True west

It's a foggy spit of a Wednesday night, and I've just joined my songwriter/guitarist friend Tom at his going-away party. The walls of his apartment are scrawled with sayings—some original, some pilfered—from the felt-tipped pen of the guest of honor. Typical of Tom.

"Wife: It is what it is.
Husband: What is it?"

"Respect the man with strings"

"It don't take an apostle to answer His call"

"Gone but not forgotten"

"What?"

"You can't always do what you're told"

Tom currently lives on the second floor of a neat two-family house in blue-collar Franklin Square, Long Island. But he's leaving for California next Tuesday. He's re-won the heart of a woman he first dated 20 years ago when he was a tour guide. She's since been married and separated, and today she busies herself with accounting and raising two children. Tom called her on a whim and went out to see her a few weeks ago; they plan to marry next June, after her divorce is finalized. Sometimes it just happens that way, but knowing Tom as I do, I am a bit concerned, as are most of the friends gathered here.

On the ledge by his living-room window, Tom has arranged a collage of photos he took of his fiancée and her teenaged son and daughter. The mother has a big, disarming smile. In one photo her daughter peers at the camera from under a floppy hat with an expression that seems to ask, who is this guy?

Tom has always been an in-your-face kind of guy with a penetrating wit. Sometimes he can be a turnoff, sometimes a blast of fresh air. Once in Manhattan he happened upon Faye Dunaway during a stroll along Fifth Avenue. The six-foot-four Tom sensed the actress looking up at him as they waited out a red light. He looked down and when he saw who it was blurted, "You know, I'm a lot taller in person." Ms. Dunaway burst into laughter, grabbed Tom's arm and proceeded to take him window-shopping, asking and mulling his opinions on the exhibited fashions.

By and large, Tom is just another guy whose idea of a party is a cowboy hat and guitar, Budweiser in the fridge, plenty of close friends and John Prine on the stereo. That's not the Tom that concerns his guests right now; we're all genuinely happy for that Tom. The Tom we're concerned about has thrown away his medication, stopped seeing his psychiatrist and proclaimed himself mentally sound, a man who was misdiagnosed as bipolar when all he really needed was the love of a good woman. A bitter poem he's written about psychiatrists and taped to a wall contains the line, "Sensitive hearts, screwed by insensitive minds."

There is truth in that. Many psychiatrists today believe the treatment of all mental illness is measured in doses, and not much else. Little-to-no attention is paid to their patients' feelings, beyond their value as "symptoms" in the diagnostic workup. "Take this as prescribed and call me in a few weeks," is the standard instruction. "We'll see if we need to adjust your dose or try another medication then." I understand that professional distance is a requirement of the vocation. But psychiatry—and psychiatrists—can do better.

This Thanksgiving I'm grateful for friends like Tom. I pray this new love in his life out west survives and overcomes the illness that has plagued him most of his adult life. The skeptic in me worries.

I'm also grateful for the people who care about friends like Tom, people like the party guest who stole Tom's pen to write these parting words on a wall:

"Landlord,
Use oil-based primer and 2 coats of paint.
Good luck"