I am typing this post from the library in Miri General Hospital, where I am doing a 3-week elective. Figured that I would find some things are done here differently compared to the UK.
In the UK, when a person comes to you, saying that he/she hears things or sees things that other people can't, there is usually not much doubt in anyone's mind that the person's got schizophrenia.
Who believes in ghosts in the UK? Even I find that I have considerably less trouble sleeping alone in the UK because:
1) It's harder to believe in the existence of ghosts/evil spirits and the like in the company of such a "rational-thinking society", as a friend of mine describes the UK. I may not agree totally about the rational-thinking bit -
hello, HEATHROW?! - but yes, it is easier to dismiss the idea of ghosts there.
Contrast that with a girl I heard about yesterday, who apparently heard either voices, or heard other girls in the dormitory talking about THEIR having heard voices
- either way, she's still a gullible kid - went back to her village, told her mother, after which her mother brought her to a
dukun. The
dukun told her to eat ?bebenang ?something and then advised her not to pray for 3 months.
?!?
So she goes back to her boarding school, and goes to take a shower. As she leaves the bathroom, guess what crosses her path?
A PREGNANT CAT.
Yep, scary sh*t.
After she sees this pregnant cat, she runs to a corner, and starts crying uncontrollably.
?!?And every other girl in the dormitory thinks it is completely reasonable that this girl should cry after seeing (gasp!) a pregnant CAT.
Do pregnant cats have powers that I know not of? Is getting toxoplasmosis THAT bad?
Fine, yes, it is, but still, to be so worried & upset that you would spontaneously cry after seeing a cat?Another reason I am not too worried about
cats ghosts in the UK is because their ghosts seem pretty harmless, with the exception of maybe poltergeists. Let's face it, headless men or screaming women are NOTHING compared to our
pontianaks, toyols, orang hitam, flying eggs...
Malaysia boleh!
Seriously, in Sarawak, in the less-educated parts of the state, you are surrounded by communities of people who are more inclined to believe that when you have a visual or an auditory hallucination, you should go to a
dukun or a priest/pastor, rather than a doctor. Heck, even in the more-educated parts of the state, you still get men of university learning telling you earnestly:
"That wind-chime is possessed! It's evil, you know!"
He is as sane as sane can be, by the way. And I do have to be careful not to dismiss the claims of Sarawakians completely out-of hand, the way they would do in the UK
(Sigh, so much easier there...) For all I know, the wind-chime could be possessed, and pregnant cats could be evil.
Point is, in Sarawak, it's easier for people to believe that they or their child is haunted or possessed, rather than that they have a mental illness.(drily)'cos paranormal encounters are that much more common than mental illnesses.
Yes, there could be something about virgin jungles that allows for an overlap between the other world & this one. For the sake of argument, I could try to suspend my skepticism. Just not when I am faced with a patient, who along with hallucinations, also has other Schneider's 1st-rank symptoms.I am doing my elective with 2 other Brit students, one of whom is my batchmate whom I convinced to do his elective here. Doing my bit for Visit Malaysia 2007 & all that. I was worried that these guys would have problems with the language barrier.
Turned out I needn't have worried:
1) They are doing surgery.
2) Doesn't matter if you know Malay, or Mandarin; people here speak 20 over dialects, and it is impossible to ever be able to communicate with all your patients. One old Penan man came from the interior, and the only information they had on him was his name, age, and his presenting complaint: Fever & Haemoptysis.
Seriously, that was ALL the history they had, because patient only speaks Penan; the nurses in the hospital speak every other language except Penan -
though there is ONE nurse they found in the entire hospital who speaks rudimentary Penan, which is how they managed to get the chief complaint - and this man's family had literally come up to the hospital, admitted the man, and then left immediately after, so there were no family members to translate.
Speaking Malay only gives you that much of an advantage; after that, you're swimming in a sea of Sarawak Malay -
which believe me, sounds NOTHING like your regular BM baku - Iban, Mandarin, Hokkien, Kelabit, Kenyah, Melanau, Bidayuh, and of course, English... And those are just the regular languages.
But, not all is lost; nearly all the patients in this morning's psychiatry clinic spoke English, with the exception of a man & his mother, who both preferred to speak in Mandarin with the Chinese MO, a man & a boy who didn't speak at all, and a boy who gargled, yes, gargled as in made a gargling noise in this throat throughout the WHOLE interview.
Even I felt like clearing my throat & gargling after he left the room.
Anyway, it's only my 3rd day. No sense in penning down all my elective tales now when I'm sure there are plenty more to come. For those of you who are intending to do your elective or housemanship here -
something which I REALLY encourage you to do as MOs in Miri, since my hometown is so beautiful & has modern contraptions, contrary to popular belief, you get an extra RM600 allowance monthly, AND you get to do so much more here - here's a tip for doing your chronic-illness bit of the history-taking:
Me: Ada penyakit asmakah?
Patient 1: Tidak ada.
(Go through patient's drawer, find a blue inhaler.)Me: Apa ini?
Patient 1: Oh, ini untuk penyakit lelah.
Me:
(Pulls hair)*******
Me: Ada penyakit asmakah? Penyakit lelah?
Patient 2: Tidak ada.
Me: Pasti, ah? Penyakit asma, penyakit lelah, tidak ada?
Patient 2: Tidak ada.
(Go through patient's drawer, find ANOTHER blue inhaler.)Me: Ini? Ini untuk apa?
Patient 2: Oh, itu. Itu untuk penyakit ampus bah.
Me: Penyakit APA?
Patient 2: Penyakit ampus. Susah nafas.
(I check the records. It's asthma.)
