“They’re just crazy people; I won’t treat them,” a preeminent neurologist recently said to me regarding mentally ill patients. If a neurologist thinks that psychiatry patients are “just crazy people,” what does the rest of the population think? I don’t always agree with many of the systematic categorizations of the DSM-IV. Afterall, it wasn’t that long ago when being a “tom-boy,” or a member of the queer community was considered a diagnosable mental illness, which spurred much discrimination that continues today in the military. One thing I do understand is that “just crazy” is neither a parameter, nor is it a diagnosis anywhere in the DSM-IV. Obviously this neurologist must have been absent that day in medical school when they covered brain disease. Oh wait, doesn’t a neurologist spend a career trying to understand pathology of the brain? The comment really made me angry, having lost my younger brother to suicide just six months ago. Given that 90% of suicides are associated with a verifiable mental illness (according to American Foundation for Suicide Prevention, www.afsp.org), I wonder how a group of survivors of suicide would take it if a famous neurologist walked into their support group and announced that their loved ones were “just crazy people.” Or that their pathologies were not grounded on verifiable brain structure changes or biochemical alterations. The notion that psychiatry is somehow a pseudoscience which just treats “behavior and not discrete pathology,” especially coming from someone who is supposed to have been trained at some point in all factions of neuroscience, strikes me as incredibly ignorant. In fact, it reminds me of the level of ignorance from a nurse I once worked with who refused to treat HIV+ patients because he feared contracting the disease. Before the time of CT and MRI scans, would it have been acceptable for a doctor to tell a patient suffering an acute stroke, exhibiting slurred speech, that he was “just drunk?” Why is it somehow acceptable for a neurologist to label all psychiatric patients as “just crazy?” As a research scientist, the comments bother me because I feel very strongly that since mental illness is still very highly stigmatized, even among the medical community, research to better understand its underlying causes, prevention, and treatment is largely neglected or ignored compared to other diseases that do not affect people with the same frequency as mental illness and suicide. For example, how many people per year die of leukemia? 12,790 in 2007. How many people per year die by suicide? 32,637 in 2005, making it the 11th leading cause of death in the U.S. (8th leading cause for males). Although suicide is over two times more prevalent then Leukemia, whenever I run a road race I see a sea of people wearing the Team in Training Leukemia Society purple fundraising gear. When I go to the store or a restaurant, pamphlets about Race for the Cure for breast cancer, AIDS Ride, and of course, Team in Training wait for me in the storefronts. These are all of course very worthy causes, but who cares about raising funds to fight the suicide epidemic? Since I have been working fastidiously in the lab fighting to find treatments for other diseases, I know how much impact even one investigator can make in a field, and how much it costs to do critical research. What I don’t understand is why we aren’t tackling the suicide/mental illness problem with as much fervency, or if we are, why the suicide rate is still increasing. The fact that the overall NIH budget has been slashed for the fifth year in a row, to an effective decrease of 15% (considering inflation) compared to 5 years ago doesn’t help. However, even if the NIH budget were increased, it seems that suicide prevention research would still be on the low priority list. This stigma, this discrimination, this ignorance, even among medical doctors, must change. When my brother died, all I could think about was “what could I have done?” Now, all I can think about is “what can I do to change this.” So, I’ve decided to apply to medical school to become a doctor. I’ve decided to work to change this. I must do this for my brother and for me. Without the medical degree, my voice will not be as loud as that neurologist’s. We need answers, not restraints and stigmas. The more I can research to understand the causes of suicide, and its prevention, the more people I can help avoid that path. If I can save just one, my journey will not have been in vein. Wish me luck; thanks for reading.
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