COMMENTARY

The Brother's Keeper: A Psychiatrist Writes About His Career Treating Physicians and Their Families

Dinah Miller, MD

February 02, 2021

I started reading "Becoming a Doctors' Doctor: A Memoir" by Michael F. Myers, MD, with high expectations and enthusiasm. Dr. Myers is a Canadian psychiatrist who has devoted his career to caring for physicians in his half-time private practice; he turns all other comers away.

Dr Michael Myers

This career path began in 1962 during his first year in medical school when Dr. Myers returned to his apartment after Thanksgiving break to be greeted with tragic news: One of the young men he shared the apartment with had died of suicide. The tragedy marked him — along with the silence about what had transpired — and he would later look back to realize it was the beginning of his journey to becoming a psychiatrist, one who cares for other physicians.

The book is filled with patient vignettes, gentle musings that Dr. Myers recounts with warmth, adding what he has learned from them.

There is, for example, the heart-wrenching account of "DJ," a lonely medical student who is emergently hospitalized for depression, after the worried author anxiously drove the patient from his office to the hospital. DJ is all alone, and he writes to a friend and offers to pay for her transportation if she will come visit him in the hospital, a fact Dr. Myers knows only because he was later shown a letter DJ had written to his friend.

"He has been diminished and altered by his disease and the requisite hospital treatment, factors that we as mental health caregivers must never forget – or minimize. Visits from friends become visits of the representatives from the outside world, the link to normality, sanity, and anticipated return. These encounters are precious," Dr. Myers writes.

As the book progressed, I began to wonder more about the author as a person. It is a memoir, so stated on the cover, but very little about his life is revealed. There are résumé-style facts: where he studied, or worked, or went to conferences, what he learned and what he spoke about, but I wanted to know more about how his experiences intertwined with his life. In the foreword, he talks about having an alcoholic mother.

He tells the reader that being a husband and father was important to him, and that his conversion to Judaism — his wife's religion — was meaningful, but there is no backstory, and I was looking for more. A quick reference is made to visiting a therapist, but those few sentences are the total of what I knew about Michael Myers midway through his memoir.

I looked for a photo of the author. I found it at the back of the book with a brief biography beneath it, ending with the fact that he lives with his husband. I had gotten halfway through the memoir, including chapters about how Myers had treated gay physicians, gay couples, and physicians with AIDS, and yet there was no mention of his husband, and how his sexual orientation influenced these encounters. I didn't quite know what to think.

And then, in a section called "Getting Personal," suddenly the tone of the book changed. Dr. Myers talked about his own sexual confusion as a young man and about the decision to marry a woman, knowing he was bisexual. He wrote about the shame he felt concerning his sexual desires at a time when homosexuality was still classified as a psychiatric disorder, the fear of judgment, and the sense that this — his ninth book — was his first genuine book.

"And so, I come full circle. It is my otherness that fundamentally — but not with full awareness — attracted me to psychiatry, and ultimately to becoming a doctors' doctor. I've been able to empathize with my doctor patients' burden with the scourge of mental illness, coping with brokenness, and struggling for acceptance and belonging in a profession of perfection and stature. And I understand what it's like to feel a bit of a misfit, less than, unclean and tattered. But as a wounded healer, I know the restorative value of listening, acceptance, caring, doggedness, and hope." And so I found Dr. Myers.

These few pages in the middle of the book pulled everything else into focus. The writing opened and the rest of the book flowed. The author's insights about physician-patients became even more insightful. It's almost as though he was anxious about revealing himself, and his writing infused itself with this worry, so that once his secret was revealed, he was free to be genuine in a way that makes this book a gem of a read.

His insights about treating troubled physicians are invaluable. He talks of their struggles with loss, and of their flawed roles as patients.

"At the point that they become a patient these individuals may already be quite ill, and this needs to be recognized and accepted by the treating psychiatrist. Judging the doctor for so many self-defeating behaviors is unacceptable and unprofessional. I have found it best to simply accept the old adage ‘It is what it is.' And I try my best to be patient and understanding with such difficult and interwoven issues, in that for physicians becoming a patient is a process not an event."

Written with empathy, warmth, and vulnerability, "Becoming a Doctors' Doctor" is a worthwhile read for any psychiatrist who treats other physicians.

Dr Miller is coauthor of "Committed: The Battle over Involuntary Psychiatric Care" (Baltimore: Johns Hopkins University Press, 2016). She has a private practice and is assistant professor of psychiatry and behavioral sciences at Johns Hopkins, both in Baltimore. Dr Miller has no conflicts of interest.

This article originally appeared on MDedge.com, part of the Medscape Professional Network.

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