Narrative Medicine Monday: Jefferson’s Children

We get a glimpse into both the patient and the physician’s perspective of a manic presentation in Maureen Hirthler’s “Jefferson’s Children“. Her dramatic opening (“If you don’t do something right now, I’m going to hurt my children.”) inserts the reader into the mindset of the patient, desperately asking for help to make sense of her racing and disturbing thoughts. As the emergency physician enters the scene, the narrative shifts and the reader becomes the provider, trying to make a definitive diagnosis and determine an appropriate treatment plan. 

The physician feels the patient should be admitted for psychiatric evaluation and treatment but is unable to find a bed for her and meets resistance from both the patient and her superior. Can you feel her frustration? Have you ever been in a similar situation?

The lack of appropriate, affordable and available psychiatric treatment has been discussed and debated much in recent years. What are the barriers you’ve noted to getting yourself, your loved ones or your patients the mental health care they need? If you could create the ideal mental health system, what would that look like?
Writing Prompt: Try writing from the first person perspective of a manic patient first arriving at the hospital or clinic. What about a severely depressed patient? A very anxious patient? Now write the same scene from the perspective of the medical provider (physician or therapist). How does the scene change?

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