Hubert
I first saw Hubert when he came to the hospital to provide
information regarding his wife. She had
been admitted to the psychiatric unit on a detention order after being arrested
by the police. She had been driving her
car down main street in the late evening at 60 miles per hour. When they apprehended her she was naked. She
was in a manic state and responded to treatment with a combination of lithium
and an antipsychotic medication.
However, she was not very compliant with her medications and her illness
was severe. This resulted in multiple
hospitalizations over the next few years.
Hubert, in spite of many interactions with the staff including myself
could never quite understand how these behaviors could be a product of mental
illness rather than volitional choices on her part. This ultimately led to his decision to
divorce her. Soon thereafter she was placed in a group home where psychiatric
treatment was provided by the local county mental health clinic.
About 10 years later, now remarried, Hubert was referred to
me by his family physician for treatment of an Obsessive Compulsive
Disorder. His repetitive behaviors were
seriously interfering with his work as well as his family and social life. His speech was concrete and
circumstantial. His main and seemingly
only interest was the church he had joined after his divorce. It was there that he had met his second wife
and had been born again. Almost all of
his family and social activities took place there. He spent his break times at
work quoting the bible. trying to convince his fellow employees to find the
truth so they could be saved as he surely had been.
His compulsive rituals responded well to treatment. During
his return visits that were scheduled for support and monitoring of his medication
he talked about his religious thoughts and endeavors. On the third appointment he asked me what
religion I belonged to and practiced. I would usually be very open with
patients who would ask this. I would
explain that I was not religious and that if that were important to them I knew
a psychiatrist in the area who was not only religious but utilized biblical
teachings as part of his therapy. I
would then offer to make a referral to this doctor if they so desired.
But the situation with Hubert was unique as I viewed
it. I did not think his needs would be
better met by a doctor who stressed the bible since he was already overly
preoccupied with it. So I responded that
I did not think it would be appropriate for me to tell him my religious preference.
Not satisfied with my refusal to answer his question it became his goal to find
out which place of worship I was attending. It apparently never occurred to him
that I might not belong to a church since he perceived me as a good person and
he viewed the one as incompatible with the other. He expressed his frustration with being
unable to find the answer. On Sunday mornings he would park his car across the
street from my house with the thought that once he would see me leave he could
follow me to my destination and his question would be answered. The problem with his plan was that his church
was a twenty minute drive from where I lived and he could never allow himself
to be late for his service. He’d wait until the last possible moment until he
would feel ineluctably compelled to drive away. He repeated his vigil Sunday
after Sunday to no avail and finally concluded that the church I attended must
have been closer to my house than was his.
Hubert remained under my care for many years. My secret remained
intact and I’d like to think this contributed at least in part to the success
of his treatment.
2006
No comments:
Post a Comment