ICU psychosis is a common phenomenon in hospitals. Most of us as clinicians deal with it well.
However, the ordeal changes when your loved one is struck with it. My grandmother, always admired for her storytelling skills, is now admitted with intestinal obstruction, and her worsening Parkinson’s has just escalated the intensity of her psychosis.
Now she tells me a story of a woman carrying knives, seeing blood everywhere, selling half the hospital to god knows who and persistently asks me to get myself some coffee from the kitchen. Too bad that she doesn’t remember much, but my love for caffeine still clings to her dying brain cells. She struggles to remember if she is at home or at a hospital. So far, I have been ordered twice to turn on the lights as the room is dark. She has repeatedly asked me to fetch myself something to drink as my visits have decreased, and she remembers we are meeting after a long time.
Somewhere in between, the nurses tell me that she has threatened them repeatedly about the fact that her granddaughter (me) is a big doctor who would come and put everyone on track. I doubt my abilities as I hear that, and I am slightly flattered at my envisioned self in her mind, for she has always glorified me to the world and trusted my abilities more than myself. I am glad I have always been able to live up to that in her eyes.
I have always enjoyed being the most favorite for unknown reasons, but it is a privilege to be admired amongst many.
In Asian countries, grandmothers hold significance in grandchildren’s lives. This is where the child grows and gets most of the love and pampering. For I like to believe I lived a simple life where she and I would bond over paratha and TV. I would skate on her terrace and learn how to embroider. Since I lived in a joint family in my younger years, her house was a sweet escape for me for its tranquility as only she resided most of the time. I have always had a problem with background noise which in my later years was diagnosed as atypical migraine.
Life has a funny way of turning around.
I have always been quite distant to patients developing psychosis and confident that the state would improve as soon as they succumb to their respective atmosphere. This is the first time I have spent a good number of hours with someone going through hospital-acquired psychosis, and I try to read where the stories come from. The subconscious mind? The fears? The expected outcomes or just plain brain-jumping scenes.
Sometimes I enjoy listening to the stories that keep changing their tangents, while at other times, I am convinced they hold something true. During this conundrum, I realized how important it is to cherish moments while the mind is functional and influential rather than wait on the final call that calls you from a loved one to spend time with.
As doctors, we tend to neglect our families while saving many others. Sometimes our work gets in the way, and sometimes it is our lazy side. Whatever the reasons may be, it is pertinent to keep in touch and take time out for valued relations as you grow old.
Natasha Khalid is a physician in Pakistan.
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