Anatomy of an Assault
by Gargi Mehra
On a late Friday afternoon in a Belfast hospital, Dr. Oak glanced up from her clipboard. Outside the window, a thin film of rain fell over the city. She noted the time on the clock—three hours left before she could drive home to her family. Her one-year-old daughter always leapt to answer the doorbell even if her bedtime had long since passed by. Three hours before Dr. Oak could dive back into her paper on patient stigma and send it out to reputed peer-reviewed journals for publication.
Dr. Oak turned her focus to the elfin woman facing her. Eva hailed from Birmingham—she had jumped on the boat from Scotland, and washed up at the shores of the hospital bearing a long history of mental-health problems. She suffered from bipolar affective disorder, which involved alternating periods of highs and lows, both in the extremes. Such patients lived through periods of clinical depression interspersed with phases of tremendous positivity. In the upbeat phases, one feels high and over-exuberant, as if all too powerful. The patient operated with a frenzied energy—she felt very overactive and subsisted on little or no sleep.
Dr. Oak concluded Eva’s psychiatric assessment and pored over the notes she had gathered, slotting the scattered pages into the medical case file. In the nursing station, a group of doctors and nurses stood huddled in a corner, debating the controversial cases of the day. Dr. Oak glanced over at her colleagues and smiled—the Irish loved their craic, and she loved that about them.
Without warning Dr. Oak found herself yanked by her hair, pulled backwards, and thrown down to the floor. She grabbed the edge of a low chair, desperate to get any leverage. The assailant was Eva, who had, unknown to others, walked out of her patient room and shown superhuman strength. Even as Dr. Oak felt herself pulled down, the surreal sense of dissonance echoed in her mind—the unusual combination of petite and strong, the juxtaposition of elf-like tininess and Herculean force. The nurses and doctors grabbed Eva’s arms in a bid to wrench her away from Dr. Oak. But even five able-bodied people couldn’t separate them. The seconds ticked along, turning into excruciating minutes, while Dr. Oak struggled in Eva’s grasp. A trail of thoughts streamed through Dr. Oak’s mind as her fingernails dug into to the wood trying to grab any purchase.
My neck will snap—I’m hanging on literally for my life…my neck… is on the line…in a weird way. My hair—my beautiful hair. My bob cut. Thank God I have short hair. Would long hair have been better? Maybe it would have come out in clumps. But then at least she would be forced to let go. Let go, Eva! Let go!
Interminable seconds passed in the tug-of-war between Eva’s sanity and psychosis. Someone, somewhere, had called security. Someone, somewhere, unglued the patient and pried her off her doctor. Released from Eva’s vice grip, Dr. Oak felt her neck with quivering hands, and staggered to her feet, knees shaking. She was in a daze.
A chorus of voices asked Dr. Oak how she felt before the scene turned blurry. She couldn’t single out any voice in particular until her boss arrived and sent her home. She hoped to make it in time before her emotions overcame her.
One year before Eva, Dr. Oak stood in line for her interview at the British embassy.
“Why do you want to work in Northern Ireland, Mrs. Oak?” the consular officer asked her. He was a giant and imposing man.
“I want to learn how psychiatry is practiced in a different country,” she responded, resolute despite her small stature.
Dr. Oak wrested her visa-stamped passport from the officer and left to join her husband in Belfast. Every so often, a cool rain broke through the day. Dr. Oak smiled, welcoming the change from the humid environs of Mumbai. She was excited for all the learning that Ireland held for her, as she was also pursuing her MRCPsych degree. She readied herself to campaign for patients in this new country and share stories about the stigma they faced. She yearned to crusade for their acceptance and integration into society. No one deserved to feel alienated. Not every mentally unwell person turned violent, at least not of their own accord.
Over the following days, the inevitable reflections poured in thick and fast. The sequence of events flashed in her mind’s eye. All that theory about safety training flew right out the window when the actual experience hit her. SOPs or Standard Operating Protocols meant nothing when faced with a patient in the throes of an episode. The incident with Eva was the ultimate example of this. Eva had attacked Dr. Oak in an open ward. It was not an enclosed space, not even a locked room. There were doctors and nurses all around, but even those trained, able professionals could not prevent it from happening. A multitude of questions unravelled before her. What did I do? What should I have done? What will I do now? What do I want to do? Can I go back to work? She couldn’t answer these questions, she wouldn’t even be able to, not until she separated what she was feeling from what had happened.
One of the questions that plagued Dr. Oak: Could she complain about the incident, given that she had chosen this line of work of her own accord? She had known the risks. Surely, she must have prepared herself to face such an occasion, just as an air force pilot trained to unclasp his parachute at the precise moment.
She resumed work three days after the incident. Her colleagues asked after her well-being, and it was only then that the first prickle of tears stung her eyes. If they showed any sign of concern, she fought off the urge to weep. She ran to the restroom and gave vent to her emotions, but in front of others, she wore her bravest face, shuffling between wards as if nothing had happened.
She shifted herself into gear and plodded through the workday, functioning like an automaton, receiving commands and issuing appropriate responses. But something tugged at her, a feeling that pushed past how bad she felt for herself, and rose to the surface instead. In the profusion of confused emotions, it dawned on her that the blame lay neither on her nor on the patient. If Dr. Oak had only just come to this conclusion, how long would it take Eva? Dr. Oak believed in recovery and improvement, and she resolved to visit her assailant. Already she suspected the incident would feature on Eva’s chart as “a history of violence.” It wasn’t always fair but that was how things had always worked.
She strolled down the corridor to Eva’s new ward. Dr. Oak found Eva’s room, and signalled to the floor nurse to accompany her inside. Eva sat on her bed, unblinking, a nurse by her side. Dr. Oak drew a chair and faced her. Eva looked at Dr. Oak as if she didn’t recognize her. But her words proved otherwise. “I am sorry, Doctor. I didn’t mean to, you know.”
Eva’s awareness surprised Dr. Oak. “I know.”
Eva still looked blank. “I don’t know why I did it.”
Dr. Oak nodded. Eva’s thinking skills had remained intact. She suspected the reason for the attack, even if Eva didn’t know precisely.
As Dr. Oak left the ward, Dr. Ian, the physician treating Eva, approached her. “She is responding well to medication,” he said.
“It’s heartening to hear that,” Dr. Oak said.
Dr. Ian looked reticent, as if he hadn’t said all that he wanted to say. His face looked like he was struggling to give voice to something on his mind.
“What is it?” Dr. Oak asked.
“Have you considered that the assault has something to do with race?”
“Does that make things any different, Dr. Ian?”
Months later, Eva was transferred back to a hospital in Dr. Oak’s catchment area. As the dust settled on the incident, so did the emotions of the patient, and indeed the doctor. With regular treatment, Eva recovered and her periods of illness became less intense and frequent. Both Eva and Dr. Oak returned to their routines—the good doctor continuing her work and moving on to higher posts and greater responsibilities. In the years to come, Dr. Oak would present papers and author articles for respected journals, on the topic of patient stigma citing Patient #1—Belfast, Eva, as a case study.
Gargi Mehra is a software professional by day, a writer by night and a mother of two at all times. Her short fiction and essays have appeared in numerous literary magazines online and in print. Check out her website at gargimehra.com. She is also active on social media: Twitter @gargimehra, Instagram @gargi_mehra.
Header image: Down Into the Blue Again by Laura Vitale