Cell 2 Soul: The Humane Health Care Blog

On Pride and the Struggle

There’s an old French saying: to cure sometimes, to relieve often, to comfort always.  It could serve a mantra for all health care professionals. It reminds us that it can be more important to treat the person who has the disease than it is to treat the disease the person has.

Two recent vignettes were sent to us that illustrate these points.

Croina’s Pride by James Channing Shaw and

My Struggle by Lee Thompson

Both provide valuable insights for patients, their families and all care givers.

They appear in The Online Journal of Community and Person-Centered Dermatology (OJCPCD), a free, post-publication peer-reviewed, full text, open-access, online publication.

Why Do Doctors Commit Suicide?

Pranay Sinha, a first year medical resident, penned an extraordinary essay on a dark side of medical training and culture (NY Times, September 4, 2014).  It exposes the self-doubt experienced by many young physicians and the toll that this can take.

“There is a strange machismo that pervades medicine. Doctors, especially fledgling doctors like me, feel pressure to project intellectual, emotional and physical prowess beyond what we truly possess…
We masquerade as strong and untroubled professionals even in our darkest and most self-doubting moments. How, then, are we supposed to identify colleagues in trouble — or admit that we may need help ourselves?"

Dr. Sinha’s article is an eloquent cry=from-the-heart.  Well worth reading and pondering.

The Letters-to-the-Editors were also worth reading.  One quoted S. Shem (House of God), “How can physicians care for others if no one cares for them?

Grave Truth

A week ago, most of us didn't know who the Inernet activist Aaron Swartz was.  Today, he is a cause celebre.  If you want to read more about Swartz and see an impressive video of a talk he gave see: Remembering Aaron Swartz.   In a 2007 post on his blog, Raw Thought,  Swartz,  related his thoughts about depression.  Swartz committed suicide at age 26 on January 11, 2013.  His candid insights about depression may help to explain how and why the legal situation he found himself in contributed to his death.

 G.M. Hopkins may have said it better:

    O the mind, mind has mountains; cliffs of fall
Frightful, sheer, no-man-fathomed. Hold them cheap
May who ne'er hung there.

Excerpts from his blog post follow:  for full text see Download Aaron Swartz on Depression

"Depressed mood: Surely there have been times when you’ve been sad. Perhaps a loved one has abandoned you or a plan has gone horribly awry. Your face falls. Perhaps you cry. You feel worthless. You wonder whether it’s worth going on. Everything you think about seems bleak — the things you’ve done, the things you hope to do, the people around you. You want to lie in bed and keep the lights off. Depressed mood is like that, only it doesn’t come for any reason and it doesn’t go for any either. Go outside and get some fresh air or cuddle with a loved one and you don’t feel any better, only more upset at being unable to feel the joy that everyone else seems to feel. Everything gets colored by the sadness.

At best, you tell yourself that your thinking is irrational, that it is simply a mood disorder, that you should get on with your life. But sometimes that is worse. You feel as if streaks of pain are running through your head, you thrash your body, you search for some escape but find none. And this is one of the more moderate forms. As George Scialabba put it, “acute depression does not feel like falling ill, it feels like being tortured … the pain is not localized; it runs along every nerve, an unconsuming fire. … Even though one knows better, one cannot believe that it will ever end, or that anyone else has ever felt anything like it.”

Hey, it could be worse. At least I have decent health insurance."

Emily Dickinson knew a fair bit about depression too.

After great pain, a formal feeling comes –

The Nerves sit ceremonious, like Tombs –

The stiff Heart questions ‘was   it He, that bore,’

And ‘Yesterday, or Centuries before’?

The Feet, mechanical, go round –

A Wooden way

Of Ground, or Air, or Ought –

Regardless grown,

A Quartz contentment, like a stone –

This is the Hour of Lead –

Remembered, if outlived,

As Freezing persons, recollect the Snow –

First – Chill – then Stupor – then the letting go –

His last post, on November 1, 2012 was written about The Dark Knight.  It ends with these two sentences. "Thus Master Wayne is left without solutions. Out of options, it’s no wonder the series ends with his staged suicide."

Related articles

Why did Aaron Swartz kill himself?

Reddit Cofounder, Digital Activist Aaron Swartz Dead from Suicide at 26

Sick (Aaron Swartz's Raw Thought)

The death of Aaron Swartz

Miracle Boy

Today's NY Times has an important Op-Ed piece by Ben Mattlin: Suicide by Choice? Not So Fast.  Our role here is not to swing anyone's vote -- but just to give voice to others.

Mr. Mattlin's book: Miracle Boy Grows UP looks interesting and his promo video is worth viweing.

 

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Nora and Ann by Renee M. Cohen

On November 6, Massachusetts voters will decide whether a physician may provide a dying patient with medication to bring about a faster, easier death if the patient chooses. On the ballot will be a Death with Dignity Act.  For more about this iniative read: May Doctors Help You Die by Marcia Angell.

Renee Marks Cohen presents us with a death story that would not be have been facilitated by this law.  It will make some uneasy and raises many questions.  We present it here to stimulate thought and discussion.

"Nora and Ann committed joint suicide; that’s what the mother, Nora, explained in the documents she left to be found in her apartment or mailed in advance. I read about the suicides in the newspaper.
     Nora was in her mid- or late 70’s; her daughter, Ann, who had cerebral palsy, was about 30. Her condition was so severe from birth that she couldn’t crawl, walk, or toilet herself. But she could feed herself from a table, use a motorized wheel chair, and master a computer to create graphics and communicate on the Internet. She could talk, but a novice listener had to concentrate intensely to understand her.

Read full essay: Download Ann and Nora

Author Bio: Renee Marks Cohen has done lifestyle writing as well as medical editing and writing. In the latter niche, she has been the managing editor of New York Medical College's New York Medical Quarterly, and the author, for Janssen Japan, of over 35 interview articles on schizophrenia. She has edited books on neurology, taught Beijing Medical University scientists how to write, and audited clinical trial case report forms. Cohen is also a zumba and yoga enthusiast. You may reach her at: RMC Email.