Several years ago, I worked as a clinical psychologist in a residential psychiatric facility. The patients who lived there were young, middle-aged, and elderly. They all had received severe psychiatric diagnoses.
None were able to function independently in society. I recall one young woman, in her early 30’s at the time that I worked in this facility. She wore a tracheotomy.
What was most fascinating, however, is that she had no medical reason for doing so. She certainly had a psychiatric reason for using this equipment.
She absolutely craved the attention of having others, both staff and fellow residents, perceive her as very seriously ill. She obviously enjoyed the many rituals surrounding the meticulous care of her medical device, too.
I spoke privately with the staff psychiatrist about this woman. He said that she absolutely required to continue to wear a tracheotomy, due to the seriousness of her psychiatric symptoms. She would be even less functional if her tracheotomy were to be removed.
As I interacted with her, this patient had absolutely no idea that I was suffering from being diagnosed with a potentially life-threatening subglottic stenosis.
Despite appearing healthy, the lining of my trachea is heavily scarred, from repeated dilatation surgeries. None of these scars are visible.