Thomas A.Ban, editor. Lithium in Psychiatry in Historical Perspective.

Peter Martin’s comments

       It is my honor to participate in this exchange concerning Reid Finlayson’s comment, My Life on Lithium and Lessons Learned.  When Reid applied for a position in the Division of Addiction Medicine at Vanderbilt, he was candid and completely honest about his psychiatric history of having bipolar illness and the challenges he had faced and overcome.  I was greatly impressed by this and admired his courage and honesty.  He provided the name of Emmanuel Persad as a reference who was familiar with his professionalism and clinical skills, as well as his illness and its treatment.  Since Reid’s and my careers have overlapped some — Emmanuel Persad was my first attending when I entered Psychiatry at the University of Toronto — it was easy to ask Emmanuel’s opinion about the applicant.  Emmanuel gave me a disimpassioned appraisal of Reid’s strengths and shortcomings.  This convinced me that I wanted to recruit Reid to the Division because I had a very good feeling about him from our personal contact.  Needless to say, I made the right decision.  Reid has become one of the very best colleagues and friends I have had in a long career in academic psychiatry and I know I am not alone in this statement. 

       Since Reid has been in Nashville, my life has not been the same.  I have learned a tremendous amount from him over the years we have been close, including how to enjoy life more (“You only go around once,” Reid is fond of saying).  He describes me in his comments as “a mentor and friend” and if that is possible, I would say the same about him.  Reid has helped me become a better physician, less judgmental and rigid and more patient and open to input from others.  He has inspired me to explore elements of humanness that I heretofore considered “soft stuff” or irrelevant to the care my patients (after all, I was a critical scientist, foremost).  All I have learned from Reid has enhanced the quality of my clinical work.  He has served as an example for my reconceptualization of the effects of trauma and mood disorders in addicted patients and thereby to increase my prescribing lithium and anticonvulsants to these complex patients in whom bipolarity, post-traumatic stress disorder and various drug use disorders are inexorably intertwined (Melvin and Martin 2008; Rich and Martin 2014). Finally, he has allowed me to experience life through his eyes and his enthusiasm, when every challenge is worth taking on without being overly cautious (which I tend to be) and collaborating on an academic journey where everything is possible and there is sufficient time for everything that is worth doing. 

       I sometimes wonder whether many of Reid’s positive attributes would be present if he did not have bipolar illness that is very well managed with lithium.  Lithium not only helps those who take it, but also those who are the family and friends of those whose lives can be fulfilled due to appropriate treatment.  There is a lesson in Reid’s story — the importance of having the courage to overcome the uncertainty and fear associated with the stigma of mental illness.  This is particularly the case for a psychiatrist who knows how destructive psychiatric disorders can be in the lives of their patients.  We should all be aware that colleagues with mental illness, when appropriately managed, may have a tremendous amount to offer in recovery, some of which is rarely found in medical curricula and may be only acquired through experience. 

References: 

Melvin KE, Martin PR. Oxcarbazepine for Treatment of Posttraumatic Stress Disorder and Alcohol Dependence: A Case Series. The Journal of pharmacy technology, 2008;24(3):149-53. 

Rich JS, Martin PR. Chapter 33 - Co-occurring psychiatric disorders and alcoholism. In: Sullivan EV, Pfefferbaum A, editors. Handbook of Clinical Neurology, 2014, Vol. 125, Pp. 573-88.

March 18, 2021