Soins
«Of course, it is happening inside your head, Harry, but why on earth should that mean that it is not real?» – J.K. Rowling, Harry Potter and the Deathly Hallows.
«You don’t choose madness, but you choose to care or not». The nurse set her up in the waiting room. Her radiant smile added: «Wait here. The neuro-sci robot will pick you up in about 15 minutes.»
«See you later», she greeted her while hanging her jaquette on the coat rack.
She began to daydream while enjoying the welcome she had received. «It’s crazy how some people have a way of cheering you up.»
The nurse was the team’s sunshine, she was in charge of management and her teammate was in charge of the caring robots.
The nursing shepherd chair lit up and said, «Mrs. Luz, please take a seat. The neuro-sci robot wants you to do some tests.»
Aliénor executed herself.
A curtain opened. «Can the neuro-sci robot access all or part of your file, do you agree with this?»
«Do you accept a blood test?»
Aliénor clicked on «Yes» in response to both questions. An arm came forward and pricked her on the arm.
«Do you accept a blood pressure reading?» Aliénor clicked weakly and had to start again. The machine asked her to put on the withers to measure it on the arm. It was as soft as velvet but it will squeeze her arm like an iron glove. It is an image, of course; it was the machine that had an iron structure. The scale will light up in turn. «Can you please weigh yourself?» «Where’s the «Yes» button?» Oh, that’s it, it was on the screen of the shepherd’s chair.»
She executed herself.
The scale will light up in turn. «Can you please weigh yourself?»
She executed herself again.
Once the care provided, the beverage dispenser suggested that she choose one on his screen. Aliénor chose a squeezed kiwi. It felt good, a little comfort, to relieve the pressure. She had tingling in the arm her arm, which was no longer red. She was particularly careful to enjoy every drop of the juice. It relaxed her even more. Blong! A file arrived in the locker perfectly cut for this purpose in a superb piece of furniture in the shape of a branch in the wind. «Please complete these questionnaires and provide your sleep records?»
These were mainly personality tests and major events that had occurred since the last meeting. Aliénor conscientiously filled everything in and then put the file and the records in the box so that it can be sent to the robot-sci. BizZZzzZZzzzz!
A bald man came through the door and this temporarily freed her from her anguish. She was fine, but psychiatry… to say the least, how many spleen she had had in the past. He declaimed, «Oh, me… I’d like a grape juice.»
Unavoidably, the machine executed the order.
He took the little drink with a cheerful eye. «I would have preferred a little Bordeaux…»
Unavoidably, the machine executed the order.
On his screen, it read: «Your alcohol quota is now empty.»
Chouf! The door opened. It had a humanoid shape but the designers had chosen to cover it with metallic pink. The light was reflected there splendidly. Would it make a rainbow of all colours if you put it in front of a light spectrum?
«Thank you for your cooperation. I was able to analyze all the results and I have all your files.»
«Perfect.»
The neuro-sci robot put his cards on the table and explained the biochemistry of her brain.
«Would you like me to read the files to you?»
Aliénor refused because she knew what was in it.
«I am a model of the V22-Z series. We are all interchangeable and we share our memory. No matter which robot receives you, you will have the same relationship…»
«The same one with any other, yes, I know. Thank you.»
It spoke without any compassion. Its designers had decided that compassion was not needed to deal with brain biochemistry.
After exchanging some technical details, the robot came to the heart of the matter:
«You had surgery five years ago on defective genes. It worked very well but you and your environment have changed and as a result, your genes are expressing themselves differently. A new operation will be needed to treat you with the best possible quality of life for you and for society. I’m going to prescribe some medication to prepare for the operation. We have to wait until the sleep is of a better quality. I will bring in a psychologist so that she can help you manage this news and schedule an appointment at the most appropriate time.» Robot operation, ready, fire, go!
She waited in the waiting room, which was now all white. «Just being here feels good», she thought. Politeness, work well done, good communication between the different interlocutors and in particular the distinction between the general case (with the robot) and the is particular (with the psychologist). She felt deep down that she was going to heal.
A flashback burst into her brain. She was not well received in her hospital; psychiatric patients were not treated separately. Public hospitals mixed people with very different pathologies. The protocol was that there was no right to exit the premises in order to observe the patient and decide whether he/she could have a stroll or not. This was even after she had been voluntarily interned there about ten times. They knew her, damn it! The files, on the other hand, seemed to stall at the red light and their content was nicknamed «medical mythology». She was presumed guilty and thrown in «jail» each time. «We don’t know you, so we have to observe you.» The two days of confinement were used to see if the patient was using substances, which she had never done before. If substance use had drastically decreased as soon as effective drugs could be offered; apart from a few who could not get rid of the addiction…. Poor them… The addicts (alcohol, medication, cigarettes, cocaine,) were special all year round, but those who had made the mistake of self-medicating with these substances only revealed how ineffective «mythological medicine» was… When you have liver disease, it doesn’t show, and patients trust their doctor and treat themselves. Why must the psychiatric patient see what he/she has in order to be treated? And finally, what was blamed on the mentally ill was often related more to substance use than to the disease they were hiding. And then, in the hospitals’ defence, it is sometimes difficult for patients to remember or recognize their problematic behaviour.
Then, when strolls were allowed at last, patients were confined to a park with trails. Moreover, the idea that they looked like wolves in a zoo had flourished. Once, a wolf dog on a leash was on the terrace, amidst the anxious smokers. The comparison between patients and wolves was quite funny. Even if they sometimes showed their fangs, even if there were sometimes accidents, the genocide that had been carried out against them was completely disproportionate. Fear, not facts, had made the wolves’ lives unbearable. Now all that was left was at the zoo. A sheep of loss once in a while, was that such an unreasonable requirement?
What had she done to deserve this deprivation of liberty apart from seeking to feel good and no longer harm others? They only had to consult her medical file if they wanted to know how she was behaving. The staff seemed jaded. «Who cares about crazy people?» could have been one of their strike slogan.
Unfortunately, the medical mythology that constituted these files did not help them much. Very poorly maintained and with misunderstandings related to the lack of listening as well as excessive hyperbole to justify internment by force or justify the lack of effectiveness of treatment; these files only served to reinforce prejudices. Only the dates of the different processing operations were clear, as well as the reports or complaints or debts or prison or other. Strangely enough, information in these areas was circulating perfectly well. Most doctors and nurses had little empathy. Was it to be able to hold on?
Did they release their own stress on patients so, in consequence, it was in the most difficult moments that patients had to fight to be treated, in a more or less effective way depending on the case, with or without the help of the family and friends who then assumed an overload of work by seizing patient advocacy associations, shaking medical mutual to hurry, requesting access to check-ups, or insisting on the phone to get the opinion of each caregiver; and, with at work, managing a replacement. «Damn it! What’s the point of being there if you don’t have the doctor’s visit at least once a day», had once commented the person who shared her room. The latent waiting for anything, a towel, a medicine, a blanket, a new treatment, a new room. The doctors were switching to Halley’s comet frequency. The mentally ill were relegated to the rank of beggars, always asking for everything. However, the visitors’ bags were not guarded, which means that you could have anything you wanted, yes everything, as long as you had an accomplice.
And then, still with that idea, that if we inform the patient, he’s going to freak out. It was much more the opposite that was happening. It hurts not to know what you have. This just led to abandoning the doctor and asking the family and friends for explanations, i.e. extending the effects of the disease to the family and friends. Is that what it was like to do the job? Avoid the crisis in the little office so that it would be the family who would deal with it?
From then on, their metal counterparts assisted them in their tasks, which made them more open and more inclined to listen to them. This also coincided with the fact that the doctor quotas had been abolished and the work reduced to 15 hours per week. Everyone wants to be healthy and pleasant in society. The gregarious instinct…… If patients refused care, it was perhaps not because of the disease but rather because of the ineffectiveness of hospitals; drugs taken illegally or not. Diseases were now diagnosed in childhood and the industry of these substances had collapsed.
Fortunately, there was sometimes a doctor who could cure them. They were then overwhelmed by demand and reacted by increasing their prices. But as they increased the number of their patients, they ended up with only half of their brains to think, which weakened the quality of their work. Incubation is essential, damn it! How could we work 50 hours a week without any reduction in efficiency? And it takes time to research.
Victims of their illness, victims of taboos, victims of their exclusion, victims of their care; some chose the worst fate and executed themselves.
A huge smile burst into the room. Aliénor realized that she was revisiting the past. Her dark thoughts, which had resurfaced. She had gotten used to not having any in the last five years.
The woman was the psychologist. Her face was as harmonious as a lotus; but in the flesh. The latter shook her hand and informed her that she had an hour to devote to her. How many hours spent in her office or at Aliénor’s home? It was unfathomable in quantity but not in quality! The appointments were not regular, the therapist was available when necessary, that’s all. Nothing could replace this type of human contact. She had been her patient for… well, twenty years now. Before meeting her, there was such a turnover in the hospital and in the city, that she felt like she was not moving forward, spending her time saying the information to get started… Get to know each other and then the caregiver made a decision after 15 minutes. The past resurfaced again; and she forced herself to be in the present. «Look, Listen, Touch, Feel, Taste» intruded into her thoughts.
They discussed things and others over a jasmine tea. Aliénor appreciated Mrs. Chaux making her diagnosis while making her feel comfortable. Mrs. Chaux consulted the neuro-sci robot and handed her a leaf:
(a) CRISPR operation to modify defective genes
(b) Phytotherapy and reflexology treatment
© Drug treatment to be taken three times a day
(d) Do nothing
The list was ranked in order of preference by the neuro-sci robot and her own. Aliénor was tempted by the second option because she liked remedies that respected nature. But she preferred the first option because a single shot would allow her to stop thinking about the disease afterwards.
«Could I go back to work?», she asked.
«If you wish, otherwise I can make a stop. You’re huitante-three years old anyway!»
«No, I prefer to work. I see people there and my colleagues are real treats.»
When Aliénor was 40 years old, she would never have believed that she would say such a thing, even less at the age of eighty-three. She could not have done it at the time… Stress, poor management, competition, … The reduction of working time to 15 hours a week for everyone had been possible thanks to the robotization of society coupled with a better distribution of wealth. Society had evolved at the speed of rock science. Humans were only in positions where human characteristics were needed, so much so that they did not make a request. There were always a few wacky people who preferred the work of robots, and their different points of view were often waky.
A memory popped into her head that drove the atmosphere down. She was thinking about the revolt that took place once when she was hospitalized. At 4:00 in the morning, the mentally ill had turned on the music in the corridors.
Each floor was not tuned to the same music. It had been useless, of course, but in the end; they blamed their caregivers for being far too metallized with their sacred protocol. Aliénor racked her head to imagine a statue representing the much-revered protocol.
Mrs. Chaux took her out of her rumination. «Aliénor… Aliénor… Aliénor… Can you come the day after tomorrow night? I asked the base about your sleep and it will not reduce your work since it is not one of your working days.»
«All right.»
«It would be preferable to come the day before so that the hospital can optimize the conditions of the operation (sleep quality, diet, blood tests, etc.).»
Aliénor was delighted. The hospital’s chef was a passionate, very creative one. He had a database with all Aliénor’s tastes, and this since her first visit to the hospital.
Another benefit of the 15 hours/week. It was easy to convert to your passion.
We had time?!! A robot-prof rented by the day was sufficient. The designers had covered them with human skin, made by grafting, so that the students felt more comfortable, but the flesh and iron robot was rather pitiful to see. In addition, it was very expensive and very constraining because of the skin’s contact with solar electricity. University for All professors were available to complete the training of robot teachers and to help them find their way around the Internet portals where all knowledge was discussed and any ideas noted by their peers. All courses were one-to-one and were given on request and at any age or social status (not the statues of protocol, it has nothing to do with it).
It was thanks to this that research in all fields had taken a lunar leap forward. And especially neuroscience research. The Everestic delay had been made up in only a few years. This phenomenon was now known as the down jacket mission… «Mission down jacket… What a good joke!» Aliénor’s upper lip formed a kind of a rather silly grimace-smile. Psychiatry was no longer the Alien of medicine. Her husband had thus been relieved of the hours of nursing care he had been providing her since they met. The solidarity of their couple had been alleviated. Their cheeky steps had led them to travel more. And there were beautiful places on this planet. Unfortunately, some «natural» disasters… Well, it was an expression so much they had been the result of the greed of a few… Without any other reason than «the alters of traditions», the room was aseptic. On the door you could read instructions, to know what was allowed or not. The nurse knocked on the door and waited for Aliénor to come and open the door.
«This is the robot-care that will accompany you. It will also record your sleep so that the psychologist and the robot-sci can compare the effects of the operation before and after. It’s best if you’re in bed by 10:00. Good night.»
«Guten agen», replied Aliénor.
That it was so great to have a single room! In the past, patients would argue with each other with cigarettes in bed, ready to burn the building down, or others who, in the middle of the night, would scream above the bed of the other patient who had the misfortune to share his room. Aliénor was never comfortable when it came to sleeping with a lunatic in the middle of a crisis. Fortunately, there were groups of patients supervised by a nice nurse. But it was still necessary to have a good health insurance company that worked after three or four days to get the single room. Associations also needed to be mobilized to obtain effective care without having to harass staff every time a drug was wanted. Relapses were fast coming. The cure-all for this room!
«Oops! It’s dinnertime in the dining room» Aliénor put on her hooves. The doors closed automatically but only when Aliénor had left the premises. This avoided theft.
It smelled good with tomato sauce. Aliénor sat in her place and greeted the other patients in circles around the tablecloth. She clicked and got mascarpone with fresh raspberries and a little fresh mint too. The guests had a completely normal conversation, not like in the days when it was sometimes necessary to endure the behaviour of addicts in need, aggressive people and lovers of saucy things. Some shared their meals with their spouses, families or guests. They then had a table just for them. Everything was very relaxed.
«Today’s patients would have been considered healthy in the past. What a giant fall when the Psycho taboo had fallen!» It had been a little bit the fault of the Prince who had taken this taboo as a battleground; but above all of the referendums that had said yes to research in most of the countries consulted. Some countries were still dictatorships, but referendums had become commonplace in the world. These referendums also made it possible to see the ideas with which countries agreed and thus encouraged collaborative work between heads of state.
Aliénor’s eyelids closed. «That’s a hell of a sleeping pill!». After greeting the group, she went to bed and slept like a horse; the robot-caregiver at her feet. He had helped her choose her alarm clock, and she had chosen a rather soft beep. She didn’t like it when a nurse or a care robot broke into the room without knocking. In his opinion, it was far too abrupt an awakening.
A beep sounded and the care robot took him to the shower. He was wearing his clothes, soap, green clay and shoes. It was very practical… It had the shape of the famous R2D2 with extra arms. Its traditional fabric pattern gave it a curtain-like look. This thought crossed the mind of Aliénor. «The designer of this robot has let loose!» She wouldn’t laugh.
He then leads her to the dining room. He simply asked him «Ope?». It was a robot joke that meant «operational». He was trying to relax her, but while she was having fun, she could not ignore her muscles, which were tense despite everything.
She was afraid, despite her confidence in the success of this operation. The jokes of other patients would help him at the table to think of something else. The smell of pastries brought for breakfast tickled his taste buds. «No?!!! Why not? Why not?» The care robot turned its witness to red. «Bad for Operation» That didn’t make her laugh at all. « A yogurt and basta!» added the robot-care. The smell of delicacies, so comforting at first, finally hits him on the system. «Here, if I hit him on the head!» she speculated. «No, just because it’s a robot doesn’t mean we should behave badly.» Torture in the nose, she resigned herself and replied «No problemo.»
As he approached the operating room, his heart began to beat. After all, genes are the most intimate thing in the world. She was afraid to become someone else when she was doing just that to be someone else. She was very afraid of losing control of herself, of not doing what she wanted to do, of feeling in a straitjacket, her head in a vice or her heart restless. She could live in full awareness of her environment without thoughts invading her mind and overlaying her life.
Her ideal was to have no more moments of despair or suicidal thoughts. More strange attitudes, which were very occasional in his case, two to three days every 6 months or so but enough to scare others and then get expelled. The exclusion was a violent and disproportionate response to her condition. People who are afraid make the wrong choices.
However, after the information campaigns, people were less afraid of atypical behaviour. The campaigns had insisted on the fact that mental people were much more often, and in a very clear-cut way, victims than perpetrators of violence.
The past was resurfacing. «Focus», she ordered herself. I can’t wait for the operation so that the present can take over. She was getting tired of these memories. «It was worse before… Well, casserole, enjoy the present!» she motivated herself. «Focus»
Today, she was the master of her destiny. She was no longer afraid.
Everything was white in the waiting room. «There were children just before.» informed him of the bright white teeth. «You can play interior decorator if you don’t want to have a headache in 10 minutes.» Aliénor chose walls covered with a green tapestry with a very refined pattern of different animals. She then selected very soft chairs made of dark green velvet and a beige leather sofa, a green carpet to finish the painting and she toasted with a kiwi pressed with sleeping pills: «A glass of green water!»
She opened her eyes. The machines that operated it smelled like new. The contact was cold. What was that all about? Metal? No, probably a new invention. It was raining with inventions!
«The operation is over, I’ll walk you to the exit.» The robot-care was spinning at high speed.
«What a look, this robot-caregiver.»Alienor amused himself. «So that’s it, then. I will always be myself and in the present.»
«If this is not the case, it will be necessary to make an appointment with the psychologist and the neuro-sci robot again.
«Danke so much», she concludes by addressing the machines.
Her husband came to get her.
«So, how was it?»
«Oh, my God, my darling! It was quite a story!»
T-soin T-soin T-soin, la blague pourrie…
Une histoire anecdotique de la psychiatrie suisse | Gérard Salem: livre sur L’histoire de notre psychiatrie racontée par sa descendante en 2050: http://www.gerardsalem.com/une-histoire-anecdotique-de-la-psychiatrie-suisse/
De l’asile au centre psychosocial : Esquisse d’une histoire de la psychiatrie suisse Broché – 1 janvier 1996 de Christian Muller: https://www.amazon.fr/lasile-centre-psychosocial-Esquisse-psychiatrie/dp/2601031689
Conférence hommage à Christian Muller: http://isps-suisse.org/wp-content/uploads/Hommage-%C3%A0-C-M%C3%BCller.pdf
Prince William makes Davos appeal to break mental health stigma – guardian: https://gu.com/p/ah2c4/stw and Prince William more CEOs need to talk about mental health: https://youtu.be/tPqpDQg0hFI
MIT research institute commited to understanding the brain in health and disease – McGovern Institute: http://mcgovern.mit.edu/about-the-institute
Mental ill-health at the workplace: Don’t let stigma be our guide – ILO:
http://www.ilo.org/global/about-the-ilo/newsroom/features/WCMS_316838/lang–en/index.htm?shared_from=shr-tls
John le Carré, The Constant Gardener: https://www.goodreads.com/book/show/19000.The_Constant_Gardener and https://en.wikipedia.org/wiki/The_Constant_Gardener_(film)
Wikipedia on Mental disorder: https://en.wikipedia.org/wiki/Mental_disorder
