The DO Book Club, September 2020: Fallible: A Memoir of a Young Physician’s Struggle with Mental Illness

Welcome back to The DO Book Club!

For September, Sherri Eldin, OMS II, of Touro College of Osteopathic Medicine in New York City, read Fallible: A Memoir of a Young Physician’s Struggle with Mental Illness by Kyle Bradford Jones, MD. If you’ve read this one, please share your thoughts in the comments below. And if you’d like to write a book review for a future month, please email Andy Brown at abrown@osteopathic.org.

My medical school’s orientation in July 2019 was booked solid with workshops that were meant to help us ease into our new lives. A few of them focused on the mental health issues that are pervasive in medicine. We were reminded of the struggles faced by many in our field, with a particular focus on suicide rates.

As someone who has personally experienced such a loss, that little alarm went off inside of me; that little twinge you feel deep down when you’re reminded of something that’s better left untouched. In front of over 130 strangers who were to be my classmates, I raised my hand.

“So if mental health and suicide are such well-known problems with such well-publicized data, what’s being done to turn it all around and make things better?”

I was told that it is difficult to make changes to something that is a deeply rooted, systemic issue, and that the data is so new that it will take at least 20 years for the industry to catch up. Exactly a year later, down to the week, I discovered and devoured Fallible. Dr. Jones is a man who is not willing to wait 20 years.

Dr. Jones courageously tells the story of his own struggle with depression and anxiety, which began as he was planning to enter medical school as a young man, and which continues in his present life as a married father of four.

Throughout the book, we sit by Dr. Jones’ side as several triggering incidents occur in various stages of his career. We are there with him as he escalates to the climax of his emotions and thoughts, to the ultimate (but not always guaranteed) resolution. The familiarity and frankness in his writing frequently left me feeling as though I was reading a text from an old friend who was venting after a long day.

In one of his most powerful stories, Dr. Jones invites us into the hospital as a series of staff members are trying to convince “Mr. P.,” a patient experiencing homelessness, to accept their help. After a number of unsuccessful attempts, Dr. Jones is the last one sent into his room, and … you’ll have to read the ending yourself. It is a story that reminds us of what happens when we allow our patients—and ourselves—to see our human side, flaws and all.

This book is not only for readers in the medical field; Dr. Jones appeals to a larger audience by addressing grand-scale human themes. He explores his decades-old habit of questioning his own self-worth and purpose in this world. His worry of “cosmic insignificance” is a theme that is ever-present throughout the book. “How could anything I … do in the future be of worth?” he asks, perhaps not only of himself, but of us. “What if I didn’t matter?” “Is raising children enough to create meaning in life?”

He also consciously works to break the stereotypes of what it means to be a man, communicating to us his inner emotional life and admitting that yes, men do cry.

Notable quotes

Many lines in this book have stuck with me. They carry a certain weight and a truth. Overall, I found solace in the knowledge that I’m not alone in the ups and the downs that come with being a medical student. My copy of the book is heavily highlighted so that I can easily go back to these quotes throughout my career. A few standouts:

• “Sometimes you don’t need solutions, just understanding.”
• “The favorite companion of depression and anxiety is guilt.”
• “Our suffering is mainly a detachment from a distinctive need for connection that we have lost.”
• “Does the altruism [of practicing medicine] fade because our educational focus in medical school emphasizes the basic science … to the exclusion of the patient as a person …?”
• “I finally accepted that perfection is not the immediate goal.”

If everyone called out these issues with the passion and fearlessness that Dr. Jones does, we wouldn’t have to wait another 20 years for the system to catch up.

National Suicide Prevention Week and World Suicide Prevention Day were earlier this month. Many marched in solidarity, which we can never have enough of. But that’s only a part of it. It is imperative that those in highly-visible positions do what they can to effect change.

As an attending physician and professor at a state university who is willing to share his own struggles with mental illness and advocate for the erasure of the stigma of mental illness among health care professionals, Dr. Jones is the voice we have been waiting for.

Takeaways

Read this book. Then make other people read it. If you’re an administrator or professor, make your students, residents, and fellow administrators read it. Share it with your MD counterparts.

Next, talk about the book. Open the floor for nonjudgemental discussion about the things we all face but have been told we must never whisper about, lest our futures come tumbling down. When we take the Osteopathic Oath, we vow to “strive always … for the interests of the students who will come after me.”

This book is the utmost exemplification of fulfilling that Oath. Whatever your affiliation—be it a school, a hospital, a clinic—you are part of the system. This is how you can help change it.

October’s book

For October, The DO Book Club will be reading The Beauty in Breaking: A Memoir by Michele Harper, MD.

As a reminder, if you read Fallible or any previous Book Club selection and want your reflections to be shared in future posts, or want to write your own book review for a future month, please leave a comment below or email abrown@osteopathic.org.

Happy reading!

Related reading:

The DO Book Club, August 2020: The Immortal Life of Henrietta Lacks

The DO Book Club, July 2020: The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma