My husband is an interventional cardiologist. Most of the people he sees are in manageable stages of cardiac disease. Some of his patients are quite sick and come in with advanced stages of illness. A few are dead and dying when they reach his cath lab. Miraculously, he can bring a few back to life, or ease their suffering greatly with stents and medications, saving them the trauma of open heart surgery.
Nobody is surprised when some of these people die. Sad. But not surprised. And certainly not outraged.
I’m a psychotherapist, as is Dr. Drew Pinsky. In the media Dr. Drew has been blamed for the recent death of country singer Mindy McCready, who appeared on his show Rehab a few seasons ago. Like my husband, we both see people in various stages of illness. We’ve held people’s lives in our hands in our offices as surely as my husband has in his cath lab.
Dr. Drew, on his show Rehab, treats the sickest of the sick. He admits people to his hospital who have a terrible prognosis, many of whom have been told they are going to die if they don’t get treatment. They are in the end stages of addiction, a disease just as surely fatal as heart disease.
Yet, for some reason, when these patients die, the good doctor is blamed. Why? He is treating those who need intensive intervention and treatment in a psychiatric facility, just as my husband treats people in his hospital. These patients can get well with interventions for a period of time and then fail, just as cardiac patients can.
I can only chalk this reaction up to the ignorance and wishful thinking of the American people. Here is what I, as a lifelong mental health practitioner, would like the general public to know:
1) Addiction is a deadly disease, no less of a threat than cancer, heart disease, or a terrible accident.
2) It takes a highly skilled practitioner, one with hundreds if not thousands of hours of training, practice and supervision to help these people get better, and, yet, like other physicians, we still may lose our patients.
3) When we do lose our patients, we feel terrible. We work so much more intimately with our patients than, say, my husband does with his. We know their secrets, their character. We have laughed with them and possibly cried with them. It is impossible to be a good therapist without attaching to our clients and they to us.
4) Clinicians don’t just ever treat addictions. Addictions are always a symptom of a much bigger problem, and, frankly, that problem almost always involves boatloads of psychological trauma.
5) Working with traumatic stress is incredibly taxing for patient and practitioner. Frankly, not that many people want to do it. If you don’t believe me ask yourself when the last time is that you asked someone to tell you about their history of abuse and neglect and then listened all the way to the end of their story. Never? I rest my case.
6) Mental health clinicians are the pariahs of the medical community in the same way our patients are pariahs in the public’s eye. We treat “losers” so we must be losers is how so many of us are seen (if you wish you can substitute the word “crazy” for “loser”). Most of us are undervalued, underpaid and disempowered, but we soldier on because we believe in our work and enjoy helping people end their suffering.
7) My husband never lacks for the tools to do his work. His patients have the best equipment, the best care, and only leave the hospital when they are well enough to go home. Often they go home with assistance of some kind or another. This is rarely true in mental health work. Our patients do not have long enough stays to get better, have trouble accessing clinicians who know how to treat them, and are often discharged without enough support at home.
Even with the best support money can buy, some patients, like the country singer Mindy McCready, fail. Some people do well until they are put under undo stress and then they collapse. This was the case, as far as I can tell, with Ms. McCready. She’d already had several suicide attempts until the completed suicide of her boyfriend. She snapped.
How is this Dr. Drew’s fault? Now, I know there is some controversy about publicly airing shows on mental health treatment, and the questions are valid. Yet, as a professional whose work is always done in complete opacity, I’m happy that the general public gets to see some of what I and thousands of my colleagues give to our clients on a daily basis. I can’t participate in Take Your Daughter to Work Day, but we can sit down and watch an episode of Rehab.
I am sorry that Mindy lost her battle with depression and addiction. I am sad that Dr. Drew is getting blamed for losing a patient in the end stages of a terrible disease process. I hope we can all use this event to deepen our understanding of the terrible costs and demands of mental health and addictions instead of using it as a way to take a cheap shot at a profession that works in areas that no one else will touch.