Prof. Dr. Kemal Arıkan
Psikiyatrist

Those Who Hit the Rock Bottom and Doctors

He had a messy hair, his eyes were completely red. He was nervous, he was at the last possible point… His entire body was shivering. The man at his early forties was in panic. He was having a sleep problem for days, he was in such a lunatic state.

It is really difficult to understand the situation some patients are in. He was one of those patients. Why is it hard? Because they come here in such a state that you cannot find the time to have empathy. You have to produce an urgent solution. It is like hitting the rock bottom with them. This is almost like the mood of an anesthetist – reanimation expert trying to help a patient who is about to die. The massive matter of life and death stands over there before the feelings of the patient. The patients hand themselves in to you. As they say, “First God, then you.”. How can one have empathy in such a way of relationship at that level? You fully internalize the patient. The only thing you think of is them breathing in and out. You feel the same level of interest and responsibility for them the way you feel for your own children. It can even go beyond that. Because you have no expectations, no judgment at all. There is only a person who is at the rock bottom. And there is you. It reaches such a point that it goes beyond having empathy.

You have some patients you risk death for in order to save them from the bottom. I had many colleagues who said “I’m ready to have cancer if I were to find a solution for it!”.

He was using the last piece of energy he had while saying “Please save me!”. He was offering me everything that he had. His home, his car, whatever he had…Now, stop and think about it. If you were a physician, would you be in a materialistic world suggested by the patient, or in completely different moral world in that situation? Here’s the answer. You would want to “save” them with everything you have. That’s it. “To save…”

What would you do to a person that is drowning in the sea? What is it like giving directions to a person who lost his way? I’m asking you: is “Saving” a thing that one expects something in return for? The answer is clear… There are things that are done without expecting anything in return. This is how it’s like being friends with those at the bottom.

The young man with messy hair was also a person at the rock bottom. The urge to “save” was triggered already. After telling him that I was going to do everything I could, I told him about the process or, in other words, about the road map I was planning. In the first phase, I started off by informing him about his sickness. I tried to tell him that the disease is very scary, yet it is never a deadly one. He was in no position to listen to me. Still, in cold blood, I took hold of his hand, and looking in his eyes, I said “We have a lot of things to do, don’t worry!”.

Then, I made the pharmacological attempts needed. And he left. I made it possible for him to contact me 24 hours. He only called for a few times, for a few days. What if I say that after some extra short meetings, first he felt relaxed, and in a couple of months, he got out of the rock bottom… I don’t know if I can tell how it feels to “save” someone for a physician if I added that I cannot forget about the happiness of seeing him shaved, with clean hair and with a smile in his eyes…

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