Tales of 2 Psychiatrists and 2 Sea Disasters

PSYCHIATRIC VIEWS ON THE DAILY NEWS

As I quickly wrote a pop-up column last Thursday afternoon when it became clear that the “Titan” vessel had imploded after a few days of an international rescue operations, its 5 passengers thereby dying, I had in the back of my mind the other recent vessel disaster. That was the sinking of a fishing boat that off the Greek coast with about 700 poor migrants from South Asia and Middle Eastern backgrounds. The rescue operation was minimal, apparently almost a hundred died, and mainstream media coverage seemed brief.

Admirably, however, my colleague Frank Clark wrote a poem on both for Psychiatric Times, trying them together in “Tragedy Times Two.” Since we often write—he a poem, me a column—on the same subject matter, we thought why not intentionally do so sometime? One way to start that process is to use my column for today on the refugees to play off his poem with some jazz riffs, if you will, on that particular tragedy. To do so, I will use each line of his poem for my response, which may or may not have anything to do with what Dr Clark intended to convey. I will close with some comments on how this may related to ethical issues in psychiatry.

“A Dream Filled Vessel”

Most likely, those migrants overfilling a rickety fishing boat run by smugglers knew they were risking their lives for a chance at a new and better life for themselves and loved ones. Our country, the United States, was founded with such a dream, though at times that dream has turned into a nightmare for some when refugees or immigrants were turned away.

“Freedom Halted By Carnage”

That boat carrying them from Libya to Italy capsized with reports of some women and children trapped inside as the boat sank. Some of the smugglers were arrested.

“Mourning Is Buoyant”

Those who survived must be mourning those lost. Some will go onto experience prolonged grief, but will they receive psychiatric services? Survivor guilt will likely be common.

“All Life is Worth Rescuing”

We have a saying in Judaism that saving a life is like saving the world. That means any chance to save anyone in either boat is equivalent and a great deed. However, who is preferred to rescue when there are not enough resources?

“Currency Irrelevant”

Astronomical wealth was embedded in the submersible, its passengers, and rescue operation. The migrants had little economic resources of their own. Yet, they all had human lives.

Ethical Conundrums

These 2 boats and the tragic lives lost on each have startling similarities and stark differences in “life, liberty, and the pursuit of happiness,” let alone social justice. For instance, perhaps the Titan tragedy could be justified as an adventure, an example of international cooperation, and one that could help understand the sinking of the Titanic, a representation of man’s hubris. On the other hand, who could predict whether a poor migrant child who might have lived would have made a great contribution to humanity someday?

Psychiatric Implications

It is not hard to apply lessons learned on these seas to psychiatry. We are not a simple system of resources relatively well-distributed among the people. In the United States, we are a system of the rich hoarding more resources and options in the private sector, whereas the poorer are served in the underfunded public sector that springs leaks. Don’t we need an ongoing rescue operation for our mental health systems?

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times.