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In a special guest blog, physician Dr Himmatrao Saluba Bawaskar writes about his experiences with mental health problems as a medical student, and how these affected his life and career.
I was born into a poor, illiterate farming family in a remote village of Marathwada, India, in 1950. Until 1972, there was no school, electricity, tap water, or mechanised road vehicles. Pebble roads and bullock cart were the only means of transport. Medical facilities were more than 30 km away. After visiting a Brahmin family at Jalna, my father became convinced that only education could cure us from the curse of poverty. He decided to educate us. When I was 9 years old, we left the village and migrated to the nearest urban area. I was given a part-time job in a pharmacy, carrying loads from to house to house.
When my parents had to return to the village to arrange my sister’s marriage, I was left alone to work in a temple. From the ages of 11–16 years, I worked there for 6–8 hours a day, but continued my education. During this period, I faced tremendous mental torture in the form of insults from my classmates and teachers because of my dirty outfits. After passing matriculation, two of my classmates gave me free accommodation in their rented room in return for taking care of their bedding, dish washing, and cleaning the room. These incidents were deeply traumatic and made me feel inferior, dependent, and demoralised. But with the goal of passing my examinations with distinction, I studied hard and attended each and every class. After scoring highest in the qualifying examination, I gained admission to study for my MBBS at the government medical college in Nagpur.
The sociocultural difference between me and my peers was huge. I kept to myself and preferred not to stay at the students’ hostel. I started feeling lonely and depressed. I slept poorly, my memory deteriorated, and I became increasingly anxious. Months went by and I told no one of my disturbed mental state. One day I decided to commit suicide. I informed my brother, and I was referred to a psychiatrist.
News that I had become a psychiatric patient spread all over the medical college. Everybody started looking on me as being insane. However, I continued to attend college. I tried various drugs but there was no improvement for a whole year. I lost weight, hope, and all interest in life and did not appear for the second MBBS examination. My psychiatrist was exhausted with managing my case, so my mother took me to the jungle for a month to stay with a tantrik. My whole family was worrying about who was going to cure their insane son. “Rather than being alive in such condition it would be better if he dies”, I remember my mother saying to other family members. “Why doesn’t a black cobra bite and kill him?”
My family decided to take me back to the village, where I stayed like a refugee in my own home. Rather than providing financial support for my family, I was a burden. I used to pray to God for sound sleep and a sound mind. I promised Him that if he gave me a sound mind I would devote the rest of my life to alleviating the suffering of human beings. And one night, God listened to my prayer. I got sound sleep and my delusions started disappearing. My mood became fresh as before and I once again started studying for my second MBBS examination. I completed my MBBS with an excellent score and joined a rural primary health centre.
There I started studying envenomation by scorpion sting, and I later completed an MD in internal medicine. My first publication in The Lancet came in 1978.1 Over the years, I have contributed to textbook chapters and published data on cadmium- and lead-induced renal failure in farmers,2 fluorosis,3 heart attack,4 thyroid disease,5 and snake bite.6 Recently my wife and I did a randomised trial and found that recovery from scorpion sting is hastened by antivenom and prazosin.7
Mental illness has not left me. It has started showing up again after being quiescent for about 30 years. But towards the end of my life I feel contented that I was able to make the best use of my intelligence in the services of humanity. It is rewarding to receive calls from readers of my research and biography, telling me how my work has inspired them. The threat to my mind continues, but I know that psychiatry is far more advanced than in those early days and I will get the best of 21st-century treatment. Early reporting to psychiatrists and appropriate medication can make for a joyful life. There is always room on top.
I am grateful to Zoe Mullan who encouraged me and improved my morale to continue to work in a rural setting over the past many years.
1. Bawaskar HS. Diagnostic cardiac premonitory signs and symptoms of red scorpion sting. Lancet 1982; 2: 552-54.
2. Bawaskar HS, Bawaskar PH, Bawaskar PH. Chronic renal failure associated with heavy metal contamination of drinking water: a clinical report from small village in Maharashtra. Clin Toxicol 2010; 48: 768.
3. Bawaskar HS, Bawaskar PH. Endemic fluorosis in a small village in western Maharashtra India.Trop Doct 2006;36: 221-23.
4. Bawaskar HS, Bawaskar PH. Thrombolytic therapy in acute myocardial infarction in a rural setting. Trop Doct 2002; 32: 66-70.
5. Bawaskar HS. Premonitory diagnostic signs and symptoms (scores) of thyroid hypofunction: a clinical observations. JAPI 1998; 46: 714-15.
6. Bawaskar HS, Bawaskar PH. Profile of snakebite envenoming in western Maharashtra, India. Trans R Soc Trop Med Hyg 2002; 96: 79-84.
7. Bawaskar HS, Bawaskar PH. Efficacy and safety of scorpion antivenom plus prazosin compared with prazosin alone for venomous scorpion (Mesobuthus tamulus) sting: randomized open label clinical trial. BMJ 2010; 341: c7136.