A Patient Receiving Care, and Returning It

Commentator and psychiatrist Elissa Ely tells of treating a patient who attempted to reciprocate.

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MICHELE NORRIS, host:

Commentator Elisa Ely is a psychiatrist in Massachusetts. She recalls one patient she treated who reminded her about the limits of her profession.

Dr. ELISA ELY, M.D. (National Syndicated Commentator and psychiatrist, Massachusetts): We met when he was living in a sober house. He'd been off cocaine six months but was still moody and irritable. He'd agreed to consultation for concerning symptoms: voices in the night and communications from strangers. Yet, he didn't seem concerned. He sat comfortably, no question was too personal. He genuinely appreciated the time and help. His handshake was firm, his palms were dry.

Yes, he'd been on medication before in jail. He couldn't say which medicine. Yes, sometimes he heard his mother's voice telling him he'd turn out like his father. His father had been drowned in one of the local rivers, probably the result of a sour drug deal. The police thought it was suicide, but he knew better. His father was terrified of water.

Well, let's start with some Zyprexa, I said. I was embarrassed. Addiction, trauma, homelessness, unemployment, psychosis, it was like trying to level a mountain with a pair of tweezers.

Oh, that sounds fine, he said. It should help with sleep and voices.

I'm sure it will. It's really only a start.

Certainly is a good one, he said. Appreciate it.

This was too much. He was so utterly philosophical, so accepting, sitting in the room with nothing to his name and no particular future ahead. What is keeping you going? I said.

Why, he said, nothing but God.

He took the prescription and folded it into a wallet. With one hand on the door, a new, intimate expression came over his face. Now, how were you raised? he said.

Me? I checked my watch. But he persisted. What do you believe in?

For a second, I was drawn to confess. It struck me that one of us had a home, a job, a family, while the other appeared to have nothing. Yet, the one with nothing was not lonely. I certainly respect people who believe, I said.

Ah, he said, recognizing a dismissal, and left.

I was writing in the chart when there was a knock on the door, and his smiling, self-possessed face reappeared. I'll pray for you, you know, he said.

(Soundbite of music)

NORRIS: Elisa Ely is a psychiatrist in Massachusetts.

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