Confessions of a GP

Peter

‘’Allo, Doc. We’ve got a right one for you’ere. Mad as a box of frogs. We found ’im running down the middle of the dual carriageway completely starkers and shouting in gobbledygook.’

It was 3 a.m. on a cold February night and I was on call for psychiatry. The police had picked up my latest patient and, after diagnosing him with being ‘as mad as a box of frogs’, a common police diagnosis, they kindly dropped him off at the psychiatric ward for me to assess. The man, who we later found out was called Peter, was in his early twenties and looked fairly frightened. He was shouting in an unfamiliar language and was miming being attacked and chased. He gave the policemen each a hug (very much unappreciated) and they left him in my less than capable hands. Peter was wrapped in a blanket kindly donated by the local constabulary and given how cold it was outside, I wondered quite how he had survived any length of time being completely nude out on the dual carriageway in the middle of nowhere.

The most likely diagnoses going through my mind were some form of paranoid psychosis, possibly drug induced or maybe schizophrenia. He may have been having some form of manic episode but without him seeming to understand a word of English, the assessment was very difficult. We sat in a quiet room and I tried in vain to communicate, as did he, but we got nowhere. He had no clothes, no wallet and absolutely nothing to identify himself with. I admitted him to the psychiatric ward. What else could I do?

The next morning, I took my consultant to see him. Peter was a bit calmer, but still gesticulating and shouting. My consultant tried speaking to him in French, which gave me the giggles as it just made an odd consultation even more ridiculous, especially as my consultant’s French was terrible and the patient was clearly from Eastern Europe somewhere. We do have interpreters available but we had no idea where this guy was from so didn’t know where to start. After nearly an hour of getting nowhere, Ludmila, the ward’s Polish cleaner, came into the room to empty the bin. The patient took one look at Ludmila and then said a few words to her and gave her a smile and a wink. Despite the language barrier, it was obvious to us that Peter was speaking the international language of leering and bad pick-up lines. Ludmila gave him an icy look and turned to us. ‘He is of Belarus. He is not mad, just drinking too much wodka. Always the same is man from Belarus. Too much drinking, gambling and chasing of womans. Not enough working. They have bad reputation in my country.’

My consultant looked annoyed. ‘Ludmila, do you actually speak his language?’

‘No, just recognise he is of Belarus. All men from there are the same. Not mad, just drunk.’

‘Thank you, Ludmila, but perhaps it might be best to leave the psychiatric diagnosis to me.’

Ludmila shrugged, gave Peter another icy stare that made the whole room shiver and left. We phoned up the interpreting service and found out that it was going to be five days before a Belarusian translator would be available. We still weren’t sure if he was having paranoid delusions and needed some form of psychiatric medication. He had no money and didn’t seem to know anyone here so we kept him on the acute psychiatric ward. Most of our young male psychiatric patients spent their time on the ward sleeping, eating, watching TV and occasionally masturbating. Peter was like a breath of fresh air. He enthusiastically joined in the ward’s activities, going to the cooking morning, creative-painting day and Sunday morning yoga class. He also didn’t let his failure to be understood prevent him from trying all his favourite Belarusian chat-up lines on the female patients, staff and visitors.

Eventually, the translator arrived and we crowded into the interview room to finally conduct a proper consultation. Peter launched into a long monologue in Belarusian and, with the help of the interpreter, we were finally able to find out a bit more about how Peter had ended up on our ward.

It turned out that Peter had arrived in England the previous week to find work and make some money. He met some Lithuanians at the coach station and they said that they could find him some work on a farm picking cabbages. To celebrate his first night, they played cards and drank vodka. He got very drunk and remembers losing his money and then his clothes in the game. He didn’t remember much else but thinks he then got into a fight with one of the Lithuanians and they chased him naked from the farm. He was a bit cold but he assured us it was nothing compared to Belarusian winters. The police picked him up after an hour or so and he was very impressed that they were kind and didn’t beat him. He also thanked us explicitly for our kind hospitality during his stay. He found that English people were very nice but some of the residents here were a little strange. He had decided to return to Belarus, as travelling wasn’t really his thing. He then invited us all to stay at his home at any time and told us that we would all be made very welcome. Apparently, his mother made the best goulash in the whole village. Peter gave us each a kiss on both cheeks and left. I dread to think how much it cost the NHS to keep him on an acute psychiatric ward for five days but probably more than Peter could earn in a year back home. Ludmila was very smug. ‘Like I am saying, all Belarus man the same. Lithuanians man even worse.’