Professional Amnesia in Psychiatry

I’m sitting on a train somewhere in southeast India. I’m 17. I’ve never left the country. I’m on a “mission trip” to spread the gospel, but I’m fucking miserable and wishing I would never see India again. The heat index is 115. There’s no a/c on this train. Every time we stop, a man jumps on board yelling in Indian English, “coldrank! coldrank!” God, he’s so loud. It’s so fucking HOT. I hate it here. I hate the curry. I hate the toilets. I’m living on bananas and boiled eggs because I don’t trust the food OR the toilets. I’m going to be constipated for weeks over this. If I can just make it back to the Franklin airport, I swear I’ll never complain about anything again. The a/c. A McDonald’s cheeseburger. “COLDRANK! COLDRANK!” I buy the Coke. It’s not even cold. I try to dissociate.

The rest of the team is ecstatic about this “adventure” into the southern Indian jungle, away from the orphanage where we at least had proximity to a city. Not wild enough for them. We’re preparing to sing our translated Jesus songs, draw a crowd, and let some young, brave white man preach the Good News. These people live in huts on dirt floors, and we’re here to tell them their gods are wrong and they need ours, especially to avoid a hell they didn’t even know existed until we arrived to scare them with it.

Is Jesus going to build them a house? Install plumbing? Bring these orphans parents?

It felt obscene. Symbolism instead of infrastructure. Meaning instead of medicine.

The orphans loved me. Especially the boys. It was 1998, and Titanic was everywhere- Jack and Rose on storefront windows. Maybe I looked like a blonde Her. I don’t know. They thought I was famous. They brought me gifts and learned my name. One night, they lined up on both sides of the bus like we were dignitaries. When I stepped off, they started screaming my name. I ducked and ran before I got in trouble. The girls on my team rolled their eyes. I loved those kids. I wished they’d let me stay behind with them instead of marching into the jungle to manufacture conversions.

I remember thinking: I can’t do this. I don’t care about this message. I don’t want to scare people into salvation. I want to help them.

“Be a nurse.”

Excuse me?

“Be a nurse.”

A what?

I had never really seen a nurse. I’d barely been sick, except for one childhood memory of being held down while someone drew my blood. That was medicine to me - force and restraint. But the idea wouldn’t leave.

Be a nurse.

Fine. Whatever. I’ll be a nurse.

And that’s where it started.

Not a calling wrapped in glory. Not a vision. Just a refusal to keep confusing symbolism with care. I wanted proximity. I wanted something tangible in my hands. I wanted medicine I could actually bring back to those kids.

Almost thirty years later, with twenty-four years in nursing and medicine behind me, I sit at my keyboard with a familiar nausea.

I am disappointed.

It seems many of us are no longer drawn to proximity. We are drawn to leverage. To scale. To optimization. To revenue.

There are entire professional communities now devoted to helping nurse practitioners become millionaires. Psychiatrists speak openly about making seven figures, eyes twinkling. And they do.

I did not enter this profession to become wealthy off other people’s suffering.

The word psychiatry comes from two Greek roots: psyche- soul, breath, the animating life force- and iatreia- healing. Psychiatry literally means the healing of the soul.

We don’t say that part out loud anymore.

Now we say: brain science. neurobiology. pharmacology.

Which are not wrong. But they are not the whole story.

The word remains. And words carry ghosts.

Some of them are hungry.

Hungry for proximity. Hungry for integrity. Hungry for clinicians who remember why they walked onto the train in the first place.

I did not become a nurse to optimize margins. I did not enter psychiatry to build a brand. I came because I wanted to bring medicine.

Actual medicine. To actual people. On actual dirt floors.

If psychiatry is the healing of the soul, then we have to decide - collectively- whether we still believe that. Or whether we are content to heal balance sheets and call it care.

The rot I smell is not ambition. It is amnesia.

And amnesia, unlike poverty, is something we can choose to reverse.