Dr. Arshad Hussain
Professor of Psychiatry at the Institute of Mental Health and Neuro Sciences, Kashmir.
In the hallowed halls of medical education, one often encounters defining moments that transcend textbooks and lectures, offering glimpses into the human condition. For me, that moment arrived during my tenure in a psychiatric hospital—a crucible of affliction and resilience that left an indelible mark on my journey as a doctor.
As a fourth-year medical student, my initial foray into psychiatric care was marked by indifference. Oblivious to the gravity of mental illness, I sought solace in the canteen of Government Medical College Srinagar and pages of Kane and Abel, until one day my batchmates insisted that I should visit, and promised it would be lots of fun. It turned out to be the most harrowing experience. I confronted the raw anguish of human suffering. I never returned until my internship.
During my 14-day internship, I found myself drawn to the hospital each day, despite its resemblance to the war-torn landscape of Tora-Bora as described by Newsweek following a devastating fire in 1996.
We were supposed to be in the OPD only writing drug slips for the house surgeon and registrar, but my interactions with Dr. Zaffar Ali, the senior resident who had recently returned from the National Institute of Mental Health And Neuro Sciences Bangalore, made me visualize psychiatry entirely through a different prism, only to have a lasting impact on me and shape my career.
My experience with schizophrenia and psychiatry deepened during the house job. Medical students during their house jobs would usually prepare for USMLE, MRCP, PGI, and AIIMS. I did my first house job in radio diagnosis with the same intention, but I spent the whole time doing USGs.
During the second stint of the house job, everybody suggested psychiatry; the reason was ‘no work in a burnt asylum’. I ultimately found myself drawn back to psychiatry—a field often characterized by misconceptions and stigma. It was here, amidst the relentless grip of schizophrenia, that I witnessed the transformative power of care and compassion.
On May 1, 2000, I started my house job and ultimately found myself drawn back to psychiatry—a field often characterized by misconceptions and stigma. It was here that I saw schizophrenia—the disease that would devastate humans, take them away from reality, and leave them at the mercy of others—and then I saw that care itself—a misery—naked, filthy, dirt dust chained, maimed—that hit me so hard I wanted to change. I dreamt of breaking those shackles of dehumanization and replacing them with tender love and care. I knew then, and I have a firm belief now, that science was the key.
Our model is simple: schizophrenia is a disease of the brain and should be treated as such. With early detection and treatment, nearly 90 percent of patients can live in their homes productively.
For those requiring institutional care, we need facilities – hospitals, and half-houses – that prevent homelessness and offer the least restrictive care options.
While pursuing my postgraduate degree in psychiatry, Dr Rafiq sahb, a faculty member in the ENT, asked me to see a young woman in her 20s suffering from a chronic daily headache. After multiple examinations, she remitted.
Later, she returned with her sister, a prefinal medical student at my medical school, GMC Srinagar. They shared their uncle’s story. In his early 20s, he had become aloof and unkempt, eventually living naked in a makeshift polythene shed even during harsh winters.
His family tried to bring him back home, but he resisted violently. Now in his late 30s, he was left to his fate. From their account, I suspected schizophrenia but required an in-person consultation.
The medico sister asked me about treatment options, and I explained various pharmacological options, including olanzapine, which had recently been introduced in India. In the conversation we had, I was also told that he would return home at least once a day for a snack or meal. The sisters left only to return after around six months, anxious but smiling. “Doctor, do you know what happened? Our uncle has recovered completely but he was now demanding his property rights, which had already been distributed by other brothers. The whole locality is saying a miracle has happened, but only we know that we are giving him olanzapine surreptitiously”. I insisted on an in-person consultation for some investigations before continuing the prescription, but they never returned. I later learned from the medico sister that he was doing fine.
In February 2006, on a cold Sunday afternoon in my private clinic in south Kashmir, I was sipping tea after finishing my quota of seven patients. My gatekeeper came in with one of my old patients, whom I had seen two months ago with schizophrenia. He had initially been brought to me in a dishevelled state, living in a cowshed. History and mental status examinations revealed schizophrenia. After prescribing a tablet nightly for six weeks, he went into complete remission. He became a spectacle in his village for faith healers who had tried their luck on him before my intervention. They convinced the villagers that I possessed some spiritual powers otherwise a a tablet at night could not reverse such a condition.
Today he was in my clinic with his elder brother, who had long left his family and was living in the wilderness. All the villagers were accompanying them to see the “Peer (faith healer)” and the miracle. It took me some time to introduce science into the culture and demystify myself as a simple human being who learned the art of science, served through it, and pleased Allah by applying it to serve humanity.
