Early in my career as a resident psychiatrist, I learned a rare lesson from a patient with bipolar disorder who urinated on herself. Back then, I had no idea what I was doing. I was incompetent. During my second year, I spent a month on an inpatient unit. One of my tasks was to facilitate a group attended by all the patients and my supervisors.
Unexpected teachings from a bipolar patient
One day, a group was going well until a woman with bipolar disorder suddenly stood up, walked to the center of the room, stared intently at me and urinated all over herself. I watched, speechless and in horror, as the urine trickled down her legs. I sat in my chair mute, hadn’t the slightest clue what to do and felt publicly humiliated. Since we shared the same diagnosis, I briefly drifted into my own thoughts. I wondered whether I was witnessing my future, one filled with hospitalizations and public urinations.
I spoke with her later that day and in her own psychotic haze, she shared with me that the psychiatry resident who had cared for her had rotated off the unit the day before before I arrived and I had taken his place. She liked him, missed him and felt that he cared about her. She was scared that I would leave her. I got it.
Earlier that day in the group, she was expressing her unspeakable distress to me using the only language she knew. She lacked the capacity to put her terrors into words and so, as she she stared at me, she created the puddle around her feet.
Our similarities: vulnerability and fear
While I have learned to express my fears in ways that don’t involve public urinations, she was making me face the reality that, in addition to our shared diagnosis, we were more similar than we were different. We both felt vulnerable, we both felt afraid and we both felt inadequate. Neither of us were in control. Unexpected teachings
Though she couldn’t know this at the time, she taught me that I could find solace in accepting that my life contains mystery and uncertainty. I’m not always the master of my universe. I‘ve gotten lost in fear and have been frightened by my vulnerability. I learned something from that brave woman that day that was both undeniable and feeing: like her, we are all merely human. I can live just fine with that.
What lessons have you learned from your patients?
To learn more about the unimaginable gifts from Bipolar Disorder, click here.