Case of Boron
By Dr. Mahesh Gandhi, M.D. (Psychiatry), Senior Consultant and Faculty, the other song
Co-authors :
Dr. Sneha Vyas, Resident Doctor, the other song
Dr. Devang Shah, Resident Doctor, the other song
Taking the session further, Dr. Gandhi then showed a case of a 19-year-old girl suffering from epilepsy and panic disorder and was on anti-epileptic medicines and tranquilizers. The mother, who had accompanied the patient, narrated that the patient was very afraid to go out of the house alone owing to her fainting spells. She was comparatively more relaxed and comfortable at home. She experienced an occasional aura in her head and felt faint before the epileptic episode, which was more when she was viewing television or when she saw bright light from the computer screen. Her epilepsy is also aggravated when she is looking at moving fans or watching out of a running train. She felt giddy and the giddiness is experienced as land or the floor shaking like a mild earthquake.
At the very sight of a crowd, she goes into a dream-like state where she could not see beyond a certain frame. The mother recounts that she first had an epileptic convulsion when she was around 16 years of age, and the second episode recurred within 6 months of the first. During the second episode, her eyes turned to the left and so did her neck and she was unconscious for 15 minutes. After this episode, her mother advised her not to go out alone and she was apprehensive of doing so ever since.
She was extremely scared of travelling due to her convulsions, as she feared that something would happen to her and there would be no on to care for her. The patient then spontaneously said that she was scared of crowds and fainted when amidst a crowd. She felt that people observe her, the thought of which makes her afraid and she goes into a dream-like state where her eyes are open but she cannot see beyond a certain frame. So, she avoids crowds, as the experience is very suffocating for her.
She then mentioned about exams, for which she prepares thoroughly but still feels she cannot write the examination. She tells that she cannot attend classes as she feels giddy due to the bright computer screen which precipitates a dream-like state where eyes cannot see beyond a certain frame. Her mother boosts her confidence, motivates her and provides her moral support. Nobody can understand her the way she does, not even her father or brother. She is an extreme hypochondriac, fearing that the disease would break into her body. She panics on trifling issues, e.g - She once had a headache and she panicked thinking that she was suffering from leptospirosis and would die.
At the moment, she is thoroughly confused about which field she would choose for her career. She thinks that she is abnormal as people look at her with a feeling that something is wrong or different about her like she is mentally retarded and slow on uptake. She perceives herself as being an odd one out, who is completely dependent on someone, i.e. her mother.
She dreams of travelling to various places, but cannot go alone, always needs mother to accompany her. She also dreams of ghosts. On seeing blood, she feels faint and is very scared on witnessing any accidents, horror movies, funerals or even a shroud. She is very scared of cockroaches, lizards and dogs as they can bite her.
We see that the central theme in her case was clinging, needing mother, needing moral support. According to her, only her mother can truly understand her. Also, there is a feeling that something is wrong with her, that she is not OK, that she is mentally retarded. Her illness has done away with all her confidence. All this is the language of Mineral kingdom where she feels she is not independent and has to depend completely on her mother.
Defining her individuality further, is the experience that she will fall when she is out alone and needs her mother around to hold on to. We see her panicking at small matters. She panics when she is alone. The main story is the need to hold on in acute situations. This is the essence of her case. This panic is experienced like an earthquake as if the ground is not stable. This kind of panic when alone is an important feature of the Lithium line.
The next feature of the case was confusion; she is confused what career to choose. Confusion is an important theme of remedies belonging to Column 3 of the periodic table (e.g. Alumina, Scandium, Yttrium – where they are confused and highly doubtful). Another key feature is a constant repetition of ‘not being able to see beyond a frame’. This is symbolic of being encased in the womb and has to come out suddenly where you cannot see beyond, so you hold on to what is familiar. The remedy that has this feature of holding on in panic as if there is earthquake, the ground is not stable, confusion and inability to see beyond certain frame from Row 2 of Mineral Kingdom is Boron.5
She was given Boron metallicum 200, to which she responded quite positively, her fear of going out having completely disappeared. She feels that she is no longer abnormal. Epileptic episodes and the dream-like state of being unable to see beyond a certain frame are non-existent and she is no longer on any modern medicine. Her parents feels that she is 100% better.