A Letter to a psychotic patient by me

Dear Mister,

If I knew your pshcosis and Russian, I would write this letter in Russian. Our instructor decided that a so called "dip" into the men's locked ward is a good way of initiating medical students into psychiatry. I accompanied my classmates, as the doctor unlocked and locked the first door. We enetered to a second door, which he unlocked and then locked the door behind us. He directed us to a courtyard where the male patients were present. There was about 25 male patients, and we were six female students, and three male students. Much like when a piece of bread is thrown in a late, and then all the ducks gather, most of the patients flocked us at the entrance, and I immitated my peers. They shook hands, and so did I, not knowing where those hands were before.

It seemed that shaking hands was going to save me from drowning into the world of the mad, repel many of the curious looks, questions, stares. I stood in the corner, watching my classmates interact with all the patients, mainly talking and sitting on benches. Are my classmates the crazy ones? How can they just start conversation with people whose history they dont know, neither will they know by the end of the conversation? Or, are the patients crazy talking to us, complete strangers? I was not mad. I just observed, much like one of the patients who was walking around in circles, with curely hair, minimum eye contact, hunched back, in his twenties. I did find someone who was on my same level of craziness! We stared at one another, shook hands. He went on to go around in circle in the courtyard, and I went back to the corner to watch people. There is comfort in company!

After a few minutes, a patient came to me, started a conversation about how he locked himself up in his room for six months, only left to buy cigarettes, and learned English on a computer, but now he forgot it! Attempting at some medical thinking, I wondered, "Hm, did he become psychotic to learn English? Does he have antisocial behavior personality?" The shield of medicine that protects medical students, namely the thoughts about diagnosis, was stripped away from me. And as I thought about how bare I stood listening to this patient, he started screaming, at apparantly someone who was standing right behind me. I understood that my Englih speaking patient wanted to prevent the one behind me from harming me. They started to argue, walked a bit away from me, and I also walked away from them. The patient standing behind me was you.

I took a further look a few minutes later and saw that you were drinking water and spitting it out. Was that what you were going to do standing behind me? I did not know. I proceeded to do what my peers were doing, chatting with other patients. I sat at a bench, started talking, babbling, just like the patients were also talking and babbling. You, then, came up to me at the bench, with your belly hanging through your unbottoned shirt, with some sort of fluid spilled on your pants, and you bent down and also started talking. I would have liked to also talk to you, but you were speaking in Russian. And, I dont speak that language, unfortunately.

You stared at me, speaking, and I wondered to myself what went on in your head, what kind of reality you lived, what your story was, how you changed, why you were speaking Russian to me, how I came to be part of your psychortic world? I remained quiet, and you continued to stare and talk. I stared back.

When we were told the time was up, I quickly slipped through a crowded door, wanting to be safe, and saved, having recognized that inside a men's locked ward, I had no shield and no protection, except my diagnosis and differenetial diagnosis. I raced to reach to my world and shield- my books, my writing.

Dear Mister, this is a letter to you, to answer your psychotic questions. I dont know what you were talking about. Here, I speak in my own psychotic language.

Sincerely, A medical student.