The Tyranny of Health

OK—if I’m alive today and writing this, it’s all because of a legend, though a legend who has escaped the fate of most of us: Having our first mention in a Google search be “Helen Whitman is on Facebook!”

Or was her first name Helen? Because I had it in my mind that her name was “Ernestine,” but that Whitman appears to have been a flutist whom I knew in the music school, not the Mrs. Whitman I knew as a head nurse at UW Hospital and Clinics.

It’s fitting, really, that I don’t know—did I ever?—her first name, since she was very much not on informal bases with anybody, much less her nurses. She was Mrs. Whitman, and everybody else was Miss or Mr. or Doctor whomever, and she applied the rule as rigidly as she applied her white nursing cap.

She ran her ward in a way that made Mrs. Thatcher look like a slacker, and no, it’s not true that she applied starch to her uniform. Rather, any uniform that Mrs. Whitman chose to wear was expected to comply with her own high standards: No creases or wrinkles ever appeared. Nor was it the case that her name was ever spoken: Rather, it was whispered.

She appeared one spring day with serious scratches on her legs: Obviously I couldn’t ask her what had happened, but a senior nurse whispered the news to me. Mrs. Whitman had “awoken” her rose bed for the season, and was I surprised? Of course not: I was gardening myself at the time, and passionately involved with heritage roses: Wonderful shrubs with tremendous French names—Madame Alfred Carriere or Souvenir de Malmaison. True, they tended to bloom only once, and they could be unruly. But Mrs. Whitman? No, she strode into the world of modern roses, much as she strode onto the unit each morning, with an appetite for errant medical students, one or two of which she would consume for breakfast (she munched steadily through the day on anyone at hand….) So of course she would have tackled the reigning hypochondriacs of the garden, with all their wilts and rots and mildews and mites. Had she been an animal lover, she would have had Siamese cats, and had them lining up in order of seniority for roll call each morning and night.

Nor was it true that no patient ever dared die on Mrs. Whitman’s unit. What can be said is that they all—terrified into obedience—waited until after Mrs. Whitman had relinquished her ward to the PM or night shifts.

Detour—my mother had three children. After the eldest child was born, in 1945, my mother spent a month in the hospital, on strict bed rest, with a long, wonderful backrub at the end on the day, and plenty of rejuvenating rest, since look—the lady had just had a baby, for God’s sakes! Anybody could see that she’d been through a hell of an ordeal!

There was a problem, of course, since after a month of lying in bed? Well, those ladies were weak, and then being sent home to care for a newborn. So for the second child—born in 1950—the month got chopped down to two weeks. And for me, born in 1956?

“Dr. Thornton strode into the room and said, ‘get up, Mrs. Newhouse, and walk!’ just hours after you were born. And I never did get a decent back rub….”

I tell you this because I had a second—and last—cataract surgery on Tuesday, and now, three days later, what has my doctor told me?

“You can do anything but bungee jumping!”

Yeah?

The surgery was not without a wrinkle or two, since it appears that the operation can be rough on the cornea. And what that meant was that the eye was swollen, painful, and mightily inflamed.

“Soak your eye in prednisone,” said the doctor, so I did. And what else did I do?

“I’ll be OK to give class on Thursday morning,” I told my newest student, who looked skeptical. Right so then I cancelled on Wednesday afternoon, and then cancelled Friday’s class as well. Why? Because it wasn’t the pain or the inflammation that was the problem: I was utterly exhausted.

I went to bed and felt guilty: I should be up and doing something about the weed trees growing in the back balcony. But wait—did I really want to be out there sweating, with my hands in the dirt, and wiping my brow? Look, I wasn’t supposed even to be reading!

I twitched, I jittered—I fell asleep and woke to guilt / shame staring me relentlessly in the face. And then I had the revelation….

Mrs. Whitman!

“You’re not to leave this bed under any circumstances,” she said, “and I’m sending Miss Porter in to attend to those hospital corners.” She sniffed, and then paused at the door. “I’ll be right outside, at the nursing station.”

Bliss!

Well, I mused about her, since I had been reading a book by Robert Whittaker: Here’s what one writer had to say:

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (Crown 2010), by the journalist Robert Whitaker, is one of the most disturbing, consequential works of investigative journalism I’ve read in a long time. Perhaps ever. Whitaker has persuaded me that American psychiatry, in collusion with the pharmaceutical industry, may be perpetrating the biggest case of iatrogenesis—harmful medical treatment–in history.

Well, my brother had recommended it to me, and my brother—unlike me—does not suffer depression. Shouldn’t it be “suffer from?” No, I meant that my brother, along with so many others, thinks that if I just got myself together, took a good long walk, and thought positive thoughts, all would be well. Am I being fair to my brother? No, of course not. But until you’ve been seriously depressed, it’s hard to imagine the peculiar hell of the noonday demon.

Well, I had read enough of the book to overcome my initial irritation. Then I had had my surgery. Then I pondered the fact that, with all our wonderful treatments for depression, the incidence of the disease is soaring, not dropping. So what gives?

It’s the tyranny of good health, I concluded. Because at no time in history have we been more healthy, and isn’t it time to speculate that sickness has a place in our evolutionary history? Even the most dreaded disease—cancer—is no excuse to take to your bed for extended periods of time: You have your chemotherapy one day, are sick as a kitten the next day, and are back peering at your computer screen at the office the next day. Repeat week after week until remission.

Consider the cancer of the 19^th century: Tuberculosis. Anybody reading Thomas Mann’s Magic Mountain will know the story. Here’s Wikipedia’s telling sentence:

In the opening chapter, Hans is symbolically transported away from the familiar life and mundane obligations he has known, in what he later learns to call "the flatlands", to the rarefied mountain air and introspective little world of the sanatorium.       

Well, a serious blogger would look into it, would see if anybody has proposed the theory: Robbed of the illnesses that would take us to our beds, isolate us, force us to look inward, put us in darkness, we have created depression, and are suffering vast amounts of it. Man spent most of his existence working outside during the day, and sleeping during the night. Now we are chained to our devices, and outside, for most of us, is the walk from office to car. So I should look into all this, except…

…Mrs. Whitman is ordering me back to bed!

Where We Cannot Go

What happened to him should never happen to any parent. Because however difficult it might be to lose a child in an accident, or through disease, how much more difficult would it be to lose a child through suicide?

Nor was it the case that they hadn’t tried everything, hadn’t gone to the best hospitals, hadn’t gotten the finest doctors. But a decade before he took his life, Matthew had gone sobbing to his father. “It’s pretty clear,” he had said, “I’m not getting better and I’m never going to get better. So why shouldn’t I kill myself? I know I’m going to heaven, Dad. So why not kill myself now?”

His father was a minister; his answer reflected that.

“Sometimes we don’t know why we’ve been given such great pain, Son. But there is a reason, and we’ll find out in the end. But I am never, ever, as a father going to give up looking for a solution to your problem….”

And it had gone on for years. Matthew, their third child, had been a remarkable child; since birth, he had been different. Shy, sensitive, he could sense in a moment the person in the room who was hurting the most, and would make a beeline for him or her. For the rest of the evening, he would stay by that person’s side, laughing, joking, trying to cheer him or her up.

“He had an amazing ability to help people, and he knew it,” his father said. “He once told me, ‘the only person I can’t help is me….’”

Yes, different; different almost from birth. The father had feared something was wrong from the very beginning; indeed, almost from the day Matthew had been born, his father had started to dread that his son would kill himself. There was that sensitivity, the inability to shrug off pain, a softness that wasn’t like other boys’. He played different, he acted different, he…well, was different.

And so they had prayed, yes, but they also knew—they had to get help. It all came clear after the first suicide attempt; then there was no choice. Matthew had swallowed the Tylenol and had left the bottle on the bed when they found him. It was, as the doctor said, the classic call for help.

Help that, despite their best efforts, they could not give him. They tried—they lost count of the number of psychiatrists, psychologists, family counselors, pastors, prayer groups, professionals, friends…  It was numbing, after a while, and in itself depressing, as well.

“We had pulled him off from the edge more than once,” said his mother. “And the night before, Matthew and I were in his bedroom, and I was begging for him not to kill himself. And he was crying and sobbing and rocking on his bed, and all I could do was hold him, and beg him to go on, and tell him that it would get better, and he just cried harder, and started pounding on the bed and shouting that I didn’t understand. That it was never going to get better and that he was in so much pain and he couldn’t go on—and it was so unfair of me to ask him to take this pain, he couldn’t bear it. He was screaming in my face that no mother would want her child in so much agony. And I was screaming back that I couldn’t let him die, I just couldn’t, no mother could. And I couldn’t bear it, seeing him in such pain and there was nothing, NOTHING I could do to help him. My son, my son, in so much pain! And I remembered when he was a child—he’d fall and cry and I’d pick him up and it would be OK. And I never imagined that there would come a day or a night when I couldn’t help him.”

“At last, he quieted down, and began to talk about going home. And something, I don’t know, something didn’t feel right. He was too calm; too collected. He had gone too quickly from utter despair to being, well, collected. We begged him to stay, we pleaded with him to stay, but he was firm. And that’s when he said it. He turned around, as he was leaving, and said, very slowly, very forcefully, ‘you know, if you ever call the police on me, or call 911 to get me help, it’s an instant suicide.’”

“I was stunned—the look in his eye was awful. But it was his voice, how cool he was, as if he had settled on something. Of course, neither of us could sleep, and we kept calling and calling. I texted him—‘just send me one word, ONE word telling me you’re OK.’ Then we drove to the house, about three in the morning. All the lights were on. That’s when I knew—but we didn’t have a key. And what should I do? Should I call 911? Was it a bluff? Would he really have the courage, or the desperation or the despair to do it? So we were sobbing, Rick and I, and holding each other in the driveway, and praying. And that’s when I knew. We left, and then got the call from the police department. We went to the house, and a cop came out, and we looked at him and he just nodded.”

All right, Readers, why have I spent 891 words telling you this story? Because I read in The New York Times last week that Rick Warren, the pastor of the mega-church Saddleback Church, and an outspoken opponent of marriage equality, was going to start a mental health outreach ministry in his church. Why? Because, with some poetic license, the story of Matthew, above, is the story of Matthew Warren, Rick and Kay’s son.

It happened just over a year ago, and if I knew about it, I had forgotten it. But what’s significant about the story—for me, at least—is that I immediately assumed Matthew was gay (which of course was why I was banging that “sensitivity” drum up there). So I turned to find a picture of him, since gaydar will—very occasionally—work with photos. Here he is, and no, it didn’t work….

Well, it’s a heart-breaking photo, this boy who seems to be telling us, ‘one day you will know, you will see, you will understand this half-smile of mine…” And it’s sad, as well, that even in death, Matthew’s photo, when I saved it just now, had “rick-warren’s-son” as the default save option. Matthew was not Matthew, but Rick Warren’s son.

Nor was I the only gay man who had wondered about the question, since apparently Twitter and the social networks erupted. And I’m sorry to report that a number of my gay brethren pounced on the death as god-or-the-devil-sent stick with which to beat up Rick Warren. Here’s one example….

Was @rickwarren's son gay? Maybe conversion therapy, condemnation and hatred towards gays was too much for matt...#ripmatt

— Samir Perez (@SamirPerez) April 7, 2013

That is by no means the most egregious; here is one of the 70 comments made to the article referenced above:

I wish I could come up with the right set of sentences that would drive this pain (if Mr. Warren actually feels such, being an experienced con man) deep, deep into Mr. Warren such that he could no longer cling to his sick delusions of god service.

The only 'god' Rick Warren serves is himself. He has poisoned the minds of millions.

He is NOT a friend to democracy.

Religion comforts...and cripples.

Or how about this:

Rick Warren's son has committed suicide // ‪#IWOULDTOOIFIWASHIM ‪#FUCKRICKWARREN ‪#UGANDA ‪#GAY ‪#EXECUTIONS ‪#LAKEFOREST

Guys? There are some places we cannot go, and just as we abhor the Phelps family—which of course came out and said the usual about Rick being an apostate and worshipping a false God and, anyway, no matter what, God hates you-know-whom—we cannot, let me say it again, we CANNOT do this to a suffering family.

That much I knew. What didn’t I know?

The skinny on Rick Warren’s celebrated AIDS program in Africa.

Drop by tomorrow, and I’ll tell you all about it….

Don't know....

Kevin Breel is 19 years old, a standup comedian, and depressed.

Three adjectives, or maybe—he might say—two adjectives and a stigma. Because that’s what mental illness is, he argues in his TED talk—there’s still a lot of shame and blame about being sick in that part of your body behind the eyes….

Well, as someone who swallows 20 mg. of Lexapro and 15 mg. of Remeron daily, I was more than prepared to listen. Also to consider the question: has anything good ever come for me from my long years of depression?

Change a life—I had never known those many, many dark days when it was only habit and custom that got me out of bed. I never sat in those toilet stalls at Wal-Mart weeping silently, never canceled classes and sat in my classroom and stared at the walls, trying to banish the thought, “I want to kill myself,” which had become the mantra echoing through my mind. I woke up every morning, felt happy, and went about my business.

In short, the forty years of depression never happened—they felt as good as I feel today.

First reaction?

God, do I wish!

Breel argues that one of the benefits of depression is that it allows you to see the bright side of life, and that you have to know the valley to appreciate the mountain. Yeah? I’m not sure; would I appreciate walking more if I had spent time wheelchair bound? Don’t think so….

The depression may have made me more sensitive to others—that’s true, I think. It also gave me a certain strength—if I survived those years, I’ll probably get through today.

And yes, I’ve read Thomas Moore’s books and I think they’re good—and I don’t buy in. Sure, if you’re going through a divorce, or a significant loss, or a major life change—you may experience the dark night of the soul. But there is one hell of a difference between a major life event and a major depression.

Consider it—I was in a stable, long-term relationship; I had a job, a home, pets, and a loving family. I was also excruciatingly depressed. Yeah, you could argue that the job wasn’t the right one, that a creative side of myself was unexpressed. But no matter how hard I tried, I couldn’t shake the depression. The only answer was medication.

Sorry—but to say anything else is just more stigmatization, another way of saying, “oh just buck up and adopt a positive attitude.” And so, by the way, is the recent spate of articles saying that antidepressants don’t work.

Yeah? Let me tell you what doesn’t work—exercise, music, writing, time spent in contemplation, meditation, talking with friends. How do I know? ‘Cause I do all of these things on a regular basis, and guess what? If I miss two days of Remeron, I start to feel shaky and anxious. That happened to me two weeks ago, but I was smart enough to go to the pharmacy, explain that I had run out of the pills two days before, and that I had an appointment with my doctor in a couple of days.

They know me, nodded, and got me the pills. I took the Remeron immediately, though my hands were shaking so hard I could barely hold the glass. And I felt perfectly fine forty minutes later.

I feel now that I’m spinning my wheels—that I need to write something and I don’t know what and it’s scary. I’m not undisciplined, I’m not a coward—but something is blocking me. So I may do the dark night of the soul—why not?—and sit down and confront myself. But trust me—no depressed person could do that. That takes every molecule of mental health—a depressed person doesn’t have the strength even to think of it.

That said—I wonder if there really is a stigma today about depression or admitting to a mental illness. Part of it is having come out as a gay man—after you do that, admitting to depression is a sort of snore. But it may be true—for many years I could not get help, and it took a screaming brother and a panicky husband to drive into the arms of a psychiatrist.

“I want to die,” I once told a student, who popped back with, “that just means you’re not listening to God.”

The fury that surged through my body was liberating—perhaps nothing she could have said was more beneficial. And so we come to the theory that depression is simply rage or some other negative emotion suppressed.

Maybe—but can we just do whoever-it-is theorem? Remember—the idea that when there are two or more competing explanations, go with the simplest? Here it is, then.

We’re gonna have to go back to the idea that there are two major types of depression—one situational and reactive, the other biochemical. And we absolutely have to get through our heads—asking anyone with a biochemical depression to do anything except take medicine is like asking a diabetic to adjust his blood sugar without insulin.

The other thing we need to do? Interventions—because a depressed person cannot get help by himself. I robbed myself of forty years because I couldn’t reach out and couldn’t get to a shrink. Until the crisis came, I was stuck. So it’s simple—we ask everyone close to us if they’re depressed. If the answer is yes, we call a shrink, make an appointment, and tell the person, “I’ve made an appointment for you, and I’ll go with you.” It’s the only way to do it.

Was it really 40 years? Were there really no good times, happy days, smiles, light moments?

Yes and no. Of course there were good times. But depression is a psychic pair of sunglasses that seem to get brighter and darker on different days, but never seem to be taken off. Change the metaphor—depression is the movie in black and white, when all the rest of world is watching in color.

And if the medium is the message? In other words, was I watching a different movie because I was seeing it black and white?

Don’t know.

Think so. 

Don’t know….