I am a psychiatrist. I knew I wanted to be one from the very first day I stepped into a psychiatry ward as a fourth-year medical student at Hospital Kuala Lumpur.
The first patient my rotation mate and I interviewed was an Indian gentleman who spoke with remarkable clarity and conviction. We took him at his word, until a medical officer passing by asked what he had shared.
When we told him, he smiled and said, “None of that is true,” and pointed us toward the case file. That patient had schizophrenia.
That evening, my groupmates and I found ourselves debating the definition of normalcy. Perhaps they have forgotten that conversation. I never did. It stayed with me, quietly shaping the path I would take.
Years later, I have worked with many patients with schizophrenia. Some have slipped out of memory. Others I carry with me still.
I remember one man from my early days working in northern Malaysia.
He was in his forties, though he looked older. His hair was already white, his skin weathered, his teeth in poor condition. He had siblings and a family home, but he lived on the streets. I was told that his family would collect him once a month to withdraw his social welfare payments, and then send him away again.
No one ensured that he took his medication, and without treatment, his psychosis always returned.
We tried what we could. Depot antipsychotics to reduce reliance on daily tablets. Community teams who attempted to locate him and bring him in for follow-up.
But care that depends on finding someone who does not wish to be found, and on systems that are already stretched, is care that often falls short.
He relapsed frequently and required repeated admissions. Repeated relapses are not benign. Over time, they are associated with worsening cognition and functional decline, leaving lasting scars on the brain.
Each time, he would arrive distressed, suspicious, sometimes combative. And each time, once he was treated, he softened. He was gentle. Kind, even. Many of us in the department had a soft spot for him.
I remember one admission when I was on call. He asked, almost shyly, if he could have pizza for dinner. There was something about the way he asked that stayed with me.
That evening, I ordered pizza for the ward. The duty nurse later told me he ate three whole slices and seemed content. He was discharged the next day.
A week later, we received news: his body had been found in a flood drain, days after he had gone missing. He had likely slipped and fallen in the dark. No one noticed. No one looked for him. He was found only after people nearby reported a smell.
I still remember that Sunday evening. I was at home when the news reached me. I broke down in tears.
The mood in the department the next morning was subdued. No one said very much, but it was felt. We had lost someone we had quietly come to care about.
He would never be our patient again. He is one of the stories I will never forget.
Schizophrenia affects around one percent of the population, yet in practice, it remains one of the most neglected and misunderstood conditions.
Public narratives often centre on exceptional figures like John Nash, but most patients do not enter the public imagination. Most live and struggle quietly, without recognition or support.
We often speak about treatment in terms of medication and follow-up. But treatment also depends on stability, on housing, on family support, on continuity of care. Without these, even the best medical plans unravel.
People with schizophrenia are often thought of in terms of risk, disruption, or decline. Less often do we speak about their humanity in moments when they are well. Their gentleness. Their humour. Their capacity for connection.
That man, who had so little, remained kind. He had been dealt a difficult hand, whether from birth or circumstance. He was failed, repeatedly, by those who should have protected him. And yet, in his lucid moments, he did not become cruel. He did not become hardened.
That is something I have seen, again and again, in my patients.
The stigma surrounding schizophrenia remains profound. It shapes how people are treated by society, by systems, and sometimes even within healthcare. It shapes whether they are helped early, or only when they reach crisis.
50With appropriate treatment and support, people with schizophrenia can and do live meaningful lives. But many never receive the conditions needed for that possibility to unfold.
Changing this does not begin with policy alone. It begins with how we see. Not as diagnoses. Not as burdens. Not as cautionary tales.
But as people whose lives might have looked very different, if only they had been met with consistency, dignity, and care.
This is my quiet request.
Let us look at those living with schizophrenia not with fear, or with pity, but with the same compassion we would hope for ourselves. Let us see them.
The author is a psychiatrist.
This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
