A Lone Walk

Wil is running and running and running. Running from the cold, unemotional, sometimes even brutal psychiatric wards where he has spent the last couple of years. He is running from himself, his anxiety, his emotional scares. He is running from his mother and everyone else who is trying to put him into a little box. All he wants is love and empathy, whatever that is.

This novella takes us inside Wil, into his head and his thinking; it takes us under his skin and allows us to feel his feelings, his anxiety, his anger, and his despair, with a remarkable intensity. The book uses stream of consciousness to describe the experiences of a young man who has spent years in psy­ chiatric hospitals. Although he certainly has some sort of psychiatric disturbance, I cannot diagnose him according to the DSM­IV or ICD­10 classification systems, but who cares? The events described are realistic, and remind me of moments when I worked as a staff member at a psychiatric hospital decades ago.

Everything is, however, not dark and black in this book-there is also the light of good hearted, engaged staff, who respect Wil and give him, and us, some hope that all mental care is not the same. Brutality and lack of empathy in wards are often unintentional.

A Lone Walk reminds us of the importance of continuing education and guidance of staff at mental institutions, a prerequisite for keeping empathy alive. Continuing education and supervision have been reduced during recent recessions in most western societies, but should be reprioritised.

While reading this book, I was also reminded of the need for health profession­ als to learn not only the science of medicine, but also the art of medical practice. The lat­ ter is easily forgotten in this era of technical and scientific developments.

This remarkable book should be read by all health professionals, especially those who work with mentally ill people. It should also be read, and discussed, by medical students and students in other health professions. I will recommend it for our own medical education. As health professionals, we con­ stantly need to be reminded of the patient's perspective on his or her care.

Ingmar Skoog, associate professor, Institute of Clinical Neurosciences, Neuropsychiatric Epidemiology Unit, Gteborgs University, Sweden


studentBMJ 2001;09:261-304 August ISSN 0966-6494