at https://www.mentalhealth.org.uk/campaigns/world-mental-health-day#:~:text=The%20World%20Health%20Organisation%20recognises,’mental%20health%20for%20all‘.

2) Hospital Permai is in the Southern state of Johor in Malaysia. Visit their Facebook page at: https://m.facebook.com/hpjohorbahru/

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