I talked to God today

Mentally Retarded and Emotionally Disturbed Children.

Today I got to spend several hours sitting in a class for ‘low-functioning’ mentally retarded and emotionally disturbed children. There were about 6 children in the class. One was a 12-year-old with Fragile X syndrome, another a 14-year-old with an IQ of about 60, a couple of girls – 9 and 11 with autism and mild MR with emotional disturbance respectively and a conduct disorder MR child (age 12). The level of the class was about that of a kindergarten class. Basically, the kids worked on tracing the lines in coloring pictures. They went over some flash cards of common signs (such as danger, poison, pedestrian crossings, etc.).

It was discouraging to hear that the two girls were raped as toddlers, one by her father (now in prison) and the other by several men at different times. Apparently, sexual abuse of the mentally retarded tends to be more common than of normal children.

It was interesting to interact with children suffering from disorders that I had only studied about in medical genetics and other courses. I had interesting discussions with their therapists and teachers regarding the goals for the children and the methods of communication. Most of these children have difficulties describing their feelings. Picture books and clever techniques are used. I felt a sense of admiration for the teachers and therapists that work with these lowest level of functioning children. Often the goal is simply to get the child to follow staff directions, to raise self-esteem and to help the child achieve the level of independence of function he or she is capable of, e.g. dressing themselves, toilet hygiene, anger management, etc.

In the afternoon, I got to talk to ‘God’. This was a 50-odd year old male who for the past 11 years has had the delusion that he is God. He does, however, also know that ‘here’, he is identified by the name that is on his official records. When he was brought in, he was paranoid, believing his neighbors and his wife and his doctors wanted to kill him. During the mental status exam, when I asked him to interpret the proverb, "People in glass houses should not throw stones" he laughed and told me "yeah, that's stupid, because the glass would fall on me!" He has since overcome this belief somewhat. He still maintains that his neighbors are trying to get him but he is content to ‘what goes around come around’. He no longer seems to manifest any homicidal tendencies. What is this person’s baseline function? What would be our goal for the inpatient treatment he is receiving? Today, he was due to appear in court. He told me he was going to tell the judge that he was ready to go home. Do we have any hope of convincing him that he is not God? Or should be just release him back into his situation when he is no longer a threat to self and others? I had some interesting discussions with his therapists and psychiatrist on these matters.