Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for May 6th, 2010

Mental Illness Gratitude

Posted by Dr. Vollmer on May 6, 2010

     Mitchell, forty-one, met me ten years ago after he received my name from someone in line at the pharmacy, while he was waiting to renew his psychiatric medications. When he started seeing me he had been three prior psychiatric hospitalizations for manic episodes. His brother has bipolar disorder also, although his three other siblings and his parents are free of psychiatric symptoms. I have seen Mitchell deteriorate over ten years; I have diagnosed him with schizoaffective disorder. He was gainfully employed as a software engineer for fifteen years after college, but now he is unable to hold a job. In talking to him, he is painfully incoherent. Roxanna, his wife of twenty years does not believe he has a mental illness. She calls him “lazy.” I have explained to her multiple times that Mitchell has a disease which does not allow his brain to work in the way that it used to. “Mitchell cannot think in a coherent fashion,” I say.  Roxanna says “I disagree.” As Roxanna and I discuss Mitchell’s brain, Mitchell sits there quietly and then returns to his incoherent conversation, this time about the Department of Water and Power and how high her bill is becoming.

    Recently, Sherry, Mitchell’s eighty-five year old mother came in with Mitchell to an appointment. Sherry walks with a cane, but otherwise, she appears quite healthy. She reminds me that she met me eight years ago and then she says “it is nice to see you again.” Sherry is down here from Montana, spending some “quality time” with her son. Sherry understands her son’s mental illness. After all, her other son suffers from very similar issues. Mitchell starts talking about his wife, but I am not sure what she is trying to tell me; Sherry is not clear either. At the end of the appointment, Sherry turns to me and says “thank you for taking such good care of my son for all these years.” I look at her with tears in my eyes and I say “your welcome. It is nice to see you too.”

     I prescribe Mitchell medication which Mitchell takes most of the time. I see him once a month for thirty minute visits. The psychotropic medication seems to keep Mitchell stable. Mitchell is very pleasant; he always has been. His wife encourages him to take his prescriptions, but she does not believe that he is “sick.” Mitchell seems to enjoy seeing me, but he cannot articulate why he comes to see me or why he needs to take medication. Sherry understands. Her comment made me think that she is grateful that Mitchell is still the loveable son she has always known.  I suspect that Sherry understands that some folks with schizoaffective disorder lose their sweetness.  Sherry appreciates that she can be with her son and she can hold on to the memories of him growing up; she can  see the twinkle in his eye; the sparkle he has had for his entire life. She gives me some credit for Mitchell’s twinkle. I accept that.  Sherry’s gratitude is touching.

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