being mentally challenged in Bangalore

Image by Little_Ricky via Flickr
"Saleem's sister's son,” Raja said of the young man in outside room that the gate led to, which served as the office. “He's a potential drug addict." The nephew took no offense, his eyes and face remained blank and emotionless. He was sitting in Saleem's chair when we entered, and rose when we went in, and left after a while. Saleem took some time to arrive.

Raja took the period of Saleem’s absence to tell us about him. The two were together in therapy thirteen years ago. Saleem wore his hair mane-style then. He apparently recovered, but Raja has stayed the typical bipolar, displaying long phases of convincing recovery which end in dramatic relapses into violence, mainly directed against his wife. Suspicion follows soon after, then paranoia and panic, all leading to the next phase of disappearance, reappearance, peripatetic nights, twenty phone calls a day each to his sister, and to his father, and mother, and daughter. After a time when his illness has seemed to be the permanent reality in the lives of his close ones, peace returns. In place of a frustrating man stands a loving father; a respectful son who runs errands for home; a caring husband making time for the wife to do her professional work (she works out of home).

Now he has slipped and beaten his wife again, suspecting that she has complained of some missing jewelry to the police, and that she has named him the suspect. He's gone and admitted himself at NIMHANS, and gotten to access his file, and torn the transcription of the wife's submission to the doctor. Then he has sent his attendant to fetch him a snack, and fled. After being missing for some days he has emerged on the phone and revealed that he has been living in Saleem's home for the mentally ill. He believes he is a counselor there.

"Everyone is tolerating him," Saleem told us, watching the gate where they were bringing in a new patient. He’d arrived from inside the building, a bigger than average house, and settled himself and his iphone and its charger. His gaze was steady, the smile was easy, but the eyes were distracted. "He is not admitted here, so we have let him loose." If his sister accepts, and her father who was with her, he will restrain him and begin his treatment—without drugs. "Then his real self will emerge. He is a manageable chap only when you say yes to him. Refuse him something, and his bloated ego will show itself.”

Is Saleem qualified? Only informally, which means that he has become a doctor (and established this home for manic-depressives and addicts) through being a long-experienced patient. He has been a patient for sixteen years, in many homes, in India and abroad. He claims to have received his education in training sessions in those homes. Saleem's Kannada and English are heavily accented with the pidgin-Urdu that local Muslims speak. Before he came in Raja had praised also the discipline of Saleem, and had spoken of his diet: a ragi-congee drunk in the morning, a full meal at night and not even a beverage between the two meals.

Saleem has a ring on every finger in both hands and two of them made an impression on me: a fat moonstone ring, and the ring with the navarathnas, a Hindu ring on a Muslim finger. His normal fee to admit a patient is Rupees 8000, but Raja had paid only 2000. He told us about the money only when Raja’s sister asked, and didn’t ask to be paid. When asked about Raja’s condition the language wasn’t very different from how Raja describes his own condition and that of others. But a psychiatrist visits, who practices in major hospitals. On checking later, the information was correct.

We asked to see inside. The door opens into a hall, into which four rooms open: a second hall, a bedroom, a toilet, and a kitchen. About fifteen men stood about in the first hall. The second hall had been quickly cleared of people, it seemed. The beds set up there, dorm-style. There were some more beds in the bedroom. A man cut tomatoes expertly into large pieces on the floor in the kitchen. Raja introduced the man as a recovered drug addict. The man smiled broadly.

A staircase wound tightly up to the second and a third floor. I expected it: they didn’t allow me to go up. They said they have about forty patients there. I went to the wall and craned up and saw and heard nothing. A man stood like a bouncer at the foot of the stairs but he was not built like a bouncer. I stepped out and stood on the outer edge of the road and stared at the windows on the upper two floors. They were all shut tight and the entire building was a silent sight. I went back into Saleem’s room and joined Raja’s sister and father and father-in-law.

Raja’s father pleaded with Saleem. Take charge of Raja. We’ll pay your charge. Don’t let him out. He should sleep. Don’t allow him to come home. Saleem assured that he’d take control of Raja, and the first thing would be to take away his phone. Raja had been detained in the hall when we’d stepped out. Saleem said he’d send the papers to sign, to admit Raja, in three days. Three men brought in a second new patient and we left.

I told Raja’s father that Saleem wasn’t qualified, and because Raja had to be restrained by force anyway, I suggested they find a place where the person in charge was qualified. The eighty-year-old father wouldn’t agree. “I’ve seen many homes these twenty years he’s been ill. They’re all like this. If Raja comes home he’ll beat his wife and shout at everyone.”

Silence was the prudent thing. But Raja’s sister agreed that we should call some psychiatrists and find through them a better home.

I might be getting involved a little in this story, and when I have more to tell about the way patients with mind disorders are treated in Bangalore, I’ll continue the story. The names are fictitious.

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