The Automatic Unstated Faith Bond

**All patient names and identifying information have been changed or left out for confidentiality.**

Nursing is hard. Dealing with people is hard. What’s worse is dealing with other muslim patients (calm down, and keep reading). No, not because we have specific things that must be taken into consideration but more because there is this unstated automatic bond between you and the patient. A bond of brothers and sisters.  A bond of faith.

The first time I met “Ahmed” was on a white board in a psychiatric unit. “Ahmed – Paranoid Schizophrenic – (insert other irrelevant information here)”. I didn’t think much of it. Maybe it’s some old and senile man (yes, I did think that, sue me). It was not until rounds that I really met “Ahmed” – a 19 year old college student.  (Side note: at rounds everyone on the care team gets update on the patient condition, medications etc. We talk to the patient and see how they are doing and make changes to medications, treatment plans and if they are doing better they get discharged. End of side note. )

Here is his back story (edited and shortened):

“Ahmed” was admitted to the ward because he was afraid that people were going to break into his house. So afraid that he used to take screwdrivers into his bedroom for protection. He was often found talking “to himself” in the bathroom, loudly. He often got into fights with his family over money and had various incidents that led to his admittance to the ward, including one specific incident that led him to throw medication at his mother’s face. Obviously, something is very wrong or this is just one weird dude. I wanted to know more. I wanted to know how, coming from a Muslim family and being the only son, he was admitted to the psych ward of all places. What was he up to and what led to this?

Luckily, after rounds I found “Ahmed” in the TV room. As I passed by I waved and before I could say anything he said “As-salamulaikum”. For a second I froze. Yes. Froze, like this was the first time I had ever heard the phrase and had no idea how to react. Once I had finally regained control over my muscles and mustered up some guts, I replied and ask if he was up for hanging out for a bit. He agreed and I joined in on the television watching. I had no idea what we were going to talk about or what to ask. My mind had gone blank. It didn’t help that he was mimicking my every move. Eventually the conversation started and I was shocked at what I heard. “Ahmed” “the paranoid schizophrenic” had real dreams and aspirations. He wanted to become an engineer, stand on his own feet and explore the world. He laughed and joked about politics, conversed about sports and he told me he spoke to his father often and helped his uncle run his convenience store. He was “a beast” at checkers and always beat his friend Paul when they played. I was elated. He was not paranoid. He was not schizophrenic! He was just a misunderstood teenager from a conservative home  being raised in a less conservative atmosphere and no one understands him. I was sure. Write it in stone. I’ll tell the world.

In conversation with the Nurse Practitioner (Whoop!) that was on his case, she asked me questions about his culture and religion and how some of his actions could be explainable such as his mumbling could be him praying? or making dua (supplication)? He could be doing tasbeeh (similar to rosary) when he taps finger to finger. Everything had a reason. He was not crazy. I was sure of it. She asked me what I thought, and I confidently answered that I was not confident he was a paranoid schizophrenic. Seriously, please. That was ridiculous. This kid talked normally, he looked me directly in the eye during our conversations, he had goals, aspirations. He was NOT crazy. I refused to believe it.

The next week that we went back I was excited to hang out with “Ahmed”, play checkers (he said he wanted to play the next time we came) and find out more about him and his condition but when we got there he was gone. “Ahmed” was sent to a more protective mental facility one day before we returned for our last week of rotation.

The Nurse Practitioner updated me on his status, then she asked me questions that made me realize all the things that I was pretending I did not see. Suddenly, my whole perspective on my conversation that day with “Ahmed” had changed…

His direct eye contact was the manipulation of a schizophrenic. His mimicking my every move was in a sense a way to impress me. A way to feed to me what he thought I wanted to hear. Just like his answers to my questions. I also found out later that “Ahmed” had been doing drugs after he dropped out of college. Remember when he told me he talked to his father often? His father died 2 years ago. (This was another one of those moments where I froze and didn’t know what to do) So if he is “talking” to his father, it’s definitely not physically his father. His chart said he sees shadows around him and they whisper. Maybe he was high? (yeah I still tried to justify) He reads the Quran. Mashallah. He reads it so fast he can’t stop himself or understand what he is reading.

I still sifted through his chart and read every note made by the nurses or doctors in hope that there was some unseen piece of the puzzle. There was nothing.

All I could do now was pray for the brother with whom I had an automatic unstated faith bond with. So I prayed that Allah (God) help my brother “Ahmed” and bring him peace and guidance so he can achieve his dreams.

The “Automatic Unstated Faith Bond” can be blinding.