![Anything to Avoid the Pain]()
Late last year my cousin went missing. For weeks he was simply just gone. His cell phone was off and any attempt at tracking him was futile. If there were ever a time that I wanted Liam Neeson's character in Taken to be real, this was it.
The reality of the situation is that my cousin has a disorder that causes him to believe he possesses certain powers that, in truth, he does not have. When he first expressed to my mother that he believed he was an Egyptian god and devised a new way to derive the mathematical factor pi, his doctors believed his grandiosity and diagnosed him with bipolar disorder. After I noticed him laughing and talking to himself over the course of a summer, I realized that he actually had schizophrenia. It was this disorder that convinced him to seek solace in freezing temperatures for a peace he could not find in the warmth of his home. The voices told him that he was not a mortal male child. The voices told him that he had to leave home with a couple dollars in his pocket and seek enlightenment in a place that was hundreds of miles beyond the reach of his family.
For the past ten years, I have risen to early morning emergencies. It's become an unfortunate ritual. The pager exclaims its presence unapologetically, convulsing across my nightstand, and the phone demands attention until it is answered. This is my life, first as a doctor-in-training and now as a full-fledged doctor responsible for managing the care of people most wouldn't want to treat. I chose to become a psychiatrist. Of the many reasons, one was because of the doctor-client relationship I'd developed over time. Many of the individuals I came in contact with early on in my career seemed to trust me in ways they didn't other doctors. They trusted me enough to allow them to dictate what I knew would help them feel better. With my help, I allowed my patients to slip off the heavy blanket of another depressive episode. Or gave them medication that would silence the voices that clogged their thoughts. Voices that rattled for so long they sometimes made people do things they'd soon regret.
In the last two years especially, early mornings have been characterized by confusion and panic. My family, despite their collection of advanced degrees from esteemed institutions and their accumulated years of wisdom, felt I was the only one who had truly dared to, and who continually wanted to, unravel illnesses that plagued the human mind. Add to all this the fact that black folks like us would rather not deal with these kinds of things. We are strong. We are resilient. We fight through it. We turn tragedy into triumph. We do this to avoid the pain. Most importantly, we do this in order to forget. Except this was different. This was something that time and artful dodging would not heal.
When I was alerted to the news of my cousin's disappearance, I first tried to assume a clinical role. I am very good at disengaging from my emotions. But anyone who is good at emotional detachment is secretly a walking ball of unexposed nerves. I was no exception. So I learned how to prevent myself from crying—often digging my nails into my palms or my outer thighs—and mastered how to will a rogue tear that dared to leave the rim of my lower eyelid back to its point of departure. I was actually pretty good at assuming a clinical role throughout most of my cousin's ordeal. But, as time passed, I grew infuriated. How dare my cousin put my closely knit family into this predicament, I protested. I thought it selfish and inconsiderate. The gall of my cousin—this self-affirmed, spoiled child—to even try to pull this stunt one week before Thanksgiving made me irate.
Internally, I fought with myself. A lot. I knew my cousin wasn't able to comprehend what he was doing. That he was under a spell that only antipsychotic medication could cure. And yet I remained steadfast in my anger all while attempting to counsel my family, who were stunned that we had to broadcast our faults to the rest of the world, the local police and campus police. This young man is trouble so we must be too, they thought. As flyers of his disappearance circulated, my anger was replaced with exasperation. But he was my cousin. And I loved him. Really, I couldn't bear if anything bad happened to him. The truth is that my family would suffer a rip in its fabric that we would not be able to mend. Because we express ourselves with either extreme, rollicking joy or fierce, frightening and decisive rage, because we go from zero to one hundred real quick, a death was something, emotionally, we simply could not afford.
Over time I became ill from fretting. I eventually lost my appetite, although it was something I expected. I'd experienced depression before, so I knew the signs and how to stave them off. I began to sleep too little and then too much. Thanksgiving came and went like snow that doesn't stick. Despite my recommendations, my cousin's father initially resisted. Denial was in no short supply. I remained clinical while internally I grew tired of talking and trying to convince those around me. It's the struggle all doctors face with every resistant patient and their families: You don't know him the way I do. You just want to make him take poison. You must get a cut of that drug money. He's fine. He just needs to sleep. They think they know better.
My cousin was found after two weeks. We were relieved, but this did not carry contentment with the news. The real work was just beginning. Parts of me wanted for him to remain missing for a little longer, just so the phone calls would subside for a few more days, weeks, months. But the calls and texts and emails recommenced almost instantly. "What do think we should do? What should he take? Can you be his doctor?"
The solace had lifted. Here we were again. Here I was again.
Things progressed. It got worse before it got better. And, quite honestly, the situation now is not much better than it was prior to my cousin's disappearance. I struggle with guilt daily. I disengage from my family because I can only do but so much. It's easier to deal with patients who are battling the same problems than to deal with my cousin's. It's easier to let a call go to voicemail or ignore a text from my cousin or his father than to deal with yet another question that warrants more reassurance than my emotionally spent psyche can muster. This is not my child. And, under the law, this child is a man. A man who cannot be forced to take medication or sign his rights to enter a hospital against his will legally.
It's hard, but I manage to deal with my day-to-day role as a physician treating other patients and families fighting the same issues that I face personally. Much like the hallucinatory voices that plague my cousin, I try not to berate myself. I am now attempting to surround myself with those who believe I am a person worthy of praise and love. I am trying to remain grounded. Yet I remain clinical. I am often troubled.
I know enough to know this: I will make a difference in the lives of those I treat, but will fall short for those whose blood runs through my own veins.
Dr. Imani J. Walker is a physician trained in general adult psychiatry. She resides in Los Angeles.
[Illustration by Jim Cooke]
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