I checked my phone before going to bed last night and I saw I’d missed a group text from a colleague earlier in the evening. She told us she’d just heard how a favorite psychiatrist on our referral list had died by suicide, and rather dramatically at that. I was dumbstruck. I stared at the dim screen in my dimmer room for several minutes trying to come up with a thoughtful response before I gave up and typed some flimsy set of words that came nowhere close to reflecting the magnitude of my feelings in the moment.
Though I had never met this psychiatrist face-to-face, and had spoken to him on the phone only a couple of times, I knew and trusted him to be an intuitive healer, one who was willing to adapt a treatment plan to a client’s personal beliefs or fears, to creatively and carefully think outside the box in order to find unusual (but effective) solutions, and to speak clear and hard truths when necessary. The only problem I had with this psychiatrist was he practiced far away from where most of my clients lived.
But this presently-very-dead psychiatrist had been my ace in the hole, my secret weapon for clients who were particularly difficult to treat medically, the ones who were super sensitive to medications or who had physical illnesses complicating their treatment plans. When giving such clients his name, I would warn them he practiced all the way up in the city and they would probably wait two to three hours before each visit. But…true story…others in his waiting room were likely to tell them this psychiatrist was well worth the wait.
Now, however, there will be no more worth-while waiting…no more ace-in-the hole…no more near-miracle cures for the clients whose presentations make me scratch my head. Instead there will be even more delays getting folks on psychiatrists’ caseloads; more clients falling between the cracks; more frustrations with a mental health system already stretched so diaphanously thin it’s hard not to laugh at the absurdity of it; more exasperated and long-winded explanations to ill-informed clients about the nature of psychiatry in the 20-10s, in Texas; and more discouragement—from all his current and awaiting patients, from his colleagues in psychiatry, and no less so from therapists and psychologists like me. Just yesterday, in fact, before I got this heart-stopping news, I spent several minutes listening and responding to messages from a family in crisis who couldn’t get their decompensating family member onto a psychiatrist’s calendar until mid-summer, which, sadly, is comparatively quick. Mid-summer, though, would not do in this case, so to the ER they went…again.
Simply put, we can’t afford to lose another psychiatrist in this nation’s fourth largest metropolis.
As if that weren’t enough, I haven’t even touched on the existential gut-punch of a psychiatrist suiciding… How, you might rightfully ask, am I going to break this news to our shared clients?
…Hey, you know that guy you paid and trusted to treat your depression? Your depression that almost killed you when your chronic illness wouldn’t? The depression that that guy has been able to keep at bay with a medication your pharmacist hadn’t even heard of before? That guy? Yeah, he just jumped in front of a train. So sorry…. Same time next week?
Fortunately (?!?), while there is no doubt he meant to do it, he had also been dealing with a painful and fatal illness for some time. This does kinda/sorta reduce the pointless-but-no-less-relentless “Why?!” of his suicide—an awkward blessing of sorts in this situation. There’s no doubt hard conversations will still be had in the coming days, but him having a terminal “reason” will make them easier to start. At least I can hope it will.
I know for certain, though, it will not lessen the human ramifications of losing any psychiatrist in this day and age, especially a uniquely skilled one, especially if he was one’s personal connection to sanity. In a word, this person mattered. He was a gift to many. His suicide leaves an echoing void and I find myself wishing I’d never known to rely on him.
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It’s not uncommon for us psychologists and therapists to hear from our clients heartfelt gratitude and insistent claims that we couldn’t possibly know how powerfully we’ve influenced their lives for the better. In those moments, I trust I probably don’t know and offer a simple, “You’re welcome.” We also hear at least once a week some variation of ‘why haven’t we heard any of this before from the other therapists? I wish we had known all this years ago. Where were you then?’ We know such comments are said whenever a good match is found between client and therapist, or, more likely, when the client, whose other therapists probably did utter the exact same mot of insight that just fell out of our mouths, is only now ready to hear it. I therefore always find myself wordless in those moments. It wouldn’t be the least bit accurate for me to reply, “Yeah, most of my peers suck. Sorry I can’t be everywhere.” So, I just smile and acknowledge their frustration while simultaneously imagining my own previous clients saying this to their new and shinier clinicians.
I was nevertheless pondering on the drive home from the office today about how things might have been different for the client or two who have said such things to me recently, and wondering about what could have been had we met sooner. This quickly led me to start thinking again about the exceptional psychiatrist who was no longer. I became tearful. A grief over the tragic loss to our small community of healing swept over me. We in the various mental health professions are stretched so very thin these days…and now the nation is rightfully clamoring for more. More mental health care. More early intervention. More prevention of homicidal acting out. I grieved how the loss meant we were now even less capable than we’d been at the beginning of the week, not more; I felt a weight I didn’t know how to carry. I reflected on how even a current case or two were potentially cases in point. I wondered what would have happened if we’d not met at all. Probably, truth be told, nothing significant, but I cannot always be so certain. I shivered in the humid Houston afternoon.
In reality, though, we did meet, just as other clients have met the right clinician for them at the right time. And many hurting folks had met and were profoundly helped by this no longer psychiatrist. Perhaps, then, he didn’t leave behind a void. Perhaps instead he left behind a mound, an abundance, a small alter of goodness. While I and everyone else might wish for a towering temple of sanity restored, one endlessly reaching to the skies, to the heavenly wholeness we all seek, a small alter is still…something. It is enough.
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Let us thus conclude: As we pass by unexpected little alters on our journeys across the deserts of life, we are reminded that all is not hopeless. Along with our fellow travelers, each of us a healer, healing, and healed, we are encouraged by these alters to keep going, even when the distance between them tries our faith and convictions. Admittedly, it doesn’t make sense entirely, but the strange compulsion these alters inspire to just keep going is undeniable.
So, may you, with me, find today not a void but an alter to give you hope. May you, with me, be one, and not just for today, but for tomorrow, too, and the day after that.
Bread in the Desert 