I'm in the Unwellness Space

An open letter to people who are "passionate" about "mental health."

This is a newsletter. It is salty. Why? Because I am a psychiatrist. That is a kind of medical doctor. Doctors, in this context, are in turn a subspecialty of physician. That means I work with human suffering. I am not in the “mental health space.” I am not in the “wellness space.” I might plausibly be best understood as in the unwellness space…

Referring to the ardent but—frankly—less than glamorous world psychiatric illness as “a space” In which anyone can blithely assert their role? By virtue of their passion alone?

This is nonsense. It is exactly the sort of hucksterism—via vague wordplay—that people who are “passionate” about sucking the blood of the suffering tend to assert.

The “mental health space” isn't glamorous—it includes profound discomfort, honor, grim pride, sorrow, horror, loss, and so much more.

I am proud of the humans I serve. Those who seek help, and those who reject it, in my experience, are humans I admire. I like the people I am proud to call my patients. This isn’t some sort of humble brag—and maybe I am just lucky.

But the people who find themselves in the humbling position of “the psych patient?” A position I have been in also… mine, at least, are overwhelmingly …awesome. I obviously can’t say who, or in what ways! If you want to know to whom my allegiance lies, and why? It is with people who I both respect and quite like. Their journey, and the privilege of being of service to “the mentally ill?”

This is not for the passionate alone. This space is something between a temple, literal war zone, Michelin starred restaurant, and an art show. It’s anything but trivial. Out of respect for what “the mentally ill” have done to enoble their suffering— with lives Awesome and challenging—allow me to say:

You passion is not important. It can go F itself.

I respect dedication. I spent decades of my life—close to all day every day since about 2005—working toward the goal of helping other humans confront their darkest hour. It is not all crisis and pity— people come out the other side. Or not. My patients—who are vastly more impressive than me and my fancy MD by the way— have been at this for a while, thanks.

What did you do with your passion? How did you earn it?

It is a serious question.

Anyone can enter a space. Not just anyone is allowed to walk into a hospital, much less a psychiatric unit, or funeral, or any of the million other remarkable moments or venues I have been a witness too. It’s a space for meaningful work.

These moments command a sense of dedication, and sacrifice. Not passion. It’s not a credential. We are called to serve—or not. Passion has nothing to do with it.

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