Nothing Was the Same Read Online Free PDF Page A

and financial consequences of doing this were substantial. I had spent long years in clinical training and had been treating patients for nearly two decades. I enjoyed broad clinical responsibilities when I was director of the UCLA Affective Disorders Clinic and had maintained active private practices, first in Los Angeles and then in Washington. Not seeing patients would be a loss, and a decision I knew I would regret. I loved clinical work and was reluctant to give it up.
    I was as well a teacher of young doctors and graduate students and, like most people, had been brought up to be private about personal matters. My father, an Air Force officer and a pilot, kept to the military code that strength of character demanded silence and forbearance in the presence of difficulty. My mother, a warm woman, was similarly reserved in dealing with personal problems. Both assumed, as they assumed the presence of the air, the undeniable correctness of the WASP ethic that one kept one’s problems to oneself, admitted no weakness. Being an Episcopalian didn’t help. The Frozen Chosen had thawed over the years but still veered toward immoderate discretion. I kept my fears hidden and grew up sealed tightly as a vault. I did not confess, concede, or admit. It wasn’t done.
    I liked and believed in this view of the world. The people I most admired embodied these values: they complained rarely and got on with life. They didn’t deposit their private struggles into the public domain. Their beliefs, which gave them an edge in assurance and ascendancy, made it difficult to acknowledge pain or personal failings. These matters were nonnegotiable and, in their certainty, they exacted a toll. But they were the only beliefs I knew.
    Such values were suited for a simpler world than the one in which I found myself as a young woman contending with a sick mind. My innocence, which had decayed alongside my sanity, never quite came back. Experiences I had as an adult made scant sense in the context of my childhood ethic. I had been brought to my knees by madness and despair, my values shaken beyond easy restoration. I was a clinician and an academic, unavoidably aware of the devastation experienced by those with mental illnesses such as my own. I looked inward and then around me: it did not take much to grasp that privacy and reticence, however admirable, made life more difficult than it needed to be. Silence about mental illness bred a quiet ugliness and set in place the conditions for unnecessary suffering and death.
    I found my own silence about manic-depressive illness increasingly intolerable. True, my parents had taught me to keep private matters private, but they also had taught me to think for myself and to have a sense of responsibility toward others. I felt myself a hypocrite, a repellent state that gradually wore down my instincts for professional self-preservation and concealment. I had studied and written about depression and bipolar illness for twenty years, had founded and directed a large clinic specializing in these diseases, and was a full professor at a major university teaching hospital. My illness had been under good control for many years. If I couldn’t be public about it, it was scarcely reasonable to hope that others would.
    I asked family, friends, and colleagues for advice. My mother and brother felt strongly that it was a bad idea to go public with my illness; they believed I had been through enough pain and that I would be personally and professionally vulnerable in unforeseen and damaging ways. My father, who himself has manic-depressive illness, encouraged me to write honestly about what I had been through. It was the courageous and right thing to do, he said, and I ought not to censor anything I wrote about him. Friends and colleagues were divided on the matter. Those not clinically trained were more inclined to think that openness was a good thing, in part because it might benefit others with mental illness and in part