Mental Illness from A Societal Perspective and a True Walk of Fame

He is a fixture outside the gates of Hospital Sacre Couer. A tall disheveled man, in his 50’s, he paces along the sidewalk, yelling obscenities, and gesturing wildly. The locals keep an eye on him, and by evening, he has disappeared, only to return the next day. I never felt concerned, and it appears that he has struck a peaceful coexistence with his fellow citizens.

A vivacious, eloquent English teacher, she began to forget names and addresses in her early 50’s, and rapidly developed early onset Alzheimer’s disease. Given her otherwise good health, she required nursing home care for 15 years until her death.

Another young man is introspective and well groomed. He sometimes laughs inappropriately, seems to have problems with impulse control, and understanding social norms. He has been diagnosed with Asperger’s syndrome, and his parents are at a loss of what to do.

A brilliant surgeon at the peak of his career suffers a bicycle accident. Despite a helmet, his brain is injured enough that it leads to a significant personality change. His ability to support and enjoy his 5 children is altered forever.

…and then there the Tuscon shooter, whose unclear need for recognition and driven by as yet unknown demons, killed and maimed many. How can he be included with the others?

Such is the broad spectrum of brain and mental illness. And along that continuum is how society chooses to deal with the victims.


In medical school we learned of French physician Philippe Pinel who supervised the unchaining of mentally ill patients in 1794 at La Salpêtrière, a large hospital in Paris. Pinel believed in treating mentally ill people with compassion and patience, rather than with cruelty and violence. Prior to that, the mentally ill were subjected to restraint and torture. In museums, I’ve examined trephines, used to drill holes in the skulls of the insane, in hopes of releasing the spirits. In some cases, the fortuitous draining of a traumatic subdural hematoma led to clinical improvement and reinforced this therapy.

The age of modern psychoanalysis began to bridge the gap between spiritual dogma and an appreciation of the complex responses of the human brain to outside stimuli, including trauma and abandonment. As we have gained the ability to watch the brain function in realtime, using functional MRI, addictions, schizophrenia, and depression are being redefined at a molecular level. New and more effective therapies will be developed.

Yet we all have twinges of discomfort when we see the homeless on the streets and wonder if they are just looking for their next drink. We debate gun control after shootings, without understanding that increasing social isolation may be the driving factor in these senseless events. We have no problem donating money for kids with cancer, but sometimes it is difficult to get behind calls to increase funding for mental health. As a society, we all suffer, yet it still remains in the shadows.

I park my car behind The Thalians building here at Cedars. The sidewalk out front has stars in it just like Hollywood Boulevard. Yet I didn’t recognize any of the names. When I went to the website, I learned that The Thalians was founded in 1955 by a group of young actors and allied professionals from the film industry who wanted to give back some of their blessings to the community. They met at actress Jayne Mansfield’s home to discuss how they could use their time, talent and energy to help children with mental health problems. Taking the name from Thalia, the Muse of Comedy and the Shepherdess of straying and lost lambs, the first Hollywood “celebrity” charity was born, and just four short years later, The Thalians Clinic for Emotionally Disturbed Children at Mt. Sinai Hospital was established. When Mt. Sinai and Cedars of Lebanon merged, The Thalians pledged $1 million toward the construction of the first building on the new campus, which was named in their honor: The Thalians Mental Health Center.

Each star represents a significant donor and from what I understand, the annual Thalians Ball is not to be missed, even if it wasn’t at The Playboy Mansion.



The way to eliminate darkness is to expose it to light. As you may have surmised, other than the Arizona vignette, all the people I mentioned, I know. Some are family members. Treating mental illness may not be as quick or dramatic as resecting a pancreatic tumor that encases the portal vein, but the long term return on investment for the patient, those they love, and society, can’t be underestimated.

In Haiti, there are few handguns, and the mentally ill would have a hard time wreaking large scale havoc with a machete. The US is different. Means for destruction are easily available. We can only hope that young men like the Columbine shooters and Loughner are recognized and helped before they explode again in violence.