While in medical school, I came across a book in the library titled "MD: doctors talk about themselves", by John Pekkanen. It was a compilation of interviews with 75 physicians (whose identities were not revealed) in which they discussed various aspects of their professional and personal lives and how their careers in medicine had shaped them. One quote from the book has stayed with me ever since. "When I was 25", one of the doctors said, "I was fascinated by the diseases. But now that I'm 40, I'm fascinated by the patients and their lives".
A few months ago, I took one of the most unusual patient histories that I've heard since starting my medical training over 21 years ago (I have changed some of the identifying details). I was seeing an 11 year old girl from a neighboring state who had been referred to my clinic because of difficulties sleeping that were felt to be causing excessive daytime sleepiness, behavioral problems and negatively affecting her school performance. She was overweight and snored, and it certainly sounded like she had obstructive sleep apnea (a condition in which the throat collapses while sleeping and stops one from breathing). She was also not getting an age appropriate amount of sleep, was sleeping in late on the weekends, had a TV in her room that remained on while she was supposed to be going to sleep, and had a dog who liked to sleep in her bed. Clearly, there was a lot to work with.
In order to complete the sleep history, I asked her about hallucinations while falling asleep or waking up, which can sometimes be a sign of another sleep disorder, called narcolepsy.
"Do you ever see or hear something you know isn't there as you are falling asleep or waking up?" I asked her.
"We have a ghost in our house" she answered. "His name is Simon". I looked over to her father to see his response, and was surprised to see him nodding his head in agreement. The conversation then continued, with both the patient and her father taking part.
"Was there a murder in your house?" I asked
"No. He's the guy who used to live in the house before us."
"Is he a benevolent ghost, or does he make trouble?
"He'll move stuff around the house sometimes, and then we just sort of laugh and say `oh, it's just Simon, up to his old tricks again'"
"Does he ever get angry, or mean?"
"Once he was upset when we put an addition on to the house. He didn't like that; it had been his house, and the change disturbed him"
"Did you need to appease him, or leave a peace offering?"
"No, he got used to it after a while"
At this point I decide to move on with the interview, not wanting to make them feel uncomfortable, though I really did want to hear more about life with Simon, never having met anyone who lived in a haunted house before.
That weekend I asked my neighbor, a psychiatrist, whether he had ever encountered a situation like this before, where two family members without any signs of overt psychiatric illness, believed that they were in frequent contact with a ghost. He had not, he replied, though the concept of haunted houses was not uncommon in New England, and so one should see it in the context of the surrounding culture.
Since then, I have met with the family a few more times. Besides helping my patient with her sleep apnea, sleep hygiene, and schedule, I have learned more about Simon (that he prefers to hang out in the basement, and that he likes to walk through people when they're doing the laundry). I've also thought a lot about what that anonymous physician said almost 20 years ago, and just how true it is for me today.