Having worked in Psychiatry for about six weeks or so, I have come across a problem which makes me quite glad that I haven’t made this a permanent career choice. I’m sure it’s something that established clinicians will have come to terms with in their own way – but how do you deal with patients who have done terrible things in their personal lives?
Of course the answer is professionally and in a non-judgemental manner. Yet even though I know this, and stick to it in my interaction with patients, sometimes you can’t help but feel complete revulsion, a surprisingly visceral reaction. I have come across patients that commit domestic abuse on elderly parents, attempted murder, sexual abuse. Sometimes it can truly be said that they are victims of their own life circumstances, or that they are so mentally ill (or were at the time) that they have no understanding of what they have done. In those situations, it could be said that there has been a failure of the system, to help those people and their victims. I suppose being non-judgemental is not about trying to decide which patients are worthy of sympathy or understanding, after all, the convicted murderer on death row is as entitled to medical care as the innocent old lady you see in the GP surgery.