Bent and Broken

Peter and Meena are fourth year medical students at St Louis University. In spite of fiancée's skepticism about his mental problem, Peter decides to take certain pivotal steps to deal with it straightway. He visits his mother at Farmington, Missouri and learns from her, dad was an alcoholic and also exhibited severe mental symptoms. She did not know much about his side of the family, but recommended to contact a grandma living in New York. Peter found Grandma Agnes extremely forthcoming about her family history and learnt from her, his father returned from Vietnam as a heroin addict, quit using it after finding out of his Hepatitis and later turned to alcohol. Grandfather lived in and out of State Hospitals and committed suicide. The next step for Peter was to find a good psychiatrist. He learnt the best way to find one was through the Physician Referral Services of a good hospital, following it up with Face to Face Assessment. He was totally surprised by the first psychiatrist selected, who in spite of his high qualifications ignored the family history he painfully collected, telling the medical student's problems came from witnessing as a child, the abuse father inflicted on the mother. With no desire to see him again, Peter met another psychiatrist who was extremely interested to hear about his family history. She told him, he definitely has a Depressive Illness, however, the family history increased the risk of developing Bipolar Disorder. After discussing the various treatment options, they decided on a trial with an antidepressant. A week into the medication, Peter woke up from sleep feeling more energetic than usual, a natural high, and asked himself if the medicine hit the target earlier than intended. He learnt from the new psychiatrist, his diagnosis now was Bipolar 2 and she told him to discontinue the antidepressant, as it could make his condition worse. Meena got perplexed hearing about Peter's new diagnosis and began to worry about her future with a seriously mentally ill person. Grabbing an offer that came from New York Presbyterian to do neurology clerkship, she moved to the Big Apple, on the pretense to be closer to her parents. Devastated Peter took an overdose. It took a while for him to recover. Couple of months later, Peter received an unexpected phone call from Meena - Her father, a neurosurgeon was in coma after a plane accident that happened on a business trip - Mother had a nervous breakdown. Meena begged him to come to New York and help her. Father died soon after his arrival. Mother showed signs of improvement only after receiving ECT. Father's sudden death and mother's illness shook up the daughter. She returned to St Louis to finish the school year and prepare for graduation. Peter was accepted to the residency program in psychiatry at the University. His main interest was to do research and wished Meena would take up residency in psychiatry as well and be part of his research team. However, she was into the neurology residency. One Sunday afternoon, after church Peter and Meena decided to take a stroll through the Saint Louis botanical garden. It was a beautiful day and a gentle breeze made it feel even better. They sat on a bench, close together, in the Japanese section and watched the people passing by. She chose this moment to reveal her secret, "Pete, I have a surprising news for you. I just found a slot open in psychiatry. Someone from overseas cannot make it. I have been promised it."