Deep Waters

Today in one of my classes we had someone come and share her story that grew out of her son who had a severe clinical depression, and who committed suicide at the age of 26. From the sounds of it, he grew up in a very loving and supportive family who continued to love and support him throughout his entire short life. At the age of 19 he had his first severe depressive episode. He was not taken seriously by anyone in the medical field, and was sent home with comments such as “you’re not the first one to have to take a semester out or college” or, after he ate every toxic drug in their home, and spent several hours in the ER, got sent home with the comment “that should change him now”. Now, his mom advocates on behalf of her lost son and for so many others who struggle with similar illnesses.

I don’t think I have ever realized the depths to which mental health problems plummet. I have had loved ones who have struggled with mental health problems, and yet I still have not realized what a powerful pull some of these illnesses can have on a person’s life, on their very soul.

The scary thing is that in the future, I will have patients who walk into my office, presenting with both dramatic symptoms of, say, depression, but also with subtle, easily missed symptoms. What will I do then? How can I be the best physician to them? My greatest fear is that I may miss the signs in a patient, and unknowingly send a suicidal patient home, or that I won’t be able to follow the right course in helping them get the necessary treatment.

Some things I wonder about: how can I best advocate for a patient to make sure that they get the care that they need? To make sure that the right people can help them and offer them the appropriate treatment that they need, and who will take them seriously? What can I do in my role? Maybe as a family doctor? Time and resources can be limiting factors in what we want to and need to do. I remember hearing of a family doctor who met with a patient one day, discovered early on that the person had severe depression, and spent 45 minutes with them, allowing them to simply sit there and cry. The initial appointment was likely a 10 minute slot. Oh that I would know when I need to do that. Sometimes it won’t be possible, but other times, it will be vital.

One of the biggest things I want to do, and I see this in so many areas of medicine, is to make sure that I know who my colleagues are, and that I know health care providers in various professions whom I trust and can refer patients to, when necessary. I also need to make sure that I never lose sight of who I am here for – to never lose sight of the person in front of me.