A father suffocates his daughter after she fails to kill herself with an overdose and receives only a two year suspended sentence. The same girl had been turned out of a psychiatric hospital allegedly for giving cannabis to a fellow patient. The Media gives the impression that 'it's all the doctors' fault'.
How do we react to this? Ignore it as another anti-doctor story, and wonder if we can bring retirement dates forward? Why should we always be the fall guys for all of life's ills? Will this prompt another siren call from the euthanasia lobby?
Can we do any better than this? The poor girl's illness was long and difficult with eating disorder, severe alcohol dependency, manic depression and self harm (BMJ 2001; 322:1311). The NHS is not a perfect institution and by chance, sooner or later, she would have received an indifferent episode of care. GP trainers are encouraged to teach our registrars (and ourselves) to be honest with their feelings, so as to avoid them unconsciously tripping us up. Having faced our negative and therefore potentially destructive first thoughts we can then move on. Prolonged mental illness in a family does put indescribable stress on the other members. Who knows what we would do in a similar situation? Perhaps the mother is projecting her anguish, not to mention guilt, on to the NHS. Maybe we can hear the pain behind the voice. She's lost her daughter and may potentially too have lost her husband to gaol. The story might encourage us to consider what our local community psychiatric services are like and to press for more resources. Depression can be a very satisfying treatment to treat, but this tragic case is a reminder that it can be a fatal disease, especially for young people. Yet we are not omnipotent. Not every depressed person wants treatment nor can be treated successfully even in optimal conditions. But not caring is not an option.
But I'm out of my depth here. Rationalising may help to a degree, but something else is required. Prayer is needed, for the girl's soul, her parents, the medical staff involved, for challenging patients with intractable problems that it is our responsibility to see, and for ourselves.
