August 21st, 2015

Re-thinking what useful means

Sometimes, the obvious distortions in the thinking of a person with mental illness can lead us to examine our own assumptions about the way we live our lives. One of the most hopeless people I know believes that he does not deserve to live because he is useless.

He is confined to the hospital because he says, and we believe, that he will kill himself if he was not closely supervised. He suffered a catastrophic loss for which he blames himself and he cannot imagine a life other than the one that is no longer available to him.

He looks around the small room where we are talking, motioning with his head toward the heart of the unit where other patients are going about their business. They’re not doing much. The ones still on the unit at this time of day have skipped their morning groups and are waiting for lunch. Useless, he says, all of them. Why should they continue to live?

His question startles me. Is he really suggesting usefulness as a criterion to determine who should live and who should die? If so, what would a person need to do in order to be considered useful, who would judge and how would the penalty for uselessness be exacted?

A vision of the Last Judgment flashes in my mind’s eye as I search for the words or the silence that I will use to respond. I ask what it means to be useful and he points to me as an example. I am useful because I am a doctor who helps people in the hospital. He is useless because biology and circumstance have conspired to rob him of his dreams and he is stuck in a place where he believes he can do nothing of consequence, a place that he has to share with people even more useless than he is, a place where he doesn’t belong.

Some people see life as a gift to be enjoyed but he sees it as a prize to be earned. We leave it at that for now but the thought lingers long after our meeting ends.

Friends who have been there have warned me that one of the hazards of retirement is the feeling of being useless. I am too new at this way of life to know for sure but I can see the possibility of empty hours pointing their accusing fingers at my indolence.

At this point, it is only a possibility because I have not had very many empty hours. They are just filled with activities different from the ones that used to occupy the focus of my attention.

While I still see a few patients, give lectures and supervise some students, these actions are not how I spend most of my time. Nor are these the only activities that give me a sense of satisfaction.

Re-connecting with old friends, spending more time with my wife, socializing with other retired couples and finding ways to stay in touch with younger colleagues and interns have become more important as well-worn routines have been replaced by the gift of time.

The quiet and solitary hours bring equally important opportunities to read the morning paper on the patio with a cup of coffee and, just by chance, to glimpse the silent flight of the hawk across the yard. There is time now to read literature that inspires and informs and to explore the neighborhoods of big cities and the narrow lanes of my favorite seaside town, to notice the way architects, stonecutters and carpenters made art of buildings. There is time to take up the carving tools in my own clumsy hands and try to fashion a small wooden boat.

Life is happening all around us whether we take the time to notice or not. More accurately, we are happening as that part of that life aware of itself. Our focus can be as narrow or as wide as we choose to make it. We can be part of a hospital for the mentally ill as doctor or patient, paying attention to the information we need to heal or be healed.

We will walk through long corridors, gaze through windows onto the green spaces below and feel the mechanically circulated air at just the right temperature against our skin.

Outside of the hospital building, I have begun to notice that the days have a texture and pace of their own. The weather is not just something to isolate ourselves from so we can be comfortable enough to do useful things. It is the ambiance in which we live and breathe.

Chores like grocery shopping are not annoying activities to be completed as efficiently as possible so that we can get back to being useful. They are the warp and woof of a bigger tapestry that we are weaving every day.

We do not weave our lives with threads of sunshine alone. There are visits to nursing homes to see elderly parents whose memories are deserting them and opportunities to meet other seniors and their families fighting similar battles. There is conflict, disappointment, loss, failure, and illness, circling every closer to those we love and, one day, to each and every one of us.

My patient tells me he is useless and deserves to die. He thinks he has failed to earn the prize of living but I wonder if he has not learned that life, no matter how difficult, is a gift. Learning to use it wisely may be the most useful thing any of us can do.

Alan Bodnar is a psychologist at the Worcester Recovery Center and Hospital.

By Alan Bodnar Ph.D.

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