If clinicians are to take anything from the Johannesburg debacle, it is that we must be even more mindful of distress and despair. Like Poe’s purloined letter, profound sorrow may lie in plain sight under one’s clinical gaze-but not yet “thought upon.”
In Act I, Scene 4, of Christopher Marlowe’s Edward II (1593), the Earls of Mortimer and Lancaster debate whether Edward’s detested low-born lover, Gaveston, should be brought back from exile. The return has been proposed to reconcile the besotted king with his angry peers. Lancaster bitterly opposes it; the wily Mortimer, his eye on the crown, counters that once Gaveston is in London, he can be quickly dispatched by some anonymous assassin to the general rejoicing of court and country, without any blame falling upon the nobility.
Lancaster: Ay, but how chance this was not done before?
Mortimer: Because, my lord, it was not thought upon.
The exchange has always seemed odd, comprising an absolutely unexpected “duh” moment in the midst of Marlowe’s sumptuous poetry. It also contains a potent, if mundane, truth.
History is strewn with calamities which stem from staggering disregard for dire consequences lying in plain sight, yet perversely “not thought upon.” One example amongst the multitude: France’s defense against the German invasion of its borders in 1944 hinged upon a “Maginot Line” of powerful fixed fortifications. It was regarded as a work of supreme military genius. But the German army simply swept around the Line into Belgium and the Low Countries, to conquer France in 6 weeks. “Duh” indeed.
Flash forward 60 years: at Nelson Mandela’s memorial service in Johannesburg on December 12, one Thamsanqa Jantjie stood a scary heartbeat away from world leaders (Barack Obama included), high South African government officials, other notables, and the Mandela family. Jantjie was tasked to sign the event to hearing impaired people in attendance and watching throughout the world.
During the long ceremony, as different languages were spoken (including African dialects), Jantjie’s gesticulations were curiously stilted, varying little from one speaker to the next. His face, often raised to the heavens, remained impassive; utterly devoid of the expressive play which fleshes out the play of hands in every deaf signing system.
Complaints from the local and worldwide deaf community quickly flooded the internet. It was obvious that Jantjie was performing a private pantomime of outlandish gibberish. One surmises that some listeners in the audience would have been apprised of the botch-up. But Jantjie kept up his bizarre performance, with not a finger raised to give him the hook.
Jantjie blames his aberrant behavior on an “attack of schizophrenia,” in which he saw angels hovering about the stage. Apparently he has been treated for past episodes, and was hospitalized a few days after the memorial service.
It turned out that schizophrenia had also been invoked on several occasions of alleged criminal behavior-including attempted murder-since the mid-1990s. Each time, Jantjie was judged unfit to be prosecuted by virtue of mental illness. In one television interview, available on YouTube, he appears quite lucid, and shows no psychotic stigmata. In fairness, this is not conclusive proof that he was not delusional at the memorial.
Jantjie claims his credentials are impeccable; states that he has signed before at other events without incident. His qualifications have yet to be ascertained. The interpreting firm that hired him out possibly has intimate ties to the ruling ANC party, and so far has not responded to phone calls. At the TV interview, Jantjie was asked to demonstrate his signing competence, but testily refused on dubious grounds.
Government officials have yet to offer a satisfactory explanation as to how Jantjie got to crash the party. The predictable investigation is being undertaken. Its conclusions are not likely to be known soon. At this writing, the only certainty amidst the swirl of uncertainty is that some agency and/or individual did not properly vet Jantje. Apparently “it was not thought upon” that he might sully this solemn occasion so flagrantly, and also pose a terrifying security threat.
One submits that the Jantjie affair is yet another example of humanity’s timeless obliviousness to one or another glaringly obvious potential for crisis, with dire or merely risible consequences. One wonders if this chuckleheaded disregard is hardwired into our genome. Down through the ages, it has afflicted brilliant minds as well as those with little wit; politicians, generals, and the average Jane or Joe.
Our profession is hardly immune. During my Bellevue residency, a patient in a trichotillomania study was a successful, apparently well put together woman with borderline personality disorder. In those green and salad days, I was blissfully unaware that a high-functioning facade could mask serious borderline pathology, and overzealous to break new research ground. I failed to recognize that my patient was gradually becoming unglued, as I probed relentlessly into her history. Fortunately, an astute supervisor counseled that I was undermining her fragile defenses. She returned to her previous tranquil state once I gentled up my approach.
Today as never before, we labor under formidable pressures to spend ever less time purely listening to our clients without rushing to judgment. The problem stems from-inter alia-the incursions of ill-managed care, the shift from an analytically oriented and supportive paradigm to biological and cognitive interventions; the prevailing yen of our age for therapeutic quick fixes.
If clinicians are to take anything from the Johannesburg debacle, it is that we must be even more mindful of distress and despair, which can easily elude a quickstep march through DSM-5 criteria. Like Poe’s purloined letter, profound sorrow may lie in plain sight under one’s clinical gaze-but not yet “thought upon.”
Dr Greenberg is Clinical Professor of Psychiatry, Albert Einstein College of Medicine, New York. He publishes widely on cinema, media, and popular culture. He was the film and media critic for Psychiatric Times.