From the Editor

“What do you wear the first day back to work after a 90-day leave of absence because of a psychotic break?”

Lawyer Zack Mcdermott asks this question at the beginning of a moving, honest, and raw essay that was published recently in The New York Times.

zack-and-cindy-1The writer and his mother

In this Reading, we look at his piece and his journey.


Illness and Recovery

“The ‘Madman’ Is Back in the Building”

Zack Mcdermott

The New York Times, 20 September 2017


What do you wear the first day back to work after a 90-day leave of absence because of a psychotic break? This is the question I found myself asking a little more than a year after I joined the Legal Aid Society of New York. The last time my colleagues had seen me, I’d been wearing a handlebar mustache better suited to a Hell’s Angel than a 26-year-old public defender. I’d also taken to wearing a Mohawk — tried a case like that even. We won, thank God.

At the happy hour following that trial, I stripped down to my underwear and did a titillating strip tease for a bunch of law students who were there as a part of a recruiting event for a white shoe law firm. It didn’t go over well but I didn’t care. I thought I nailed it.

For my first day back to work I dressed in a sober navy sweater and a pair of dark slacks. Normal haircut, neatly trimmed beard. I got there early to avoid the morning rush and the inevitable stares and whispers. I had been “away with some issues” — that was the official company line, but offices are gossip hotbeds, and I wondered how much of the real story had filtered through. Did they know that I’d marched through the city for 12 hours — manic, psychotic and convinced I was being videotaped by secret TV producers, the star of my own reality show? That the police had found me later that evening shirtless, barefoot and crying on a subway platform? That I’d been involuntarily committed to Bellevue, the notorious psych ward to which we at Legal Aid routinely sent our most mentally ill clients?

For most, an involuntary stay in a locked psychiatric ward becomes a closely guarded secret. But part of me wanted everyone to know. I wanted them to know that I had received a Bipolar I diagnosis — that the “madman” they’d been covering for was actually a very sick young man who did things he feels guilty about, but who also knows that he had no more control over the doing of those things than a cancer patient has over the state of his lymph nodes.

9780316315142_zack-mcdermott_fall-2017Zack Mcdermott

So begins an essay written by Zack Mcdermott. The piece is highly readable and doesn’t require much of a summary.

He talks about his experiences with illness.

The “madman” had raided my checking account, and there was no overdraft protection for “Sorry, I had a manic episode and rang up $800 worth of novelty T-shirts at Urban Outfitters.” I’d lost friends, an apartment, maybe my job and reputation, too.

But in the darkness, Mcdermott is able to count on one person.

Mercifully, one person stuck by me through it all — my mom, nicknamed the Bird on account of the choppy, avian head movements she makes when her feathers are ruffled. She had been my tether in a hurricane.

The essay recounts the reality of return to work – and the return to life.

I knew I had a lifelong disease and that bipolar disorder is something to be managed, not cured. I knew I’d need to take medication for the rest of my life and that I’d humiliated myself in front of countless friends and strangers alike. I knew that I had more in common than I’d have liked with my schizophrenic uncle Eddie who lived the last 15 years of his life in a state mental institution. That no matter how early I got to work, no matter how useful I made myself, no matter how reasonable and modest my khakis and my sweater were, I was and would always be the “crazy” dude.

A few thoughts:

  1. This is a great essay.
  1. The last essay like this – also by a lawyer, also describing the experiences of living with bipolar – was a Reading a few weeks ago. I’ll repeat my comment: I’m looking forward to the day when we can share more stories like this, including stories from physicians.
  1. If you find Mcdermott’s story interesting, his book is now available. For the record, it looks great.


Reading of the Week. Every week I pick articles and papers from the world of Psychiatry.