Issues

Three (Make It Four) Short Essays

Musings on the way things are.

Short Essay One

By the year 2020, according to the World Health Organization, unipolar major depression is expected to be the leading cause of disability in terms of life years for women and throughout the developing regions of the world, where four fifths of the world’s population lives.

In its report, "The Global Burden of Disease," WHO states that the toll of mental illness has been seriously underestimated in the past, largely because it doesn’t produce the body counts that make health officials sit up and take notice. Nevertheless, despite being credited for just one percent of deaths, psychiatric conditions account for almost 11 per cent of the total disease burden worldwide. That figure is expected to increase by half to nearly 15 percent in 2020.

Worldwide, unipolar major depression leads all diseases in years lived with disabilities. Bipolar disorder is sixth on the list. In developed countries, depression is second only to ischemic heart disease. In the 15-44 age bracket worldwide, depression tops the list with bipolar at number six.

One of these days, someone will adjust the death figures to account for the silent killer role unipolar and bipolar depression plays in heart disease and other illnesses, and then we’ll see those grim reaper stats go through the roof. Then, perhaps, certain people will sit up and take notice. In the meantime, the NIMH is the poor relation in the NIH family, with a 2001 budget of $1.03 billion, of which AIDS projects unaccountably lopped off a lion’s share of $135 million. By contrast, the National Cancer Institute received $3.5 billion and the National Heart, Lung, and Blood Institute $1.76 billion.

As to why WHO sees no end in sight for depression and bipolar despite all the new medications on the market and scientific advances on the horizon, a simple real-life compare and contrast situation is helpful:

A member of my family very recently had open heart surgery. The operation took five hours as doctors cracked her open like a lobster, took her heart out of the body and grafted four sections of veins from her leg to bypass the four partially blocked arteries in her heart. In addition, they replaced her aorta valve with muscle tissue from a cow. Then they put her back together again.

The next day, she was laughing and joking. A few days later, she was transferred to a care facility for physical rehab. It will still take several weeks before her body fully heals, but soon enough she will be singing and tap dancing, perhaps this time on key. A heart operation may well be one of the most complex procedures known to medical science, but when it’s over there is a sense of completion - of rebirth, even - of one being fully restored to good health.

By contrast, taking a pill or two for depression or bipolar is a deceptively simple exercise, one that utterly belies the intricately subtle chemical processes taking place throughout the brain, all of it off-limits to the surgeon’s scalpel. But having swallowed our pills, who amongst us can claim that same sense of completion? If only getting our brains back in working order were as simple as heart surgery. If only we had that kind of option.

Short Essay Two

Many spiritual beliefs teach us we pick the lives we're born into, and many times I have played the scene in my head, of me a half century ago ready to disembark the godly planes as I negotiate with my cosmic broker the terms for my upcoming earthly existence. I have been singled out, he informs me. I can have all the worldly success of a George Bush Republican, he lets me know. The catch is I will BE a George Bush Republican. The other path, he tells me, leads to a deeper humanity and spirituality through a trail of a thousand sorrows.

I am clearly being honored. Precious few souls, I realize, are presented with such spectacular options. Nevertheless, I find myself trying to strike a better deal.

Can't I have the spirituality and humanity, I ask, with the Republican success, without the sorrows? And the cosmic broker only laughs. He sees my hesitation, then presents me with another choice - of a successful but modest professional life, a family, security, perhaps a light karmic obligation or two. He catches the wistful look in my eyes, of a simple dream denied by someone who has already made up his mind. He reaches over and hands me the thousand sorrows documents, which I sign without reading.

God, I hate you! I hear myself crying out many years later. But God doesn't hold this against me. God knows the deal, even if you and I can only imagine it.

Short Essay Three

There’s a parallel universe out there where I married the girl I dated in high school. There’s yet another parallel universe that finds me with the girl I was afraid to date. Yet more parallel universes backtrack further into my youth, recrossing key crossroads, turning this way where I had previously turned that way, turning that way where I had previously turned this way. Other parallel universes are more recent in origin, involving choices I made well into adulthood.

Every conceivable possibility is mapped out to infinity, all of them painful. Yes, one can be extremely grateful for having avoided the obvious disasters, but the could-have-beens leave a bitter taste in the mouth. Consciously, I choose to live in the present, in this universe, but then at the least expected moment, usually engaged in the most mundane task, a little piece of long-forgotten memory jars loose and takes me by surprise - a woman I met in college, a person I played in a band with, a ninth-grade history teacher, and - bam! kapow! - a new parallel universe.

Sometimes, I even allow myself the indulgence of imagining a happier more successful me occupying some small point in the time-space continuum.

Inevitably, though, all those countless parallel universes converge, for no matter which direction my life could have taken every one of them, sooner or later, would have smashed head-on into the condition I was born with, and suddenly I find myself a helpless bystander. Like an imploding supernova, there goes my marriage to the girl I dated in high school, not to mention the one I was afraid to date. My dream personality, my dream family, my dream career, everything nothing. One thing you can say about this illness, it is the great leveler, no universes excepted.

Short Essay Four

My 23-year-old daughter is a joy to be with. She has recently completed a double law and business degree in New Zealand, where I lived for 11 years, and has dropped in on her way to be with her beau in Ireland. She knows all about my illness and tries hard to understand me. Her questions are intelligent and penetrating and I am good at explaining. But then she makes a comment that makes me realize that she is an outsider looking in. I am saddened, of course, but the realist in me says the only way you can understand this illness is to have it.

That night I find myself praying to God that my daughter, and any children she may have, never understand me.

Published during the early 2000s, republished Feb 11, 2008