THE PSYCHOLOGICAL IMPACT OF THE PARTITION OF INDIA
By Sanjeev Jain and Alok Sarin Sage Publications, 2018, pp. 260, R 850.00

This appeared in the recent edition of The Book Review. Thank you Adnan Farooqui for the opportunity.

As a lay person interested in mental health, personal and community, I feel this book opens a space the nation should have been discussing and sorting out ever since our blood dimmed independence.

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Q: What was your motivation to make your story public?

Ans. The motivation for Sepia Leaves was that through my growing up years the society called me a ‘mad woman’s son’ and hence unworthy of equality but worthy of a lot of sympathy and even some pity. I asked myself: is there no space in the world beyond our home where our family’s story can make sense? Is madness truly as dehumanizing as it is made out to be? Can’t we live in a world, or even inside a story?

Read on…

I was leaning against a door looking into the male ward. The young man on a bed, about sixteen years old, had just thrown away the drip administered into his arm. The cannula had ruptured and he was bleeding. Drop by drop, the white bed sheet was turning red. The nurse was trying to calm him, adjust the catheter. When she was leaving the room I asked, ‘What is wrong with him?’ She answered, ‘Not eating anything.’

The young man wanted to skip a ritual. A ritual that we don’t allow each other to skip. The ritual of eating. A hungry he would, on being given energy fluids, find ways of throwing away the feeding mechanism. As the nurse moved away, the young man tried to sit up in bed. Weak, he collapsed again. The society, the legal system, the public opinion, are all tilted in favour of fulfilling the ritual. The society demands that the young man give a coherent explanation on why he does not want to eat. Until then, we try to feed him, try to make him ‘see’ sense.

While we try to make him see ‘sense’, he also sees us. Like did another man who approached me while I was still standing at the door. A 40-ish Sikh man with an open beard. His tummy swollen. He reaches near my face, almost whispers in my ear, ‘You look familiar.’ I think to myself, ‘I have lived in your head a long long time.’ I asked him why his tummy was swollen. He says, ‘One week. I have not gone to toilet.’ I ask him to go to the medical counter opposite the ward and ask for a tablet to relive constipation. ‘Go get it. I am watching over you,’ I said.

He goes, gets the tablet. When he is ready with an open bottle of water and tablet in another hand, he looks at me. It is a ritual. In the hospital he takes tablets every few hours. He might be taking tablets every few hours even when he is not in the hospital. Who knows whether he has a home or if he lives on the streets or in a Gurdwara. I do not know him. Standing at that door, I am watching him. Our eyes meet. We both smile, add a personal touch to the ritual.

Another man sees us smiling at each other. In white kurta pyjama, his hair well trimmed, he must be around 65 years old. He holds my hand. ‘When I came here 2 weeks ago I was insisting that they give me something that would kill me.’ He wanted to end another ritual: of living. ‘And now?’ I asked. ‘Now I want to go home. Come to my room.’ We sit on cots across each other. The light is off, it is dark, we can barely see silhouettes. He counts all the times he takes food and all the tablets per dosages. Rituals. ‘Do you feel better Baba?’ I ask. He answers, ‘Yes.’ I will go home and pray. He is ready for another ritual. ‘Oh! I forgot to switch on the light,’ he says, and puts on the tube-light. I touch his feet, he pats my head. I leave him in his lit room.

These were real people and there was nothing new that I could have told them. A tragedy has befallen their lives and they come here to share their experiences. We must draw on those experiences, process them, strip them of presumptions, and make nuggets of knowledge that maybe other care givers can use. We did that by starting a conversation. For example,

1. When users feel the medication is not working we have to take into account that the pharmaceutical psychiatry industry is growing the fastest in the world today but they still do not have effective ways to find new drugs. There is no easy co-relation between chemicals and effectiveness because the results are not tied to figures. All they have are some subjective type tests and the users’ word, which also depends upon the mood of those who are trying the trial drugs.
2. Regular medication also has very hard side-effects. Most often we get angry with a victim for being lazy, but it might be that the medication that he or she is consuming is causing the blood sugar to rise and it is not as someone was saying ‘opium is mixed in drugs’.
3. The discipline of psychiatry has still not evolved enough for the practitioners to be able to make effective and absolute diagnoses. To reach a consensus that the same condition is called the same name by different people in different contexts. That is why it is important that the care givers make the effort to participate in the process of diagnoses and care.
4. Genetics plays an important role in transmitting the illnesses between generations in a family but it can again not be tied to exact percentages. Neither can we rule out the environment or individual behaviour patterns. Genes also work on the basis of whether they are active or dormant or repressive and so on.

We ended up with the question what is it that exactly happens in the mind of a victim. We had with us a lady who has successfully combated her schizophrenia. She said, ‘A strong iron door is locked on the mind. Whatever happens, washes over the person whose mind is locked. We do not have the right keys to open the locks. While the world grows around us, we live in the closed room.’

A very important point to consider, and this was the first time I heard it from a user. Thank you lady.

Your book was an eye-opener. I always thought that I was a compassionate doctor who wanted to bring peace to the troubled minds.

The very word Paagal infuriates me and I have always tried to convince people that every patient of Psychiatry can be made to have a normal social life with the help of meds, counselling, etc. But, I never saw beyond the patients. I never saw what it did to the families. All I was bothered was about making sure that the patient took the right prescription, came for regular follow-ups and went back to being normal till the relapse occured.

Your book gives me a newer perspective of things and strengthens my resolve to be a Psychiatrist.