"I don’t know why I think I need this much sleep. I wonder if it’s just that I'm mentally weak."
This was one of the first things a new patient said to me in a recent visit. He’d been suffering from chronic pain and extreme fatigue since 1990, and I knew he didn’t come up with this theory of mental weakness on his own. My guess was that it had been strongly implied by his doctors over the years. But whether his issues were psychosocial or biochemical, is this the message we want our patients leaving with, that they are somehow weak?
Compassion. I’ve said it before, and I’ll say it again: We are living in a society that is aggressively devoid of compassion. Nowhere does that appear more frequently than in medicine—the very place where compassion should be the order of the day.
If indeed this gentleman had a mental ailment, it should have been treated in a compassionate way, in a way that showed him it was an illness, not a personal failing. On the other hand, if his was a biochemical problem (and most evidence now points to the fact that most mental illness is biochemical), then it should have been treated appropriately. And if the problem originated from some environmental influence, whether an infectious agent, a toxin, or an allergen, that should have been treated appropriately as well.
But instead, when people don't fall neatly into categories, we physicians tend to think that we know everything and that the only thing that could possibly be wrong with the patient is a weakness of personality, a character flaw, or a mental illness that we're just going to ignore.
This is decidedly not okay. Our patients come to us because they need help. It is our sacred duty to find that help. We can't always heal people of their illnesses, but we can help them find comfort without making them feel like they’re insane.