Ill Treatment Quotes

You live like this, sheltered, in a delicate world, and you believe you are living. Then you read a book… or you take a trip… and you discover that you are not living, that you are hibernating. The symptoms of hibernating are easily detectable: first, restlessness. The second symptom (when hibernating becomes dangerous and might degenerate into death): absence of pleasure. That is all. It appears like an innocuous illness. Monotony, boredom, death. Millions live like this (or die like this) without knowing it. They work in offices. They drive a car. They picnic with their families. They raise children. And then some shock treatment takes place, a person, a book, a song, and it awakens them and saves them from death. Some never awaken.

To those human beings who are of any concern to me I wish suffering, desolation, sickness, ill-treatment, indignities—I wish that they should not remain unfamiliar with profound self-contempt, the torture of self-mistrust, the wretchedness of the vanquished: I have no pity for them, because I wish them the only thing that can prove today whether one is worth anything or not—that one endures.

AI-powered passive monitoring is taking off and has huge advantages over the traditional way of monitoring patients. The advantage of passive monitoring, as opposed to data collected from wearables, is that it doesn’t require patients or seniors to actively wear a device at all times. Used in a hospital setting, the tech reduces healthcare workers’ risk of exposure to COVID-19 by limiting their contact with patients and automating data collection for vital signs. Also, camera-based monitoring is unpopular for the simple reason that a lot of people don’t like being watched by a camera.

We are all a collection of lost causes, stashed here so no one has to see just how wounded we are.

Avoiding triggers is a symptom of PTSD, not a treatment for it.

Mental illness" is among the most stigmatized of categories.' People are ashamed of being mentally ill. They fear disclosing their condition to their friends and confidants-and certainly to their employers.

What tormented Ivan Ilych most was the deception, the lie, which for some reason they all accepted, that he was not dying but was simply ill, and that he only need keep quiet and undergo a treatment and then something very good would result.

I now know for certain that my mind and emotions, my fix on the real and my family's well-being, depend on just a few grams of salt. But treatment's the easy part. Without honesty, without a true family reckoning, that salt's next to worthless.

We don’t have to take things so personally. We take things to heart that we have no business taking to heart. For instance, saying “If you loved me you wouldn’t drink” to an alcoholic makes as much sense as saying “If you loved me, you wouldn’t cough” to someone who has pneumonia. Pneumonia victims will cough until they get appropriate treatment for their illness. Alcoholics will drink until they get the same. When people with a compulsive disorder do whatever it is they are compelled to do, they are not saying they don’t love you—they are saying they don’t love themselves.

I am (obviously) much in love with plants and above all trees, and always have been; and I find human maltreatment of them as hard to bear as some find ill-treatment of animals.

There is a worse tyranny than that of ill-treatment. It is the tyranny of tears, vapours, appeals to feelings of affection and of gratitude!

Dropping in and out of your own life (for psychotic breaks, or treatment in a hospital) isn’t like getting off a train at one stop and later getting back on at another. Even if you can get back on (and the odds are not in your favor), you’re lonely there. The people you boarded with originally are far, far ahead of you, and now you’re stuck playing catch-up.

In response to threat and injury, animals, including humans, execute biologically based, non-conscious action patterns that prepare them to meet the threat and defend themselves. The very structure of trauma, including activation, dissociation and freezing are based on the evolution of survival behaviors. When threatened or injured, all animals draw from a "library" of possible responses. We orient, dodge, duck, stiffen, brace, retract, fight, flee, freeze, collapse, etc. All of these coordinated responses are somatically based- they are things that the body does to protect and defend itself. It is when these orienting and defending responses are overwhelmed that we see trauma. The bodies of traumatized people portray "snapshots" of their unsuccessful attempts to defend themselves in the face of threat and injury. Trauma is a highly activated incomplete biological response to threat, frozen in time. For example, when we prepare to fight or to flee, muscles throughout our entire body are tensed in specific patterns of high energy readiness. When we are unable to complete the appropriate actions, we fail to discharge the tremendous energy generated by our survival preparations. This energy becomes fixed in specific patterns of neuromuscular readiness. The person then stays in a state of acute and then chronic arousal and dysfunction in the central nervous system. Traumatized people are not suffering from a disease in the normal sense of the word- they have become stuck in an aroused state. It is difficult if not impossible to function normally under these circumstances.

When the world has once begun to use us ill, it afterwards continues the same treatment with less scruple or ceremony, as men do to a whore.

You don't need treatment. The fever, inflammation, coughing, etc., constitute the healing process. Just get out of their way and permit them to complete their work. Don't try to 'aid' nature. She doesn't need your puny aid—she only asks that you cease interfering.

Without knowing the cause of illness, any treatment must be considered a guess.

With psychiatric medications, you solve one problem for a period of time, but the next thing you know you end up with two problems. The treatment turns a period of crisis into a chronic mental illness. - Amy Upham

Does your manager know that you talk to your customers like this? (Blaine) If you’d like to talk to my mother, who owns this bar, my overindulgent brother, who manages it, or my father, who delights in kicking everyone’s ass around, about your treatment by me, just let me know and I’ll be more than happy to go get one of them for you. I know they’d just love to waste their time dealing with you. They’re real understanding that way. (Aimee)

No human being should be maltreated under any circumstances. We are all wonderful creation of God. May we affectionately love one another.

The Four Noble Truths are pragmatic rather than dogmatic. They suggest a course of action to be followed rather than a set of dogmas to be believed. The four truths are prescriptions for behavior rather than descriptions of reality. The Buddha compares himself to a doctor who offers a course of therapeutic treatment to heal one’s ills. To embark on such a therapy is not designed to bring one any closer to ‘the Truth’ but to enable one’s life to flourish here and now, hopefully leaving a legacy that will continue to have beneficial repercussions after one’s death. (154)

...Jesus did not advocate nonviolence merely as a technique for outwitting the enemy, but as a just means of opposing the enemy in such a way as to hold open the possibility of the enemy's becoming just as well. Both sides must win. We are summoned to pray for our enemies' transformation, and to respond to ill-treatment with a love that not only is godly but also, I am convinced, can only be found in God.

It is time to embrace mental health and substance use/abuse as illnesses. Addiction is a disease.

In some cases, you can tell how somebody is being treated by their own boss from the way they are treating someone to whom they are a boss.

Been under treatment for PTSD and bipolar since 1992. I’m not ashamed of my illness. I’ve been shunned by many and I feel for those shunned, too.

It is exhausting explaining over and over again that yes, I am doing great and I feel fantastic, but I still cannot do the things I once did. My new normal with Cancer Related Fatigue.

When others seem to take advantage of you, do not retaliate by trying to take advantage of them. Use your power in improving yourself, so that you can do better and better work. That is how you are going to win in the race. Later on, those who tried to take advantage of you will be left in the rear. Remember, those who are dealing unjustly with you or with anybody are misusing their mind. They are therefore losing their power, and will, in the course of time, begin to lose ground; but if you, in the mean time, are turning the full power of your mind to good account, you will not only gain more power, but you will soon begin to gain ground. You will gain and continue to gain in the long run, while others who have been misusing their minds will lose mostly everything in the long run. That is how you are going to win, and win splendidly regardless of ill treatment or opposition.

All the world used her ill, said this young misanthropist, ... and we may be pretty certain that persons whom all the world treats ill, deserve entirely the treatment they get. The world is a looking-glass, and gives back to every man the reflection of his own face. Frown at it, and it will in turn look sourly upon you; laugh at it and with it, and it is a jolly kind companion; and so let all young persons take their choice.

The cruelty intrinsic to the workhouse system was excused by the need to discourage idleness, much as the malice intrinsic to the mental hospital system has been excused by the need to provide treatment.

Because drugs have become so profitable, major medical journals rarely publish studies on nondrug treatments of mental health problems.31 Practitioners who explore treatments are typically marginalized as “alternative.” Studies of nondrug treatments are rarely funded unless they involve so-called manualized protocols, where patients and therapists go through narrowly prescribed sequences that allow little fine-tuning to individual patients’ needs. Mainstream medicine is firmly committed to a better life through chemistry, and the fact that we can actually change our own physiology and inner equilibrium by means other than drugs is rarely considered.

Our treatment of animals and our attitude toward them are crucial not only to any pretensions we have to ethical behavior but the humankind's intellectual and moral evolution. Which is how the human animal is meant to evolve, isn't it?

Cancer - a more or less permanent traffic jam in the body.

The night before brain surgery, I thought about death. I searched out my larger values, and I asked myself, if I was going to die, did I want to do it fighting and clawing or in peaceful surrender? What sort of character did I hope to show? Was I content with myself and what I had done with my life so far? I decided that I was essentially a good person, although I could have been better--but at the same time I understood that the cancer didn't care. I asked myself what I believed. I had never prayed a lot. I hoped hard, I wished hard, but I didn't pray. I had developed a certain distrust of organized religion growing up, but I felt I had the capacity to be a spiritual person, and to hold some fervent beliefs. Quite simply, I believed I had a responsibility to be a good person, and that meant fair, honest, hardworking, and honorable. If I did that, if I was good to my family, true to my friends, if I gave back to my community or to some cause, if I wasn't a liar, a cheat, or a thief, then I believed that should be enough. At the end of the day, if there was indeed some Body or presence standing there to judge me, I hoped I would be judged on whether I had lived a true life, not on whether I believed in a certain book, or whether I'd been baptized. If there was indeed a God at the end of my days, I hoped he didn't say, 'But you were never a Christian, so you're going the other way from heaven.' If so, I was going to reply, 'You know what? You're right. Fine.' I believed, too, in the doctors and the medicine and the surgeries--I believed in that. I believed in them. A person like Dr. Einhorn [his oncologist], that's someone to believe in, I thought, a person with the mind to develop an experimental treatment 20 years ago that now could save my life. I believed in the hard currency of his intelligence and his research. Beyond that, I had no idea where to draw the line between spiritual belief and science. But I knew this much: I believed in belief, for its own shining sake. To believe in the face of utter hopelessness, every article of evidence to the contrary, to ignore apparent catastrophe--what other choice was there? We do it every day, I realized. We are so much stronger than we imagine, and belief is one of the most valiant and long-lived human characteristics. To believe, when all along we humans know that nothing can cure the briefness of this life, that there is no remedy for our basic mortality, that is a form of bravery. To continue believing in yourself, believing in the doctors, believing in the treatment, believing in whatever I chose to believe in, that was the most important thing, I decided. It had to be. Without belief, we would be left with nothing but an overwhelming doom, every single day. And it will beat you. I didn't fully see, until the cancer, how we fight every day against the creeping negatives of the world, how we struggle daily against the slow lapping of cynicism. Dispiritedness and disappointment, these were the real perils of life, not some sudden illness or cataclysmic millennium doomsday. I knew now why people fear cancer: because it is a slow and inevitable death, it is the very definition of cynicism and loss of spirit. So, I believed.

The mental health system is filled with survivors of prolonged, repeated childhood trauma. This is true even though most people who have been abused in childhood never come to psychiatric attention. To the extent that these people recover, they do so on their own.[21] While only a small minority of survivors, usually those with the most severe abuse histories, eventually become psychiatric patients, many or even most psychiatric patients are survivors of childhood abuse.[22] The data on this point are beyond contention. On careful questioning, 50-60 percent of psychiatric inpatients and 40-60 percent of outpatients report childhood histories of physical or sexual abuse or both.[23] In one study of psychiatric emergency room patients, 70 percent had abuse histories.[24] Thus abuse in childhood appears to be one of the main factors that lead a person to seek psychiatric treatment as an adult.[25]

It's as if people -- normal people -- are made of silver. Shiny to start with, but tarnished by time, by ill-treatment. Luca... Luca is gold. Nothing in the world could ever make him shine less brightly.

Depression, somehow, is much more in line with society's notions of what women are all about: passive, sensitive, hopeless, helpless, stricken, dependent, confused, rather tiresome, and with limited aspirations. Manic states, on the other hand, seem to be more the provenance of men: restless, fiery, aggressive, volatile, energetic, risk taking, grandiose and visionary, and impatient with the status quo. Anger or irritability in men, under such circumstances, is more tolerated and understandable; leaders or takers of voyages are permitted a wider latitude for being temperamental. Journalists and other writers, quite understandably, have tended to focus on women and depression, rather than women and mania. This is not surprising: depression is twice as common in women as men. But manic-depressive illness occurs equally often in women and men, and, being a relatively common condition, mania ends up affecting a large number of women. They, in turn, often are misdiagnosed, receive poor, if any, psychiatric treatment, and are at high risk for suicide, alcoholism, drug abuse, and violence. But they, like men who have manic-depressive illness, also often contribute a great deal of energy, fire, enthusiasm, and imagination to the people and world around them.

The symptoms of hibernating are easily detectable: first, restlessness. The second symptom (when hibernating becomes dangerous and might degenerate into death): absence of pleasure. That is all. It appears like an innocuous illness. Monotony, boredom, death. Millions live like this (or die like this) without knowing it. They work in offices. They drive a car. They picnic with their families. They raise children. And then some shock treatment takes place, a person, a book, a song, and it awakens them and saves them from death.

So, what role does memory play in the understanding and treatment of trauma? There is a form of implicit memory that is profoundly unconscious and forms the basis for the imprint trauma leaves on the body/mind. The type of memory utilized in learning most physical activities (walking, riding a bike, skiing, etc.) is a form of implicit memory called procedural memory. Procedural or "body memories" are learned sequences of coordinated "motor acts" chained together into meaningful actions. You may not remember explicitly how and when you learned them, but, at the appropriate moment, they are (implicitly) "recalled" and mobilized (acted out) simultaneously. These memories (action patterns) are formed and orchestrated largely by involuntary structures in the cerebellum and basal ganglia. When a person is exposed to overwhelming stress, threat or injury, they develop a procedural memory. Trauma occurs when these implicit procedures are not neutralized. The failure to restore homeostasis is at the basis for the maladaptive and debilitating symptoms of trauma.

The primary driver to pathological dissociation is attachment disorganization in early life: when that is followed by severe and repeated trauma, then a major disorder of structural dissociation is created (Lyons-Ruth, Dutra, Schuder, & Bianchi, 2006).

Dissociative Disorders have a high rate of responsiveness to therapy and that with proper treatment, their prognosis is quite good.

The acknowledgement of having suffered evil is the greatest step forward in mental health.

Uh, Miss, you have second and third degree burns that need treatment,"he said. "They'll be okay. I'll just use concealer for a while.

While a psychiatric diagnosis can serve a purpose in treatment plans, it should not become a tool to discredit a person's disclosure of abuse.

The philosopher's treatment of a question is like the treatment of an illness.

I didn't fail in responding to past treatments...those treatments failed to work for me.

Health is normal. The human body is a self-repairing, self-defending, self-healing marvel. Disease is relatively difficult to induce, considering the body's powerful immune system. However, this complicated and delicate machinery can be damaged if fed the wrong fuel during the formative years. ... Healthy living with nutritional excellence throughout life can slow the decline of aging. It can prevent the years and years of suffering in ill health that is so common today as people get older and become dependent on medical treatments, drugs, and surgery. Nutritional excellence is the only real fountain of youth.

In around 2020 a severe pneumonia-like illness will spread throughout the globe, attacking the lungs and the bronchial tubes and resisting all known treatments. Almost more baffling than the illness itself will be the fact that it will suddenly vanish as quickly as it arrived, attack again ten years later, and then disappear completely.

Unlike ‘mere’ medical or physical disorders, mental disorders are not just problems. If successfully navigated, they can also present opportunities. Simply acknowledging this can empower people to heal themselves and, much more than that, to grow from their experiences.

If a child stays quiet in the context of extroverted friends, or even prefers time alone, a parent may worry and even send her to therapy. She might be thrilled— she’ll finally get to talk about the stuff she cares about, and without interruption! But if the therapist concludes that the child has a social phobia, the treatment of choice is to increasingly expose her to the situations she fears. This behavioral treatment is effective for treating phobias — if that is truly the problem. If it’s not the problem, and the child just likes hanging out inside better than chatting, she’ll have a problem soon. Her “illness” now will be an internalized self-reproach: “Why don’t I enjoy this like everyone else?” The otherwise carefree child learns that something is wrong with her. She not only is pulled away from her home, she is supposed to like it. Now she is anxious and unhappy, confirming the suspicion that she has a problem.

One of the paradoxical and transformative aspects of implicit traumatic memory is that once it is accessed in a resourced way (through the felt sense), it, by its very nature, changes. Out of the shattered fragments of her deeply injured psyche, Jody discovered and nurtured a nascent, emergent self. From the ashes of the frantically activated, hypervigilant, frozen, traumatized girl of twenty-five years ago, Jody began to reorient to a new, less threatening world. Gradually she shaped into a more fluid, resilient, woman, coming to terms with the felt capacity to fiercely defend herself when necessary, and to surrender in quiet ecstasy.

Ill treatment by opponents Is a catalyst for your meditation; Insulting reproaches you don’t deserve Spur your practice onward; Those who do you harm are teachers Challenging your attachment and aversion— How could you ever repay their kindness? Indeed, you are unlikely to make much spiritual progress if you lack the courage to face your own hidden faults. Any person or situation that helps you to see those faults, however uncomfortable and humiliating it may be, is doing you a great service.

The process of reforming the mental health system never includes the complaints that families and caregivers have regarding a need for increased access to resources, treatment, education, and financial support. Reform has continued to ignore the basic needs of families and suffering individuals with severe mental illness and special needs.

There are stages to the process of being betrayed by your society. One is jolted from a place of complacency by the discovery of difference, by hypocrisy, by inexplicable or incongruous ill treatment. What follows is a time of confusion—unlearning what one thought to be the truth. Immersing oneself in the new truth. And then a decision must be made. Some accept their fate. Swallow their pride, forget the real truth, embrace the falsehood for all they’re worth—because, they decide, they cannot be worth much. If a whole society has dedicated itself to their subjugation, after all, then surely they deserve it? Even if they don’t, fighting back is too painful, too impossible. At least this way there is peace, of a sort. Fleetingly. The alternative is to demand the impossible. It isn’t right, they whisper, weep, shout; what has been done to them is not right. They are not inferior. They do not deserve it. And so it is the society that must change. There can be peace this way, too, but not before conflict. No one reaches this place without a false start or two.

A landmark 2010 study from the Massachusetts General Hospital had even more startling findings. The researchers randomly assigned 151 patients with stage IV lung cancer, like Sara’s, to one of two possible approaches to treatment. Half received usual oncology care. The other half received usual oncology care plus parallel visits with a palliative care specialist. These are specialists in preventing and relieving the suffering of patients, and to see one, no determination of whether they are dying or not is required. If a person has serious, complex illness, palliative specialists are happy to help. The ones in the study discussed with the patients their goals and priorities for if and when their condition worsened. The result: those who saw a palliative care specialist stopped chemotherapy sooner, entered hospice far earlier, experienced less suffering at the end of their lives—and they lived 25 percent longer. In other words, our decision making in medicine has failed so spectacularly that we have reached the point of actively inflicting harm on patients rather than confronting the subject of mortality.

I mention a paradox of psychiatry: mental illness is recognized by the patient's distorted thoughts, but treatment is largely indifferent to their content. (104)

And what science had revealed was this: Prior to treatment, patients diagnosed with schizophrenia, depression, and other psychiatric disorders do not suffer from any known "chemical imbalance". However, once a person is put on a psychiatric medication, which, in one manner or another, throws a wrench into the usual mechanics of a neuronal pathway, his or her brain begins to function, as Hyman observed, abnormally.

Looks like I'll be sucking your cock for food, but entirely my way." Vadim paused. "No. Food is free. I'll give you money so you can buy food." Dan's head hidden, lowered, Vadim couldn't see his facial expression. Surprise. Astonishment, his Russkie was more decent to him than he'd expected. Had hoped for a scrap to eat, but this treatment was more of a royal one. "You're treating me like I used to treat my pussies." Dan smirked, lifting his head. "You shaved their heads? You weird man." Vadim chuckled while Dan muttered one of his choice obscenities.

What tormented Ivan Ilyich most was the deception, the lie, which for some reason they all accepted, that he was not dying but was simply ill, and the only need keep quiet and undergo a treatment and then something very good would result.

We have a genuine and devastating epidemic of opiate abuse in this country, and it is of critical importance that this problem be addressed. But we must do so in a way that doesn’t cut off an effective (and often the only) treatment for the chronically ill, many of whom are able to function in this world at all only because of the small respite that responsible opiate use provides.

Doctors diagnosed us with everything from PTSD to ADHD. We collected an alphabet of acronyms, but no treatment or therapy ever seemed to be able to reset us to how we’d been before it happened. We weren’t ill, it was decided: We were just strange.

A permanent possibility of selfishness arises from the mere fact of having a self, and not from any accidents of education or ill-treatment. And the weakness of all Utopias is this, that they take the greatest difficulty of man and assume it to be overcome, and then give an elaborate account of the overcoming of the smaller ones. They first assume that no man will want more than his share, and then are very ingenious in explaining whether his share will be delivered by motor-car or balloon.

You don’t have to spend much time with the elderly or those with terminal illness to see how often medicine fails the people it is supposed to help. The waning days of our lives are given over to treatments that addle our brains and sap our bodies for a sliver’s chance of benefit. These days are spent in institutions—nursing homes and intensive-care units—where regimented, anonymous routines cut us off from all the things that matter to us in life.

Knowledge brings the hope of treatment or cure. And even if there is no cure, a diagnosis is a form of knowing (the word “diagnosis” derives from the Greek gignōskein, “to know”) that allows others to recognize our experience and enables us to tell its story

What I rather wish to say is that the humanity we all share is more important than the mental illness we may not. With proper treatment, someone who is mentally ill can lead a full and rich life. What makes life wonderful--good friends, a satisfying job, loving relationships--is just as valuable for those of us who struggle with schizophrenia as for anyone else.

By one tomorrow, I'll look enough like her to pass. I'm calling Mavis." "Oh." Peabody brightened. "Oh, that's iced." "Easy for you to say. You won't have to listen to lectures from her and Trina on why I haven't had my eyebrows shaped lately, or why I haven't used the butt cream or whatever. And I'll probably have to agree to a full treatment after the op." This was said with undisguised bitterness. "I know how they work." "You're a true soldier, sir, sacrificing yourself for the cause." "Wipe that smile off your face, Officer." "Wiping, sir.

[Hot flashes] are the prime cause of sleep disruption in women over age fifty, Suzanne Woodward of Wayne State University School of Medicine reports. Her studies show that hot flashes in sleep occur about once an hour. Most prompt an arousal of three minutes or longer. Independently of their hot flashes, women who have them still awaken briefly every eight minutes on average. The sleep process dramatically blunts memory for awakenings, Woodward said, and in the morning women seldom realize how poorly they slept. Instead, they often focus on the daytime consequences of poor sleep, which include fatigue, lethargy, mood swings, depression, and irritability. Many women and their doctors, Woodward said, dismiss such symptoms as "just menopause." This is a mistake, she suggested, because treatment can reduce or eliminate hot flashes, aid sleep, relieve other symptoms, and improve a woman's quality of life. Treatment also helps keep frequent awakenings from becoming a bad habit that continues after hot flashes subside.

Any important disease whose causality is murky, and for which treatment is ineffectual, tends to be awash in significance. First, the subjects of deepest dread (corruption, decay, pollution, anomie, weakness) are identified with the disease. The disease itself becomes a metaphor. Then, in the name of the disease (that is, using it as a metaphor), that horror is imposed on other things. The disease becomes adjectival. Something is said to be disease-like, meaning that it is disgusting or ugly.

The third point is that some of our efforts to treat psychopaths may be misplaced. The term treatment implies that there is something to treat: illness, subjective distress, maladaprive behaviors, and so forth. But, as far as we can determine, psychopaths are perfectly happy with themselves, and they see no need for treatment, at least in the traditional sense of the term.

We are often given pills or fluids to help remedy illness, yet little has been taught to us about the power of smell to do the exact same thing. It is known that the scent of fresh rosemary increases memory, but this cure for memory loss is not divulged by doctors to help the elderly. I also know that the most effective use of the blue lotus flower is not from its dilution with wine or tea – but from its scent. To really maximize the positive effects of the blue lily (or the pink lotus), it must be sniffed within minutes of plucking. This is why it is frequently shown being sniffed by my ancient ancestors on the walls of temples and on papyrus. Even countries across the Orient share the same imagery. The sacred lotus not only creates a relaxing sensation of euphoria, and increases vibrations of the heart, but also triggers genetic memory - and good memory with an awakened heart ushers wisdom.

            Tempting as it may be to draw one conclusion or another from my story and universalize it to apply to another's experience, it is not my intention for my book to be seen as some sort of cookie-cutter approach and explanation of mental illness, It is not ab advocacy of any particular form of therapy over another. Nor is it meant to take sides in the legitimate and necessary debate within the mental health profession if which treatments are most effective for this or any other mental illness.             What it is, I hope, is a way for readers to get a true feel for what it's like to be in the grips of mental illness and what it's like to strive for recovery.

Oh, and you should know . . . if you keep calling me harlot, sooner or later I’m going to have a rage blackout, and then I’ll wake up to find you—awfully sadly—dead.” “You threaten me? A powerless, physically weak sorceress?” he sneered. “I must amend my treatment of you forthwith.” “You’ve turned into a sarcastic, unbalanced, judgmental dick.” To herself, she muttered, “Man, can I pick ’em.” “If you take issue with the term harlot, then perhaps you shouldn’t have slept with half the Lore.” “Half?” she scoffed. “Three-quarters for the win!

I have chosen to write about this painfully ironic experience because my illness and the brutal side effects of the treatment caused me to realize that food was not just a huge part of my life; it basically was my life. Food at once grounded me and took me to other places. It comforted me and challenged me. It was part of the fabric that made up my creative self and my domestic self. It allowed me to express my love for the people I love and make connections with new people I might come to love.

Although, in principle, the psychoanalytical theory of borderlines is not punitive, in practice 'borderline' is almost always used to indicate that the patient is hostile, demanding, unpleasant, manipulative, attention-seeking, and prone to regression and dependency if admitted to hospital; in other words patient is a witch by Malleus Maleficarum criteria. The term 'borderline' functions to rationalize sadistic counter-transference, and to legitimize rejecting triaging decisions within the health-care system. Actually, most of the time, in my experience, the splitting is coming from the staff, not the patient, and it is the mental-health professionals who are using projection and denial. This is an example of 'blaming the victim,' which is a fundamental borderline psychodynamic.

Through the various discourses, legal sanctions against minor perversions were multiplied; sexual irregularity was annexed to mental illness; from childhood to old age, a norm of sexual development was defined and all the possible deviations were carefully described; pedagogical controls and medical treatments were organized; around the least fantasies, moralists, but especially doctors, brandished the whole emphatic vocabulary of abomination.

At its heart, Codependency is a set of behaviors developed to manage the anxiety that comes when our primary attachments are formed with people who are inconsistent or unavailable in their response to us. Our anxiety-based responses to life can include over-reactivity, image management, unrealistic beliefs about our limits, and attempts to control the reality of others to the point where we lose our boundaries, self-esteem, and even our own reality. Ultimately, Codependency is a chronic stress disease, which can devastate our immune system and lead to systemic and even life-threatening illness.

I also very well remember that on another occasion the father dean said: ‘In order that at responsible age a man may be a real man and not a parasite, his education must without fail be based on the following ten principles. ‘From early childhood there should be instilled in the child: Belief in receiving punishment for disobedience. Hope of receiving reward only for merit. Love of God—but indiference to the saints. Remorse of conscience for the ill-treatment of animals. Fear of grieving parents and teachers. Fearlessness towards devils, snakes and mice. Joy in being content merely with what one has. Sorrow at the loss of the goodwill of others. Patient endurance of pain and hunger. The striving early to earn one’s bread.

I remember going to the British Museum one day to read up the treatment for some slight ailment of which I had a touch – hay fever, I fancy it was. I got down the book, and read all I came to read; and then, in an unthinking moment, I idly turned the leaves, and began to indolently study diseases, generally. I forget which was the first distemper I plunged into – some fearful, devastating scourge, I know – and, before I had glanced half down the list of “premonitory symptoms,” it was borne in upon me that I had fairly got it. I sat for awhile, frozen with horror; and then, in the listlessness of despair, I again turned over the pages. I came to typhoid fever – read the symptoms – discovered that I had typhoid fever, must have had it for months without knowing it – wondered what else I had got; turned up St. Vitus’s Dance – found, as I expected, that I had that too, – began to get interested in my case, and determined to sift it to the bottom, and so started alphabetically – read up ague, and learnt that I was sickening for it, and that the acute stage would commence in about another fortnight. Bright’s disease, I was relieved to find, I had only in a modified form, and, so far as that was concerned, I might live for years. Cholera I had, with severe complications; and diphtheria I seemed to have been born with. I plodded conscientiously through the twenty-six letters, and the only malady I could conclude I had not got was housemaid’s knee. ... I had walked into that reading-room a happy, healthy man. I crawled out a decrepit wreck. I went to my medical man. He is an old chum of mine, and feels my pulse, and looks at my tongue, and talks about the weather, all for nothing, when I fancy I’m ill; so I thought I would do him a good turn by going to him now. “What a doctor wants,” I said, “is practice. He shall have me. He will get more practice out of me than out of seventeen hundred of your ordinary, commonplace patients, with only one or two diseases each.” So I went straight up and saw him, and he said: “Well, what’s the matter with you?” I said: “I will not take up your time, dear boy, with telling you what is the matter with me. Life is brief, and you might pass away before I had finished. But I will tell you what is NOT the matter with me. I have not got housemaid’s knee. Why I have not got housemaid’s knee, I cannot tell you; but the fact remains that I have not got it. Everything else, however, I HAVE got.” And I told him how I came to discover it all. Then he opened me and looked down me, and clutched hold of my wrist, and then he hit me over the chest when I wasn’t expecting it – a cowardly thing to do, I call it – and immediately afterwards butted me with the side of his head. After that, he sat down and wrote out a prescription, and folded it up and gave it me, and I put it in my pocket and went out. I did not open it. I took it to the nearest chemist’s, and handed it in. The man read it, and then handed it back. He said he didn’t keep it. I said: “You are a chemist?” He said: “I am a chemist. If I was a co-operative stores and family hotel combined, I might be able to oblige you. Being only a chemist hampers me.” I read the prescription. It ran: “1 lb. beefsteak, with 1 pt. bitter beer every 6 hours. 1 ten-mile walk every morning. 1 bed at 11 sharp every night. And don’t stuff up your head with things you don’t understand.” I followed the directions, with the happy result – speaking for myself – that my life was preserved, and is still going on.

No,” said a third student. “Novartis is a public company. It’s not the boss or the board who decides. It’s the shareholders. If the board changes its priorities the shareholders will just elect a new board.” “That’s right,” I said. “It’s the shareholders who want this company to spend their money on researching rich people’s illnesses. That’s how they get a good return on their shares.” So there’s nothing wrong with the employees, the boss, or the board, then. “Now, the question is”—I looked at the student who had first suggested the face punching—“who owns the shares in these big pharmaceutical companies?” “Well, it’s the rich.” He shrugged. “No. It’s actually interesting because pharmaceutical shares are very stable. When the stock market goes up and down, or oil prices go up and down, pharma shares keep giving a pretty steady return. Many other kinds of companies’ shares follow the economy—they do better or worse as people go on spending sprees or cut back—but the cancer patients always need treatment. So who owns the shares in these stable companies?” My young audience looked back at me, their faces like one big question mark. “It’s retirement funds.” Silence. “So maybe I don’t have to do any punching, because I will not meet the shareholders. But you will. This weekend, go visit your grandma and punch her in the face. If you feel you need someone to blame and punish, it’s the seniors and their greedy need for stable stocks.

Although it is important to be able to recognise and disclose symptom of physical illnesses or injury, you need to be more careful about revealing psychiatric symptoms. Unless you know that your doctor understands trauma symptoms, including dissociation, you are wise not to reveal too much. Too many medical professionals, including psychiatrists, believe that hearing voices is a sign of schizophrenia, that mood swings mean bipolar disorder which has to be medicated, and that depression requires electro-convulsive therapy if medication does not relieve it sufficiently. The “medical model” simply does not work for dissociation, and many treatments can do more harm than good... You do not have to tell someone everything just because he is she is a doctor. However, if you have a therapist, even a psychiatrist, who does understand, you need to encourage your parts to be honest with that person. Then you can get appropriate help.

Hi there, cutie." Ash turned his head to find an extremely attractive college student by his side. With black curly hair, she was dressed in jeans and a tight green top that displayed her curves to perfection. "Hi." "You want to go inside for a drink? It's on me." Ash paused as he saw her past, present, and future simultaneously in his mind. Her name was Tracy Phillips. A political science major, she was going to end up at Harvard Med School and then be one of the leading researchers to help isolate a mutated genome that the human race didn't even know existed yet. The discovery of that genome would save the life of her youngest daughter and cause her daughter to go on to medical school herself. That daughter, with the help and guidance of her mother, would one day lobby for medical reforms that would change the way the medical world and governments treated health care. The two of them would shape generations of doctors and save thousands of lives by allowing people to have groundbreaking medical treatments that they wouldn't have otherwise been able to afford. And right now, all Tracy could think about was how cute his ass was in leather pants, and how much she'd like to peel them off him. In a few seconds, she'd head into the coffee shop and meet a waitress named Gina Torres. Gina's dream was to go to college herself to be a doctor and save the lives of the working poor who couldn't afford health care, but because of family problems she wasn't able to take classes this year. Still Gina would tell Tracy how she planned to go next year on a scholarship. Late tonight, after most of the college students were headed off, the two of them would be chatting about Gina's plans and dreams. And a month from now, Gina would be dead from a freak car accident that Tracy would see on the news. That one tragic event combined with the happenstance meeting tonight would lead Tracy to her destiny. In one instant, she'd realize how shallow her life had been, and she'd seek to change that and be more aware of the people around her and of their needs. Her youngest daughter would be named Gina Tory in honor of the Gina who was currently busy wiping down tables while she imagined a better life for everyone. So in effect, Gina would achieve her dream. By dying she'd save thousands of lives and she'd bring health care to those who couldn't afford it... The human race was an amazing thing. So few people ever realized just how many lives they inadvertently touched. How the right or wrong word spoken casually could empower or destroy another's life. If Ash were to accept Tracy's invitation for coffee, her destiny would be changed and she would end up working as a well-paid bank officer. She'd decide that marriage wasn't for her and go on to live her life with a partner and never have children. Everything would change. All the lives that would have been saved would be lost. And knowing the nuance of every word spoken and every gesture made was the heaviest of all the burdens Ash carried. Smiling gently, he shook his head. "Thanks for asking, but I have to head off. You have a good night." She gave him a hot once-over. "Okay, but if you change your mind, I'll be in here studying for the next few hours." Ash watched as she left him and entered the shop. She set her backpack down at a table and started unpacking her books. Sighing from exhaustion, Gina grabbed a glass of water and made her way over to her... And as he observed them through the painted glass, the two women struck up a conversation and set their destined futures into motion. His heart heavy, he glanced in the direction Cael had vanished and hated the future that awaited his friend. But it was Cael's destiny. His fate... "Imora thea mi savur," Ash whispered under his breath in Atlantean. God save me from love.

But Carol Gill says that it is differential treatment—disability discrimination—to try to prevent most suicides while facilitating the suicides of ill and disabled people. The social science literature suggests that the public in general, and physicians in particular, tend to underestimate the quality of life of disabled people, compared with our own assessments of our lives. The case for assisted suicide rests on stereotypes that our lives are inherently so bad that it is entirely rational if we want to die.

The pressure to reduce health care costs is aimed only at the treatment of real diseases. There is no pressure to reduce the costs of treating fictitious diseases. On the contrary, there is pressure to define ever more types of undesirable behaviors as mental disorders or addictions and to spend ever more tax dollars on developing new psychiatric diagnoses and facilities for storing and treating the victims of such diseases, whose members now include alcoholics, drug abusers, smokers, overeaters, self-starvers, gamblers, etc.

Other personalities are created to handle new traumas, their existence usually occurring one at a time. Each has a singular purpose and is totally focused on that task. The important aspect of the mind's extreme dissociation is that each ego state is totally without knowledge of the other. Because of this, the researchers for the CIA and the Department of Defense believed they could take a personality, train him or her to be a killer and no other ego stares would be aware of the violence that was taking place. The personality running the body would be genuinely unaware of the deaths another personality was causing. Even torture could not expose the with, because the personality experiencing the torture would have no awareness of the information being sought. Earlier, such knowledge was gained from therapists working with adults who had multiple personalities. The earliest pioneers in the field, such as Dr. Ralph Alison, a psychiatrist then living in Santa Cruz, California, were helping victims of severe early childhood trauma. Because there were no protocols for treatment, the pioneers made careful notes, publishing their discoveries so other therapists would understand how to help these rare cases. By 1965, the information was fairly extensive, including the knowledge that only unusually intelligent children become multiple personalities and that sexual trauma endured by a restrained child under the age of seven is the most common way to induce hysteric dissociation.

If you tell someone you have depression, they will often say, "Oh, I've been depressed before, too." The difference lies between being depressed and having depression. Everyone's been depressed at one time or another, but these are far from being the same things. One is a passing mood. The other is a chronic illness that does not come and go, ebb and flow, is here one day and gone the next. The difference between being depressed and having depression is that one is a mood and the other is an illness. One is a momentary bout of melancholy. The other is a debilitating condition that requires medical treatment. Would you feel better about having a cancerous lesion if I likened it to the rash I had last week? The difference between being depressed and having depression is the difference between a mood that will soon pass, and a serious illness that disrupts your ability to function and will take years to treat. The difference between being depressed and having depression is the difference between Cleveland and Bangkok, or your frying pan and the surface of the sun. So, no, we (depressives) do not feel better when you tell us about your rash. We'll do our best to be polite about it, but no, it really doesn't help at all.

If everyone has the capacity for some measure of depression under some circumstances, everyone also has the capacity to fight depression to some degree under some circumstances. Often, the fight takes the form of seeking out the treatments that will be most effective in the battle. It involves finding help while you are still strong enough to do so. It involves making the most of the life you have between your most severe episodes. Some horrendously symptom-ridden people are able to achieve real success in life; and some people are utterly destroyed by the mildest forms of the illness.

Kaysen elaborates through parts of the book on her thoughts about how mental illness is treated. She explains that families who are willing to pay the rather high costs of hospitalization do so to prove their own sanity. Once one member of the family is hospitalized, it becomes easier for the rest of the family to distance themselves from the problem and to create a clear boundary between the sane and the insane. Recognizing a family member or friend as insane makes others around them, says Kaysen, compare themselves to that individual. Hospitalization allows for distance from this questioning of self that makes us so uncomfortable. Her view that mental illness often includes the entire family means the hospitalized family member becomes an excuse for other family members not to look at their own problems. This explains the willingness to pay the high financial costs of hospitalization.

The United States spends more than twice as much per capita on health care as other rich capitalist countries —around $9,400 compared to around $3,600—and for that money its citizens can expect lives that are three years shorter. The United States spends more per capita on health care than any other country in the world, but 39 countries have longer life expectancies. [...] Under the current US system, rich, insured patients visit doctors more than they need, running up costs, while poor patients cannot afford even simple, inexpensive treatments and die younger than they should. Doctors spend time that could be used to save lives or treat illness by providing unnecessary, meaningless care. What a tragic waste of physician care.

The uncomfortable, as well as the miraculous, fact about the human mind is how it varies from individual to individual. The process of treatment can therefore be long and complicated. Finding the right balance of drugs, whether lithium salts, anti-psychotics, SSRIs or other kinds of treatment can be a very hit or miss heuristic process requiring great patience and classy, caring doctoring. Some patients would rather reject the chemical path and look for ways of using diet, exercise and talk-therapy. For some the condition is so bad that ECT is indicated. One of my best friends regularly goes to a clinic for doses of electroconvulsive therapy, a treatment looked on by many as a kind of horrific torture that isn’t even understood by those who administer it. This friend of mine is just about one of the most intelligent people I have ever met and she says, “I know. It ought to be wrong. But it works. It makes me feel better. I sometimes forget my own name, but it makes me happier. It’s the only thing that works.” For her. Lord knows, I’m not a doctor, and I don’t understand the brain or the mind anything like enough to presume to judge or know better than any other semi-informed individual, but if it works for her…. well then, it works for her. Which is not to say that it will work for you, for me or for others.

If you think about it, the public perception of funky brain chemistry has been as varied and weird as the symptoms, historically speaking. If I had been born a Native American in another time, I might have been lauded as a medicine man. My voices would have been seen as the voices of ancestors imparting wisdom. I would have been treated with great mystical regard. If I had lived in biblical times, I might have been seen as a prophet, because, let’s face it, there are really only two possibilities: either prophets were actually hearing God speaking to them, or they were mentally ill. I’m sure if an actual prophet surfaced today, he or she would receive plenty of Haldol injections, until the sky opened up and the doctors were slapped silly by the Hand of God. In the Dark Ages my parents would have sent for an exorcist, because I was clearly possessed by evil spirits, or maybe even the Devil himself. And if I lived in Dickensian England, I would have been thrown into Bedlam, which is more than just a description of madness. It was an actual place—a “madhouse” where the insane were imprisoned in unthinkable conditions. Living in the twenty-first century gives a person a much better prognosis for treatment, but sometimes I wish I’d lived in an age before technology. I would much rather everyone think I was a prophet than some poor sick kid.

Trina and her consultants will be here by four to start setting up.” “Joy and—what? Who? Trina? Why? What have you done?” “You said no silly games, and no strippers,” Peabody reminded her. “We’re doing the full-out girl party. Champagne, decadent food, body, hair, face treatments. Chick-vids, presents, gooey desserts. Big girl slumber party, followed by champagne brunch tomorrow.” “You mean . . .” The shock was sharp and cruel, a stunner blast against the heart. “Overnight? All night into tomorrow?” “Yeah.” Peabody grinned around her carrot. “Didn’t I mention that?” “I have to kill you now.” “Uh-uh. No games, no strippers. Those were your only rules.” “I’ll find a way to hurt you for this.

Why isn't every woman a feminist? Feminism tells a tale of female injury, but the average woman in heterosexual intimacy knows that men are injured too, as indeed they are. She may be willing to grant, this average woman, that men in general have more power than women in general. This undoubted fact is merely a fact; it is abstract, while the man of flesh and blood who stands before her is concrete: His hurts are real, his fears palpable. And like those heroic doctors on the late show who work tirelessly through the epidemic even though they may be fainting from fatigue, the woman in intimacy may set her own needs to one side in order better to attend to his. She does this not because she is "chauvinized" or has "false consciousness," but because this is what the work requires. Indeed, she may even excuse the man's abuse of her, having glimpsed the great reservoir of pain and rage from which it issues. Here is a further gloss on the ethical disempowerment attendant upon women's caregiving: in such a situation, a woman may be tempted to collude in her own ill-treatment.

People who live with ADHD are at high risk of addiction, especially adolescents, because of their poorly functioning frontal lobes. Years ago, when the illness was less well understood, doctors and parents were reluctant to give these vulnerable children addictive drugs such as Ritalin and amphetamine. It sounded reasonable: don’t give addictive substances to people at risk for addiction. But rigorous testing showed unambiguously that adolescents who were treated with stimulant drugs were less likely to develop addictions. In fact, those who started the drug at the youngest age and took the highest doses were the least likely to develop problems with illicit drugs. Here’s why: if you strengthen the dopamine control circuit, it’s a lot easier to make wise decisions. On the other hand, if effective treatment is withheld, the weakness of the control circuit is not corrected. The desire circuit acts unopposed, increasing the likelihood of high-risk, pleasure-seeking behavior.

The act of consciously and purposefully paying attention to symptoms and their antecedents and consequences makes the symptoms more an objective target for thoughtful observation than an intolerable source of subjective anxiety, dysphoria, and frustration. In ACT, the act of accepting the symptoms as an expectable feature of a disorder or illness, has been shown to be associated with relief rather than increased distress (Hayes et al., 2006). From a traumatic stress perspective, any symptom can be reframed as an understandable, albeit unpleasant and difficult to cope with, reaction or survival skill (Ford, 2009b, 2009c). In this way, monitoring symptoms and their environmental or experiential/body state "triggers" can enhance client's willingness and ability to reflectively observe them without feeling overwhelmed, terrified, or powerless. This is not only beneficial for personal and life stabilization but is also essential to the successful processing of traumatic events and reactions that occur in the next phase of therapy (Ford & Russo, 2006).

I have rules,” she said to him. He stilled his pen, raised expressionless eyes to her face, and waited. “When you bring me an old servant who’s come willingly where the king’s men have bidden him, a man who’s never been convicted, or even accused, of a crime,” Fire said, “I will not take his mind. I’ll sit before him and ask questions, and if my presence makes him more talkative, very well. But I will not compel him to say things he would otherwise not have said. Nor,” she added, voice rising, “will I take the mind of a person who’s been fed too little, or denied medicines, or beaten in your jails. I won’t manipulate a prisoner you’ve mistreated.” Garan sat back and crossed his arms. “That’s rich, isn’t it? Your own manipulation is mistreatment; you’ve said it yourself.” “Yes, but mine is meant to be for good reason. Yours is not.” “It’s not my mistreatment. I don’t give the orders down there, I’ve no idea what goes on.” “If you want me to question them, you’d best find out.” To Garan’s credit, the treatment of Dellian prisoners did change after that. One particularly laconic man, after a session in which Fire learned positively nothing, thanked her for it specifically. “Best dungeons I ever been in,” he said, chewing on a toothpick. “Wonderful,” Garan grumbled when he’d gone. “We’ll grow a reputation for our kindness to lawbreakers.

I have another scan this week," I say lightly, hoping to reassure my loved ones that it is safe to rejoin my orbit. There is always another scan, because this is my reality. But the people I know are often busy contending with mildly painful ambition and the possibility of reward. I try to begrudge them nothing, except I'm not alongside them anymore. In the meantime, I have been hunkering down with old medical supplies and swelling resentment. I tried— haven't I tried? — to avoid fights and remember birthdays. I showed up for dance recitals and listened to weight-loss dreams and kept the granularity of my medical treatments in soft focus. A person like that would be easier to love, I reasoned. I try a small experiment and stop calling my regular rotation of friends and family, hoping that they will call me back on their own. _This is not a test. This is not a test._ The phone goes quiet, except for a handful of calls. I feel heavy with strange new grief. Is it bitter or unkind to want everyone to remember what I can't forget? Who wants to be confronted with the reality that we are all a breath away from a problem that could alter our lives completely? A friend with a very sick child said it best: I'm everyone's inspiration and and no one's friend. I am asked all the time to say that, given what I've gained in perspective, I would never go back. Who would want to know the truth? Before was better.

McKusick's belief in this paradigm-the focus on disability rather than abnormalcy-was actualized in the treatment of patients in his clinic. Patients with dwarfism, for instance, were treated by an interdisciplinary team of genetic counselors, neurologists, orthopedic surgeons, nurses, and psychiatrists trained to focus on specific disabilities of persons with short stature. Surgical interventions were reserved to correct specific deformities as they arose. The goal was not to restore "normalcy"-but vitality, joy, and function. McKusic had rediscovered the founding principles of modern genetics in the realm of human pathology. In humans as in wild flies, genetic variations abounded. Here too genetic variants, environments, and gene-environment interactions ultimately collaborated to cause phenotypes-except in this case, the "phenotype" in question was disease. Here too some genes had partial penetrance and widely variable expressivity. One gene could cause many diseases, and one disease could be caused by many genes. And here too "fitness" could not be judged in absolutes. Rather the lack of fitness-illness [italicized, sic] in colloquial terms- was defined by the relative mismatch between an organism and environment.

It’s normally agreed that the question “How are you?” doesn’t put you on your oath to give a full or honest answer. So when asked these days, I tend to say something cryptic like, “A bit early to say.” (If it’s the wonderful staff at my oncology clinic who inquire, I sometimes go so far as to respond, “I seem to have cancer today.”) Nobody wants to be told about the countless minor horrors and humiliations that become facts of “life” when your body turns from being a friend to being a foe: the boring switch from chronic constipation to its sudden dramatic opposite; the equally nasty double cross of feeling acute hunger while fearing even the scent of food; the absolute misery of gut–wringing nausea on an utterly empty stomach; or the pathetic discovery that hair loss extends to the disappearance of the follicles in your nostrils, and thus to the childish and irritating phenomenon of a permanently runny nose. Sorry, but you did ask... It’s no fun to appreciate to the full the truth of the materialist proposition that I don’t have a body, I am a body. But it’s not really possible to adopt a stance of “Don’t ask, don’t tell,” either. Like its original, this is a prescription for hypocrisy and double standards. Friends and relatives, obviously, don’t really have the option of not making kind inquiries. One way of trying to put them at their ease is to be as candid as possible and not to adopt any sort of euphemism or denial. The swiftest way of doing this is to note that the thing about Stage Four is that there is no such thing as Stage Five. Quite rightly, some take me up on it. I recently had to accept that I wasn’t going to be able to attend my niece’s wedding, in my old hometown and former university in Oxford. This depressed me for more than one reason, and an especially close friend inquired, “Is it that you’re afraid you’ll never see England again?” As it happens he was exactly right to ask, and it had been precisely that which had been bothering me, but I was unreasonably shocked by his bluntness. I’ll do the facing of hard facts, thanks. Don’t you be doing it too. And yet I had absolutely invited the question. Telling someone else, with deliberate realism, that once I’d had a few more scans and treatments I might be told by the doctors that things from now on could be mainly a matter of “management,” I again had the wind knocked out of me when she said, “Yes, I suppose a time comes when you have to consider letting go.” How true, and how crisp a summary of what I had just said myself. But again there was the unreasonable urge to have a kind of monopoly on, or a sort of veto over, what was actually sayable. Cancer victimhood contains a permanent temptation to be self–centered and even solipsistic.

I have indeed lived life in a very rough school and have seen more than the average man's share of inhumanity and cruelty, from the forecastle and the prison, the slum and the desert, the execution-chamber and the lazar-house, to the battlefield and the military hospital. I have seen horrible deaths and mutilations. I have seen imbeciles hanged, because, being imbeciles, they did not possess the hire of lawyers. I have seen the hearts and stamina of strong men broken, and I have seen other men, by ill-treatment, driven to permanent and howling madness. I have witnessed the deaths of old and young, and even infants, from sheer starvation. I have seen men and women beaten by whips and clubs and fists, and I have seen the rhinoceros-hide whips laid around the naked torsos of black boys so heartily that each stroke stripped away the skin in full circle. And yet, let me add finally, never have I been so appalled and shocked by the world's cruelty as have I been appalled and shocked in the midst of happy, laughing, and applauding audiences when trained-animal turns were being performed on the stage.

Until fairly recently, every family had a cornucopia of favorite home remedies--plants and household items that could be prepared to treat minor medical emergencies, or to prevent a common ailment becoming something much more serious. Most households had someone with a little understanding of home cures, and when knowledge fell short, or more serious illness took hold, the family physician or village healer would be called in for a consultation, and a treatment would be agreed upon. In those days we took personal responsibility for our health--we took steps to prevent illness and were more aware of our bodies and of changes in them. And when illness struck, we frequently had the personal means to remedy it. More often than not, the treatment could be found in the garden or the larder. In the middle of the twentieth century we began to change our outlook. The advent of modern medicine, together with its many miracles, also led to a much greater dependency on our physicians and to an increasingly stretched healthcare system. The growth of the pharmaceutical industry has meant that there are indeed "cures" for most symptoms, and we have become accustomed to putting our health in the hands of someone else, and to purchasing products that make us feel good. Somewhere along the line we began to believe that technology was in some way superior to what was natural, and so we willingly gave up control of even minor health problems.

Once I had been diagnosed with a terminal illness, I began to view the world through two perspectives; I was starting to see death as both doctor and patient. As a doctor, I knew not to declare “Cancer is a battle I’m going to win!” or ask “Why me?” (Answer: Why not me?) I knew a lot about medical care, complications, and treatment algorithms. I quickly learned from my oncologist and my own study that stage IV lung cancer today was a disease whose story might be changing, like AIDS in the late 1980s: still a rapidly fatal illness but with emerging therapies that were, for the first time, providing years of life. While being trained as a physician and scientist had helped me process the data and accept the limits of what that data could reveal about my prognosis, it didn’t help me as a patient. It didn’t tell Lucy and me whether we should go ahead and have a child, or what it meant to nurture a new life while mine faded. Nor did it tell me whether to fight for my career, to reclaim the ambitions I had single-mindedly pursued for so long, but without the surety of the time to complete them. Like my own patients, I had to face my mortality and try to understand what made my life worth living—and I needed Emma’s help to do so. Torn between being a doctor and being a patient, delving into medical science and turning back to literature for answers, I struggled, while facing my own death, to rebuild my old life—or perhaps find a new one. —

Most of the time, we have to be strong, we must not show our fragility. We’ve known that since the schoolyard. There is always a fragile bit of us, but we keep it very hidden. Yet Venetian glass doesn’t apologise for its weakness. It admits its delicacy; it is confident enough to demand careful treatment; it makes the world understand it could easily be damaged. It’s not fragile because of a deficiency, or by mistake. It's not as if its maker was trying to make it tough and hardy and then - stupidly - ended up with something a child could snap, or that would be shattered by clumsy mishandling. It is fragile and easily harmed as the consequence of its search for transparency and refinement and its desire to welcome sunlight and candle light into its depths. Glass can achieve wonderful effects but the necessary price is fragility. Some good things things have to be delicate - the dish says: ‘I am delightful, but if you knock me about I’ll break, and that’s not my fault.’ It is the duty of civilisation to allow the more delicate forms of human activity to thrive; to create environments where it is OK to be fragile. And we know, really, that it is not glass which most needs this care, it is ourselves. It’s obvious the glass could easily be smashed, so it makes you use your fingers tenderly; you have to be careful how you grasp the stem. It teaches us that moderation is admirable, and elegant, not just a tedious demand. It tells us that being careful is glamorous and exciting - even fashionable. It is a moral tale about gentleness, told by means of a drinking vessel. This is training for the more important moments in life when moderation will make a real difference to other people. Being mature - and civilised - means being aware of the effect of one’s strength on others.