What I Never Told You: My Journey to Recovery from Conversion Disorder

 30TH MAY 2021 – OUTSIDE KNH WARD 7B- NEUROLOGY WARD

I sat there on the floor outside the lift door. With my head my head sunk in between my thighs over the hospital gown. Deep in thoughts after a tug of strife with the hospital guards. On lifting up my head, they were still there guarding me as though I was an armed and dangerous criminal on the run. “Why are you harassing me? I am leaving today as you look.” I yelled at them.

“Please get back to the ward and await discharge.” The guards tried to plead with me.

I could hear none of that. I was so sick of the stay at the hospital and I was fed up to the brim. I knew I had a pharmacology CAT coming up and I couldn’t afford to miss it. I became more aggressive and told off the guards whom I felt were infringing on my rights. Luckily my classmate who had come to see me found me there causing a wreak havoc. He managed to convince me back into the ward with the promise that he would follow up on discharge immediately while assuring me that the CAT had been postponed oblivious of the fact that I had my phone with me and so I could access all the information about class while at the hospital. Well I trusted him and calmed down but still charged against anyone who talked to me.

22ND MAY 2021 EARLY MORNING

6th year medical student: “This is A.K, a 21 year old male, a third year medical student at the University of Nairobi who resides in the university’s hall of residence. The patient was brought in through the casualty as a referral from the university health services. The patient was brought in by a classmate while unconscious following a single episode of syncopal event outside the halls of residence, the patient reports numbness of the ulnar aspects of the hand bilaterally, burning sensation and severe pain along the whole back and extending to the gluteal folds as well as the plantar aspects of the feet bilaterally.

Consultant: Is that all you had in the history?

6th year medical student: “Well the patient was irritable an agitated at the time of clerkship so I couldn’t get a comprehensive history.”

Consultant: “Well can you do a quick neurological examination and help us localize the lesion and tell us the dermatomal patterns of the sensations”

All this while I had tightly wrapped myself with the blanket and pretended that I was sound asleep, until a soft tap on my knees to wake me up threatened my peace. I jolted boisterously in defense and yelled at everyone amidst sobs of draining wells.

“Why do you keep on disturbing me with your myriad of questions and yet you can’t help me. I am here agonizing in pain yet you got the guts to keep on examining me. Can’t you have some empathy? Don’t surround me as though I am a corpse. Leave me alone I want to leave this hospital and die at the hostels”

Consultant: “Can you allow us to do our work or we have you restrained. Calm down.” He yelled back and picked me as though I were some papers weight. I decided to cooperate to avoid restraint. I ate the most humble pie and allowed the student to use me as a guinea pig as I perceived.

Consultant: “What are your findings? Can you localize the lesion?”

6th year medical student: “Well, all cranial nerves and spinal nerves are intact, I can’t localize the lesion or find a dermatomal pattern.”

Consultant: (To the resident) “Order an MRI of the whole spine, HbA1c and antinuclear antibody test. Then dig up the family social history and drop a psychiatric consult.”

1ST JUNE 2021- DURING A MAJOR WARD ROUND

At 8:00 am, I sat at the edge of the bed. Having not slept a pinch and demanding a discharge. I had gone on a hunger strike and poured water on the bed so that I could not sleep on it in a bid to coerce the resident to discharge me home. Tired of the hospital stay to the brim and I started yapping loudly. The consultant looked different and had a deep raspy voice. I imagined my pain and started crying uncontrollably demanding for discharge.

Consultant: “what do we have here?”

Resident: “we haven’t arrived at a definitive diagnosis yet but we are working with an unknown neurological disorder with features of somatoform disorders after consulting with psychiatry. MRI of the whole spine normal HbA1c normal, antinuclear antibodies negative in a patient with a longstanding history of severe back pain, numbness of the ulnar aspects of the hands and a burning sensation of the plantar aspects of the feet. A psychiatric review hinted at a somatoform disorder in a patient with a positive history of suicidal ideations, posttraumatic stress disorder and repeated episodes of physical abuse and neglect at a tender age”

Consultant: “well, there is nothing medical in this patient. This patient has conversion disorder. Discharge through mental health clinic.”

I struggled to sit up or rather to stand up to hug the God sent consultant. He had done what I had yearned for a discharge.

2ND JUNE 2021-AFTERNOON

Discharge summary;

Final diagnosis; Conversion disorder

Discharge through mental health clinic

Discharge meds; duloxetine 15mg P.O OD nocte

TCA 2/52

I was so happy to leave the leave the prison. I wanted to sit down, read and write the pharmacology exam. However, I was convinced I didn’t have a psychiatric disorder and had vowed not to take a single tablet of the medication. I couldn’t take drugs for mad people while I knew I was not. Luckily I had an adamant classmate who stuck close than a brother. He convinced me to take the drugs and I got better. He forced me to show up at the mental health clinic severally for follow up and Hurray! After several therapy sessions, I was never the same. What a damn experience that was!

By the way I did the pharmacology CAT and aced it.

• Doctors are the worst patients. But no, medical students are the worstest if only grammar would allow.