This week’s sad news of the death of comedian/film star Robin Williams and his ongoing battles with addiction and depression are the center of this thoughtful article by EIC Veronica Combs in MedCityNews. Even with access to the best care and innovations such as virtual visits, Mr Williams committed suicide. The larger point made is that access and healthcare innovation don’t mean automatic adoption or a positive outcome. Some of those with chronic physical or mental illnesses choose not to change their behaviors, comply with a regimen or even to seek help, much less seek out technology or be a QSer. And some are simply beaten down and depressed by the perpetual Battle of Stalingrad that is chronic disease–ask any diabetic [TTA 5 Apr 2013]. Her conclusion is that though innovation may not help everyone, it doesn’t mean we should not pursue it. And, this Editor would add, for developers to realize that they must make technologies simple and affordable enough–‘tear down that wall’–so that those who won’t access help become fewer. (And, yes, there is a spiritual aspect of care that must be addressed–see VOX Telehealth’s work with HealthCare Chaplaincy Network TTA 25 July.)
Update: Other factors may have tipped Mr Williams’ depression flare-up. The first is heart disease; he had open heart surgery to correct several conditions in 2009. Cardiologists and internists tend to be dismissive of the short- and long-term effects of surviving a heart attack or having cardiac surgery–between the physical effects (emboli in the brain, post-anesthesia) and emotional aftermath it is likely, not rare. Hat tip to reader/guest contributor ‘HeartSister’ Carolyn Thomas; her Jan blog post. And the psychiatrists know–NY Daily News has an excellent interview with Dr Jeffrey Lieberman, chief of psychiatry at New York-Presbyterian Hospital Columbia. Another factor is a career fail reminder. While his TV series canceled some months ago after only one season, the start of the fall TV season with the seasonal media hype surround would only serve to remind Mr Williams of it. Though he lived away from Los Angeles, this could only have added to his feelings of being on the downslope of his career.
As I learned back in my airline days reading about incidents and crashes (a morbid pursuit that almost everyone who loves flying does), every airplane crash is a concatenation of events–subtract one or two factors and you may not have one.