Overlapping

Hail,

Things progress. Off the quetiapine (still on the other stuff), which means no more "accidentally slept in to lunchtime" for me. And it also means I am able to think again, which means a return to spontaneous social intercourse and, less importantly, work.

I will post hopefully non-gushing thanks/replies to posts in the next few days. And I should be able to read other people's blogs, now that I am chemically capable of being interested in somebody other than myself. Hope all goes, if not well, at least non-catastrophically for you.

So, what's been going on? A fair amount. In the last week, one friend has died, and now another is gravely unwell in hospital. I do not think I am able to put either of these things into words now, so I won't try.

The moods - which until recently were relatively stable, seem to be returning to an equilibrium. There was the up, then the down, then the getting better, then the recent events, which convinced my psych to suggest that perhaps I should stay on everything a little longer than we had originally planned, and now things coming back to normal.

By normal, by the way, I mean fewer of those embarrassing descents into morbid panic. But anyway, I am bored witless talking about myself and my feelings (surely a sign of returning health), so I thought I'd talk about something else.

Specifically, men and their feelings.

So, the last few days I've been thinking. Some of this stuff is going to be hard to put into words, but here goes: Here are three brief stories. I don't know if I can tell them so that the common theme is evident, but here goes.

I spoke to a friend of mine from medical school a few weeks back. He is, by all accounts, a successful man, and by most measures we are friends. Our respective partners, Sarah and Melissa are good friends, they talk cats together, and thus Mark and I have often found ourselves in the same place at the same time - sitting around his place in the Hills, drinking very good red wine and eating food made from vegetables he'd grown in his garden, while the chickens probed amongst the cabbages and the whippets poked at our knees.

This has gone on for five or so years. We see each other, usually via our wives' arrangements, most months, which is more often than I see most of my friends. And he's good at cricket, and can tell some interesting stories about the old bikie days, and he's always interested to hear about my patients, and wonder if he really did the right thing going into administration.

Anyway, I was speaking to him a fortnight or so back, when the depression was at its worst, and he could tell something was wrong. I have not told him previously about the bipolar, but these things osmose out. I mentioned - very briefly - the few weeks of increased energy, the projects started, the ideas that seemed so much better than they turned out to be, the new friendships and plans - and then the subsequent period of deflirting, jobsloughing, unvolunteering. I stated that this was a fairly uncomfortable process, and one that was more than a little embarrassing.

And then I mentioned, in a kind of a "listen to this ridiculous shit" way, the few-hour long descents into panic, the fact that at times I fear that patients I discharged three years ago will become the subject of a coronial enquiry, or that my brother will crash his car and die, that my friends will see reason and abandon me in droves, or that my wife will discover The Horrible Truth and leave me.

Mark said the appropriate things. This is something he's always been very good at, he should have done psychiatry. He said a lot of people have these fears at one time or another. He asserted that a person is known by the quality of his friends, and that if I have this sterling wife, this remarkably good brother, this circle of good and loyal and deeply decent friends then that says something fairly irrefutable about me. And he said a lot of men do insanely stupid things, things that seem like a good idea at the time, things that can't be said to strengthen the marriage, and a lot of men come closer to screwing things up than anyone on the outside ever knows.

I nodded, in a kind of recently medicated way, and said that him and Melissa had always seemed to have something right about their marriage. Him, the classic "tall, dark and handsome", and touchingly devoted, her slim and blonde and vivacious.

And here he looked at me with his dark, quick, expressive eyes, and sort of nodded. And then he said that sometimes he wished, when they were watching the television together, and it was some comedy or something, that she'd find the same things funny as he did. Get the same jokes, that kind of thing. And there was in that short sentence a whole unspoken conversation about someone who'd married someone who was kind and loving and all that stuff but with whom he couldn't share some things.

We quickly moved on to something else after that. I suspect that we will never touch on anything like that again, and in fact I got the strong feeling that I was the first person he had told this, and that he regretted it almost immediately afterwards, some form of disloyalty. But it got me thinking.

And yesterday I heard from a friend of mine, a trainee radiologist who had worked in France for a while before med school. I hadn't heard from him for a while, and the other day he rang up, and we met down the pub. Over a few ciders he told me what had happened.

His cousin had been unwell, he said, between drinks. Cancer, in fact, a non-seminomatous testicular tumour. CT showed no regional spread and surgery - which we both knew was removal of the affected testicle and surrounding tissue - looked like it had cleared things up. There was little chance he'd need the chemo.

He had another drink, and explained how this had brought back to the surface of his mind something that had happened to him ten years ago in the south of France - a girl he'd met, one wet summer, a few months of sex in a beach house. Things already going wrong between them when she first became unwell, something he'd dismissed as some form of emotional blackmail, some histrionics. The separation - eventually agreed upon as the only sensible course - and him climbing the stairs to the plane, and her saying "don't keep in touch". He remembered how sick she'd looked when he left, how pale and thin.

And a letter from a sister a year and a half later, saying she'd died. Cancer - that horribly aggressive subset of chronic myelogenous leukemia that younger people sometimes get.

And then ten years had passed - medical school, marriage, training. And then this diagnosis, the second time cancer had stuck at someone close to him - and how this had all detonated under him in the last few months - couldn't work, couldn't think, took time off from the training programme, stayed at home and stared. Only now starting to get over what had happened, what he'd done. Thought he was losing his mind. Nobody knew but me, and I was to swear not to tell anyone.

And then from another friend I heard of a psychiatrist - no-one known to me, but my friend's supervisor when she did her psych attachment in Melbourne. A tall, handsome, eloquent man, surgical-steel smart, who had been in charge of the largest open psych ward south of the Yarra, and lectured at Melbourne's best medical schools, where he presumably covered ethics and similar stuff. And whose beautiful Asian wife came home one week a day early from a conference, and found that he had stocked the house with prostitutes (three at a time, apparently), and then it all came out, the gambling, the prostitutes, the sex with patients and pupils - and now he was done for, struck off the register of licensed practitioners (and he had also been struck off by the psych registrar, whom he was also screwing).

Anyway - to me there is something that ties all these together, something about men and feelings. I don't know how to put it, except it's got something to do with the difficulty of being alone.

See, the first two examples - my friend Mark, my friend the radiologist, both deeply anonymised - the things they told me they had told no-one else. And I had known both of them for years, and at least one of them immediately regretted the discussion. And the last guy, the uberpsychiatrist - at some stage, he must have thought "this is all getting out of hand, maybe I should ask advice".

How did things come to this? Didn’t he have a friend?

It's a cliché that men don't talk about their feelings as much as women do. I have a number of fairly close male friends, I wouldn't have two to whom I could confess, say, a difficulty in my marriage, or an ethical or diagnostic mistake I had made. The most humiliating thing about the bipolar is that the extreme mood states that occur are often fairly public events, and I do and say and reveal things I find myself cringing over later on.

Last time, I am given to understand, apparently involved kung fu. I didn't have many bruises when I got home, evidently things worked out fine.

I wonder - my wife says she's noticed that cats conceal their illnesses, and that she has heard that this is a common thing about predators, maybe a common thing about animals surrounded by dangerous opponents. I wonder if there is some element of this in that, if all men at some deep, silent level see each other as potential threats, and do not dare confess a weakness for fear it will be exploited. The leader of the pack thing.

I think that there is no secret men's business.

This may be why, by the by, men live longer when married (although I doubt it's that simple), whereas I understand the reverse is true for women. And it may be why men commit suicide more, and may even be the victims of more violence - from other men, of course.

However, I think sometimes men, when they can't confess their feelings to other men, are able to confess them to women.

The problems that arise out of this are several. It is hard for a man (and I am speaking predominantly of my own experience here - I am certain that there are many men, decent men, who feel that everything I've written today is baffling) - to meet up with a woman, get to know her, talk about his feelings and then stop it there. It's hard not to make what seems like the natural, pre-programmed step, the natural progression. I don't know if it's a subconscious thing, or if it's hard not to fall in love with someone you can talk to, or if it's a deliberate strategy, the "talking about your feelings to get her into bed" thing.

I think, by the way, this is what's behind that phenomenon of overlapping, that infidelity that arises in some relationships, where you have some troubles with your partner, you don’t know who you can tell, you find some sympathetic female ear to talk to about it, and six months later it's a monstrous cock-up that everyone but you saw coming, and you see your kids every second Saturday. More about this over-lapping later on.

This is why I suspect it would not be a good idea for me to become good friends with the mordant black-garbed secretary at Central who likes Star Wars, or the wide-eyed-and-possibly-crazy social worker at the southern office, or the shy blonde ICU nurse with the ponytail. Because next time I'm even a little bit disinhibited, bang. Embarrassment all round.

I don’t know. Men (again, by which I mean myself) find it hard to be alone. The psych term for that is dependent. I don't know, I don't need a lot of people I can depend on, but I do know I need one. I suspect that if I hadn’t met Sarah I would have married around that time, anyway, married someone. It would have been stupid and it would have been for the wrong reasons and it would have been a disaster - but that wouldn't have stopped me. I happened to get incredibly lucky - so lucky I still shake my head about it - and find her, the only person who could have kept me going all this time.

Anyway, random thoughts. Womenfolk, don't trust your man's new good female friend - from what I can work out female friends he's had for a few years are generally okay. Men, don't trust yourself. People with medical conditions, take your tablets. Talk to each other, because you never know if the other one's going to die on you, and you'll be left with something still unsaid.

Enough of this. I have a plethora of possible topics for next post - it's been an interesting month - and should be able to get back to it soon.

Thanks for listening, and everything else.

John