MY VIEW OF HEALTH CARE CHANGED AS A PATIENT

In February, I found myself alone, having retired from an active and fulfilling career in the medical field and having my daughters leave our residence in Mira Mesa, where I was living at the time, to pursue their own professional aspirations. It was then that severe depression engulfed my being. I developed headaches and a loss of appetite, slept poorly, became forgetful, and noted a loss of interest in life’s pleasures.

I took several oxycodone tablets prescribed for my back pain in an attempt to depart from this world.

The seriousness of this action took me to the emergency room the next day, where I remained under observation for several hours before being transferred to a nearby hospital with inpatient psychiatric unit facilities.

The next morning, I observed a group of patients in the corridor being attended to by a group of harried nurses. I was allocated a psychiatrist whom I never met. The nursing staff informed me that the attending psychiatrists never visited the patients in the unit! One of my daughters removed me from that unsavory establishment and took me to a facility with which we were familiar, to attend its outpatient program.

The depressive disorder progressed relentlessly, making life intolerable. In April, I took many more oxycodone tabs. This medication depresses the respiratory center in the brain and damages the body organs by diminishing their oxygen supply. One of my daughters found me comatose and called emergency services.

Later that day, I found myself in a nearby hospital, having been intubated and placed on a respirator. The endotracheal tube was removed later on that day, leaving me with a sore throat and a hoarse voice. At the hospital, I was allocated a physician who came by daily, placed his stethoscope on my chest, nodded and left without saying a word. He showed little compassion and even less concern about my situation. Occasionally the “psychiatric team” would appear, and acknowledge our repeated requests for my transfer to a psychiatrist in-patient facility for appropriate therapy. But the health officials were unable to quickly do anything positive, telling me that an in-patient bed at another facility would become available soon and that I would have to wait.

Daily tests continued to be performed. My arms were black and blue from multiple blood draws and the daily painful testing continued in spite of my protestations. It became apparent that the nursing staff ran the show. Any problem that arose on the floor was passed on to the registered nurse by the licensed vocational nurses. The registered nurse would then decide on a response. Occasionally, the on-call psychiatrist would be contacted for advice, which would be implemented by the registered

nurse. The actual appearance of a psychiatrist on the floor to visit a patient was non-existent!

Based on my experience of over 60 years in the field, the practice of medicine has altered considerably in recent years in that there is now very little physicianpatient interaction and negligible empathy or concern shown by the staff towards patients.

I demanded to be discharged and returned to the facility where I had been an out-patient. Arrangements were made for my admission to the in-patient unit immediately. There, a variety of medications were administered, but none proved effective in combating my illness. It was then decided that electroconvulsive therapy should be used. In this treatment, the patient is anesthetized and an electric current is applied to the patient’s head. This produces a controlled seizure in the patient, who recovers consciousness a few minutes later.

This treatment came into existence following the observation that patients with seizure disorders were in some way protected from depressive illnesses. I was given several such treatments, which resulted in marked improvement in my mood. This therapy was continued on an out-patient basis. The side effects of electroconvulsive therapy include occasional headaches, confusion and sometimes memory loss, all of which are reversible with time. This form of therapy is considered to be among the most effective treatments for major depressive disorder.

Of immense concern during this difficult period of my life has been the challenge of finding a welltrained and caring psychiatrist to consult with on a face-to-face basis for ongoing care. Payment for such services seems to be a problem in that many caregivers do not welcome commercial forms of insurance and prefer cash payments. This is something the majority of patients can not afford. If my case is any indication, improvements in mental health care are solely needed in San Diego County. Time is of the essence. Legislation that provides for adequate training in mental health care (understanding root causes, how to communicate and interact with individuals that suffer from mental health disorders and effective treatments) and appropriate health care funding is required without delay for success in this much-needed and overdue endeavor.

Sedaghat,