I think I've pinpointed what is most disturbing about the psych ward. It's in the very nature of the problem. What we see as a human is based upon the mind, and when the mind is disturbed, it is difficult to see the human.
Flowing from that, I wonder what the standing of the schizophrenic patient is before G-d. If someone lacks, or seems to lack, all capacity to reason, what are they? I guess the Western idea "I think, therefore I am" is an unconcious part of my value judgments. I realize, on one level, that G-d loves all His creations, and that the elect, no matter who they are, will be saved, but when there is literally nothing you can do to get through to a person, when there is no hope of external, human forces making any change on a person, it forces you back to utter reliance on the providence of G-d. There is no room for witness, no way preaching or demonstrating is going to change a mind incapable of change.
So what is to be done? I can pray for my patients, but little else. I know too much and too little. I know medically how little can be done, I know that the medicines we give them will give them diabetes or Parkinson's, but I know that without them, these patients will commit suicide, even without meaning to. I know spiritually that I can pray for them, I feel humanly that it is a failure of faith or effort on my part when they don't improve, and I know intellectually that G-d is in control. The conflict between free-will and predestination is quite clear. Can my prayers help more than medicine? Where is the boundary between professional ethics and spiritual responsibility?
I take heart in a poem by John Greenleaf Whittier, one of my favorites. He wrote to a young physician of his acquaintance:
To a Young Physician, with Dore's Picture of Christ Healing the Sick
So stood of old the holy Christ
Amidst the suffering throng;
With whom His lightest touch sufficed
To make the weakest strong.
That healing gift He lends to them
Who use it in His name;
The power that filled His garment's hem
Is evermore the same.
For lo! in human hearts unseen
The Healer dwelleth still,
And they who make His temples clean
The best subserve His will.
The holiest task by Heaven decreed,
An errand all divine,
The burden of our common need
To render less is thine.
The paths of pain are thine. Go forth
With patience, trust, and hope;
The sufferings of a sin-sick earth
Shall give thee ample scope.
Beside the unveiled mysteries
Of life and death go stand,
With guarded lips and reverent eyes
And pure of heart and hand.
So shalt thou be with power endued
From Him who went about
The Syrian hillsides doing good,
And casting demons out.
That Good Physician liveth yet
Thy friend and guide to be;
The Healer by Gennesaret
Shall walk the rounds with thee.