My First Depression

Psychotic Depression

During my third year of medical school a foreboding of things to come occurred in January of 1973. To say I began to have anxiety puts it mildly. I faced issues I’d never experienced before. I’d awaken at four o’clock in the morning and lie in bed obsessing about “nothing” for the rest of the night. Those mornings, I had a difficult time getting out of bed. I was simply afraid of the coming day. I called it “morning terror”.

With it came feelings of hopelessness, despair, fatigue, agitation and isolation. After weeks knew something was happening psychologically but what exactly?

After a few weeks of this the morning terror began to take on a shape like smoke.

One day I knew I needed help—and fast. I called the Department of Psychiatry at Renard which is associated with Barnes Hospital, our teaching hospital.

I told the receptionist I was a medical student in deep trouble and needed help now. She got me in with a Dr.McClure that day. I include his surname because Dr. McClure died in 2010. He SAVED MY LIFE. I saw him that afternoon. I was in the middle of a major depression with agitation. He gave me Librium to take the edge off, but it did absolutely nothing. The next week he tried Norpramin, a tricyclic antidepressant.

Again, over the next two weeks, I felt no better and knew I was falling deeper into a dark hole. The crisis came one night when I went driving aimlessly around the county of St. Louis and found myself having difficulty finding my way. Oncoming cars seemed to be in my lane. I did manage to get to the Blueberry Hill Bar. My platonic girlfriend I nicknamed Crazy M was there. It was our favorite watering hole. She was a free spirit, bisexual and had become my best friend. She looked at me and knew something was wrong. Her face had a look. I was afraid of her and could not talk.

I stayed at the bar just a few minutes. I drove to Barnes Hospital and went screaming and crying into the back entrance to the Emergency Room. I must have created quite a scene because the next day I woke up on the sixth floor of Renard Hospital. I was in a padded cell with no belt or shoelaces. I had only a little twelve-by-twelve window with wires crisscrossing it to see out of.

The next day Dr. McClure placed an order to transfer me to the third floor where the affective disorder patients were and the closest floor to being out. I found out I’d had a psychotic depression. They had given me a huge dose of Thorazine in the E.R. Apparently, I had shouted that a “crawling eye” was chasing me.

Then began Dr. McClure’s experimenting with various drugs: Elavil, Stelazine, Valium, higher doses of Norpramin, and Navane over about two weeks.

I guess I was looking better on the outside. One evening, Dr. McClure asked if I felt well enough to go home. I said yes, but all that night I stayed awake cowering in the corner. When he came by in the morning, I told him nothing was working and asked if I could I get ECT, electroconvulsive therapy. I had treatments every other day for eight treatments altogether. The last four as an outpatient. Amazingly, by the third I was back to Paul and back to my medical student rotations.

Israel and First Hypomania  

I was slated to go to Israel in late December of 1973. This was only about ten months after the depression. A year in the planning, the Yom Kippur war broke out in September after a surprise attack on Israel by Syria and Egypt.  Being young and immortal, and against the wishes of my parents, I boarded

Flight 812, which started in New York City. The next stops were Paris, Rome, Athens, and then Tel Aviv. After that, it would fly to Bombay and eventually back to NYC. Clearly, I was traveling there at a volatile time. The waiting area of Da Vinci airport had been shot up by PLO just a few weeks earlier with multiple deaths.

Dr. Lazar, an eye surgeon I had done research with at Mt. Sinai Hospital in N.Y.C. summers while at Yale, picked me up at the Tel Aviv airport. Shortly after leaving the airport, we saw a soldier in full battle gear with some form of AK-47. Much to my surprise, Dr. Lazar stopped our VW Beetle to pick him up. This move was quite a change from what I’d been taught by my folks about picking up hitchhikers.

Instead of my learning about diseases of the eye in textbooks, Dr. Lazar and I spent our time driving to kibbutz, mostly of them in the north of Israel. We’d pick up soldiers with eye injuries two at a time in that very same VW.

Back in the hospital, almost all these wounds required removal of a bad eye. Dr. Lazar showed me how to do this surgery onetime. An old adage in medicine—“See one, do one, then teach one”—applied here.

I was beginning to get into all this. The excitement was more. It was an exuberance. It was not wanting to go to sleep. So, I started smoking and drinking a lot of scotch at night in my room and fashioned myself a war corresponded. Then I sought the night life of Disengoff street and the food. Back in my room the Jerusalem Post needed to be longer. With little sleep I did not feel tired. I couldn’t get dressed fast enough and be back at the hospital.

Many of the men my age were off to war and the mothers of the Lazar’s friends called to set me up with their daughters. I had many movie dates. Neither they or me wanted to go whole hog but after one or two nights we were intimate. There were too many for three months. Was it because of a shortage of men or because I was going to be a nice Jewish doctor in America?

The next six weeks I chose to work in the E.R. instead of doing cardiology. Tel Ashomer was the military hospital. One weekend I got a flight on a small military plane to Eilat on the Red Sea. I could see Jordan, Saudi Arabia and Egypt from one spot along the beach. Just west on the coast was Aqqaba of Lawrence fame.

My best friend and guide on some of my day trips was Brach (Brak to me), who was a technician in the Eye Department. He toured me around Israel by car.

Shortly before I left for home, he was relaxing on a beach in Netanya, just north of Tel Aviv, when he was killed by a Syrian rocket launched from Lebanon by Hezbollah. The trip home was supposed to be non-stop from Tel Aviv to New York City. Instead it was three 747s over 24 hours. One malfunctioned over the Mediterranean. The replacement in London needed to be replaced. The third one over the Atlantic had to be diverted to Washington, D.C. because of a storm in N.Y.C.

None of us seemed bothered as the drinks were free over the Atlantic and the seat belt sign remained off. We were put up that night at the Sheraton. The next day I flew on to St. Louis.  I saw Dr. McClure and did not want to label me bipolar but he put me on Tegretol, to which I immediately had a rash, and increasing doses of valium. It seemed the good time was over.