How Do You Feel?
Psychiatrist Jessi Gold’s new book on well-being in medicine
I’d been pals with psychiatrist Jessi Gold for years when she asked if she could interview me while she researched her memoir about being a psychiatrist and mental health advocate. We talked about COVID and its impact on me and my career. We chatted about the mental, physical, and emotional burdens so many of us were facing in hospitals and clinics around the country.
Then therapy came up.
I told Jessi, “I finally got a therapist in July 2020.”
“You went back to therapy?”
“No, it was my first time.”
Long pause… “You’d never had therapy before… ever?”
I’m from Los Angeles, so never having had a therapist was particularly unbelievable, but it was also true.
Like many physicians, before the pandemic, I had never formally sought mental health support, despite my own absolute certainty that I needed it. I was taking care of children with life-threatening emergencies. I was counseling families facing decisions about their children’s impending deaths. I was doing liver transplant anesthesia in the middle of the night on babies whose total body blood volume could be compared to cans of soda. Not to mention the major and minor events of my childhood that continue to bubble up.
The vibes in my household growing up were that there was something wrong with people who needed therapy. Therapy was for rich people with nothing better to do with their time and money. Psychologists and psychiatrists were to be disdained and their work belittled. We commonly heard “I’ll give you something to cry about” if we expressed any negative emotion.
Hidden Curriculum
This childhood education prepared me well for the hidden curriculum in medical education and in my anesthesiology residency. Medicine mirrors the broader society, and back in 2022, 47% of Americans believed seeking therapy was a sign of weakness. Getting help (or letting it get out that you were getting it) was a sign that you weren’t good enough, strong enough, or worthy enough to be in medicine. Never in a million years would a colleague have admitted to taking anti-depressants. If you ever experienced mental overwhelm for any reason, how could you possibly be in charge of someone’s anesthesia? How can you belong in this super special club?
Meanwhile, I watched people in my residency use alcohol and drugs to deal with the consequences of our own pain from caregiving. We were (and are) surrounded by socially acceptable maladaptive coping, but dissuaded at every turn from the kinds of services we suggested to our patients.
Secrecy or Bust
Physicians who do seek therapy often do so in total secrecy, using a pseudonym and only ever paying in cash. Beyond social pressures, there are other important (messed up) reasons for this: state medical license “fitness” questions and disability insurance. Depending on how a state asks its licensing questions, any mental health diagnosis might jeopardize our ability to practice medicine. Can’t pay off your massive student debt when you can’t work as a physician. Additionally, a diagnosis of any kind might mean our physician disability insurance won’t cover any mental health consequences of the job. (The Affordable Care Act got rid of pre-existing condition exemptions for health insurance, but other insurers still have a carve-out to discriminate against people with such conditions.)
Shouldn’t we expect that caregivers will need care too? Shouldn’t we encourage caregivers to develop and maintain healthy coping skills in the face of careers surrounded by suffering?
How Do You Feel?
Jessi Gold’s book How Do You Feel? One Doctor’s Search for Humanity in Medicine is exactly the message medicine needs to hear. Her work pushes medicine and society to reimagine what health looks like - by owning up to our humanity and embracing it.
“For the humans and the ones who lift them up, and perhaps most specifically, the ones in healthcare who are both.”
- Dedication in Jessi Gold’s How Do You Feel?
Jessi’s book will be released next week on October 8. I can’t recommend it enough!
To read more about this awesome book and get your copy:
"A psychiatrist shines a much-needed light on the mental health challenges that healthcare workers face. With clarity and compassion, Jessi Gold reveals how we can do a better job caring for caregivers." –Adam Grant, PHD, #1 New York Times bestselling author of HIDDEN POTENTIAL and THINK AGAIN, and host of the podcast WorkLife
"How Do You Feel? is a thought-provoking exploration of healing and compassion in the face of adversity. Guided by Dr. Gold’s keen insight and sharp writing, we are afforded a rare glimpse into psychiatry’s inner sanctum. Dr. Gold has an extraordinary understanding of the human condition, and her empathy emanates from the pages. A must-read."—Jen Gunter, MD, New York Times bestselling author of The Menopause Manifesto and The Vagina Bible
“If you’ve ever said “I’m fine” when you weren’t. If you’ve ever been so many things to so many people that you became unavailable to yourself. If you’ve ever believed you were too much, not nearly enough, or somehow, inexplicably, both at once. This book is for you. For us. Jessi Gold’s How Do You Feel? is one of the most human, most reassuring books I’ve ever read about the intersection of mental health, work, medicine, and culture. What a gift.” —Maggie Smith, New York Times bestselling author of You Could Make This Place Beautiful
If you care about mental health, I know you’ll want to hear the incredible personal story of a millennial psychiatrist at the forefront of the well-being movement in medicine.