<p>Somasekhar is fifty-something, shabbily dressed and intensely dejected. This villager is an alcoholic with related complications of liver and kidney problems and psychological problems too. Alcohol can lead to a variety of complications––neuropsychiatric conditions; diseases of the liver, pancreas and kidneys––besides impairing reproductive functioning, etc. And he suffers from them all. The psychiatrist in attendance and Assistant Professor Dr G P Gururaj, tells us that Somasekhar is not only a patient who keeps returning to his addiction after cure and discharge, but also a classic case.<br /><br />Sitting on his bed in the charitable De-addiction Centre of MVJ Medical College and Research Hospital, Somasekhar pleads for sympathy and understanding as he narrates his story. “I began with occasional and casual drinking whenever I faced tension. Gradually it became a dependency. I got admitted to hospital and was discharged after cure. I stayed off alcohol. But, not for long. I faced so much distrust and suspicion that it drove me back to drink in disappointment. This is why, during my abstinence, if I came home late, my wife and children would accuse me of having stayed out to drink. If there was some shortage of money, it was attributed to secret spending on alcohol. If I was irritable, it was attributed to secret drinking.” All these false accusations broke his self-esteem and resolve, and he returned to drink. Again and again, he ended. <br /><br />Dr Gururaj tells us why this is a classic case. “Every time, we as a family and a society attach stigma on an offender and don’t give him trust and love even after he has reformed, we are sending him back to his negative ways. The offender thinks: ‘If I get the same negative reactions even after turning over a new leaf, why should I take the trouble to change?’ It is highly unfair to the person who has given up his addiction. And it is tough for us doctors who spend so much time and effort in treating patients. In addiction cases, we doctors can only initiate a cure, the complete recovery is in the hands of family and society. Alcohol especially is a societal issue.”<br /><br />The other patients are victims of alcohol, ganja, nicotine and in many cases, they have multiple addictions. “The common addictions we encounter are to alcohol, nicotine, cannabis (ganja), opioids (brown sugar), sleeping pills, solvents,” explains Dr Gururaj. Nicotine is the gateway drug. Once a person gets used to it, the other addictions can follow easily––alcohol, cannabis, etc. <br /><br />At MVJ’s De-addiction Centre, there is a standard three-week de-addiction programme. <br />The tools used are detoxification; anti-craving medicines to smoothen withdrawal effects; individual, family and marital counselling; family and group therapy, etc. However, depending on the nature of the patient and the intensity of his/her problem, the treatment could go beyond three weeks. The de-addiction team consists of psychiatrists, psychologists and social workers, he adds. <br /><br />Boon to villagers around Hoskote<br /><br />The 760-bed MVJ Medical College and Research Hospital is at Hoskote, on the outskirts of Bangalore. The Chairman and Founder, Dr M J Mohan, set it up in fulfillment of the dream and vision of his father and philanthropist Dr M V Jayaraman. Part of the Venkatesha Education Society group, this charitable hospital is a boon to the villages around this area as there is no speciality hospital in the entire section from Ulsoor to Kolar, explains Dharani Mohan, Chief Administrative Officer. <br /><br />“The institute was set up in Hoskote in 2004. The hospital serves about 300 villages around here, but we also get cases from Bangalore, and neighbouring states,” she reveals. <br /><br />“Currently, we offer wide-ranging services through these departments––General Medicine, Pediatrics, Dermatology, TB and Chest Diseases, General Surgery, Anaesthesiology, Obstetrics and Gynaecology, Psychiatry, ENT, Opthalmology, Dentistry, Casualty and Emergency, and Radiology.” <br /><br />Adds Y S Srinath, Medical Superintendent. “So far, we have treated several lakh people as outpatients and inpatients including nearly one lakh surgeries which cover both minor and major ones.”<br /><br />As we venture out of the male section of the de-addiction centre, groups of young women wearing white coats and studious expressions walk past us. <br /><br />They are all medical-college students. We enter the female ward where we see Parvathamma, a woman in her seventies, with vacant eyes, and a defeated expression on her face. <br /><br />She does not return our smile and keeps staring at us expressionlessly. An alcoholic, she has also developed symptoms of dementia secondary to her alcoholism. Her treatment is in progress and the doctors are optimistic of a cure. <br /><br />Generally, effective preventive-medicine reduces the burden on hospitals and health services in general. The regular medical camps held in rural areas also help to educate villages and spot any cases which are then brought to the hospital whenever necessary. Since awareness of symptoms is low among those with poor education, many cases including psychiatric ones go undetected and these camps go a long way in detecting problems and promoting general health.<br /><br />R J Patil, Lecturer and HEO, Community Medicine Department, explains how they venture out into nearby villages educating people about preventive medicine. “We teach them that prevention is better than cure. The idea is to reduce the incidence of disease and reduce the burden on the families that ill-health causes.” Talking of this, psychiatrist Gururaj points out, “Given that we in India have such a vast population and so much of it lives below the poverty line, community medicine has a lot of potential to ease the stress on medical services. This is especially relevant for psychiatry considering we have only about 5,000 psychiatrists for a population of over one billion.” Food for thought. <br /><br /><em>(All patients’ names have been changed.)</em></p>
<p>Somasekhar is fifty-something, shabbily dressed and intensely dejected. This villager is an alcoholic with related complications of liver and kidney problems and psychological problems too. Alcohol can lead to a variety of complications––neuropsychiatric conditions; diseases of the liver, pancreas and kidneys––besides impairing reproductive functioning, etc. And he suffers from them all. The psychiatrist in attendance and Assistant Professor Dr G P Gururaj, tells us that Somasekhar is not only a patient who keeps returning to his addiction after cure and discharge, but also a classic case.<br /><br />Sitting on his bed in the charitable De-addiction Centre of MVJ Medical College and Research Hospital, Somasekhar pleads for sympathy and understanding as he narrates his story. “I began with occasional and casual drinking whenever I faced tension. Gradually it became a dependency. I got admitted to hospital and was discharged after cure. I stayed off alcohol. But, not for long. I faced so much distrust and suspicion that it drove me back to drink in disappointment. This is why, during my abstinence, if I came home late, my wife and children would accuse me of having stayed out to drink. If there was some shortage of money, it was attributed to secret spending on alcohol. If I was irritable, it was attributed to secret drinking.” All these false accusations broke his self-esteem and resolve, and he returned to drink. Again and again, he ended. <br /><br />Dr Gururaj tells us why this is a classic case. “Every time, we as a family and a society attach stigma on an offender and don’t give him trust and love even after he has reformed, we are sending him back to his negative ways. The offender thinks: ‘If I get the same negative reactions even after turning over a new leaf, why should I take the trouble to change?’ It is highly unfair to the person who has given up his addiction. And it is tough for us doctors who spend so much time and effort in treating patients. In addiction cases, we doctors can only initiate a cure, the complete recovery is in the hands of family and society. Alcohol especially is a societal issue.”<br /><br />The other patients are victims of alcohol, ganja, nicotine and in many cases, they have multiple addictions. “The common addictions we encounter are to alcohol, nicotine, cannabis (ganja), opioids (brown sugar), sleeping pills, solvents,” explains Dr Gururaj. Nicotine is the gateway drug. Once a person gets used to it, the other addictions can follow easily––alcohol, cannabis, etc. <br /><br />At MVJ’s De-addiction Centre, there is a standard three-week de-addiction programme. <br />The tools used are detoxification; anti-craving medicines to smoothen withdrawal effects; individual, family and marital counselling; family and group therapy, etc. However, depending on the nature of the patient and the intensity of his/her problem, the treatment could go beyond three weeks. The de-addiction team consists of psychiatrists, psychologists and social workers, he adds. <br /><br />Boon to villagers around Hoskote<br /><br />The 760-bed MVJ Medical College and Research Hospital is at Hoskote, on the outskirts of Bangalore. The Chairman and Founder, Dr M J Mohan, set it up in fulfillment of the dream and vision of his father and philanthropist Dr M V Jayaraman. Part of the Venkatesha Education Society group, this charitable hospital is a boon to the villages around this area as there is no speciality hospital in the entire section from Ulsoor to Kolar, explains Dharani Mohan, Chief Administrative Officer. <br /><br />“The institute was set up in Hoskote in 2004. The hospital serves about 300 villages around here, but we also get cases from Bangalore, and neighbouring states,” she reveals. <br /><br />“Currently, we offer wide-ranging services through these departments––General Medicine, Pediatrics, Dermatology, TB and Chest Diseases, General Surgery, Anaesthesiology, Obstetrics and Gynaecology, Psychiatry, ENT, Opthalmology, Dentistry, Casualty and Emergency, and Radiology.” <br /><br />Adds Y S Srinath, Medical Superintendent. “So far, we have treated several lakh people as outpatients and inpatients including nearly one lakh surgeries which cover both minor and major ones.”<br /><br />As we venture out of the male section of the de-addiction centre, groups of young women wearing white coats and studious expressions walk past us. <br /><br />They are all medical-college students. We enter the female ward where we see Parvathamma, a woman in her seventies, with vacant eyes, and a defeated expression on her face. <br /><br />She does not return our smile and keeps staring at us expressionlessly. An alcoholic, she has also developed symptoms of dementia secondary to her alcoholism. Her treatment is in progress and the doctors are optimistic of a cure. <br /><br />Generally, effective preventive-medicine reduces the burden on hospitals and health services in general. The regular medical camps held in rural areas also help to educate villages and spot any cases which are then brought to the hospital whenever necessary. Since awareness of symptoms is low among those with poor education, many cases including psychiatric ones go undetected and these camps go a long way in detecting problems and promoting general health.<br /><br />R J Patil, Lecturer and HEO, Community Medicine Department, explains how they venture out into nearby villages educating people about preventive medicine. “We teach them that prevention is better than cure. The idea is to reduce the incidence of disease and reduce the burden on the families that ill-health causes.” Talking of this, psychiatrist Gururaj points out, “Given that we in India have such a vast population and so much of it lives below the poverty line, community medicine has a lot of potential to ease the stress on medical services. This is especially relevant for psychiatry considering we have only about 5,000 psychiatrists for a population of over one billion.” Food for thought. <br /><br /><em>(All patients’ names have been changed.)</em></p>
