Archive for December 2009
I was invited to attend the weekly ward round at Chaffinch Ward(medium secure), River House, Bethlem Hospital last Thursday 10/12/09. I was escorted to the
ward through a series of locked doors by a ward staff member. In the
ward I immediately saw the ward round team in a room with large glass
panel walls by the entrance. The ward round team consisted of a Psychologist, Forensic
Psychiatrist, Occupational Therapist, three medical students, two ward
nurses and myself.
There had been a significant event on the ward the previous evening
and the immediate conversation was addressing this matter. There where
issues to sort out with organizations like MAPPA and Interpol, the
police and the press. I listened while the team discussed how best to
deal with these issues keeping the safety of all involved as priority.
When these matters had been dealt with, the ward round began. The team began to discuss patients on the ward- any problems they where having,
progress they had made and how to address this appropriately. For example, granting
more unescorted leave to a patient who had behaved responsibly and
postponing leave of a patient who had behaved in a disruptive or
negative way. Each patient was called in after these discussions and
the psychiatrist explained to them what the team had decided and
discussed this with the patient. Some patients seemed very happy with
their progress and situation and others where noticeably unhappy or
disappointed by the news they received, others made jokes about the
the atmosphere was one of total concentration. The meeting covered so
many issues and had to be kept within the 9.30am-1pm time schedule.
during this meeting all people present contributed to the discussion,
offering different perspectives, and I learnt a huge amount from
observing the meeting.
In the afternoon, I sat in on meetings one of which was a meeting to release a young male patient who had been in psychiatric hospital for a number of years. his mother was
with him in the meeting. The occupational therapist discussed
possibilities for voluntary work in the community and possible adult
education course he may be able to enroll for. The hostel worker from
he hostel he is moving to was there and they had a discussion about
what kind of expectations the hostel had for him. He will be spending
Christmas with his mum this year, she said “I have not had him for
Christmas for a long time”, and she had a great smile. It was an
emotional meeting. The team wished him good luck with his new
life and he left the room with his mother. From my seat I could see
them hugging in the corridor when they left and it was very
moving. I found it very difficult not to cry at
Patient A is an adolescent GCSE student at school. I went to his school to meet him and to draw him. The art teacher was very helpful and we set up an area in the art class to do the portrait. Patient A was in a very good mood when I met him. A bit shy but very happy to talk once we where sitting down. He told me that his favourite subjects where art and drama and showed me some of his art-work. He wants to go to college after his GCSEs and learn a trade rather than going to university. He has a cousin who is an artist and he told me that he has made a sculpture that he will send for thousands of pounds, Patient A seemed impressed by his cousin. We talked about being at school and thinking that anyone over 20 is old and how that changes as you get older yourself. He had two badges on that said “CITIZEN” which had been given to him in reward for a good deed he had done for the school. He is also a sports captain and told me he loves playing basketball and football at break-time with his friends. We talked about the canteen, pizza, cheese toasties portugese custard tarts, portugal and Ireland. He sat still and really concentrated for over an hour and said he enjoyed the experience of being drawn. When I had finished the drawing he brought one of his friends into the class to show him the drawing and seemed proud and said thank-you. Below you can see self portraits A made in his GCSE art class.
Dr F came to the Maudsley as a medical student on a short elective and worked in the emergency clinic with a famous psychiatrist called Antony Clare and enjoyed this.When a medical student on my surgical placement her consultant noted how hopeless she was in surgery but how good she was with patients and suggested she do psychiatry. Her interests are campaigning and teaching on improving the lot of children in the UK and she is also involved in an NGO which helps asylum seekers in detentiton to get treatment and get out when necessary.
Dr F has a wonderful realtionship with her patient (Patient C). Her patient attributes her full recovery to meeting Dr F. When I asked what they had in common she replied “So much! I have just been luckier in my life experiences”.
She is a lover of nature and finds peace when walking or cycling in the country side or by the sea. She love elephants, wild animals and birds.
She is influenced by the work of John Bowlby and his followers carrying out attachment research has influenced the way she works and is the conceptual basis for her understanding of working with survivors of abuse and of torture.
She has a collection of miniature houses, animals and pots made by south americans, who she lived with as a kid.
When I asked her what she would change about psychiatry she said “Remove the right to section people”
Dr V is a child and adolescent Psychiatrist. Influenced by Freud, Klein, Bion, Winnicot, as well as the systemic family therapists like Minuchen and also very interested in narrative approaches to medicine and psychiatry, particularly therapeutic letter writing. She is a mother and seems to balance her work and home life very well. When talking about this she mentioned how supportive the NHS is as a working mother. Outside of her job she enjoys theatre, art, walking, swimming, yoga incl Sanskrit chanting.Dr V loves the Autumn leaves especially acers, cherry blossom and lapis lazul.
Her patient is at school and Dr V works with his family, school teacher and various NHS workers on his case. They have a good relationship and it is obvious that Dr V cares for her patient. When asked what they had in common Dr V said they both had experience of anxiety.
Dr S works as a Psychiatrist on the National Pyschosis Ward at Bethlem Royal Hospital. He became a psychiatrist because he was always curious about other people and their motivations and lives. He also researches at the Institute of psychiatry and has produced many research papers for example “Mapping Auditory Hallucinations in Schizophrenia using Functional Magnetic Resonance Imaging”. He is Sikh, likes Neitzsche, practices martial arts (iaido; jodo and karate)
meditation and prayer, likes roses and rubies, waterfalls and mountains. He is the only psychiatrist who choose to look directly at me while I was drawing, which I thought was quite brave. He is also the psychiatrist I have drawn who was not recruited for me by Dr Tim McInerny. Two of the Arts Therapists told me they thought he would be good to work with so I approached him myself. They had told me that he was one of the few Psychiatrists who spent time in Bethlem Art Gallery and he always brought sweets and left them at the gallery for visitors. He is a very warm and friendly character and when I asked what he had in common with his patient, he said “Everything, just different life experiences”.