A Tragedy in Three Parts

Part I

My friend had been fighting a heart condition as long as I had known him, and that was a long time.

Most people had no idea. For most of the thirty years I knew him he was under treatment, and it worked just fine and kept him healthy.

My friend was an officer in the US Navy, a computer engineer, an MBA and a PhD economist. An officer in his college fraternity and a huge fan of Florida football. He worked for Procter and Gamble in the US and Europe, and taught at colleges here and there as well. My friend had two young kids, an ex-wife, supportive extended family and friends – real, honest-to-goodness friends – across the globe.

This was no average schmoe.

But that cardiac problem, it kept creeping up on him. Most people don’t know it but that’s what made him leave the Navy. My guess is that it had a (big) hand in his divorce and in several academic positions that didn’t work out as well as they should have.

We like to think modern medicine has a firm grasp on problems like these. But with a condition like his – a constantly ticking bomb – there were things he just couldn’t do.

To make things worse, some of the places he lived didn’t take the condition seriously and he had a hard time finding the right kind of specialists to help him stay safe. Not to make this political, but for the last few months of his life he couldn’t get health insurance and he couldn’t afford private-pay care.

Without regular medical care the ticking got louder. Sometimes when I talked to him or read his emails I could hear it from a thousand miles away.

So if I’m honest with myself, I have to say it wasn’t a complete shock when his sister called to tell me the ticking had stopped and his great big heart had finally burst.
Part II

I haven’t been entirely honest with you.  He didn’t have a heart condition.

It’s true my friend was all of the things I told you. It’s true he had trouble getting the medical care that almost certainly would have saved his life. It’s true we were like brothers for more than three decades. He was the best man at my wedding and godfather to my oldest child.

What killed him wasn’t a heart condition, it was a head condition. His heart didn’t burst, he killed himself. He was alone and afraid and so very sad that he just couldn’t be here any longer.

And now you think of him in an entirely different way than you did when you believed he died of a heart attack.

Of course you do.

Because here in twenty-first century America we still draw a bright line between physical illness and mental illness. A middle-aged man walking around with a heart condition needs care, observation and the best medicine science can provide, right?

But a middle-aged man walking around in a deep-blue funk just needs to cheer up, right? Got the occasional delusion? You just need a good night’s sleep and some perspective. You’ll be fine.

If the electrical impulses that make your heart beat on schedule go haywire everybody knows you need to get to the ER, stat! But if the electrical impulses between your ears skip a beat, well, you’ll need good insurance, several referrals and a fair bit of experimentation with an array of meds before you get even a little relief.

We all – most of us, at least – know intellectually that mental illness, in addition to being a miserable set of ailments, is dangerous. That it kills. We know it ruins lives and families. But insurance companies know it tends to be chronic and hard to treat and is therefore expensive. And because it’s expensive it’s easier to keep it in the same shadows it’s been in for most of human history.

I’d like to think we’re better than that. That the twenty-first century is more progressive and that we’re not so cheap as a society that for all intents and purposes we leave people to tough it out or die trying.

I’d like to believe that, but I know that what killed my friend almost certainly could have been treated if the world thought about severe depression the way it thinks about heart disease.

Part III

In a world full of friends and family who would have done anything to help him, my friend couldn’t be helped when he needed it most.

I’m angry about that. Here it is, the middle of the strangest Florida football season I remember, and I don’t have my friend to commiserate with. His nephews are leaving college and stepping out into the working world and nobody could give them better advice than he could have. His son and daughter, they’re growing up without the funniest, most brilliant and caring dad a kid could have. And I’m angry about that.

I could go on and on about my friend. We were going to be old men sitting on a front porch, solving the world’s problems over a glass of bourbon. Now, we’re not.

This is the part where I tell you that if things are bad for you, if you can’t see a way out, you need to call a friend or a family member. You know the drill, and it’s all true. There are people out there who need you and value you. Suicide is a permanent solution to a temporary problem. Etc.

But that’s not the sermon I’m going to preach today. My friend – and too many other people in my life – have taught me that telling you all the things you have to live for isn’t going to help.

So my message isn’t for you. It’s for those who still think mental and physical illness are different. They aren’t. They can both be treated and they both must be treated.

My message today is for everyone who has someone close to you who is struggling right now. It’s your responsibility to advocate for them in the world. Yes, be there for them, listen, encourage them to stay on their meds if they have them, but you also have a bigger, louder job.

You have to tell their story. You have to break open the doors and lead mental illness out of the shadows. You have to speak up. You have to lobby. You have to work for the people you care about. You have to fight for them. Because they are fighting an entirely different battle that you can’t see.

Fight for them.

Fight for my friend.

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