A leg to stand on

Dr Oliver Sacks is a British neurologist who wrote a series of books on some of the mysterious workings of the human brain capturing the experiences of his patients compassionately and sympathetically.

In his book titled ‘A Leg to Stand On,’ he writes about his own experience as a patient receiving medical care after falling while hiking in a mountain in Norway when he was in his early forties.

Dr Sacks described his feelings of pain, fear, and helplessness lying in a small-town hospital away from home. In his book, he writes “I went through what I thought would be my last day on earth.”

After the operation, he felt that his leg was alien to his body and outside his control. He disagreed with the surgeon who told him that his symptoms were a type of hysteria.

Dr Sacks, now a patient himself, had to experience what many people go through when their psychological state is affected by their physical condition. He interacted with his colleagues who treated him as a patient, and his experience in the medical field influenced his recovery and acceptance of care from another doctor.

The book explores the relationships between doctors and patients and the various ethical issues in patient care.

From my personal experience as a psychiatrist, I have treated some fellow doctors who suffered from various mental illnesses. Some avoid seeking psychiatric consultation due to the stigma associated with mental illness and the fear of being told, ‘You are a physician and should be able to heal yourself’.

Unfortunately, some doctors harbour a kind of hostility toward psychiatric medication and hesitate to start it even after lengthy discussions.

I remember one doctor who suffered from severe depression that affected his work and caused him to lose confidence in his medical skills. He experienced insomnia for several days, lost his appetite, and showed signs of sadness and misery.

I explained the diagnosis and treatment plan, but he sought consultations from many psychiatrists despite my clarification that the medication takes time to be effective.

His condition gradually improved, he regained his energy and confidence, and his smile returned. I have learned a lot from treating colleagues. I learned that once they come for a consultation, our relationship shifts from colleagues to doctor and patient. This awareness is crucial for the success of the therapeutic relationship and setting boundaries.

When I am on leave, I inform my patients that they should consult another doctor or go to the emergency department if needed. I have also realised that other doctors don’t always know the details of psychiatric treatment, just as my knowledge of various physical treatments may be outdated since each of us focuses on our specialty.

So, when explaining psychiatric medication I use the same amount of information even when my patient is also a doctor. I have also learned that recovery from mental illness is a unique experience that can change a person’s perspective towards others, making them more compassionate and more aware of others’ suffering, refraining from judging or belittling their struggles, and instead trying to help and guide them to consult specialists in the field.