Mental illness is not a death sentence

After the end of the internship, I was sent to  Izmail city in Odesa region for the post of psychiatrist. The head of the psychiatric department was a woman of 35-40 years, extremely sharp and emotional, she really liked to handle the department and she enjoyed it so much. Nevertheless, it didn't make her a good psychiatrist. She considered it to be her duty to patronize me, which was usually expressed in the correction of my appointments without my knowledge and prior discussion. At the same time, I had to prove the correctness of my appointments by referring to special literature known to me and in all cases I was right. After some time I realized that I always had good arguments when prescribing these or other medications, she stopped interfering with my appointments.
Soon I was faced with another situation: the head of the department did not know how a spinal puncture was conducted and did not want to make it, and when I felt the need to get it done, I invited the head of the neurology department to conduct it.

One of the days when I had to make a puncture ща a patient in a state of alcoholic psychosis, the head of the neurology department learned that a new doctor had appeared, demanded that I attend and learn how to do this procedure properly. At the same time, she said that the second time I would do spinal puncture myself.  She explained in detail and showed how to do everything and then she left. For the second time, I had to do this procedure myself in her presence and everything went well. For the next more than ten times, I had to do puncture, although before that I had never practiced it.

After having worked for a year, I was suddenly left alone to run the department and lead the reception in the clinic, while all the other six doctors went on vacation  together in then month (probably so the managing department decided to take care of me). In fact,  I was left alone in the old town and the surrounding area. Thanks to a clear organization of work in the department, the right treatment, I coped with that difficult situation.
I used to occasionally replace retired doctors working in the clinic (they were two women for the time being) and was surprised that so few of them come to see patients. They would receive 2-3 patients per day and it allowed me to work with medical literature to increase the level of my knowledge of the specific.

But when I started receiving patients regularly, I could take up to 25 peoplewhile working half-time. There were not only mentally ill, but also ordinary people with neurotic symptoms. I had to forget about literature and lead the reception with full load. Needless to say that there were 60 patients in the department. As I said, I coped with all that burden and received a reward equal to 0.5 doctor's rate (our socialist state strictly ensured that the doctor did not suddenly receive a penny more).
Suddenly I recalled that during one of the lectures at the Medical Institute, one of the professors said that the doctor should be dressed modestly, so that it does not irritate patients and should preferably be in a good physical shape, in the opinion that perhaps he will have to go to a call on a bicycle.
I still dress modestly and sometimes love to ride a bike (thanks to the mainsteam homeland party!).

In that difficult month for me, a new patient appeared. Her mother turned to me with a request to conduct a consultation for her daughter, who has been treated at the executive department for 2 months to no avail.
When they turn to you with hope, I certainly want to help, so I agreed. The patient turned out to be a pretty girl of about 17 years old. She was badly irritated, aggressive, she would throw things in her room, refused food and believed her mother was poisoning food. In some unfathomable way, with human attitude alone, I managed to calm her down and, moreover, convince her to begin treatment. The managing department diagnosed her with schizophrenia. I cancelled all previous appointments and prescribed 1/2 ml. of moditen-depo (a drug of prolonged action) and as it turned out that the choice was correct. A week later, the patient's behavior normalized and ridiculous ideas disappeared. She went on to receive treatment-supporting moditen depots for about 2 months.

Throughout her time at work in Izmail, she had no acute illness.
Later, 3 year after , I received a letter from her in which she said that she felt fine, got married and had a baby.
After having worked for 1.5 years, I transferred to the psychiatric hospital G. B-Dnestrovsky where important events occurred in my medical life.

Another quite curious patient of mine was a boy about 14 years old. His mom turned to me for help. She reported that her son has been suffering from involuntary seizures in his body, arms and legs for several years. At the same time, he was treated by the head of the neurology department, but there was no positive result. I came to the conclusion that there might   not be an ordinary hyperkinesis, but something more complicated.

Since I did not possess the necessary medical literature, I came to the decision that I should go to the library of the medical institute in Odessa and seek information about my patient's illness. Since no one would not let me go on a working day, I went on my days off (the road was tiring, by the way, I had to go only at one end for more than 7 hours). Having noticed the necessary literature, I put out to the patient for the first time in my practice a diagnosis: "Gilles de Tourette's syndrome." I prescribed the recommended treatment (the haloperidol drug ), I got an amazing result, completely after two weeks of taking the medication, the seizures disappeared and
he recovered from  pain. A few years later, working at the Bilhorod-Dnistrovsky psychiatric hospital, I learned from the mother of the patient that he was so healthy that he could be even recruited to  the army.