Dancing with Medusa: A Life in Psychiatry
A Memoir
by
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I met Bella for the first time six weeks into my three-year psychiatric fellowship. That day, I came to work at 8:30 AM, walked into the immense formal lobby of Haverford State Hospital’s building four and took one of the elevators to the third floor. As the elevator doors opened, I heard a woman yelling, “Stop. Stop,” in a high-pitched voice. There, down the hall near the women’s ward, I saw an agitated young lady in a yellow and white dress. Her blond hair streamed down her back and flew from side to side as she screamed. She reminded me of Medusa, one of the Gorgon monsters of Greek mythology with snakes for hair. “Can’t you see I’m the queen? How can you treat me this way?” She flailed her hands in a threatening manner, thought that she was royalty and yet seemed fearful that someone (Perseus and his forces?) was out to destroy her. The female psychiatric aide that had brought her from the first floor admissions suite, stood by frozen, looking frightened and helpless, not knowing what to do. The ring of metal keys in the aide’s hand made a soft musical clanging sound as she trembled.
Scared and hesitant, I walked slowly down the hall concerned that if I looked at her, her deadly powers would turn me instantly into stone, as predicted in the Greek myth. When I reached where she was, I took her hand. She stopped screaming and looked at me with luminous blue eyes that emanated a translucent glow. I walked her gently toward the women’s ward, three north, as you would lead someone onto a crowded dance floor, unlocked the door and took her to the nurse’s station. She turned back, looked at me and smiled as the aide took her to her room. (From Chapter 1)
Doing therapy involves not only dealing with the patient’s biological symptoms but also trying to understand and respond to the unique person within. This includes his/her background, frustrations, hopes, dreams and needs. Even with psychotic patients, it is often this human element that we deal with in therapy. Growing up with the patient again and understanding his/her trials, tribulations and traumas will allow the therapist to gain a perspective and help him/her mature and heal the child within. To be most useful, the therapist must also gradually understand him or herself and use this knowledge and the wisdom born of life experiences, as well as all his/her clinical and scientific information, to help the patient. My childhood and adolescent experiences made me a better, more empathetic and insightful psychiatrist.
Regardless of diagnosis, the patient and the psychiatrist are both human beings, or as Bella would say, “Human beans.” The delicate balance between the biological basis of psychiatric illness, the uniqueness of the individual patient and the therapists’ own life experiences are the three dimensions of understanding that a psychiatrist, like Perseus in Greek mythology, must constantly keep in view to be successful. These three things are the psychiatrist’s best tools when doing therapy. They came into play the moment that I met Bella, took her hand and gently led her through the door of ward 3N. This balancing act has played out many times between my patients and me through the years. This is the dance with medusa that has occupied the core of my life in psychiatry. (From Epilogue)
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About the Book
This is a story about Bella, a beautiful tale of caring, trust and emotional healing. It begins when Dr. Zal, a first-year resident in Psychiatry, meets a 20-year-old in the throws of a severe psychotic episode. It chronicles thirty-seven years of psychiatric treatment. Focusing on family relationships, he tells how both Bella and he resolved issues with a significant parent. Although his life was quite different, he was able to draw parallels that allowed him to empathize with some of her life events.
Bella was a role model of strength, endurance and caring for her children and husband. She survived childhood abuse, molestation and a dysfunctional family background. In the end, mental illness did not ravish her life. Rather it was a physical disease.
The book also shows how Dr. Zal changed from an inexperienced, anxious, psychiatric resident and become a wiser, more empathetic therapist. It illustrates how he learned to balance personal angst, the biologic basis of psychiatric illness and the uniqueness of the individual patient into a therapeutic tool. This balancing act, illustrated through Bella’s story, is the dance with medusa that has occupied the core of his life in psychiatry.
Dr. Zal is able to weave a 40-year history of psychiatry through this story, including sweeping changes in treatment, mental health laws and the role of the psychiatrist. Using Haverford State Hospital, he tells the story of the transition to community mental health.
Bella’s story is about hope, overcoming the stigma of mental illness and the role that determination can play in life success. Her accomplishments reinforce Dr. Zal’s firm belief that although psychiatric medications can facilitate improvement in mental disorders, it is people working with people, on a sustained long-term basis, that is equally or even more important, in maintaining recovery and producing emotional growth.
About the Author
H Michael Zal, D.O., F.A.C.N., F.A.P.A. has been a psychiatrist for over thirty-nine years. He is currently in private practice and a Clinical Professor in the Department of Psychiatry at the Philadelphia College of Osteopathic Medicine. He is board certified, a Fellow of American College of Neurology and Psychiatry and a Distinguished Life Fellow of the American Psychiatric Association.
Dr. Zal is a graduate of the University of Pennsylvania and the Philadelphia College of Osteopathic Medicine. He completed a three year Psychiatric Fellowship sponsored by the National Institute of Mental Health at the Philadelphia Mental Health Clinic and Haverford State Hospital.
He is Emeritus at the Belmont Center for Comprehensive Treatment and served as President of their Medical Staff. He was Chairman of the Psychiatric Service at Metropolitan Hospital in Philadelphia and a member of the University Of Pennsylvania Private Practice Research Group. He was also on the staff of Charter-Fairmount Institute, Mercy Suburban Hospital and the Medical College of Pennsylvania.
Dr. Zal received the Albert Einstein Healthcare Foundation Physicians’ Award for Excellence and the Practitioner of the Year Award, from the Philadelphia Psychiatric Society, for outstanding character, dedication and commitment to patient care.
He is a lecturer, medical writer and editor on mental health topics with numerous published articles to his credit. He was the winner of the Eric W. Martin Memorial Award, presented by the American Medical Writers Association, for outstanding writing and the Frances Larson Memorial Award for excellence. Dr. Zal is also the author of Panic Disorder: The Great Pretender and The Sandwich Generation: Caught Between Growing Children and Aging Parents. (Perseus Press).