Stretching back to the earliest days of recorded history, those with mental illness have been signaled out as broken, deficient, helpless, and even possessed by demons. Bedlam’s Door: True Tales of Madness and Hope by Mark Rubinstein M.D. offers modern day stories of those same people, who in the past would likely have been locked up, tortured, and possibly executed for something no one truly understood. The inner workings of the brain and how it affects not only the rest of the body, but also the rest of that person’s reality, is only now being more understood. That understanding is exactly what the author talks about in this book.
Each chapter is another case from his past showing any number of the neverending facets of mental illness. Very early on he makes a incredibly important point, saying:
One hundred people suffering from a similar condition (for instance, depression) will have one hundred different stories to tell.
The weight of that cannot be understated and it is the main reason why solutions and remedies for various mental illnesses can never be used as a catch-all for every patient. The cause and the effect of these maladies are as unique as the individuals suffering from them. Dr. Rubinstein goes case by case to illustrate just how detailed and careful one must be when it comes to diagnosing a patient and recommending the next course of action.
The book also serves another noble purpose, which is helping to remove the stigma around mental illness, both for the patients and the practitioners. As I mentioned above, it wasn’t so long ago that people who suffered were thrown into institutions and left to rot. The irony of that is those institutions were called asylums, which literally meant a safe haven, and were anything but. As a patient myself, I am genuinely thankful we’ve made progress from those dark days.
On the other side of the coin, for many years the doctors who specialized in this field were looked down upon by the rest of the medical community because psychiatry was viewed as ‘quack science’ or purely an invention by professional pill-pushers. Today psychiatrists are not only more common, but in certain places absolutely required (like in many Law Schools to help deal with first year students.)
Bedlam’s Door also touches on another facet of practicing in this field, having to prove it in court to other people who likely don’t believe you. The defense of mental illnesses can be frustratingly difficult because it cannot be shown in a blood test or by the presence of a genetic marker (at least not yet.) In two of the stories included, Dr. Rubinstein details how delicate a line the doctor must walk in order to convince those in control. On certain occasions it’s not to protect the doctor or hospital, but to defend the patient from themselves, and when those efforts fail they can have deadly consequences.
Many people who suffer can find themselves in very dark places and suicide begins to creep forward as the only viable option to end the pain. Dr. Rubinstein notes some very interesting facts about suicide rates in our population:
A few facts about suicide and suicide attempts are worth mentioning. According to the Centers for Disease Control and Prevention, nearly forty thousand Americans managed to kill themselves in 2010. As residents, we learned about gender differences concerning suicide. Four times as many women as men attempt suicide, yet four times as many men succeed in killing themselves.
He goes on to explain that this phenomenon occurs due to the methods employed by each gender when attempting suicide. Women tend to try pills, oven gas, or other methods that can be stopped if reached in time. Men, on the other hand, more often use guns, jumping off buildings, or methods that nearly insure success instantly.
Bedlam’s Door: True Tales of Madness and Hope is informative, encapsulating, and endearing. Dr. Rubinstein doesn’t just document experiences he had, he rather recounts them like stories around a campfire, each one meant to deliver another lesson and moral. He shows more than just a clinician’s eye. He shows a caretaker’s heart.