By Anonymous

Discuss with a medical practitioner in your rotation who manages patients with chronic illnesses. Has he/she experienced any change with the National Strategic Framework?

The therapeutic hum of the engine filled the cabin as the car tore down the motor way. I sat in the passenger seat marvelling at how proud and tall the hood ornament stood against the backdrop of the endless black tarmac stretching into the distance. The hovering like sensation the car gave us as it smoothed out the inconsistencies in the road seemed surreal, supernatural even. The psychiatrist sat leaned back in the driver’s seat, calmly staring out over the cowl. His right hand gripped the wood grain steering wheel and barely ever seemed to make any adjustments to the car’s trajectory. There was an eerie serenity to the journey, like he’d done it dozens; if not hundreds; of times before.

There was a question that had been nagging at me since we’d torn out of the community clinic car park a few minutes ago, and I sat in the passenger seat in silence slowly working up the courage to ask it.

“What’s up?” he asked me, not taking his eyes off the road. It was always disconcerting how he managed to sense when I was hesitating to say something.

“Well, I know I’m new to this, but aren’t there a host of teams that usually go out to visit patients at home then report the situation to you back at the hospital? I mean there’s Hospital in the Home and the Crisis Assessment and Treatment Team. Is there a reason that you’re handling this particular call out?” I sat there doubting the validity of the question for a moment before he offered an answer.

“Some cases require more… finesse.” With that we turned off the motorway and started to meander down the side streets. The houses that littered the area sat sadly in various states of disrepair. As he navigated the derelict neighbourhoods, he took the opportunity to explain further, “Patient name is Melissa Jenkins, 58 years old, chronic schizophrenia. Background of alcohol and methamphetamine abuse. Discharged from an inpatient unit a month ago after an almost a yearlong stay. Has been unresponsive to our attempts to make contact. We’ve got questions about her compliance, whether she’s adjusting to community life again. She’s been known to our network for a long time. From what I can tell it’s a vicious cycle of poverty, abuse and mental illness.” He sighed. “The underlying issues are difficult to address from our position, but the house call, it goes a long way to help us understand of what’s going on.”

Eventually we pulled into the driveway of quite a dejected looking house. The timber panelling on the façade seemed veritably allergic to the remnants of paint that clung to it, having shed all but a flake or two of the dull white hue. We left the burgundy limousine in the driveway and walked up to the patio, which seemed to hold itself up out of sheer will and little else, the supporting timber pillars were bowed and warped in all directions.

The psychiatrist adjusted his cuffs such that the prescribed inch of shirt was exposed under his jacket, before raising a fist and vigorously rapping on the door. After a moment the door creaked open just a few degrees and I caught a glimpse of a figure lurking in the shadowy interior of the house. “Melissa?” the psychiatrist questioned, “I work with the doctors that treated you in the hospital, I’ve come to see how you’re doing.”

I could sense a reluctance on the other side of the door before it swung open and revealed a small, feeble woman standing at threshold of the house. She seemed to disappear underneath the expansive brown shawl draped over her slumping shoulders. She looked up at the psychiatrist but couldn’t seem to say anything coherent. Utterances of gibberish escaped her thin lips every now and then. She quickly lost interest in us and headed back into the house.

We followed her in and were greeted by a horrid stench. My eyes struggled to adjust to the darkness of the house, but I soon was able to identify the complete disarray that had engulfed the place. A massacre of litter carpeted the floor and decrepit pieces of furniture lay about like the corpses in a battlefield. It looked like it had been abandoned for decades. Dereliction had started to swallow it up whole. The woman seemed to wonder around the house aimlessly, her eyes darting from corner to corner, the murmurs never ceasing. She seemed completely unaware of our presence.

“Melissa,” the psychiatrist addressed her, but she seemed unable to recognise her name. He turned away from her and started investigating a box of medication that sat on the mantel piece. He opened it and emptied the contents out. Tray after tray of sealed, untouched medication spilled out. He looked at me, “we’ve gotta take her in, this doesn’t bode well for her.”

In her listlessness she didn’t put up much resistance to our assistance as we helped her out of the delipidated house and into the back seat of the big Ford. When we had resumed our seats in the front he turned the key and the car rumbled to life. We reversed out of the driveway and turned back the way we came.

Melissa continued to murmur to herself in the back seat. The psychiatrist handed me his phone, “Call the doctor’s office on the psych ward.” He instructed me, “tell ‘em we need to make room for a frequent flyer.”

 

By Phoebe Chen

Part 1. Finding meaning in the madness through music

There is always this distinct something that I feel but can never quite articulate…like breathing out a sigh — where all it leaves is a certain hollow emptiness in your body which sinks in your chest and amplifies with silence. On a low-key Friday night, it settles in as the world goes quiet, the lights have dimmed, and all that remains in your mind is the company of your own thoughts.

The mood blends between the grey sonic echoes of Billie Eilish’s when the party’s over and the blue weariness of Lolo Zouaï’s Here to Stay. As it seeps out, the melancholy fades into numbness, and evaporates by the next morning.

Isolation is introvert heaven, drawing you into a strangely comfortable embrace, yet subtly unsettling — pulling you deeper until you can’t tell whether you’re really okay or not. Last week feels like a month ago, and the days blur into one another, until that feeling lasts much longer than a night.

Even when it did end, I knew it had never really gone. It was just wavering in the background, ready to appear once the screen went dark and all the Netflix and YouTube and TV critic reviews couldn’t keep it at bay any longer. It was poised to return once the conversations ended, exacerbated by a quarantine-induced asocial crisis, so that I couldn’t even be bothered messaging in the first place.

Ever waxing and waning, it had already been with me for years. I was reaching for a stone I couldn’t turn. And eventually, you give up, you withdraw, and you don’t talk about it; because even though support is within reach, you don’t ask because it doesn’t help at all.

We’re never alone, but always depressed

Love my friends to death

But I never call and I never text

— Lauv, Modern Loneliness

Those lyrics hit a little too close to home. When you’re alone in the crowd, but surrounded by people, you can lie to yourself and say you’re fine. But in isolation, physically separated from others, you are forced to confront the truth and face it alone.

When you don’t even know how you want to help yourself, it’s much harder to believe you can even ask for it to begin with, let alone find others to help you. Because the biggest thing holding you back is that you don’t even know how to say what you feel.

So what do you do when nothing seems to overcome that lingering apathy?

~

When it comes to emotions, I have always been naturally inclined to compartmentalise and put them aside, which is really just a form of denial — so it takes more conscious effort to recognise my own state of mind in the first place.

There are moments in life when I viscerally feel this something, but can’t find a single word to capture it; even though labelling it is the first step to reducing its intensity. So the next step is externalise what you experience, to lower the volume of confusion and frustration beginning to roar inside you.

That’s when you turn to the rhythm and the beat.

Even though there’s a 76.95% chance that a moody RnB song is playing in my head at any given time, there’s something to be said about how therapeutic they are for the catharsis they bring.

In the midst of a low, Drake really captures the atmosphere in my feelings through the dark gloominess of Don’t Matter to Me, as the hauntingly beautiful falsetto of The Weeknd brings out the beauty behind the madness. Because whilst you might be Alone Again, the smoky and soulful vibes hold up a mirror to your mood in the moment; reflecting your emotions with sharpened clarity. Paradoxically, once you are acquainted with your frame of mind, you feel more put together, less empty, so you can begin to let it go.

Then you turn to the lyrics to channel how you want to feel.

Drawing on gratitude from the dreamy whispers To Me, Alina Baraz reframes life with lenses slightly rose tinted — it’s self-care in a song, a spa day and a pink clay face mask, a reminder to get in touch with myself again; before raising the Tempo with the self-love of Lizzo for a boost of confidence to lift my spirits.

Stirring at those inklings of strength, Faouzia elevates it to a soaring crescendo through the intensity of Tears of Gold with the motivation of facing This Mountain. Hitting those high notes in all the glory of cinematic pop, shining triumphant and hopeful rays — it’s the equivalent of recalibrating a compass, feet to the ground, sights set once again on being the best version of me.

That’s why I love music — not just because of how it sounds, but because it helps you get in tune with how you feel, regardless of the baseline of your own emotional awareness.

If you look at your own playlists, you’ll notice the music that truly resonates with you can be classified into two: the relatability of who you are, and the aspiration of who you want to be. That’s why you love them, that’s why they’re on repeat; the only thing you need to do is pay attention.

~

There’s a lot of reasons at play when it comes to modern loneliness. But the first step is realising you’re well within your power to make it right.

Rather than being chained to your feelings, think of it this way.

Pretty early on, as med students we learn to use vital signs to get a brief snapshot of health. We pay so much attention to the body — you wouldn’t want to ignore a low blood pressure — so isn’t it the same principle to extend this to your own mind?

It’s simply checking in with yourself, which you can do in the same amount of time as taking a blood pressure; because your emotions are the personal thermometer of your wellbeing. So there is nothing shameful about having them — even the negative feelings — because you’re human, and we all have them too.

If you’re feeling low, you have to acknowledge it before you can begin to feel okay again. Like taking an antihypotensive to bring your blood pressure back to homeostasis, a dose of music is a Happy Little Pill when you’re feeling as blue as the Troye Sivan song, where both make you feel much better once it’s flowing in your veins.

Sometimes you just need to wait it out and let it pass, knowing you’ll feel better when tomorrow comes. But if you’ve been chronically low, definitely talk to a trusted friend or seek a professional.

You can’t always choose how you react, but you can always choose how you respond.

So to sum up, Rx: adjust your dosage according to emotion and change regimen as required.

Now the stone has been turned, and I have found my inner peace — it’s just about balance. The highs will be high, the lows will be low, ephemeral yet everlasting, so it’s a matter of finding the equilibrium in the emotions.

All you need is patience and practice, because if you listen closely, you realise it’s just a musical with reprisals that will play for the rest of your life — where you get better at leading the symphony.

Listen to Phoebe’s Spotify playlist for all songs mentioned.