Just Like Someone Without Mental Illness Only More So_ A Memoir - Mark Vonnegut [25]
The megavitamin docs and their critics all seemed like self-absorbed babies whose interest in helping patients was outweighed by the joys of self-righteous vehemence. Their primary interest was in yelling at one another.
A pox on both their houses. Where are the adults when you need them?
Gradually and carefully I’d stopped taking most of the vitamins. It didn’t seem to make any difference. So when I discovered my own enlarged thyroid in anatomy class and the doctors at Harvard’s Health Services suggested I stop taking the lithium, I didn’t think much about it. It was increasingly clear that there wasn’t really much wrong with me anyway. I had been started on lithium by one of the “vitamin doctors.” He didn’t change my diagnosis but said, “You’re the kind of schizophrenic who gets better on lithium.” This was all pre–DSM III, the modern way to slice and dice mental illness. The only thing I really had come to believe in, more than any specific therapy, was the medical model itself, which got rid of shame, blame, and other hurtful voodoo. That was worth doing.
The basic science and the preclinical courses were easy. I was looking forward to learning how to use a stethoscope and those cool little lights and how to draw blood. We practiced on one another and ourselves until we were ready to be unleashed on the world.
After a year and a half of amphitheater/classroom learning, we put on white coats and learned medicine by pretending to be doctors with people who really were patients with the whole show being overseen by people who really were doctors in real hospitals.
If you’re not sure what to say to a patient or the patient pauses for a while in his story, what you say is, “That must be hard for you.”
I remember staring and watching carefully as our Introduction to Clinical Medicine instructor easily took a patient’s hand and gently stroked his arm. I wanted to be able to do that. I was moving from a world where I couldn’t touch people I didn’t know to one where I could.
It was an advantage for me, over most of my classmates, to know that I was in medical school, at least partly, to save my own life.
We knew some things in amazing detail, right down to the microscopic and molecular level, like how cholera kills people. And over the years cholera has killed a ton of people; there were accounts of cholera epidemics where dehydrated corpses were stacked like cordwood. And now, because we understood it, we could prevent it and/or treat it. All those people who would have died from cholera and been stacked like cordwood got to do something else, like maybe have a son or daughter who went to Harvard Medical School.
There were no stains whatsoever on my coat, which was so white it glowed. I was an HMS II—Harvard Medical student, second year—doing Introduction to Clinical Medicine hoping I might stumble into doing something right or good or at least not humiliate myself too badly.
“Excuse me, but I’m one of the new HMS IIs, and the monitor and the guy next to the nursing station right back there both look really bad.”
“Thank you,” the nurse said kindly as she walked me back to the room. She looked briefly at the monitor and pulled the door closed.
The patient had had a heart attack at home and his family had gotten the heart going again but hadn’t done the breathing part of CPR, so his brain had been deprived of oxygen too long for there to be any hope of recovery. We were just watching him till he died, which was what he was in the process of doing. The nurse told me that the family came in every evening and that this would be a relief to them.
The breathing stopped after a few gasps. The monitor showed a flat line. The nurse unclipped his leads, looked at the clock, and noted on his chart the official time of death. We sat there quietly for a bit. Then we both had lots we had to do. I had gotten to be thirty years old without