No One and Nobody

No One and Nobody

munchausenThere are some patients you meet that changes your very core. Some years ago I had the following experience whilst working as a nurse.
One day a man, who was a patient came onto the ward for heart investigations, for as he reported, chest pain. However, on examination by a consultant it was found that the patient had had no chest pain in recent weeks, but had undergone the same procedure he had come in for, just a couple of years previously. He told the Doctor that his heart had stopped after the procedure and he had had to stay in hospital overnight. The Doctor wasn’t keen about carrying out the procedure until he had more understanding of what had happened last time. To help both the Doctor and the patient I agreed to search through the patient’s notes, which were quite a stack, whilst the Doctor continued taking care of the other patients on his theatre list.
As I read through the patient’s notes, at first I came across the in-patient notes from his previous procedure. It appeared from the notes that although his heart hadn’t stopped after the procedure, what in fact had happened was that he had experienced a Vasovagal response, which means that his heart rate had slowed and his blood pressure had dropped causing him to ‘black out’ or faint. After treatment to correct the problem at the time, both returned his heart rate and his blood pressure returned to normal and it seemed that the ward had kept him in overnight for observation. The test itself was clear, he had no heart disease and he was discharged from hospital care.
However, within the same patient’s notes were notes from Psychiatry. It was a thin folder compared to the rest and it had been tucked into the back of the notes. I pulled it out and began to read. The said patient had been sent by an understanding General Practitioner to a Psychiatrist. After meeting with the patient the Psychiatrist had made a recommendation and a possible diagnosis. The results from the first one was very sad, because it had never happened and the result from the second made perfect sense to all that had been written on this man.
At that point another Doctor, who was working on the ward, came to the nurses’ desk. I turned to him and asked him what diagnosis he thought this particular patient had received and preceded to read part of the notes to him. His actually words were, ‘WOW, he has Munchausen Syndrome.’ which was the diagnosis that had been suggested by the Psychiatrist. However, the recommendation for further assessment had not been carried out and the patient had fallen through and out of the system and had got lost.
His story was, that as a young man he had nursed his sick father until he died and then his ailing and then sick mother until she died. He had cared for others all his life and no one had cared for him. No one had taken care of him. No one had said to him that he was doing alright. He had not been loved in any particular way that showed him what it meant. He had become a no-one and nobody and he had had to do something so that others would see him and that was to develop an unconscious craving for people to care for him, which he had found out years before when he had had his appendix removed, could be obtained from doctors and nurses. He had gone on to develop the mental illness known as, Munchausen syndrome as the only means of being able to receive the care that he needed, not just for his body, but for his mind and his heart as well.
I do not know what became of him, but i do know that the Consultant would have done all that he could to make sure this man received the correct treatment and help that he needed. The mind is a powerful and yet it can be bent, twisted and shaped with such devastating results. Often the illnesses the patient thinks they have are not real and yet the mental illness is.


4 thoughts on “No One and Nobody

  1. A sad story of someone who cared for others and yet perhaps no one had cared for him.. Let us hope after your actions in his notes it alerted further investigations to take place and he no longer fell through the loop..
    And I agree with Joss… we can only do what we can in any given moment.. ❤

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