Rodney King with mother Eve
It’s tough not to notice the patchy skin on Rodney King’s hands as he extends a greeting at his Jaslok Hospital room.
They are his battle scars — the result of years of panic-washing his hands with methylated spirits to make sure they are clean. That’s a chemical that technicians usually use to scrub the stubborn grime off glass and marble.
The 51-year-old Australian citizen, diagnosed with obsessive compulsive disorder (OCD), recently underwent a psychiatric surgery at the Mumbai hospital to cure him of the disorder .
AN UPHILL BATTLE
Psychiatrist Dr Yusuf Matcheswalla says OCD, an anxiety disorder characterised by obsessive thoughts and compulsive actions such as cleaning, checking on things repeatedly, counting or hoarding, is a potentially disabling condition. “The patient is trapped in a pattern of repetitive thoughts and behaviours that are senseless and distressing, but extremely difficult to overcome.”
Between two to five per cent of the world’s population suffers from it, and only a handful of these cases worsen into treatment resistant ones. For King, it did, and that meant that he’d constantly worry about contamination from germs. “I’d spend hours every day washing my hands, wiping door handles, and even the insides of my wallet, often having to dry currency later,” he remembers, as his 80-year-old mother Evis, who accompanied him from Gosford, looks on.
“When I’d step out of the house to get to work, my eyes would be fixed on the rear view mirror. Even on an empty road, I’d turn the car to see if I’d hit someone.” Psychiatrists say most OCD cases are triggered by traumatic events.
Evis recalls first citing symptoms when King was 13. “It was soon after a car crash in which his elder brother died. He, who was also in the car, blamed himself for his brother’s death. He began obsessing about death, would want to stop at cemeteries and often imagined gravestones around him,” Evis says.
Over the years, King’s compulsive behaviour intensified, affecting not only his professional but personal life, too. King, whose last job was as an apprentice at a telecom firm, stopped going to work 10 years ago after being consistently yelled at for missing deadlines.
“His marriage ended after two years in 2008; his wife could no longer cope with his compulsive behaviour,” Evis adds. “It’s not that I didn’t try medication or traditional therapy,” King says.
In the last 33 years, he has undergone 40 sessions of electro convulsive therapies (ECT), and 20 sessions of cognitive and behavioural therapy and transcranial magnetic stimulation. But it only offered him temporary relief. Three months ago, doctors at Sydney’s Prince of Wales Hospital suggested that he opt for a neurosurgery to treat his OCD.
Dr Matcheswalla says OCD has been linked to abnormalities with the neurotransmitter serotonin in the brain which is believed to have a role in regulating anxiety. “To send chemical messages from one neuron to another, serotonin must bind to the receptor sites located on the neighbouring nerve cell. It is hypothesised that the serotonin receptors of OCD sufferers may be relatively under-stimulated,” he adds.
The five-hour surgery on King, performed by Dr Paresh Doshi, is called bilateral anterior capsulotomy and involves inserting electrodes in the limbic circuit area of the brain, associated with mood and behaviour. The surgeons then used a radio frequency lesion generator to heat the tip of the electrode and create lesions within the brain.
“We wanted to work at the ventral part of anterior limb of internal capsule, a region deeply embedded in the brain, known to be the nodal point where the behaviour and mood pathways converge,” Dr Doshi says, and adds that six lesions were made on the left and right side of the brain. Because of the damage this caused to cells, the abnormal hyperactivity in the area is likely to reduce.
A RARE CASE
King is the second patient to have undergone this procedure in India. While India has drafted guidelines on psychiatric surgery (depending on the patient’s treatment history and thorough scrutiny), countries like Sweden and Japan have banned it fearing indiscriminate use. When he walked into the hospital, Dr Doshi says, King was restless, often seen dusting the hospital bed or wiping a chair before sitting on it. While it’s still too early to decide how successful the surgery has been, King says, he is feeling “lighter”.
►►► Even on an empty road, I’d turn the car to see if I’d hit someone