The slow moving elevator in this old Harlem building had seen better days, it groaned in protest as the man pressed the
button with urgency. He was trying to get on the elevator to escape me. Physically, I cut a pretty non threatening figure
for most New Yorkers, but he appeared petrified as he desperately tried to hurry the elevator .

He was a slightly overweight man with silver hair who reminded me of the mobs of middle aged white men in blue pin
striped suits who descend upon New York City every morning from innumerable commuter trains to steer the world of
trade and finance from their Manhattan offices. Had it not been for the strong body odor, he would have seemed out of
place in this residence for the homeless.

I knew that it would take many days of patient, non threatening , yet persistent effort to win him over. One month later,
cautiously, he walked into my office.
I sat across from him, and he finally started telling me his story. He grew up in a middle class household, had a happy
childhood, went to a reputable college, obtained a master’s degree, and started a career on New York’s Wall Street.
Things were looking wonderful, he had a home in a snazzy part of the town, a successful career, friends and family who
cared for him, a listing in the who’s who of business, and then his reality changed.

The path that led him from Wall Street to the streets of New York was all too familiar, he passionately described that sad
journey after he overcame his suspicions about me. In his world of conspiracy, fear and cryptic messages, everyone had
to be examined carefully for the signs that let him decide about whether that person was sent to spy on him or not.

He was a brilliant man with an phenomenal memory, I listened in awe of his abilities as he recapitulated the history of
finance in America, and gave a succinct explanation of it’s various components. Yet , his account of the history was
distorted as he tried to look at the facts with through the haze of his paranoia. As he was hospitalized at one mental
institution after another to prevent him from hurting himself, or others, his life became a constant battle .

Through a combination of biological , psychological and social factors, he had developed schizophrenia, a mental
disorder that distorted his reality, muddled and derailed his thought processes, and gradually changed his personality. He
of course had no insight into these symptoms being the result of an illness, and steadfastly refused all treatment.


Schizophrenia occurs all over the world. It is an illness that results from abnormalities in the brain, it seems that the our
genes have more to do with getting the disease than anything else. People affected by schizophrenia often suffer from
fearfulness, many hear voices, often those voices sound like those of familiar people, and often they say derogatory and
disturbing things about the sufferer, and sometimes command them to do things. There is frequently a general change in
personality over time, those who suffer from schizophrenia can become quiet and withdrawn.

There is no cure, fortunately the symptoms can be treated so that as long as the person continues treatment, they can
expect to lead a pretty normal life, not very different from some one who had the misfortune of developing diabetes, or
high blood pressure.


Without treatment, the illness can progress until the affected person loses almost everything . Friends and family may
eventually tire of the incessant suspiciousness, work performance declines as fears of being persecuted start interfering
with everything. Voices addressing the person may cause them to act in irrational ways; suicide is not uncommon.



Symptoms of mental illness are often attributed to supernatural
phenomenon in Pakistani culture, exemplified by the word 'Majnoon' or
Junooni derived from the word Jinn . A young woman who becomes fearful,
starts talking to the voices in her head, believes that the devil controls
her, is much more likely to be referred to a spiritual healer than a
psychiatrist.


Then there is the stigma of being mentally ill, often considered a sign of
being morally weak, or a result of doing something wrong .Popular
literature is replete with the stories of women who became insane after
they went out in the evening, and sat under the old haunted tree, of evil
men who suffered divine retribution for sinful ways, modern science tells
us otherwise.


In the west, one of the ways people with mental illness and their families
have dealt with this stigma, is by organizing themselves into vocal forums.
Education about the true nature of mental illness has been their most
effective weapon against being stigmatized and being discriminated against.
The secrecy that shrouds mental illness in Pakistani is perhaps one of the
biggest burdens that the mentally ill and their families are forced to
bear. As the man with schizophrenia battles with the demons that his mind
unleashes every day, he shouldn't have to battle those in the minds
of his neighbors.