September 12th, 2014

The Greatest Taboo: Mental Illness, Society, Science, and Medicine

By Andrew M. Harrison

By Andrew M. Harrison

In 1902, Bertrand Russell wrote, “Mathematics, rightly viewed, possesses not only truth, but supreme beauty—a beauty cold and austere, like that of sculpture, without appeal to any part of our weaker nature, without the gorgeous trappings of painting or music, yet sublimely pure, and capable of a stern perfection such as only the greatest art can show.” Beautiful words by one of my heroes and also the pathetic opening to my medical school application essay in the summer of 2009. I did not even get the date correct, but it did not matter then and does not matter now. This post is not about facts and figures: my comfort zone. This post is about emotions and the intangible.

As a reader of autobiographies, I am lucky: Bertrand Russell was a prolific writer and lived to age 97 (1872 to 1970). In the final decades of his life, Russell wrote his autobiography in three volumes. The first volume covers birth to age 42 (1914), which encompasses his most seminal scientific work, Principia Mathematica, also published in three volumes. Alfred Nobel did not have the foresight to establish a prize for mathematics and the Fields Medal is not awarded to anyone over the age of 40 (feel free to do the math on Russell and his co-author at some other time). However, he did receive the Nobel Prize in Literature in 1950 (a true polymath). Unfortunately, this is beyond the scope of the first volume that I wish to discuss. When an autobiography exists, it always fascinates me how little “great minds” reflect on their “accomplishments”. In over 500 pages, Principia Mathematica is merely referenced as a few lines in the first volume of Russell’s autobiography. The rest is mostly obsession, infatuation, and love. To varying degrees and to pick two random examples, the same is true of James Watson (a few great stories about epiphanies and/or theft) and Craig Venter (a paragraph or two about a great epiphany on a plane ride). Many other great minds who wrote autobiographies also chose to reflect on topics other than their “accomplishments”, such as love, sex, drugs, and mental illness.

In the interest of space, I must limit my discussion to only mental illness. What I wish to discuss is the complex relationship between mental illness and society’s perception of it. There exists a stereotype in our society of the “mad scientist”. Whether they suffer from mental illness or not, these people are “pardoned” for their eccentricities in the name of genius. However, many of these great minds, scientist or not, paid the highest price for their suffering: Nicolas Leblanc, Ludwig Boltzmann, Vincent van Gogh, Charlie Parker, and the greatest of them all, Alan Turing. I often wonder how much more each would have given back to society if they had lived even one more decade. Unfortunately, the story is very different in medicine. Society does not want “crazy doctors”. Thankfully, it seems the days of state licensing boards and medical training programs attempting to “weed out” mentally ill physicians has come to an end in the US. Likewise, if they knew, patients might tolerate physicians with “minor” mental illness, such as major depressive disorder and generalized anxiety disorder. However, “major” mental illnesses with the potential for psychosis, such as schizophrenia and bipolar disorder, would certainly be rejected. Ironically, Leblanc was both a scientist and surgeon, but from a very different time and place.

In this limited space I can only hope to start a discussion on this greatest of taboos. So, rather than descend into rambling commentary, opinions, and “solutions”, I wish to end with an extraordinary story of hope from one of my own life experiences. In my first semester of college in “honors” general chemistry, I befriended a random chemistry major and soon became deeply involved in our university’s chemistry society with him. As a physics major, I hated chemistry, but chemists were oh so much fun. I would eventually come to spend many semesters in complete seclusion, but he was the only person who could ever tolerate me as a roommate. (I still don’t know how.) I always knew he had “problems”, but there were constantly so many more interesting things to discuss and do. It was not until I was bound for the prestigious Medical Scientist Training Program at Mayo Clinic and he declined a PhD chemistry spot at UPenn that I knew something was truly wrong. Although he would eventually pursue PhD training in Materials Science elsewhere, he left that program with a Master’s degree to pursue a career in magic. In recent years, I have watched him struggle to both pursue a career as a magician and also attempt to gain entry into highly competitive cognitive psychology PhD programs (an intertwined interest). However, in these years, I also learned of his psychological and psychiatric struggles, including a schizophrenic episode with psychosis in high school, and watched him (along with so many others) descend into romantic obsession, infatuation, love, and destruction. Nonetheless, after years of struggling, his magic career is finally becoming increasingly successful and he is currently enrolled in a psychology Master’s program. More importantly, he is content with his life in a way few other people I know are. In my opinion, he is a great mind in the making. Most burn out before achieving greatness. However, I suspect he will not.

Magic trick with firePerforming a magic trick with fire for Rutgers University students. The Magician & Illusionist Society of Rutgers performance in 2012.

And for those of you who made it this far in search of my own lifelong struggle with mental illness: my apologies. Unfortunately, there is just not enough space. Stay tuned for the autobiography…

Andrew M. Harrison is one of the co-managers of Mayo Clinic’s Diversity in Education Blog and a student in the Medical Scientist Training Program at Mayo Clinic.

Acknowledgement: I wish to thank my dear, anonymous friend for allowing me to share his story. In a world of mediocrity, he still inspires me to this day. I also wish to thank my unnamed mentors, physicians, and other friends: past, present, and future. Without you, I would not be where I am today.

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