Why mental health—and what’s it like?

People often ask me why I chose to do mental health of all the available medical specialties.

Well, it started with my grandfather, even though he doesn’t know it—and maybe never will, because he now has dementia.

See, my grandfather was in that category of people I think of as “old formally educated Yoruba”—which is basically my category for Yoruba people I know who were educated during colonial British rule. And the reason they’re a category is because in addition to traits they share with colonially educated Nigerians from other ethnic groups (like faith in education, calligraphy-level handwriting, a love of reading and a library to match), and there’s that distinct Yoruba-flavoured English diction.

Grandpa was deliberate about our education. He once gave me a Yoruba Bible to ensure I could read our language as well as I spoke it. And later he offered his beautiful typewriter from when he was still teaching business studies. It was on that machine I first learned the typing skills that enable me to write these words.

But it was his library that would prove arguably his most influential contribution to my education. It was a multi-site library: there was the long two-shelf cabinet in the sitting room (which was one of my first haunts because I could easily reach the books), the even smaller shelf behind the living room table that served as his official space which I only dared check when he wasn’t in, and the two long shelves in one bedroom that I started checking as soon as I was tall enough, and the wardrobes in the other two bedrooms with books secreted away. Everyone was quickly familiar with how I would disappear within minutes of arriving at our grandparents’ house—they would come find me in one of the rooms when they were ready to go.

And it was during one such visit, when I was about 8 or 9 years old, that I ran into a book titled Child Jealousy. That’s the title as my memory recalls it, at least, although I have been unable to find it since. But I remember it as a small book that I had ignored several times, and only picked up because I had read everything else that seemed interesting, only to find myself utterly fascinated by its contents. I learned sibling jealousy was an entire field of study and that it could explain some children continuing to bedwet, or regressed to it after the arrival of a younger sibling.

It was my introduction to the complexity of the human mind.

But I didn’t know any psychologists, and so it never really felt like a profession I could practice in Nigeria. I still recall, near the end of secondary school I was choosing medicine, wishing I could envision myself as a psychologist. Halfway through medical school, when I still wasn’t sure what kind of doctor I wanted to be, psychiatry posting happened, and for the second time I experienced the familiar thrill. I remember telling my mother I realised an aspect of medicine had finally set off a spark for me: I was far more interested in the human mind than the human body.

And yet…

You see, all this time I had been focused on psychology because it was—as the name itself implied—about the study of the human mind. Psychiatry on the other hand was heavily focused on the treatment of the disordered mind, and that felt quite different from what I had been looking for. For some reason, this felt like a real block, and so weeks after the posting, I was no longer seriously considering psychiatry as a specialty of choice. By the time I had finished medical school, I was back to square one—except now my uncertainty was about the right choice of medical specialty.

And then it clicked. In a sudden flash of insight on an otherwise ordinary day, I realised that of course psychiatry was the perfect specialty for me. It was so plain to me that I could only wonder why it had not been so obvious before—I couldn’t be happy devoting myself to any other. This happened during my year of community service (mandatory for Nigerian graduates) and it’s one of the most dramatic moments of my life. There have been only two other times I have felt as certain of anything. The first was the moment I converted to Christian faith alone on a top-floor balcony in medical school. The second was the moment I knew the woman sitting across the table from me as I write these words was the woman I wanted to spend my life with.

I remember quickly checking the application dates for the required exams to go into psychiatry training, and realising I was only two weeks away from the closing date. I had barely enough time to put my application together, including obtaining the required signatures and mailing it (by courier, of course!) to the training body. 

So my journey began—and what a journey! 

When people ask what it’s like, I often take pleasure in noting how in my over a decade of being in psychiatry I haven’t been hit once by a patient. That’s often a nice way to drive home the falsity of public perceptions of people with mental illness being violent. (Especially when I point out my colleagues who work in emergency being, on the other hand, attacked by otherwise well, but angry, patients and relatives!)

Really, though, what it’s like is I get to work in a field of medicine that allows me to play not just to my strengths, but also to the things I love. Psychiatry is more dependent than any other on words, on communication. It’s also a field that, by its very nature, is almost metaphysical: where the rest of medicine takes for its goal the ideal of the human body, psychiatry has to think about what is the ideal for the human person—that’s at least a philosophical question, not merely a scientific one. And as such it’s a field in which there are few easy answers, which is just the kind of field I’m drawn to.