If Not Us, Who? If Not Now, When?

Okay.

This is going to be a hard post to write. Even after thinking about it last night and sleeping on it (the time when many of my posts write themselves, ready to pop out at 5:30 in the morning with little help from me), there is a jumble of thoughts in my mind that need to come out in some logical order. That may not be the case this morning, but I beg your indulgence as I try to make some sense of them. I want to make you think about some important things today, as well as sort out some of my own thoughts. 

I got home yesterday evening and sat down for supper. I reached for my iPhone and fired up the NPR app, ready to  listen to some of the stories of the day. One hit me especially hard. I am a middle-aged white man living in the southern United States, and I grew up in the sixties and seventies. I know about racial tension and inequality and the struggles that have gone hand-in-hand with them for the decades since Reconstruction in my home state of Georgia and my now adopted home state of South Carolina. To hear this story about racial tensions as pertaining to the extension of bids for sorority pledges at the University of Alabama, for some reason, just made me want to scream. I don’t really know, yet, why it affected me so much last night. It just did. I got really angry. I think I scared one of my Facebook friends. (I’m sorry about that.) 

From NPR:

“The campus newspaper, The Crimson White, reported allegations this month that two prospective black members were passed over by all-white sororities because of pressure from alumnae, and in one case, an adviser. The coverage caused a wide-ranging debate, even prompting Alabama Gov. Robert Bentley, an alumnus, to say that fraternal organizations should choose members based on their qualifications, not their race.

The debate came at an embarrassing time for Bonner’s university, which is marking the 50th anniversary of its racial integration. Alabama admitted its first black students in 1963 after then-Gov. George C. Wallace infamously stood in a schoolhouse door to protest their enrollment. Wallace relented under pressure from President John F. Kennedy’s administration.” 

I immediately flashed to that iconic image of Governor George Wallace standing in the doorway denying black students admission to his state’s school, defiant until President John F. Kennedy’s administration finally made him see his way clear to step aside and allow events to unfold as they finally did, and for the better. I thought about the judge talking to us prospective jurors in the courthouse in my hometown two years ago, two years ago, about the colored only and white only signs on water fountains and bathroom doors that were still there, even though not enforced, after all those years. 

I thought about the injustice of these things. It bothered me. A lot.

Later in the evening, a Twitter friend who reads this blog commented on my not-so-subtle hint that I would soon be returning to a combination clinical and administrative mental health job in the public sector in South Carolina. Her responses to me, in her usual straightforward, no-nonsense way?

“Glad to read that you’re getting back into the fray. You should be out there fighting for the things you’ve been writing about.”

These two things, separate but related, got me thinking a lot last night about our individual and collective responsibility to make the world a better place. To right wrongs. To push for changes that need to be made because they are right. To stand up for those who cannot fend for themselves. To get out of our comfort zones and stick our necks out and push for social and institutional and political change when it is called for. To not be complacent as we go forward in life. To not succumb to the feeling that this is the best it’s ever going to be. 

When I gave up my medical director job four years ago, I was tired. I realized how burned out I was. I was tired of dealing with issues that were out of my control. I was tired of trying to motivate people who just wanted to whine and complain. I as tired of trying to mold systems into positive forces for good, when the architects of the systems and the people who held the purse strings that funded them just wanted to keep things quietly the same, knowing how poorly the target populations were being served. I just wanted to fill my days with clinical work, seeing my patients and making a difference in the world one visit at a time, helping those that I could and hoping that by the grace of God that all the others would find their peace and redemption some other way, through some other channel. Their salvation would not be my direct responsibility. I could not take on the weight of the world. I was no Mother Teresa. 

I have quietly worked in this mode for almost four years now, seeing patient after patient, hearing story after story, writing prescriptions and admonishing and advising and reassuring and listening. It has all been good. One thing has really hit me in the last few months though.

Just because I sit in my office and see patients and pretend that the big picture problems, the systems issues and the moral dilemmas are no longer real does not make it so

I will be fifty-six years old next month. I am highly skilled, highly educated and in the prime of my career. I am not alone. There are many of us. There are big problems in this country and in this world today. They need to be addressed. 

If not us, then who? If not now, then when?

Some twenty-something kid just out of training who is idealistic as hell but has not a clue how the world works? Some seventy-five year old who has all the wisdom and experience in the world but little energy left to be a player on the field?

No.

The people just like me who are old enough to have experience but still young enough to be energetic and resourceful and willing to shake things up must, I mean MUST, get out of their chairs and start the process of change for the better. This is imperative. 

If we don’t tell the world, again and again and again, that it is wrong to discriminate based on the color of one’s skin, Martin Luther King, Jr., will have died in vain.

If we don’t tell the world, again and again and again,  that it is wrong to marginalize someone just because they have mental illness, then more Navy Yard shootings will occur. 

If we don’t tell colleges and universities, again and again and again, that it is wrong to look the other way for decades while children are being abused, then more Penn State coverups will happen.

Count on it.

What is wrong with us?

Why can’t we see that we must be stand up and be responsible for the world around us and do something to make it better for those who will come after us? Why can’t we see that there can be, and should be, more than just one Greatest Generation? 

If not us, who?

If not now, when?

 

Thou Shalt Not Steal

Image

Okay, I’m a little late getting saddled up this morning, but this is the pet peeve that’s stuck in my head and needs to find its way out today.

Just because you have a mental illness, you don’t get a free pass when you make bad choices and get yourself into trouble. (Yes, of course there’s a story or two or three or five that have spurred this thought in my brain today, but you know I can’t share those with you, so don’t ask, okay? Thanks) You don’t get a Get Out of Jail Free card.

I’m sorry if this is news to you.

Get over it.

This is how it goes down, among other ways. These are just the ones I can remember on 1 1/2 cups of coffee.

Mom brings little Johnny in. Little Johnny has been dancing on desktops and throwing books at his teachers and giving other little Johnnies and Jillies wedgies on the playground. He is a hellion. He can turn this behavior on and off at will. He is not psychotic. He does not have a brain tumor. He is, at seven years old, not under the influence of alcohol or street drugs. (Oh, yeah, I’ve seen that even at six years old. Another story for another day) He sits in my office as mother goes on and on and on about her frustrations, smiling a little sly smile as he listens to her and shoots me that see, what would you have me do? look that kids can shoot you.

Mom wants me to declare him terminally attention-deficit-ed, conduct disordered, defiant, learning disordered. Impaired. Damaged. Unable to conform to playground or classroom rules, much less the extreme sport of being a productive and cooperative family member in a loving home. She wants a pass. So, at the tender young age of seven, does the kid. He may have a conduct problem, but he is certainly not stupid.

The other one that sticks in my craw (I don’t actually have a craw, which is the crop of a bird or an insect, but I have always really loved the graphics that term conjures up in one’s mind) is the thirty-something lady who comes crying into clinic and demands that I release her from the clutches of a policing and legal system that found her shoplifting at Walmart or some such. Why? Because she is bipolar, by God, and bipolar people are not responsible for their actions. Especially when it involves pilfering nail polish, packages of glitter, and small cartons of half and half.  Really?

(Wait. Brb. Checking DSM V.)

I can’t find it anywhere. I don’t see it. I don’t see the out that you earn by wearing the Red Badge of Moodage. The invisibility cloak imparted by your mental illness that allows you to run red lights, drink and drive, and steal at will until caught, immediately followed by an outraged cry that you are Sick, sick, sick I tell you all!, sick to the point of not knowing what you are doing.

I am not responsible for my actions! I cannot be trusted to make decisions. I cannot be faulted for lying, cheating, stealing, pilfering, pandering, and jaywalking. You cannot touch me, because I am ill!

(clearing throat).

Bullshit.

So sorry, but come on, people, there is no other word that gets the point across better, is there?

Okay.

As you start your day, remember these things.

People with mental illness, legitimate mental illness, deserve the very best evaluation, diagnosis and treatment.

People with mental illness sometimes do things that are outside of the expected social dance. They can be forgiven for these faux pas, if they are actively engaged in trying to get treatment for their symptoms and make their way through life the best way they can given their skill set, talents, and limitations.

People with mental illness who break social rules, commit crimes, abuse others, steal things, disregard the normal boundaries and dignity of others, and trample the system do NOT get a free pass just because they have an Adjustment Disorder or PTSD or Generalized Anxiety Disorder.

Last time I checked, most of my patients with schizophrenia had never heard voices that told them to hot wire a candy apple red Mustang, steal it, and drive it at a high rate of speed across state lines and show it off to their friends (true story).  Come to think of it, none of my patients with schizophrenia. Zero. Zilch. Nada.

Come up with a better story for me, Skippy. Try again.

Mental illness is bad.

It is sickness, just like diabetes and migraine and hypertension.

It impairs ability to live a normal, happy life.

It does NOT act as a universal excuse for bad behavior.

As we say in the South, that dog just won’t hunt.