Just West of Dagenham

There is a patient on the ward who has lost their mind.

This is a quaint turn of phrase which implies an act of carelessness on their behalf.  It suggests they weren’t concentrating properly, became distracted and somehow mislaid it.  Like a set of house keys or a Jack Russell Terrier.  It also suggests that it was their own fault.  It suggests that we are all responsible for our own sanity and, if we should be foolish enough to shirk that responsibility, well … to be honest, we deserve all that we get.

Of course, we don’t use that phrase.  Not to their face.  We say they have a “deficit”.  A good, solid medical word, you would think.  But despite its clinical acceptability, it too means failure.  In no other specialty would you be allowed to label a patient a failure.  We don’t even have renal failure anymore, we have “kidney injury” and heaven forbid you should describe a woman in labour as having “failed to progress”.  We live in a society where our bodies are not allowed to fail.  Our bodies become injured, distressed or neglected.  They simply do not fail.  Our minds, however, are a different matter.

There are many different ways of determining whether someone has lost their mind.  In medicine, everything has to be quantified.  If it can’t be scored out of a hundred and expressed as a percentage, then it really isn’t worth knowing about.  If you want to find out whether you’re depressed, psychotic or demented then there’s a test out there for you.  Part of the Alzheimer’s test involves asking patients to count backwards from 100 in sevens.  It always makes me smile that, for the benefit of the examiner, the answers are written at the side of the page.

Once diagnosed, mental illness is a bag for life.  Our minds govern our defining status.  We may be the woman with bowel cancer or the man with an enlarged prostate … but if our minds start messing us about, we become schizophrenic or manic depressive.  We are what we think.

So if someone finds themselves just west of Dagenham (Barking) it would appear they only have themselves to blame.  They will be bounced around the hospital from service to service, until someone has the good grace to give them a psych referral.  Psychiatry will then either fill them with drugs until they forget who they are or introduce them to the joys of woodwork – in the vague hope that it will one day, miraculously, restore their sanity.

But to their face, we will say they have a deficit.

I think I prefer “lost their mind”, because it suggests there is a possibility, however slim, that they may find it again.


  1. November 27, 2010 / 10:04 am

    I couldn’t agree more! The bit about ‘failure to progress’ did make me laugh though 🙂

  2. FionasRotties
    November 28, 2010 / 5:00 pm

    Have added your blog to my favourites…. It’s so true what you say… The medical profession has a lot to answer for in the way we view people eh… I personally detest it when patients are referred to as their illness, ie, ‘is that the appandix?’ ‘It’s the HIV patient’ ‘has the bowel rersection been consented?’ and on and on it goes…

  3. December 10, 2010 / 8:33 pm

    “Count backwards from 100 in sevens”? Is this actually possible? I tried – I said 100… 97… realised I was doomed and made a cup of tea.

  4. December 10, 2010 / 10:20 pm

    As someone who has suffered from lifelong anxiety and for 10 years depression, I welcomed a diagnosis, I wanted a label I could put on what was happening to me so others might understand me better & not judge me as fake, lazy etc. I feel better when I communicate my ‘labels’. But I know that if I want to move on and progress in life – get a job again, meet someone special – I need to leave this behind because most people cannot accept these disabilities.

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