Excerpt – 5FB


An Excerpt from Five Fathoms Beneath

When I think about my father, several things strike me. One is how he defied all the negative stereotypes about his illness, demonstrating a person with bipolar disorder can be successful both professionally and in his personal relationships. Another is how his philosophy—which was a blend of existentialism, romanticism, idealism, and glorious bits of Loren Eiseley’s spiritual naturalism—so fits what being a doctor is all about. But what strikes me hardest about my dad is how he dedicated his life to salvaging hopeless situations, yet when he was in trouble, when he urgently needed help, he felt as though he could not ask for it.

I’d like to say things have changed since my father was hospitalized for bipolar disorder in 1945 and his suicide in 1974, and they have, but they haven’t changed enough. Well into the supposedly enlightened twenty-first century, mental illness remains the last bastion of widespread intolerance and stigma. Individuals with mental illnesses are reviled as violent and exploited to prove political points by both sides in gun control debates, stereotypically cast as unpredictable and dangerous criminals in literature and movies, and used as fodder for jokes by people who otherwise pride themselves on being “progressive.” In casual conversations and political discussions, mental illness is bandied about as a pejorative, as a way to fear monger or to undermine the credibility of those we dislike or disagree with, without any regard for how hurtful, cruel, and stigmatizing such practices are to the people who suffer from those illnesses.

The resulting stigma is oppressive.

The resulting stigma is alienating.

The resulting stigma kills.

It especially kills doctors, something which concerns me not only because of what happened to my father and what almost happened to me, but because my son and daughter have become physicians. Studies estimate upwards of thirty percent of doctors suffer from depression, and a significant number of those clinicians—a little over one per day in the United States—end up taking their lives. I’ve done what little I can to remedy that; three years after returning to Stirling, I founded a committee for physicians with mental health issues or suffering burnout. Sitting and listening to a colleague struggling the way I once had may pale beside the heart-pounding drama of performing an emergency thoracotomy, but my father was right. Many ways exist to lessen misery, pain, and suffering, and this quieter, but no less significant, work is where I was called.

It may be necessary work, but it’s never easy work. The ingrained societal prejudices I mentioned earlier also infect doctors, and physicians are demonstrably poor at recognizing subtle signs of mental illness in colleagues. Unsurprisingly, many doctors who struggle with mental illness still share my father’s fear of being treated punitively by licensing boards, administrators, and malpractice insurers. And, of course, there’s always the delicate balancing act between protecting a distressed physician’s privacy and keeping patients free from harm. However, even when we solve those problems, we still understand too little about the suicidal mind to develop a foolproof program, something which promises no one else falls victim to the darkness of the abyss, to the awful myth the world is better off without them, to the Siren song which offers a deceptive and false liberty, to the deceitful idea they are valueless, to the permanent “solution” to temporary problems.

But the program is something.

And through its work, we’ve managed to toss a few starfish.