“I was holding the scissors in my hand as a weapon and I kept yelling hysterically ‘stay away from me .. stay away from’ .. I didn’t recognize him as my father .. he was standing near the kitchen door, stunned, while my mother was sobbing as she lay on the floor” he made the statement with a look of horror on his face, as he sat in the dental chair.
I looked at his handsome, innocent face and I felt a gush of deep pain overcome me, yet I realized it was imperative for me to handle the situation as a dentist and not as a psychiatrist. I barely could muster a faint smile, and said,
“This was over… a while ago, Jo.. John.. and now we have to make sure that your teeth are OK. Did you complain of any pain in your mouth lately?”
“Yes.. I feel some pain in my tongue and it keeps me from eating sometimes ..” the patient John said.
“very well, let us take a look at this..” I said kindly
“No.. I want to tell you what happened..” John objected.
“OK, John.. your therapist must follow-up about this because I am only your dentist ___” I tried to be as gentle as possible.
“No, you should hear the whole story.. ” He interrupted rather sharply.
“But John, I have several other patients to take care of_______” I tried again.
“Nobody wants to hear the whole story.. I am not crazy.. please listen to__” he began to yell.
“OK .. OK.. I am going to listen..” I said, waving the muscular man-nurse away .. while my assistant took a step back.
“OK John, you understand, you are in a hospital.. you have many specialized doctors to take care of you.. everyone of us want to do the best we can to help you get better____” I started to explain.
“I don’t belong in this hospital.. mental hospital.. they think I am crazy.. they think I am ..crazy .. But I saw them.. they killed my brother and Sammy our friend as we were getting out from church.. nobody wants to hear the whole story.. why?” He started to cry
My heart was heavy and I felt like sitting down and crying with him.. but I knew I must be the rational person now..
“John.. how about I promise to hear the whole story.. and all the details.. if you will allow me to take care of your teeth first, and finish with the other patients .. and then I give you all the time you need to tell me everything..” I spoke as fast as I could so he would not interrupt..
He thought for a moment, then he said,
“But if you finish my treatment, the nurse will take me back to the ward.”
“No.. I shall let you stay in my office until I finish the rest of my work.” I promised.
It was a long day. I forgot about John, until I was ready to leave, when the assistant reminded me that he was still waiting in my office.. So, I went in to see him.. the nurse whispered in my ear, that it was time for his medication at the ward. I had to call his therapist to get permission to have the medication delivered at the dental office.
“OK, John.. I am all ears.” I said, unloading my weary body on the couch in the office.
“I am sorry to have burdened you so much.. but I need to tell someone who will believe me.. nobody wants to believe me.. the cops, the doctors .. even my family.” He replied
I took a good look at the young man.. he was a teenager .. fragile and terrified..
“it’s all right.. I am listening..” I said wearily with a faint smile.
“Rene my brother, Sammy our friend and myself, we got out of the church after the prayer meeting, we were in a very good spirit, when those five thugs with long beards appeared from nowhere suddenly.. it was like they were waiting for us.. I knew one of them because he was in my class at school.. they didn’t talk or ask for money.. they just started to scream at us in foul language and curse our religion.. then they attacked us with knives and daggers.. I ran.. but Rene and Sammy tried to fight back.. later I knew that both of them were killed.. Rene died at the scene while Sammy died at the hospital later..” John’s tears were flooding his face and he continued through his sobbing, “I was so frightened.. when I reached home I went to the kitchen where my Mom used to keep a large pair of scissors ..I grabbed them and I was screaming .. when my Mom came running into the kitchen and tried to touch me, I pushed her away and she fell to the ground.. I saw her fall and I screamed louder.. my eyes were blurred with tears.. and then I heard my father’s voice .. ‘stop John… stop John what are you doing?’ .. he was standing at the door .. then.. then”
He stopped as he was overcome by an hysteric bout of sniffling..
The nurse tried to approach him with the medication.. but the patient screamed at his face , and I waved him away.
“we have to force him to take his drugs” the nurse said.
“Force him? Are you crazy? .. that is why he doesn’t trust you !!” I answered.
Finally John calmed down.. and stared at the air in front of him..
“John.. my friend .. would you like to tell me the rest of the story or this is enough for today?” I said gently as I got off the couch and pulled a chair near to the poor youngster. He looked at me very sadly .. a really broken man.. his tears still pouring out like a fountain,
“they came in.. they followed me to the house.. and .. they killed my father.. and my Mom.. they killed them .. they.. they try to say that I .. killed them .. can you believe this? they.. they .. killed them.. why did I live ? why didn’t they kill me too ?.. they ..” he wailed.
“the cops arrived.. ” the nurse whispered to me..
I had to hide my face while wiping away my tears.
I got up and tried to approach John, when the nurse grabbed my arm and warned me, offering to hold him down in his chair.. but I declined.
“don’t get closer.. he gets scared and suddenly becomes violent..” the nurse explained
“John.. my friend.. I believe you.. I heard the whole story_________” I tried to speak
” No.. No.. you didn’t .. they still come after me.. they are trying to get me.. I wish they kill me too.. but I get scared.. I have to go fighting like my brother.. please.. please don’t let them get me..” he squealed in pain.
Now I understood why it was decided to keep him in the mental hospital. And at this point his therapist arrived in my office.
“Doctor George, this is a serious breach of protocol____” He started..
I pulled him out of the office and into the operatory,
“Breach my foot.. this patient needs sympathy more than he needs drugs. I had no way of getting rid of him until he told me everything he wanted to say .. he is a college student .. at his age .. I saw his chart.. does he have a family .. is it at all possible that he would be treated as an outpatient ?” I asked angrily.
“we are doing everything we can for him and for every other patient.. you came into the ward and saw a sample of the problems we face.. if you tried so much as touch him, he would tear you to pieces.. don’t be fooled by his crying and fragile appearance.” He answered.
“I did touch him when he was in the dental chair.. I did treat his lingual ulcers.. and I charted several other problems he has.. nothing happened.” I said, watching his amazement.. when he stayed silent, I added..
“I believe people need genuine empathy and not just contrived feelings..”
He walked away a little, and turned around to say,
“Thank you for your help.. but you don’t understand.. these are disturbed, unbalanced creatures .. you cannot take what they say as facts.. they are delusional.. they have no functional brain.. they lost the capacity to reason like you and me.. so ____”
I had to interrupt,
“So, they need even more attention and more care .. we cannot just dismiss everything they say as stupid blubbering .. No, wait.. I understand that you are trying to help your patient just as much as I am trying to help him.. so let us cooperate to achieve the best possible results for a poor human being who is not being allowed to speak for himself… he is a human being .. not a dumb animal that has to be corralled, fed and whipped when necessary.”
He thought for a few seconds, then he smiled in a vague alarming way and answered,
“OK, Doctor George, I shall keep this in mind, now I shall take it from here.”
“I am going to schedule a weekly appointment for him to take care of the rest of his dental problems.” I said and he shrugged his shoulder as we both walked back to the office where the patient was guarded by the two nurses.
As soon as we got in, the patient shouted,
“doc. I must come here every day.. I have a lot of problems with my teeth and___”
“John, I have scheduled you to come for the rest of the treatments on a weekly basis until your dental treatment is complete” I said smiling..
“I want to come every day.. please” he insisted.
“John, it is not fair for the other patients. We have to take care of everyone.. besides, I am not here every day.. doctor Peter and doctor Sal are also in charge here when I go on my rounds .. we too have a schedule..”
I seemed to have convinced him as he reluctantly looked at me as if to beg for a way around it. I shocked everyone as I approached him and touched his shoulder encouragingly .. he grabbed my hand for a moment and in a split second he was hugging me.. I did not stop him.. and assured the nurse by a wave of my hand..
“John.. Doctor Mo your therapist and all the nurses are going to take good care of you.. listen to them and they will listen to you .. if you have any problem you can tell doctor Mo and you can tell me when you see me next week.. OK.?” I said gently.. and he finally let go..
The day ended, and I took my seat in the train on my way home.. but John remained with me.. a shadow of a man tormented unfairly by other men.. and the injustice inflicted on him was enormously compounded by the very treatment which was supposed to relieve his pain.. a human being badly in need of a hug and someone to listen… not much to ask for .. or is it?
The following day as I arrived at the hospital, I got a note asking me to meet with the hospital manager. So, I finished the early tasks of the day and went to see him. He was jovial as usual and we exchanged some little pleasantries until he cleared his throat and put on a blank face asking,
“Dr. Mo told me about the great help you offered in dealing with one of his patients yesterday, I am pleased to hear how diligent you were even though the usual protocol had been breached.”
“That patient had been through a very tragic trauma and I believe he needs all the attention we can afford to offer.” I said bluntly, fully aware that Dr. Mo’s report was not as friendly as the manager portrayed it to be.
“I am sure .. I am sure Dr. Mo is doing a great job. But you also realize we have three thousand patients in this hospital.. and we have to distribute our resources fairly without favoring one patient over the others. So we are providing the best possible service within the limitations of our resources.” He said with a sharp edge to every syllable.
“Well, I understand our limitations.. it is very frustrating to all of us. Any way I have scheduled the patient for a weekly visit to finish his dental work. At least we have the resources for that..” I answered.
“that is fine Doctor George, but he shall be transferred to the care of Doctor Sal, at the request of his therapist.” He said with a bland face.
“What is that?” I was shocked, “Why .. this is .. very nasty ..”
“No, No please don’t take it personally .. he probably feels that Doctor Sal will be able to follow-up with him, especially that you are about to leave us in a couple of weeks.” He said almost sarcastically.
“I would continue to handle the case until I would hand it over to the next dentist.. that would be the proper protocol ..” I said trying to control my anger.
“well now doctor George.. you have started by breaching the protocol yesterday.. and anyway, I would advise you to focus on your paper work now. After all, you are going to leave any way, and you don’t want this case of a person you never met before and actually a patient who is deranged and delusional derail all your plans for the future..” the manager said leaning forward in his chair behind the desk. It was a clear threat. I pretended not to understand.
“What do you mean?” I asked with a silly smile..
“You are going to greener pastures.. you shall forget about this patient and this hospital as soon as you take your seat in the plane flying you out of the country.. so just focus on that, so that you don’t have to deal with further delay of your paper work.”
I was stunned .. I did not answer… so he stood up, and reached out to shake hands .. and as I shook his hand I felt a storm raging within my soul.. did I betray the poor man who needed my help? Should I do more to help him.. how can I be sure that the story he told me is true .. and even if it is, was it in my power to change anything at this point.. ?
Three weeks later, I was on that flight. I decided to stick with the passion of my life which was dentistry but never to have to deal with patients any more.. it seemed like I had a soft spot, or call it a weakness, for humanity .. I could serve humanity without having to make decisions about who lives and who dies.. who is right and who is wrong..
Much to my surprise, and disappointment… I discovered that there is no such place in this world where any person is immune to such fateful choices on a daily basis, in a myriad of different ways.