Tuesday, March 17, 2009

From Bipolar Darkness, the Empathy to Be a Doctor

MANIC PHASE Dr. Alice W. Flaherty wrote everywhere, even on her arm.

Dr. Flaherty, now 45, is director of the movement disorders fellowship at Massachusetts General Hospital and an assistant professor of neurology at Harvard Medical School. But those technical descriptors do not begin to capture the way she uses the racing mind of her manic phases to drive her ideas into forceful, highly personal treatments.

The idea of using one's mania, instead of trying to suppress it, is fascinating.

“What made me empathic was my depressions,” she said recently. “People’s emotions were pounding me in the face. The mania is like wasps under the skin, like my head’s going to explode with ideas. But the depressions help the doctor aspect of me.”


Letters run up the back of her wrist. They are one consequence of hypergraphia, the overwhelming urge to write; she writes during manias and edits during depressions. (She keeps the illness under control with medication.) Dr. Jerrold F. Rosenbaum, chief of psychiatry at Mass General, says he used to get notes from Dr. Flaherty on napkins.

What is the opposite of hypergraphia?

The wrist notes could be on any of a dozen topics. They may be more thoughts on empathic pain, or about research she is conducting on the side about light boxes and creativity in Harvard undergraduates.

Maybe they are about the informal consultation she made several years ago to an Off Broadway adaptation of “A Doll’s House,” directed by Lee Breuer, a former colleague of hers at the Radcliffe Institute at Harvard, where they were both fellows in 2005.

When weeping during a scene, the actress who played Nora was alarmed upon noticing that the mascara ran from her left eye more quickly than from her right. Dr. Flaherty reassured her that the neurology was normal: the right brain, which controls the opposite side of the body, also controls negative emotions. Therefore, one side seems, and is, sadder than the other. This will go in Dr. Flaherty’s next book, which will be about the neurobiology of illness behaviors ranging from hysteria to stoicism, and, of course, empathy.

I've noticed, now that I reflect on it, that when I weep, say while watching an emotional film scene, my right eye waters more than the left.

“For me,” Dr. Flaherty replied, “it wasn’t memory, but getting my brain to feel right. The psychiatrists said, ‘You should get used to this as your new normal,’ but I never did. It was always alienating when people said, ‘Oh, that’s just bipolar illness talking.’ No, hello — that’s me.”

That last point is so very important.

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