What you never know.

He looks like the average teenager, maybe a little dull, that’s all. I mean, that’s how you’d judge him, wouldn’t you, since he works full-time in his father’s retail store selling gaudy clothes to middle-aged ladies in a heartland district. What you don’t know is, he’s been hearing voices, and they drive him crazy, literally. They forced him to drop out of school. The voices tell him everyone’s against him, he constantly feels spied on and feels as if his thoughts can be read from, plucked out of and inserted into his mind. Because of this torture, he’s tried to kill himself countless of times. Once, out of fear, he hurled himself off his balcony.

That’s schizophrenia for you. A classic history of schizophrenia. It’s nothing like the split personality the media portrays it to be- there’s no such thing.

If there’s anything Psychiatry has taught me, it’s compassion. Not the sympathetic kind of pity or comforting, but really, the common compassion we can have for the average human being but choose not to have, because hey, doesn’t he/she look normal?

She looks perfectly normal, like your average high-school girl with a cheery smile. Maybe she’s a little dramatic because she cries and whines a bit once in a while. What you don’t know is, she’s bulimic. She throws up all the time, and it hurts everyone around her. She has what the doctors call “smiling depression” because it doesn’t show. Nobody would guess she has an eating disorder because her weight is normal.

That’s her story- she who has a major depressive disorder and has suffered from it for years. Opposite her is another patient who has thrown up so much from his eating disorder that all that stomach acid has eroded all his front teeth. He’s only twenty.

She has perfectly straight hair, beautiful mascara-lined eyes and a expensive handbag to match. If you saw her on the train, you’d easily think she was living the good life.

But she comes into the clinic shouting that she wants to end her life. What you don’t know is that her husband divorced her sometime back, her daughter who bore a child out of wedlock has been brought to court and labelled “Beyond Parental Control”, her current boyfriend wants to leave her and her ex-husband’s mistress wants to sue her. All this happens within a very short span of time. If she didn’t open her mouth, you’d think she was just another normal mother.

They look like the most loving couple. They come in holding hands. But she confesses to the doctor that he’s been losing his memory. He keeps forgetting simple things, things he’s just been told, and lately, he got into an accident. An accident? Yes, an accident, but just a teeny weeny one, no one got injured, he says. The doctor probes and says he needs to go for a re-assessment of his driving, especially because of his condition. What? he says to his wife, now tearing a little, I been driving you to and fro from work every day for the past 20 years and this is what you do to me? Why did you have to tell the doctor? What if he takes my car away? Driving is an essential part of me, what is my life without driving? What’s wrong with you! She is in tears and he storms out.

The doctor presses on to see other patients. He has a whole line of them. Within minutes, the couple is destroyed. They looked like a perfectly normal couple.

Dementia. It hits some people sooner or later.

And then there’s me, looking perfectly normal and professional, cool and collected as a final year medical student going about my Psychiatric module talking to patients and attending tutorials. We’re interviewing a patient with anorexia and I’m looking perfectly in control. But I’m nervous inside because it brings back so many, many memories. They seem so far away, and yet, become so real when they’re described by somebody else. When I had to throw my old ‘small’ clothes away, I cried. I cried because it was like saying goodbye to my illness. And that, for some reason, hurt a lot- throwing away my ‘sick’ clothes. She, the emaciated girl with sunken cheeks and wasted limbs, drew a self-portrait of herself with thick arms and thighs and a huge belly and a puffed up face. It looked like the self-portrait I did before.

And I sat there, calm, slightly detached, yet understanding everything she had shared with an intensity no one else could have.

It only reminded me, how perhaps, we just need to have a little more compassion, smile a little more and go a little out of our way to say hello, how are you, have you had lunch. Because you just never can tell who’s struggling through a divorce, who hears voices telling them deprecating things, who constantly battles against a meaningless sense of self-worth. It’s easy to say they brought it upon themselves, but only one look at their classical, patterned histories would tell you that it could have been you. It would have been you had you grown up in their kind of environment, faced their kind of stressors.

It could have been you. Or me.

So stop a little when you’ve the time. Say hello to the elderly person clearing your table. Ask if he’s had his lunch. Ask the cleaner if she’s had a good day. Be prepared for a surprised look, because they never think they deserve your attention. Then, forgive that disinterested waiter (which I often don’t because I expect good service and feedback to the manager when it’s terrible) because maybe that hum-drum job is the only thing keeping him going day after day, day after day, before he returns to an empty home at night.

Thank God for your weaknesses and pains, hurts and struggles, because maybe, they help remind you that no one can tell what you’re going through, and maybe you should give them the benefit of the doubt, too. Don’t take up the seat in the train if you’re feeling okay because you just can’t tell if someone needs it, not always at least. I know I am now always grateful for a seat because no one can see that my legs are hurting. Once, I gave up my seat to a middle-aged lady who didn’t really look particularly aged or frail, and she gave her seat to her daughter, a young lady my age. Out of concern, I asked, “Is she okay?”

“No. Just came out of hospital. Low platelets. Very, very weak.”

So stop, smile, and spare a little compassion. Remember the times you were weak and exercise that compassion you wished you had for yourself. Because you just never know, you might be the reason behind the unexplainable force holding someone back in the dead of the night when he feels like throwing himself out of the balcony.

You just never know.