The hunting of the schizophrenic Snark

There was an elderly psychiatrist, whose life hadn't made him wise

And then a neuroscientist, who had trouble with his eyes.

Several new psychologists wished to come along

And all the undergraduates who said "Surely these guys can't be wrong!"

The Government gave them money and injunctions to find out

What this 'Schizophrenia' was really all about

They said, "We can't have all these people being poor, sad, and confused

Just think of all the stories on the early evening news!"

The Pharmaceutical Industry

The pharmaceutical industry (With lots of pens and mugs

and lunches – all expenses paid - to make us choose their drugs)

Had lots of happy shareholders and CEO's who've said:

"I'm sorry for the side effects – you say they're really dead?"

"But this one here is still alive (though with dry mouth and the shakes

Impotence, and muzzy head, nausea, and aches)

They're so much better off you see, and while it's not a cure

(the shareholders wouldn't stand for that) at least our motive's pure"

"To make lots of money… No! let me start again

It's for a better quality of life - to ease these people's pain.

They don't need work or love or joy with motivation gone

They can 'express themselves' at day centres through poetry and song."

"I've heard there's lovely places, now the brick asylums closed

And care in the 'Community' (I think there's one of those?)

We stole their motivation?, well that wasn't up to me

It's clinicians you must go to, we just give them stuff for 'free'."

The Psychiatrist

The psychiatrist in his office, dressed all in Harris tweed

Wrote a letter to his journal in which he disagreed:

"These CEOs do sterling work – I just can't say it plainer"

(And though no one else could read it there) he earnt a large retainer

Then he settled in his leather chair and sucked upon his briar pipe

"These new psychologists (he thought) are really not my type

They need to know we have to blame our patients - old and new

For all their many failures – else they'd just be me and you!

We need to give them lots of drugs, and if that's not enough

We'll give them more, and then again, to show them that we're tough

And if the symptoms soon remit, though they can't move or speak,

We'll know then that then the job's well done; and see them once a week.

We don't know how, we don't know why, we frankly don't much care

This hunt for Schizophrenia just makes me want to swear

The blasted thing's illogical and where I once would look

I simply shift responsibility onto the latest book:

The DSM, the ICD it's all the same to me

I give the drugs, I sign the forms, I then collect my fee

And if it seems the entry's wrong well, could I care less?

I simply end my sentence with the letters: N. O. S.

This cure you see is all we want - it proves we're not talking tosh

This 'lack of asprin causing headaches' rebuttal doesn't wash

Right I'm for drinks, a round of golf, and dinner at the Ivy

They've not enough to eat you say? Well, they should stop their skiving!"

The Psychologists

"You can't say that!" young Emma said. "And Emma here agrees

And we should know they cried aghast, we've got psychology degrees.

We may be interchangeable, down to our hair and shoes,

Female, white, and twenty-three but we so much like to use

the complicated knowledge we got from reading books

and feel our very special strength lies in uniformity of looks

You see we really, really care (at least we thought so at the start)

And though we haven't travelled far, we know the DSM by heart.

And should we meet an elder, with eyes lined-creased in pain

Of course we'll know the thing to say – from book learning again!

You see we're rather clever, (In a limited sort of way)

And if that makes us patronise, well hey what can we say?

Where is Schizophrenia? But we just do as we're told!

You'd need some sort of maverick to crack that pot of gold

Were far too busy trying to prove this 'science' that we're taught

And thus we lose capacity for independent thought."

But they tried their best to find it out with lots of big long words

"Dementa praecox – so passé – I'm not sure if you've heard?

We'll call it Schizophrenia and think we've reduced the pain

To a symptomatic definition, located in the brain

Perhaps, they said (most quietly, while looking left and right)

You need someone more qualified to see those neurones light

Encephalography, eye blink, MRI, PET and CAT

The Wisconsisn card sort test, yes! Someone else'll help with that."

The neuroscientist

The neuroscientist, however, had turned a shade of puce

And was crying in his scanner – "O for pity's sake what's the use?

I'll never find this illness - it seems like there's nothing there

The ventricles enlarge, then shrink, and no one seems to care

Blood flow – low frontality, the limbic system too

It seems that over time – well, they're just like me and you!

I've tried dopamine receptors; D two and three and four

And just when it seems I've got it down – they go and find some more!

I'm on to serotonin now, norepinephrine must be next

With all these many things involved I'm feeling rather vexed!

I'll ask the medics - they must know; they're paid so much more than I

Right one last go with gross volume before I start to cry."

The nurses

But the medics didn't know and they passed it down the line

To the nurses – they're the workers who seem to spend the time

With the patients "One-to-one you know?" – yes, they must be the ones

Who'll find this Schizophrenia – they'll spot it when it comes

But the nurses couldn't find it, for it wasn't written down

"Though I'm sure it was at handover", said one nurse with a frown

Nor, though, was it visible from the nurses' station chair

"Blast this search!" the charge nurse said "We'll call it patient-centred care"

The people who knew

And somewhere in this chaos a Person raised a hand

Dignified and understated, they thought to take a stand

Thinking those with some experience might help to find a way

And that a lifetime in the System meant that they should have a say

Knowing only what their truth is, they rose to try their luck

with the band of arguing 'professionals' – "Now, first, you don't know Fuc/"Was that a patient!?" Came an outraged cry. "We're trying to make you well!"

(And the Person started thinking of a very special hell)

"Service User!" cried another "Client!" cried a third

"No", there spoke the Person – "I fear you have misheard."

"It's not about your labels, It's all about our lives.

Procrustes would have helped you, with his special set of knives.

If you see us, not as one-in-four, but as a Person (as we are)

Then therein lies your answer (though it won't make you the star)

You won't get power or promotions; or a kick from 'Doing Good'

You'll have to help out with housing, education, and our food

You'll have to see your racism, your prejudice, and more.

And know the many tragedies upon the psych-ward floor.

You'll have to learn of winter streets and scariness made ill

About the way a friendship slides and how we pay the Reapers bill

But you'll learn about our laughter too, about our hopes and dreams

You'll learn about a Person – and what that truly means.

You're hunting for a concept which we don't recognise

It's a Person in the mirror; not a label meets our eyes

Though we've walked a path less travelled, and sometimes do let go.

We have a deepened beauty - which you just might come to know.

Postscript

So all of us professionals (yes, for my sins I'm one of you)

I'll take your rage and terror (and your rebuttal papers too)

You can write here in a temper; take your frustration out on me

But you can't catch this Snark - it's not a thing: it's just a Boojum

Can you see?

Dr Christina Richards 

MSc DCPsych CPsychol MBACP (Accred.) AFBPsS

HCPC Registered Counselling Psychologist

Senior Specialist Psychology Associate

Clinical Research Fellow