A young man had been filled to the brim with an anti-psychotic at another hospital. He was given so much that it froze him in place– like a plaster cast dried all around him: he was trying to smile but his face remained still, trying to move his legs to scratch an itch he felt and they couldn’t budge. The itch just kept itching, unrelieved. I saw him in this hospital and he lifted his arm just barely off the bed in an attempt to wave hello, a marked improvement from when he had arrived. I saw a man who was trying to crack and hatch out of the shell the medicine made around him, if he only had a beak. Even though his body was stuck, he kept trying to get loose. He kept trying to smile and he kept trying to talk. I learned his name, learned that he is an artist. I even got to see his art. Learned that he may not have had schizophrenia at all. More and more, cracks in the shell spread and he continued to break out of the medicine. Even with us on the outside unaware, he bravely kept pushing and poking from the inside until finally breaking the surface.
A woman I saw kept rocking back and forth to comfort herself. Her anxiety was no higher than usual, she said, she lives her whole life in constant fear. She tells me that she doesn’t want to talk about why because I will never believe her. She says no one ever believes her, so she will stop trying to explain. As a result, she must start each day having to cope with the fact that she is the only person in the world who knows of the wizards who are turning cats into people, and people into cats. Worse, regardless of their original state, she alone knows cats are being killed in swaths. She feels the responsibility of thousands, if not millions, of lives on her hands. Their fate depends on whether she can interfere. She wakes up and knows it is her against the world– a futile choice to make: to try to convince people why she needs their help, or try to fix the problem all by herself. She ends up tortured day after day by her own complicity. She can’t bear anticipating how many more cats may die and that she will grieve them alone. The outside remained unaware of the world as she knew it. And yet, this woman told me again the knowledge she had that so many others had dismissed. She too was brave enough to keep trying.
Two Ways the Inner World Can Stand Up For Itself
Commentary
I have been impressed by every single patient's courage this year. Deciding to go to the hospital at all is an enormous act of bravery, and then choosing to trust, choosing to share about yourself, and choosing to relinquish control only compound the bravery. In this piece, I bring to the forefront two vignettes about patients I saw while on the psychiatry consult-liaison service. I felt like they both overcame great odds, with immense courage, to advocate for something inside themselves that others weren't seeing. I picked these two vignettes because I think they show the same conflict in two different ways: sometimes a person must advocate for their inner self because the world thinks the world is right, and sometimes one must advocate for their inner self because the world thinks that person is wrong. These are slight variations of the same thing and deciding to face this challenge head-on demands courage.
Bio
Morgan Biele is a second-year medical student at the University of Michigan Medical School. She is from Woodstock, Vermont and attended Duke University for her bachelor's degree in Neuroscience as well as Columbia University for her master's degree in Narrative Medicine. Now that she has begun her clinical education, Morgan has been committed to discovering how to incorporate Narrative Medicine as often as possible. Psychiatry was her first rotation, where she was part of the Consult-Liaison team. In the time since, she has been part of the neurology service and is beginning family medicine. She also has been continuing her involvement in qualitative studies about adolescents and young adults with cancer and is also serving as a Jan Maudlin Sarcoma Scholar for 2025-2026.