Today I met this lovely little 70 years old lady at work. She had come in as a patient for a minor procedure under anaesthesia. She was well dressed and I couldn’t help but notice her hair. It was as though she had just walked out of a hair salon. It was beautifully styled. I could imagine her sitting with her rollers on under the hair dryer reading a magazine. I was impressed by the effort she had put into looking so good to come into a hospital for cancer surgery.
Instantly my mind flashed back to 2 days before Day 0. That day we had an appointment to see the GP. I had requested my son to shave as I gently woke him up reminding him of our planned visit. 10 minutes before we were to leave the house he came down the stairs. He had not shaved. I sent him right back and insisted he shave even if it meant we were a few minutes late. He really didn’t want to but he did. (Now I know how terribly difficult it must have been for him.) I was pleased to see him looking so neat and tidy.
The doctor’s report to the Coroner says – “He was well dressed, shaven and fresh. He made good eye contact. His speech was coherent and we had good rapport throughout. He said he had had a recent ‘set-back’. On being asked if he had suicidal thoughts he said yes but he had no plans. He said that he felt he would never recover from this illness. I reassured him that he would. He asked me how long it would take……. If other patients had returned to work….. There was nothing to indicate a relapse of psychotic features. The Citalopram was increased from 10mg to 20 mg daily.”
Despite the fact that during the previous visit 2 weeks prior, his PHQ9 (Patient Health Questionnaire 9, a monitoring tool for depression) score was 27/27, indicating the worst possible level of depression, the GP did not repeat the test on this visit. Was it because he looked ‘well dressed, shaven and fresh’? Would it have made any difference?
We will never know.
What we do know is that there is a huge need for education. Pills alone do not save lives.