Dr. Raviteja Innamuri
Consultant Psychiatrist, CMC Vellore

Strangely, some of life’s most valuable lessons can be learned by spending some time at hospitals. It seems that witnessing the extreme form of anything can alter one’s perception of life itself, say a woman in labor, a forest fire, a psychopath. Hospitals are places designed for healing but allow one to witness the entire transition from birth to death – all in one place.

I work at the Department of Psychiatry, Christian Medical College, Vellore. The Mental Health Centre (MHC) is located in a serene environment, a few kilometers away from the main hospital. With the dry scorching heat, the hustle and bustle of more than 6000 patients visiting every day; most of the staff here wouldn’t disagree with me when I say that MHC is one of the most peaceful places around Vellore. Call it an irony or not, it’s true! Where else can you find peace more easily than the mental hospital, I say! Working at MHC for the last 5 years also offered me some of my life’s greatest experiences and lessons. Here are some of them:

  1. Trust

Leap of faith is something I have heard over and over again. It makes one vulnerable and provides immense strength, at the same time. More often than not, patients have failed or have been failed several times before they come to tertiary psychiatric care for help. Strangely, very often, they are once again willing to hold our hand and go through the entire journey of medication, lifestyle modification, allowing us into their deepest corners of their mind and even give them electric shocks (if and when needed) to jolt them back to reality! They were willing to take that leap of faith, once again. Sometimes, it’s all that is needed even when life hits rock bottom.

  1. Avoidance

The more you avoid something, the more likely it is to get back at you (with even worse intensity it got you the first time). From both personal life experiences and that of my several patients, I am sure of this one. If not this lifetime, then the next one! It could be the public speaking or relationships that one fears. The only way ahead, it seems, is to fight your fears and sort it out – one on one!

  1. Moves like a shadow

This may seem very similar to the last one but is very different. Have you ever tried catching your shadow? The more you try to reach it, the more it runs away from you. Life too is such an experience. When someone is desperate for love or success or progress, it only seems to go away from them. The only way out here is to find the sun and walk towards it. I remember a funny example of this. The more the patient demands discharge, the less likely the doctors are to be convinced for it. But ones he/she follows routine, medications, exercise and looks happy – he is out the next minute (even if he wants to stay)! Remember, follow the sun/light!

  1. Flowery isn’t flowery all

Use of sweet, complex and mesmerizing words only have a short term effect and sometimes can mean nothing. Following meeting the family of a patient, a postgraduate student presented – ‘ventilation and support were given. They were psychoeducated about the illness. Coping strategies and psychosocial interventions were discussed.’ It sounded impressive. But later when I met the family, they confessed to me that they understood zilch.

  1. Finding your emotion

Like finding your cheese, this is another extremely interesting phenomena that alter our experience of life on a second-to-second basis. But would you believe me when I say that, irrespective of your environment, the emotion that you want to live with, is yours to find. Here a few exercises to prove my point. Spot an angry chap yelling at the pitch of their voice. You can easily calm them down by calling them to the side (cuts off public attention), saying softly that you understand their distress (by labeling, shifts the active region from limbic network to cortical network) and continuing to listen and respond in a very calm voice(the chosen opposite emotion of the angry person). Similarly, when you laugh with your happy friend, the laughter more than doubles. If you respond calmly to that irritable man in the busy traffic, suddenly the anger has dissipated into the polluted air! Now tell me, isn’t it each of us who have to find our emotion. Easier said than done, right!

  1. Humour is a ‘mature’ defense mechanism 😀

Some of the most bitter life truths become very digestible when coated with a dash of humor. I don’t think I can explain this better than by narrating a recent incident. A postgraduate (PG) student brought an old lady to my chamber for therapy. She looked sad, distraught with heavy bags underneath her eyes. The PG student reported that she was referred from the casualty after her stomach was washed and her vitals were stabilized. She attempted suicide last night, for the third time in the last 10 days. The main reason being that she wasn’t able to fall asleep and she thought life wasn’t worth living with a troubling insomnia!

Instead of asking her to come back for psychotherapy on another day, I felt like talking to her.

I asked her, “What do think there is ‘after-death?’ She looked surprised. I asked again. “I think, once you are dead, you either reach God or you become a ghost”, she hesitantly replied. “And what decides this?”, I quickly asked before I lost her attention. “Well, my mother used to tell me that it depends on how you die”, she said and looked down. I softly remarked, “and if one dies due to suicide, where would that take them?” “That will turn me to a ghost, I guess”, she said nervously and met me in the eye. I continued, “Well, patiamma (granny in Tamil), you are sleeping for at least 3 hours now but as you know ghosts don’t sleep. This is definitely not going to help with your problem. Shall we together, try something else?”

She looked dumbstruck and then we all broke into a burst of laughter together! That was the end of her suicide attempts. She now sleeps for a good 6 hours with some medication, sleep hygiene techniques, and occasional humor.



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