A LITTLE BLUE
27 September 2002
The message could not have been more plain if she'd been wearing a
sandwich board. I knew immediately who she was when she walked through the office door.
Her sister, one of our patients, had called the day before to say that she needed to make
an appointment for her sister who was having severe menopause problems as well as
personal problems, and was very depressed.
I didn't need an MD after my name to see that she was depressed.
Pain was etched into every line on her face. She looked like a dark cloud had settled on
her head, she grabbed her elbows and bent over slightly as if trying to hold the pain in.
Even the tone of her skin was depressed. The skin had a sallow look, there were deep, dark
circles under her eyes, her hair hadn't been combed. Her clothes were rumpled
and she had a monochromatic look, drab olive green.
"I'm not a psychiatrist," Dr. G told me before he saw her,
when I gave him a brief rundown on what he was to expect, "but I'll do my best."
I have had some experience with clinical depression. Fortunately not
a lot, and only briefly in my own life ("Guess what--I'm clinically depressed,"
I said to a friend after seeing a therapist some months after David's death. "Well,
duhhhhhh," she said. We could at least laugh about it, and that helped get me on the
road to my new "normal.")
I worked for a time for a psychiatrist whose specialty was doing
evaluations for clients who were going through the Workers Compensation process. He dealt
with the emotional components of the injury and how it factored into the ultimate Workers
Comprehension settlement. (More often than not, the very process itself left clients who
only had physical injuries severely emotionally affected, severely depressed, and
everything else. Trying to jump through the hoops sometimes was worse than the original
I remember one time walking out the door and seeing this man who was
in excruciating pain. He was sitting between the orthopedist's office and the
psychiatrist's office and both were refusing to see him because Workers Comprehension said
it would no longer cover his visits. (Your government in action.)
In truth, I sometimes wondered about the reality of some of the
claims. It seemed incredible to think that some of the minor stresses the clients
experienced could result in insomnia, mood lability (crying all the time), nervousness,
inability to concentrate, etc., etc., etc.
But the effect of stress on the human psyche was brought home to me
very forcibly. This was a teeny office (I've always worked in teeny offices). There was
the psychiatrist, his wife, his daughter, and me. I was the only non-family, the only
non-African American. I was also between the mother and daughter in age, so I was old
enough to be pals with the mother and young enough to be pals with ths daughter.
This was a great arrangement until there was family turmoil and I
was the person that both mother and daughter used to confide in about each other. At the
same time, the son got married and the new daughter-in-law, who for some reason hated me
on sight, came to work at the office. The wedding brought about a repair of
the rift between mother and daughter, and for all sorts of reasons, I became the bad guy,
the one everyone in the office--mother, daughter, and daughter-in-law--hated (the father,
being a physician just sat in his leather-lined office and let the cat fights go on).
Nobody would speak to me and they began to examine everything I did with a microscope. If
"i's" were not dotted and "t's" were not crossed, I got a lecture. If
I left at 5:58 and put 6:00 on my timesheet, I got a lecture. The files were not
filed fast enough. The desk was never straight enough. Nothing I did satisfied
The weirdest thing began to happen. Within literally days, I
began to experience every single symptom I had questioned in the reports I had been typing
all those months. The number of mistakes I made escalated, I couldn't sleep, I would burst
into tears over nothing, I had stomach pains and headaches. If I could have stepped aside
and just watched this as a phenomenon, it would have been very interesting, but it was
happening to me. Fortunately, the job didn't last too much longer. The doctor
decided he didn't have enough work to keep me busy full time and so I took all of his work
back to the secretarial service which had sent me there in the first place, and I did his
typing in a much more relaxed and non-judgemental atmosphere. But I learned a lot
about job stress in those few months.
My most memorable experience with depression was not my own, but
that of a young Brasilian girl who had come to the US to earn some money. She was one of
those "friends of friends" that seemed to cross our path on a weekly basis for
ten years or so. Her friend promised to try to get her a job in the States and asked my
help. I managed to find a family which would give her room and board in exchange for
housekeeping. What could go wrong?
Well...everything. First of all, she spoke no English. None.
Secondly, it had never occurred to her that when she went to a foreign country the
language would be different, the food would be different, the customs would be different.
Within a week, the family which had taken her in called me in desperation. They simply
couldn't deal with her. I decided I'd take a crack at it, and moved her to our house.
But I was totally unfamiliar with clinical depression--and she was deep in the
throes of it.
She sat up for more than 24 hours crying. In those days I could
speak some Portuguese so I was at least able to speak with her. Not realizing that there
was nothing short of a therapist who could help her, I decided to treat her to a day in
San Francisco. Everybody's favorite city, especially Brasilians. I thought if she had a
bit of fun, it would help to cheer her up.
She was so incredibly depressed that she fixated on the fact that
there was a Brasilian consulate in San Francisco and the only thing she wanted to see was
the consulate. I took her there and she insisted she wanted to go back to Brasil today.
Not tomorrow, today. Obviously this was not possible, but the staff at the
consulate managed to get her on a plane the following day. She spent the day at the
consulate while I worked at the Lamplighters and the kids played in San Francisco.
A woman from the consulate took her back to her own home, where I was to pick
her up. She refused to enter the woman's home and I found her sitting on the edge of the
curb, crying, when I drove up.
We got her all packed up and drove her back to the San Francisco
airport the next day. When we got her to the gate of the plane (in those days you could go
to the gate with passengers), she got cold feet and refused to leave. We were at our wits
end and we managed to find some Brasilians who agreed to watch out for her on the plane,
and she did, finally get on.
I heard, a year later, that she had a total emotional breakdown when
she returned to Brasil and spent the next six months in a mental hospital.
So I did recognize the face of this patient and I knew that she was
way beyond being "fixed" by some hormones and an exercise program. Dr. G is
good, but he's not that good. She did look a bit brighter after her hour with him, but she
had a long way to go.
I felt very sorry for her and I hope that she's able to get some
help to lift the clouds.