Wednesday, 17 July 2013

Shadow of the Wounded Healer

Dean in the Underworld: Act I Scene 5

            In the previous scene the Caregiver, now turned Gatekeeper, had just indicated that there were no medics around to give Dean a prescription for lessening the after effects of anti~psychotic drugs. The Mediator must now move offstage, and make way for the Clinician to deal with the situation.

            In medical terms a ‘gatekeeper’ is a health care professional, such as a GP, who is the patient's first point of contact with the health care system; they assess the degree of urgency of a patient’s needs and facilitates the individual's further access to the system.

The gatekeeper to Dean’s access needs some encouragement to do the right thing. It’s time for the Clinician to engage and use her specialist knowledge as leverage. Her manner is deceptively mild and unruffled.

            Since this is a psychiatric hospital you must have a doctor on site or on call somewhere in the vicinity, Clinician says. All anti~psychotic drugs act on the part of the central nervous system located in the brain, said the Clinician, surely it's not your intention that the patient's brains get fried, she continues with a smile. Gatekeeper’s eyes widen.

            Gatekeeper turns to Dean and says: If you agree to take the injection, I will then find the duty doctor. (Oh, there is one about then). Dean agrees. But it seems the duty doctor is assessing a patient just brought in by the police and simply does not have time to read Dean’s file, and the off~site doctor’s phone goes to voicemail.

            Caregiver/Gatekeeper looks at me helplessly.

            It’s not your fault I say, I know you are not in charge here (speaking to Caregiver)…but nevertheless we are not leaving this place today without Dean’s prescription (speaking to Gatekeeper). If he has a massive reaction to Haldol Depot in the next few days, then this hospital will be responsible

          I guess he is on the highest possible dosage, the Clinician asks? Caregiver nods. Have you checked him out for any physiological contra~indicators for this drug, given the high dosage prescribed, Clinician asks? Or is the system a little cavalier with patients who have the propensity to become psychotic? No, of course not replies Caregiver, now a little distressed. I’ll see what I can do, says the Gatekeeper as she hurries away. 

            I feel a little sorry for her. National Health Service staff are stressed and harassed all the time. They are overworked, underpaid and undervalued. People like this lady do the best they can under enormous pressure, but she is the gatekeeper and the gate needs to open.

          Twenty minutes later Caregiver returns with the appropriate prescription. Apparently Dr Bedlam’s junior had miraculously appeared. He must have skived off from his training course.

            Something is going on here; something that I have missed or is not being said, but I am going to get to the bottom of it. I’ll be calling on the Detective’s forensic skills. For now this mad, chaotic day is over. What a relief, at last I can go home. It’s 4 p.m.

            Dean has an appointment with Dr Bedlam in about 10 days time; that should be fun.

INTERMISSION

4 comments:

  1. Well the Detective wants to point out with a chuckle...
    Appt with Dr. Bedlam from the psychiatric ward???!!! Are you kidding me???

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    Replies
    1. Don't know what his name is do I, but Bedlam works and will do for now. It might be Jack Nicholson of course....

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  2. You know I was thinking bout I flew over the cuckoo's nest!!!

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  3. Maybe Robert Powell in Asylum...

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