In her epic decision to crash through the wall of silence, clinician Kay Redfield Jamison made the bold decision in 1995 to reveal that she has bipolar disorder. Her bestseller, An Unquiet Mind, describes her terrible depressions that led to a suicide attempt and her elevated highs that caused reckless spending sprees and acts of violence.
Her revelation was courageous. She stepped forward at a time when others didn’t in the midst of a successful career, placing her life’s vocation at risk. Even more impressive, she went on to become one of the nation’s leading experts on mood disorders. She is the definition of a courageous trailblazer and all those who have followed in her footsteps are indebted to her bravery.
She was resistant to taking medications, something those with mental health conditions understand. Her firsthand experience lends clout to her anguish and makes her words ring true with authenticity. She has helped reduce the mental health stigma that pervades the medical community; a feat that few have dared to attempt. In so doing, she has saved lives and given hope to those who have, at moments, lost faith:
Time will pass; these moods will pass; and eventually, I will be myself again. Kay Redfield Jamison
I see her as a towering figure of truthfulness and integrity. We humans struggle to chart our own journeys in life but can’t do so without those role models who have inspired us to follow in their inspirational footsteps. There are few in life who I admire more than her. We would do well to remember all those who have cleared the way for us to survive and thrive. In our own unquiet minds, we move in the direction of peace and contentment only because others have shined a light on our pathway forward. Thank you, Kay.
Anne has been a doctor for over 30 years. She loves her work, her patients, teaching and writing. Her voice is one of love shining a light on the need for compassion in the practice of medicine. Courageous in sharing her lived experience, she extends her hand to all of us so that we may learn from herwisdom. I’m honored to call her a colleague and friend and am privileged to share this wonderful post from her website, aptly namedTo Medicine with Love.
My comment’s on Anne’s post: Beautifully written in the warm style that befits this post, Anne speaks of her favorite patients. She writes of being drawn into their inspiring world views and what she has learned from them. As a patient herself, she describes her triumphant journey through physical and psychiatric adversity. I was struck by the lens through which she views herself and others: she is deeply human and gives us permission to embrace ourselves for being human, too. It’s such a pleasure to read. Enjoy!
Doctors aren’t supposed to have favourite patients.
We are not supposed to feel anything, really. We are supposed to be objective, dispassionate, and to not favour anyone over any other, for we are to have no feelings for any of them. No matter who they are, what they are going through, how they are behaving, how much we relate to them, or how much they inspire us. For we are scientists, and medicine is a serious business.
I thought that was true and tried to live like that once, and ended up in a rehab centre at a young age.
So, now I just live my life as a human being, who practises the art and craft of medicine, and loves it.
I now work in a small country town, and live nearby, and have been caring for some of my patients for up to 20 years. I also see them down the street, at the markets, on the beach, and I have a relationship with them, as a doctor, and as a person.
I see myself as having a relationship with all of my patients, and some of these relationships are closer than others, just as we have many friends and acquaintances but there are some we feel particularly close to. And as with all my relationships, I learn a great deal from my patients, about medicine, about people, and about life.
Going blind is not the end of the world
One of my patients is in her 90s, and when I inherited her from another doctor who had retired, she was already blind from macular degeneration. It was the dry, wear-and-tear, just-old-age kind, so there was nothing we could have done about it, even now. It came on relatively quickly, after her husband died. Her vision is only count fingers in each eye, but this does not seem to stop her from doing much. Despite her disability, she still cares for herself, writes letters, gets people to help her read the replies and listens to talking books, but mainly spends time connecting with and engaging people in conversation.
She comes to see me with her daughter, to say hello and to have her eyes checked for other treatable diseases like glaucoma. We all love these visits. We laugh and joke and just have fun together. We both know there is nothing I can do for her in a physical sense, apart from these checks, but that does not mean I shut down to her as a person.
She is not fazed by her blindness, has accepted it, and makes the most of life in spite of it.
She is not fazed by her age, is mentally as sharp as a tack, and is as joyful as she was when a young girl.
She has taught me that it is okay to just love my patients, and to say “I love you” to each other, as we would to any other old friend.
She has taught me that even if I cannot “do” anything more for my patients, that just being me with them is enough; that just being myself can be healing for them, and for me.
Having a hard life does not have to make you hard
I have another favourite patient who comes to see me for regular checks. I took his cataracts out several years ago. He is a Vietnam veteran who has been through horrors that we can only imagine, and yet he has the sunniest outlook on life, and is a big, jolly, giant-hearted man. The only sign of residual hardness is that when he gives you a hug, or shakes your hand, you feel like he may just crush the life out of you!
I have many patients whom I love dearly. Children whose squints I have operated on who have now grown tall and look me straight in the eye; people whose cataracts I have removed and who delight in being able to see clearly again (except for seeing their now obvious wrinkles); people whose glaucoma I tend to and check on regularly so that their vision is preserved for life and whose 6-monthly visits are a marker in both of our lives of the passing of time; people who gracefully submit to injections for macular degeneration, knowing that they would not be able to see without them; people who just come to see me for eye health checks and their appointments roll around with clockwork regularity and we both say we cannot believe that another year has passed already and delight in sharing stories of what the year has been for us.
My favourite patient of all
But perhaps my favourite patient of all is me. I have learned so much from being a patient – how to be a better patient, how to be a better doctor, and how to be a better person.
I have mainly learned the hard way – not seeking help when I was struggling with depression and alcohol addiction during my training, so that I had to get really sick before I was willing to submit to rehab; not seeking help after the birth of my second child when I developed an ovarian abscess due to undiagnosed pelvic inflammatory disease and let it go undiagnosed and untreated until I had to have emergency surgery for a suspected ovarian tumour; not resting after the surgery and lifting my small kids too soon and stretching the scar on my belly; seeking help when I found a lump in my leg and having a cold node removed, but not resting afterwards, going back to work and re-bleeding, causing a huge secondary haematoma that had me on the couch for far longer than I would have spent there had I heeded my surgeon’s sensible advice; not taking time off when I had to have 3 weeks’ radiotherapy when the lymphoma recurred (I had refused it the first time), but going in for treatment early in the morning, then driving to work for the day. I finally relented and let my husband come with me for the last treatment, and when I felt what I had been doing to myself, collapsed in a blubbering heap, from which I had to recover to operate that afternoon.
These life experiences have taught me that doctors in general (or perhaps just me in particular) make pretty terrible patients. We think we know better, we do not follow the rules, we do not grant ourselves the time and space needed to care for ourselves, to heal after surgery, to rest when we are ill. We expect ourselves to be superhuman, and think that the world will stop turning if we take time off to recover from illness and surgery.
But along the way I have also learned to be humble, to be compassionate, to no longer try to self-diagnose but to seek help, to have a GP I trust who knows me well and whom I see regularly for check-ups, to follow instructions when I am given them, and to understand why people don’t, which makes me much more able to sniff out people who are going to flaunt the rules in my own practice and gently set them straight.
And since I have learned these humbling life lessons, I rarely get a cold, let alone a serious illness. I work hard but give myself time off to play, I care for myself deeply, I rest when I am tired, I eat and drink in a way which nourishes my body, and I make time and space for my partner, my children, our large family and our friends. I love my life and I love being a doctor who has also learned to be a great patient.
I flipped open my iPad as I awoke this morning to get the latest update on what was happening in our corona-virus world. It’s my go-to-upon-awakening task. My pattern has become to check in on my various devices no matter where I am, no matter the time of day and see what is transpiring in our newly pandemic world. So, no question about it, I have a psychiatric disorder: I am obsessed with Covid-19 news!. Notwithstanding, when I hear the latest update, I feel afraid. I’m somehow always hoping to find some relief. We have a saying in psychiatry that doing the same thing endless times, hoping for a different outcome is the definition of insanity. So each day I’m acting like an addict who has lost his mind. Why am I doing something that repeatedly scares me? Let’s think about this for a bit.
Obsessed to witness scary things
Why do we stop to look at things that frighten us like accidents along the highway, scary movies or lions at the zoo? One reason, oddly, is that witnessing these particularly scary and disturbing things makes us feel more safe. How’s that? During our distress, we are in the safety of our non-crashed car, sitting in our comfy movie seat or standing high on the perch above the lion that lurks far below. We can look fear in the eye knowing that we are safe and sound. We’re in control while we are witnessing something that could easily be beyond our control. Nonetheless, though terrified, we watch and we watch. But that’s not the real reason we are compelled to be glued to our devices. Why are we? In case you’re wondering, it’s not because we are a nation of masochists or that we enjoy ghoulish macabre things.
What’s behind Covid-19 news obsession?
Ask yourself this: what do you feel when you watch the news about the pandemic? Likely, terrified that this tiny virus has had the power to upend and snuff out our lives. Besides fear, though, what other emotions do we experience when we watch Covid-19 news? We feel empathy for those who are ill or who have died; compassion for those afflicted, blessed for all that we have in our lives; a desire to connect with our loved ones; appreciative of living; spared and lucky. And, we know that we must live our life to it’s fullest. So what do all these feelings add up to? It’s simple: we feel our own humanness.
Drawn to our own humanity
Though fear is in the mix, we feel comforted and nourished as we connect with our best human self, the person we want to be. If that isn’t intoxicating, I don’t know what is. Doing so makes us feel human in many ways. My iPad and TV screens are mirrors and I see a kind, decent, caring, empathic, grateful, blessed reflection looking back at me. I like the person that I see. When I remember that all this lies just beneath my layer of fear, it’s very comforting. When I can touch those parts of myself, I no longer feel so alone and I no longer feel so afraid. My humanness makes me feel safe. I’m experiencing my humanness rather than my virus fearfulness. So, for Covid-19 news obsession, don’t live in your superficial scary world…live in your deep human one.
Edward Lorenz worked on mathematical models to predict weather systems, many years ago. He would use extremely exacting numbers and run his programs repeatedly, analyzing the results. One day, numbers were input that were rounded off in seemingly small inconsequential ways. He was startled to find that a very tiny change in initial conditions created huge differences in the experiments outcome. This is the butterfly effect. It means very minor perturbations such as the flapping of the wings of a butterfly far, far away could influence a hurricane occurring half way around the world. Small acts can have big effects.
Why did you hug your daughter yesterday? What was the reason you gave your college students a pop quiz earlier this week? Why did you smile at the barista making your coffee this morning? Because you wanted to show your child that you love them. You were trying to impart knowledge to young minds. You were appreciative that the barista was doing something for you. All true, but all missing the larger point.
Butterfly effect: Small acts today, big effects tomorrow
We act in these ways because of the effects these actions might have far in the future. The hope that our daughters will live lives knowing love. Our expectation that our students will do good deeds in life with the wisdom we impart. We know the barista will have a better day having seen our smile that morning. Here’s the thing: we do these acts even though the effects might not be apparent until far down the road. Here’s the bigger thing: we do these acts even though we will likely never see the positive outcomes that might arise from our good deeds. Our small acts today can have big effects on others tomorrow. The butterfly effect.
The world will be in a better place
I define faith as believing that the acts of goodness, kindness and decency done every day will ultimately lead to a greater good. We can’t see that the hug, the quiz or the smile will result in anything wondrous but we have faith that it will. Perhaps without realizing, we hope our actions will play some small part in leaving our world in a better place.
So flap your wings and rest assured that you will usher in the winds of a better tomorrow for us all.
Most viruses are about .0000008 inches long. We can’t even see such a thing with most microscopes, but this little bit of matter we call Covid-19 has brought our world to a screeching halt. It’s gone viral…that’s power. We read the daily depressing stories of those whose bodies have been ravaged in numbers the likes of which we haven’t seen in our lifetime.
Covid-19 and love: Uncertainty and insecurity
We crave structure and security in our lives. We may push back against these things but mostly, we like the trash to be picked up on the day it’s supposed to be hauled away, we like our house to get warm when we turn up the thermostat and we like that the veal parmigiana always comes with a side of ziti at our local Italian joint. Covid-19 has pulled the rug out from us in all these ways, but the biggie is security. This little virus has caused almost all aspects of our lives to become uncertain. We’re unsure when we can return to school, when we can hug a friend, when we can go to work, when we can take our kids out to play, when we can eat out and mostly, when we can stop using hand wipes.
With all the security that has been ripped from our lives, it’s kinda remarkable that internal anarchy hasn’t overtaken our psyches. But for the most part, it hasn’t. Perhaps we humans are just a resilient bunch. Likely so, but I don’t think that explains why we are navigating our way through “sheltering-in-place” as well as we are given that so much is now so uncertain.
Connections and kindness in so many powerful ways
The reason is this: we humans are going to get our security one way or another and this virus has forced us to be creative. It’s true that we have lost seeing Uncle Danny tell bad jokes or tasting Grandma’s awful cooking. But in place of that we have reinforced and enhanced the things in our life that matter the most. You and I connect with each other in ways that are different than in our pre-Covid-19 lives. All of us are more concerned and more supportive. We are more heroic and more generous. Our lives are more kind and more decent. We are more compassionate and more caring. Quite simply, we express more love. Covid-19 and Love. Because of this, ironically, we are more secure now than we have been in a very long time. This is why we are going to be ok.
I wonder whether you have experienced more love in your life lately?
Early in my career as a resident psychiatrist, I learned a rare lesson from a patient with bipolar disorder who urinated on herself. Back then, I had no idea what I was doing. I was incompetent. During my second year, I spent a month on an inpatient unit. One of my tasks was to facilitate a group attended by all the patients and my supervisors.
Unexpected teachings from a bipolar patient
One day, a group was going well until a woman with bipolar disorder suddenly stood up, walked to the center of the room, stared intently at me and urinated all over herself. I watched, speechless and in horror, as the urine trickled down her legs. I sat in my chair mute, hadn’t the slightest clue what to do and felt publicly humiliated. Since we shared the same diagnosis, I briefly drifted into my own thoughts. I wondered whether I was witnessing my future, one filled with hospitalizations and public urinations.
I spoke with her later that day and in her own psychotic haze, she shared with me that the psychiatry resident who had cared for her had rotated off the unit the day before before I arrived and I had taken his place. She liked him, missed him and felt that he cared about her. She was scared that I would leave her. I got it.
Earlier that day in the group, she was expressing her unspeakable distress to me using the only language she knew. She lacked the capacity to put her terrors into words and so, as she she stared at me, she created the puddle around her feet.
Our similarities: vulnerability and fear
While I have learned to express my fears in ways that don’t involve public urinations, she was making me face the reality that, in addition to our shared diagnosis, we were more similar than we were different. We both felt vulnerable, we both felt afraid and we both felt inadequate. Neither of us were in control. Unexpected teachings
Though she couldn’t know this at the time, she taught me that I could find solace in accepting that my life contains mystery and uncertainty. I’m not always the master of my universe. I‘ve gotten lost in fear and have been frightened by my vulnerability. I learned something from that brave woman that day that was both undeniable and feeing: like her, we are all merely human. I can live just fine with that.
I’m a sucker for Disney movies and I must admit that I recently had a brief love affair with Frozen’s Elsa. Here we have a princess most definitely at odds with herself, kicking up an eternal snowstorm and freezing everyone out along the way. Brrr…
The gifts of belonging
Bipolar disorder nearly snuffed out my soul. So it might sound surprising, but I have come to see that this psychiatric illness has bestowed meaningful gifts upon me. If I were still symptomatic, I’m sure I’d feel differently but I have the lucky luxury now of living in a stable space. Having bipolar disorder allowed me to become a member of a psychiatric club (though I did pay my entrance fees with some mood swings). I now have kindred spirits who help ease my loneliness and lessen my sense of isolation. These connections affirm what I already learned long ago as a psychiatrist: we humans can only be our healthiest and truest selves by engaging with each other. We simply can’t do it alone. At some point you’re going to need to come down from that mountaintop, Elsa.
The gifts of navigating through adversity
I now know that i can navigate my way through diversity, because of my bipolar disorder. I forced myself to get out of bed when I thought I couldn’t. There were many impulses to harm myself and I resisted those. I functioned when it might have been understandable for me to collapse. It’s clear to me now that I see a person in the mirror that I admire and this self-affirmation has been a much-needed antidote for my feelings of shame.
The gifts of love
Most important, bipolar disorder allows me to experience the larger and deeper things that matter the most in my life: decency, honesty, compassion, forgiveness and humanity. I have the love of others and I love others in ways that I never have before. This is the most precious gift of all. I am truly blessed. Bipolar disorder has become integral and essential to who I am. It changed my identity by revealing my best and truest self. And what about that older me? I “Let it Go”.
Has living with a mental illness been a blessing? a curse? both?
Read more about the other gifts I have learned from patients by clicking here.
I am a physician living with bipolar disorder. For many years, I travelled the bumpy road of refusing to accept my diagnosis. I avoided psychiatric care for far too long. And, I internalized the shame and the stigma of being a doctor with a mental illness. This caused me to nail my bipolar closet closet door firmly shut. Despite this, I opted a few years ago to step forward and publicly acknowledge that I have a mood disorder. I hoped that there would be a greater good in doing so. I have shared my diagnosis with family, friends, colleagues and at international conferences. It was the start of a bipolar doctor becomes authentic.
I never expected it but I have received more hugs and support from those who now know my story than I ever thought could come my way. Although I had been worried about personal and professional repercussions, it turned out that these fears were unwarranted. My biggest hurdle turned out to be the guy staring back at me from a mirror colored with self-condemnation. I have come to see that there are few things in life more powerful than authenticity. Replacing the corrosive inner narratives that had been swirling in my head with ones of affirmation and self respect has freed me in a way I couldn’t previously imagine. By coming out of these shadows, I have stepped into the light of a much brighter and healthier day.