Gargoyles

https://en.wikipedia.org/wiki/Darth_Vader_grotesque

I think gargoyles are cool. They have that scary façade, looking like they are ready to attack at a moment’s notice. And then there are the REALLY cool ones that are for fun, like Darth Vader on the National Cathedral in Washington, DC, or ones picking their nose, or just making silly faces. I love it.

Their purpose is to protect the cathedral or church from evil spirits, thus keeping the building sacred. (They also serve as drain pipes, and technically many of what we think as gargoyles are actually grotesques, but just stick with me here.) They also seem to be looking out over the city to fight whatever evil may be lurking in the hearts of men.

In my book Fallible: A Memoir of a Young Physician’s Struggle with Mental Illness, I describe my anxiety and depression as a gargoyle:

“[The anxiety and depression] appear as a gargoyle forever watching me. Though I know it should be fake and harmless, its appearance is disconcerting enough that I don’t know what it is or what it may do. I can’t even be sure that it’s really there. But it feels like it is. The gargoyle typically fills the purpose of scaring away evil spirits from sacred spaces, an essential purpose if effective. But sometimes the gargoyle turns and becomes the evil spirit—not only unable to prevent fear, but in fact constantly creating it. The gargoyle becomes no different from the real monster it portrays.”

How do you tame your gargoyle, whatever it may be?

Kirkus Reviews Profile

from Kirkusreviews.com

It’s interesting to see the life that your book takes on. Each one is different, and you can’t always predict how things will turn out. (Or so I’m told; after all, this is only my first book.)

My book Fallible: a memoir of a young physician’s struggle with mental illness, can be hard to read given it’s subject matter. While book sales are overall up during the COVID-19 quarantine, Fallible hasn’t sold much because it’s tough to read about such hard things when we are going through difficult times. People tend to want more comfort at such times.

There is also the matter of critical “acclaim” versus actual readers. I have received some very positive reviews from prominent outlets. Sometimes it makes me think that Fallible is more important of a book than enjoyable as a book, which shouldn’t surprise me too much. It’s a critical topic that we continue to talk about, but that doesn’t always lead to sales. That being said, I think it’s one that we all need to read. Of COURSE I would say that as the author, but the topic is so timely and needed that we all should have a greater awareness of it. I feel very strongly about that. It is well worth your time. If you don’t think so, check out some of the reader reviews (in addition to the professional reviews linked to above).

Kirkus Reviews has been great with promoting the book. They gave me a very nice review initially, and now have provided a wonderful profile on me. Please check it out!

And as always, order Fallible now and spread the good word!

Is mental illness a choice?

from Treehugger.com

I received an interesting and very kind letter from Patch Adams recently after sending him a copy of Fallible. (Of note: he is one of the few people I know of that still hand-writes letters. It’s very charming.) He relayed to me his story of severe depression. Instead of receiving treatment however, he simply decided to “never had a bad day again” many years ago, and he supposedly hasn’t. He also mentioned that he has been able to “cure” PTSD in a small group of returning soldiers with humor. In all his years of practice, he has never diagnosed someone with a mental illness nor treated anyone with a psychotropic.

I’m having a hard time with this. I don’t want to disbelieve him, or the many others who have similar beliefs that mental illness is little more than a pharmaceutical company invention, but it is certainly inconsistent with the medical view of mental illness. There was a great book that I quote in Fallible called Lost Connections by Johann Hari. It’s a very interesting read, but the main thesis is that the dramatically changing ways in which we interact with each other and the world is the cause of increased “mental illness.” He also points to evidence that much of the scientific data on the medical model is weak at best, though he doesn’t boil down the presence of mental illness to a choice. He mainly focuses on depression and anxiety.

I definitely think that Hari’s correct on the origins of the current epidemic of depression and anxiety, but I’m torn as to what the best response may be. There is a strong likelihood of an element of placebo in taking a psychotropic medication for depression and/or anxiety, probably even in my own case. I frankly don’t care if it’s a placebo effect for me or not. You could argue that the side effects outweigh the placebo benefit, but I do feel that my medications make a difference in my anxiety and depression.

Dr. Adams, a very kind and generous man, takes it beyond depression and anxiety to any mental illness, choosing not to diagnose mental illnesses that can lead to psychosis such as bipolar or schizophrenia. I do think that is too far, but could someone with depression or anxiety simply “decide” to not struggle with that anymore? There is always an element of choice in how we respond to external or internal stimuli, but you wonder if deciding not to deal with such things depends upon a matter of degree; it begs the question of whether the individual truly had a diagnosable condition in the first place.

As with most things in life, there is unlikely to be a black-and-white answer to any of this. Some people require medication, but it should not be viewed as an ultimate solution in and of itself, no matter the circumstances. There is likely a large cause of depression and anxiety from our ever-evolving interactions with life, but that doesn’t make it less real, or negate the need for true treatment. Some of us probably can improve our illness through deciding how to approach it differently. But to boil it down completely to a basic choice is too simplistic and binary to fit in the real world.

Leave your thoughts in the comments section below.