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Sorry for the delayed response…I promise in the future I will be timelier. Part of the reason I did not post was that I returned home for two days in the middle of the week to see my doctor. I was there for a physical needed to enter medical school and it was the most intense examination I have ever received. A large part of it involved blood tests checking for immunity to all the diseases I have been vaccinated against since I was a toddler. Like everybody else I always assumed that once I got the shot there was nothing to worry about…measles, mumps, hep B, all taken care of. The idea that the vaccinations’ efficacies were so variable that testing was required was a serious shock. A great deal of our conversation focused on contrasted the mental healthcare system with normal healthcare. I was a strong proponent that the mental system was “50 years behind” the rest of the medical profession but I’m not sure that is really true. Instead I have come to believe that physical healthcare possesses the same degree of uncertainty and variability of mental healthcare but simply packages it in a way that hides it from the average patient. 

We indicted mental health for failing to provide patients with the full “menu” of treatment options and accused providers for suggesting what they know and specialize in rather than utilizing a holistic model of care that best utilizes each method for a particular patient. The same thing is really true of regular healthcare once we move beyond the most high-end of facilities. Certainly large, prestigious teaching hospitals and places such as the Mayo and Cleveland clinics utilize a multi-disciplinary team approach to care. However imagine the average person with chest pain right here in Haverford Township. Delaware County Hospital and Bryn Mawr Hospital are both the same distance away. Both are big ugly buildings with a red “emergency” sign out front. However Bryn Mawr has an advanced cardiac catheterization lab while Delaware County has no such thing. Thus a heart attack at Delaware County cannot be treated the same way and the patient faces a long wait to be transferred to another facility. 

Physical healthcare posses the same lack of standardization, however they have been able to dodge the blame. A heart attack has such a negative connotation that when somebody dies from one it is not a matter of whether they received a timely angioplasty but rather a serious ailment with an unfortunate outcome. The treatment (except in cases of malpractice) avoids the blame. In mental health, the conditions don’t come with a societal allowance for severity, you are depressed, nothing less than full recovery is acceptable. The crucial difference is that we can say somebody has a “failing heart” without being seen as attacking their character but the same certainly doesn’t work for a “failing brain”. Mental health conditions are so irrevocably linked to who we are that when treatment fails it must be the fault of the treatment and not the strength of the disorder. We cannot separate our brain from our “self” as we do any other diseased organ. I am not suggesting that mental healthcare is a perfectly (or even adequately) hard science based, just that physical healthcare only appears better in a topical sense.