Paul's problem...Mental Illness : LUSENET : ER Discussions : One Thread

I think people were given a negative insite on a very real topic, MENTAL ILLNESS. This bothers me because people are afraid, so they judge, or ignore it instead of try to understand it. What do you think?

-- kris vieira (, February 18, 2000


I disagree. I think a few comments made it clear that he was a patient who was sick and not properly treated... I think it was not particularly heavy handed or condemning in terms of him... first, he was given the achingly tragic pregnant wife (that was a little much, actually) then there was her comment, "If he was so sick, why wasn't somebody with him." That comment worked on many levels... the audience's knowledge that the people who WERE with him were stabbed... but also the audience knowledge that he had been allowed to wander around the hospital, even after he had manifested clear signs of a psychotic break... Also, when the wife was told about her husband, it was in a non-judgemental way, sensitively stated, and emphasized that Paul was sick, and was likely to hurt himself... and even though Kerry couldn't work on him, Mark was totally professional, and when talking to the wife, almost sympathetic... and I think all of the dramatic illustrations of his mental illness... the flight of ideas, the paranoid delusions, and the obvious fear and terror Paul displayed made things clear that it was the intensity of the untreated schizophrenia, rather than the man, that was the real source of harm... finally, the last words we hear from Paul are "I want to go home. I have to feed my dog." This was ironic and poignant... in a moment of clarity peeking through the overwhelming force of shizophrenia, we are reminded that this is a man whose whole life will also be/ has also been destroyed. He will no longer be a law student, an available husband or father, or even a person capable of taking care of a dog... the rest of his life will likely be spent in a prison for the criminally insane... it just seemed tragic all around... it showed that five lives were permanently, and horribly, changed in one fell swoop... Carter, Lucy, Paul, Wife, and Unborn child... there are no winners... and as for villians... once they get into the blame game, it will be interesting to see how much acrimony falls on Paul and how much anger lands on the doctors who were not able to prevent him from acting out.

-- L (, February 18, 2000.

they said pauls wife was pregnant? did i leave the room or something???

-- dawn (, February 18, 2000.

kudos to L-. Very nicely put!

-- PRN (, February 18, 2000.

Dawn -- did you SEE the wife's belly?

-- L (, February 18, 2000.

Where was Malik? I don't think he was "not properly treated" as much as they didn't have the chance to treat him. Why is psych always backed up?

-- (, February 18, 2000.

L. -- beautifully said. Just one minor additional point... yes, those 5 lives were permanently affected, but let's not forget all our friends in the ER who had to witness the slow ebbing away of life while working on their colleagues John & Lucy. I am not in the medical field myself, but I can vividly imagine that in their shoes, I could not ever see my job and workplace in the same way again...

-- M. (, February 18, 2000.

Sorry L. As someone who has a loved one who has been diagnosed with paranoid schizophrenia, I've got to disagree with your analysis. Unless you have lived with it first hand, it's hard to know how misunderstood this illness is and how stigmatized people who suffer from it can feel. It's true that they made it clear that Paul was suffering from an illness and that was what was responsible for his actions and that he had not received the help he needed. However, to make even a suggestion of a schizophrenia diagnosis and then have the character go on a murderous rampage simply reinforces a lot of preconceived notions and fears people have about mental illness. Just look at the other threads on the message board about these episodes and see how many people are calling Paul "the psycho" or "crazy". The truth of the matter is that most schizophrenics are not violent and the illness has many different symptoms and varying degrees of severity. You yourself jumped to the conclusion that Paul's illness was untreatable and he would most likely be locked up for the rest of his life. In reality, there are many more options today for people with mental illness and many schizophrenics, with proper treatment, go on to live full and productive lives. Granted, with respect to this episode, you are correct in assuming the ramifications of Paul's actions are lifelong for many people. But that's pretty much my point. This kind of sensationalism hurts the efforts of the many organizations and individuals who are trying to educate and enlighten about this very real problem. Maybe as Paul's case progresses, they'll be able to incorporate more sensitivity and education into the story line, but I'm not holding my breath.

Thanks, Kris for bringing up this subject. It's been on my mind since the eps aired.

-- J. (, February 22, 2000.

J -- you are absolutely right. Thank you for bringing up Kris' original concern. After reading the other postings on the board, I have to agree with you both that, given the hostility with which people have reacted to Paul, perhaps my take on the writers' sensitivity to mental illness was colored by my own bias... Like you, I am intimately familiar with the nature of schizophrenia, and am constantly horrrified by public misconceptions and medieval attitudes about the disease... My take on the episode was that the point of the storyline was to show how hosptial and staff error and inattention could lead to tragedy... but I think very few viewers shared that perception of the course of events... as you pointed out, most people just 'blame the psycho.' Which is so tragic, but also pretty classic mob mentality.

The anger and blame that has been focused on Paul throughout this discussion board troubles me, but doesn't surprise me. That's the thing about mental illness -- most people just don't get it. If a patient suffers from a disease that causes their muscles to atrophy, people don't look down on the patient for being lazy, expect them to shake it off and just get up and walk, or mock them for being crippled... yet, if a person suffers from mental illness, there is this prevalent and unrealistic public attitude that the patient should just pull it together, act normal, and if they don't, the patient is labeled a 'psycho.' The whole victim blaming syndrome with mental illness is very similar to the condmening way much of the public used to react to people with AIDS... it's just ignorant, cruel, and, well... wrong.

And I am also glad you point out that violence and murder are not typical manifestations of schizophrenia... of course you are right, and I suppose this kind of portrayal does lead to more public contempt for the disease. However, in my experience, it is not entirely outside of the realm of possiblity that an untreated, unattended, and incredibly frightened paranoid schizophrenic could act out violently... But, in a scenario like that, especially in the setting of a hosptial, it is hard to imagine how the patient himself could be held accountable for the consequences stemming from his untreated illness. Yet, as I have seen here, the popular sentiment is that the whole thing was 'the psycho's' fault. What an injustice, what a shame.

One last point -- when I said that Paul would likely be locked away, that is not because I am unaware of the treatability of schizophrenia, but rather, that I am all too aware of the public's thirst for a lynching... From what I have seen, sadly, most mentally ill people who committ violent crimes, even if they are deemed legitimately criminally insane, are pretty much locked up, with the keys thrown away... Despite the fact that mental illness can be treated with proper medical management, structure, empathy, and therapy, most people who have 'acted out' as a result of their disease have been involuntarily institutionalized indefinitely... Just another sad reality of public prejudice.

-- L (, February 22, 2000.

Well said, L. You are is not outside of the realm of possibility for an untreated schizophrenic to act out violently and with tragic consequences. Isn't it a shame that those are the only ones we ever hear about? Not too many news stories about the recovered patient who has gone on to get an MD and PhD and is now an activist for mental health issues...guess that wouldn't pull in the ratings, though.

Thanks for your insight and compassion. Keep the faith!

-- J. (, February 23, 2000.

Just briefly, one little thing bothers me about this subject...notice that you have commented several times on the fact that Paul was Schizophrenic, and as such, should have been more restrained. It seems to me that everyone is forgetting, that Paul HAD NOT been diagnosed, by anyone, even at the very end of the show. No one fron Psych had seen hime, he dissapeared after the violent episode, and the evaluation was just beginning at the end of the episode.

Given that he came in with a headache, and that Lucy began treatment as medical, calling for a psych consult only later in the day, No one in the ER could have, or would have known that he was Schizophrenic, and only a few MIGHT have known it was a possibility. In fact, we don't even know it officially, we assume it.

Just a thought......

-- Tres (, February 23, 2000.

The reason I assumed Paul had schizophrenia, about midway through the episode where he was introduced, was because he had, by then, exhibited many classic symptoms of mental illness. We, through Lucy's eyes, were given many clues... his disorganized thought pattern was revealed when he spoke to her, his intense fear and violent reaction to treatment had been manifested during the spinal tap fiasco, the comments by his old friend from college had indicated that Paul suffered from a rapidly progressing thought disorder, Paul's violent and bizarre reaction to seeing his old friend indicated paranoia, and Paul's wandering around the hospital rooms, constantly requiring redirection, was the final tip off... I think the diagnosis was pretty solid -- that's why psych was called in the first place... all the tests had been run, and other possible diseases had been ruled out... and, if memory serves, I think once the tentative diagnosis was made, Carter had wanted Malik to stay with Paul... I'm not sure about that, though... so those are the roots from which my assumption stems.

-- L (, February 23, 2000.

Yes, Lola, all those things happened...but as you point out yourself, they happened WITH LUCY. As you say...we saw them, thru Lucy's eyes. Lucy was the one who thought it might be a mental illness...Lucy got the go-ahead from Carter to call Psych, and Malich MAY have been aware of the possibility. So, who else, besides Lucy, and Carter, would have given a great deal of thought or attention to him, or to the possibility that he was psychotic? Until Psych did an evaluation, and made a formal diagnosis, he was not officially "schizophrenic". I guess thats what I was driving at...yes, we *knew* as the audience, because *we* "saw what Lucy saw"...but the other ER staffers were not "watching the show". They couldn't have known. He could have been high, or drunk, for all they knew...IF they even gave him a second glance.

-- Tres (, February 23, 2000.

On the schizo thing I think Luka tells Paul's wife that the ER think he's schizo. One more comment, I too readily wanted to blame Paul, but it was more his illness than actually Paul and the many, many hospital mistakes that ended in this tragedy.

-- Cai (, February 23, 2000.

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