Sunday, 21 May 2017

The Postman Rang Twice on Talcott Parsons Door

Many readers of this blog might not remember the famous film noir – The Postman Always Rings Twice. Released in 1946, it was based upon the 1934 novel of the same name written by James Cain. The film has a classic plot line - boy (Frank) meets girl (Cora), girl is already married, so they kill her husband. Although they go to court, neither are convicted of the murder due to some double crossing deal making and lack of evidence. Shortly after Cora is accidently killed in a car crash, and Frank who was driving the car, is wrongly convicted of her murder and given the death sentence. It’s a great film and if you haven’t seen it, look out the original not the 1981 remake version.

The ‘postman’ in the film’s title is a metaphor (although not a very good one). It gets explained at the end of the film by Frank who posits that when we are expecting to receive a letter or a parcel, it is of no concern if at first you don’t hear the postman ring the doorbell as the postman will always ring twice. The second ring will invariably be heard. In the story, Frank and Cora escaped punishment for the murder of her husband but with Cora dead from the RTA and Frank facing the death penalty, the postman has indeed rung a second time for them both.  

Now I guess, dear reader you might be wondering where this is going. Let me try and explain. Last Sunday I shared the struggles I was having with depression, a struggle that had slowly crept up on me. I usually let the world know I have posted my blog, and last week I didn’t, instead I just quietly posted it on-line. I was overwhelmed by the number of people, friends, and colleagues and even from those I don’t know, who took the time to send messages of support and kind wishes. I was buoyed up. I enjoyed a day of family fun with a house full of children and grandchildren celebrating my birthday.

Although I knew that acknowledging my mental health struggles was just the first step, and it felt like an important step, actually I hadn’t heard the postman ring for the first time. Last Monday was my birthday and arriving at work, I realised that the family celebrations the day before hadn’t changed anything. For the first couple of hours I sat in my office feeling absolutely desolate and effectively doing nothing. In the silence, my twitter notification pinged and it was my friend June asking how I was doing. Out poured a long rambling response from me that probably sounded very incoherent.

However, she came back with warm and wise words for me to consider. Speak with my GP, find some time and space to recalibrate, sleep, rest, and gently exercise, go up to Scotland. Just lose work. All of which was sound advice and all of which seemed pretty impossible to do. I was trapped in a classic case of Parsonion role conflict – professional role versus sick role. As people started to arrive, I went back into professional role, and the day turned into a series of meetings, present giving and good wishes being exchanged. I got through the day, but it was hard - and the emotional drain took the edge of my evenings birthday celebration with W.

The following day had a similar start to it and by the time I had got to lunchtime I knew the road to recovery was going to be difficult if I didn’t change anything. The postman had rung twice. It was time to step off the Merry-go-round. And so I reported sick on Wednesday and agreed with my GP some time off work, and started a course of anti-depressants. Of course the classical Parsonion sick role has evolved these days. Elements of the concept around entitlements and obligations remain, but the rise in the numbers of people living with long term conditions (currently 15 million people and rising in England) has challenged our understanding of the sick role. 

In mental health care, the concept of recovery, also flips the relationship from the doctor being the expert to the patient being the expert and co-creator of what interventions might be the most helpful to ensure a return to a place of well-being.  This is an approach that has given me a pathway to follow. And please don’t worry dear reader, whilst I love writing my blog, and have written one every Sunday since 2nd August 2009, I do not intend for it to become a ‘diary of the depressed professor’ – so I shall continue to try and write a new blog each Sunday, and all I ask of you the reader is please bear with me as I try and regain my inner equilibrium and blog persona. It will return.