Photo of an ashtray full of cigarettes
Bad for mental health, too Robert Ruggiero

There is a seemingly obvious and trivial rule that patients in a psychiatric ward have to enforce, for everyone’s safety: no smoking at night.

But making sure that people understand and accept it is perhaps one of the most difficult things in our job, especially if the night is busy.

Imagine, then, an agitated patient being admitted at 2 a.m.: ambulances, hubbub, voices of people chasing each other — eventually everybody is awake, and after a while, despite things having quieted down around 3 a.m., no one can fall back to sleep. And that’s when the procession starts: patient after patient knocking on my door asking for a cigarette, and a lighter.

And the night goes on, with “no” after “no” seemingly falling on deaf ears.

Finally at 6 o’clock I lose my patience and bark back, and so they finally leave me alone for about an hour, until ward life resumes in full swing.

Having taken care of the last tasks, at 8 a.m., I get dressed and walk out of the locker room only to find all of them outside the door waiting for me, looking shyly down.

“Dottoré, we’re sorry.”

I am tired and still angry but they managed to catch me off guard.

“Yes, you went too far, but in the end, it’s not like they’re paying me to sleep!”

The truth is just that. We, physicians, as much as any other workers, are paid to perform often thankless tasks — but it is precisely in these tricky times that the dignity of the task lies.

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