Next to me was an emaciated, homeless Vietnamese man in his late fifties. We were sitting in the Emergency Room together, his hand tightly clasped in mine. He was dressed in dirt and wore a baggy, tattered overcoat. He smelled of cigarette smoke and days without proper hygiene. He often alternated between mumbling to himself and laughing furiously out loud. Sometimes, he would spontaneously screech at the world in front of him, showing off the few yellow teeth he had. Whenever he spoke, his words were disorganized and his thoughts discontinuous. This man was my father.
As student doctors, we are continuously trained to recognize a plethora of different signs and symptoms in order to correctly identify and diagnose our patients’ diseases and conditions. After having just finished the psychiatry lectures from the REBLS block and learning about different mental conditions, lately, I have been reminiscing about my father — whose symptoms I now know extremely well. What was not taught in lecture, however, was how inconspicuous and difficult it really is to notice these signs. And once they are noticed, it may be too late — as the mental disease may have already progressed so much such that it is life-changing. Unfortunately, I noticed too late, so I want to take this opportunity to share my story.
My father showed signs of schizophrenia while I was a young grade-schooler. At that time, I did not understand this mental condition. Even while growing up, I thought all of his actions were normal for fathers. Sure, he was kind of “weird,” but I thought all fathers were weird. For instance, he often told himself a joke or suddenly laughed at his own thoughts. Whenever I asked about it, he responded that it was an old Vietnamese joke and that I would not understand it — which is true, I do not speak Vietnamese and thus would not understand the cultural humor. And so I did not pay much mind to it; I assumed that he was just nostalgic over some witty Vietnamese tales that only he understood.
A less noticeable example would be his discontinuous thoughts and speech. As a Vietnamese immigrant, it made sense to me that he spoke in broken English. Whenever we conversed, he often spoke incoherently; however, I just attributed his word salad to the fact that English was not his first language. Whenever he jumped from topic to topic, I figured that his mind just went faster than he could speak.
Although these examples were both positive signs of schizophrenia, my family and I rationalized them as “normal” for my father. As such, we always shrugged it off as one of his weird quirks. It was not until his mental condition progressed to a more advanced stage that we started thinking something was off.
When I hit my pre-teenage years, I noticed that he was often wary of my friends. He would continuously warn me not to trust anyone in my neighborhood, either because they could harm me or someday backstab me. While this seemed a bit over the top, I always thought this was that “overprotective father” phase that all fathers go through. I was at the start of my pubertal age, and my neighborhood was, subjectively, not the safest. As such, I never paid attention to his exaggerations; I just thought my father wanted me to be safe.
However, this overprotectiveness became more severe when I hit high school, when my father started accusing my friends of stealing his money. A brief disclaimer: my father often misplaced his wallet, and so it was not uncommon for his money to be missing for a period of time; additionally, it wasn’t until high school that I brought friends over to my home for the first time. As such, I simply thought it was just this coincidence in timing that classically conditioned him to associate my friends with stealing his money.
Unfortunately, this paranoid delusion became more apparent when my father started accusing the government of stealing his money and ruining his life, as well. He often participated in the Mega Millions lottery games, and whenever he lost, he would strongly claim that he had the winning numbers that were “stolen by Hillary Clinton” (who was trying to run for president at the time). I remember this clearly, as my father urged me to write a very passive-aggressive letter to the White House, demanding to be given his rightful money that he won “from Australia.” Mind you, we had never gone to Australia before.
Years passed, and he eventually started sticking post-it notes on the walls. It was a mixture of other accusations and writings in Vietnamese that I did not fully understand. At this time, my mother grew disturbed and often demanded he clean up his “mess.” Her disbelief and distrust in his accusations caused their relationship to deteriorate. His concerns were real to him, and he was visibly upset that he was being dismissed by his own family. Fed up with the judgment, my father one day became noticeably violent towards his surroundings, pounding the tables and walls. Unable to deal with my father’s actions, my distressed mother decided to divorce my father in 2010. My father left the household without ever contacting us.
Several years later, we were reunited when I saw him trespassing at our front door; however, the man I saw was not the man I remembered. I was still not allowed to bring him into my own home per my mother’s request; nonetheless, I was determined that my father find a safe bed because of the risk to himself and others. I sought medical help at the nearest hospital, and sat with him that day, waiting and hoping for a psychiatric consult.
Schizophrenia is a disease that may not be obvious, especially since the delusions and hallucinations are extremely real to the person that is experiencing them. Additionally, the signs and symptoms of schizophrenia may not be obvious to the person’s loved ones either, especially to the loved ones who rationalize normality as my family and I had done. It is because of this that early detection and treatment are important. I cannot emphasize this point enough, as I have had firsthand experience in seeing the progression of untreated schizophrenia. The conversation may not be an easy one, but I hope that my experience will bring an awareness and openness to a treatable condition.
Julie Tran is a student at The University of Arizona College of Medicine — Phoenix, Class of 2022. She graduated from Franklin & Marshall College in 2017 with a bachelor’s degree in molecular biology and a minor in philosophy. Her interests include spending time with her boyfriend, cooking, traveling, and cosplaying for different conventions (i.e., ComicCon, Anime Con, etc.).