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Live and learn blog

Humanity before horror

Tony was notorious. Well before our first encounter, I already knew the full memorable psychiatric history.

Abuse as a child and a borderline personality disorder had led him into a pattern of angry, aggressive behaviour, with severe self-mutilation of grotesque proportions.

He was reported to show greatest resentment towards unfamiliar young women, and so it was with some trepidation that I collected my personal alarm and joined the nursing team for the evening shift seclusion review.

My acute self-concern was further heightened when it transpired that Tony’s mother had died that day following a long illness, and he was to be informed that very evening.

As we entered the ward cell, I shuffled at the periphery, eyes downcast, trying to remain as inconspicuous as possible. Tony’s primary nurse gently broke the news of his mother’s death, and I cowered, awaiting the fierce backlash.

But I was wrong. In my self-absorption, I had completely neglected that despite his violent outbursts, he was also a vulnerable son, distraught in the knowledge that the only person who loved him was now gone. Tony’s face crumpled in despair, and as he buried his face in the nurse’s shoulder, a second nurse elbowed me.

‘Are you alright?’ she enquired, and I realised with shame that my dark expectations were evident for the whole room to see. And so it is not the gruesome horror stories that remain with me from my time with Tony, but the lesson to look first for humanity in every patient, who is also first and foremost a person.

Susanna Mills is a specialty trainee 1 in public health in Newcastle. At the time of the incident, she was an foundation year 2 in psychiatry.