I find myself 'helping' friends with schizophrenia often (over a dozen in the past decade, clinically diagnosed, some having even been committed for periods). Most are scientists, mathematicians, or engineers. It seems to be common among such special people (sadly).

In fact I have my own name I coined ‘Nash syndrome’ to describe very smart people who hide their ailments, mostly effectively, or for a longer duration.

They tell me I've been helpful to them (and perhaps this is why they seek me out) because they appreciate that I don't judge them, and am patient, and I don't instantly assume what they are describing is just wrong per se.

Here is a great recent example: A friend, going through a very difficult situation losing touch with reality, they described evil eyes watching them in the sky, a bit of terror from it the night before while driving. Later they drew me a picture (below), which at first glance made no sense. Eventually, I got them to tell me what they thought it was, and they said it was a power-line pole. But, that it had changed, as in, they were now in the wrong universe, and things all looked more evil to them. This pole suddenly stood out to them, dramatically.

I got them to send me a pic of the real pole a few days later, in the daylight. And I agree with them, I can see what they were scared of. But by respecting their reality, and recognising that indeed, it did look evil even to me, we could then move past that to talk about the how and why they ‘suddenly’ noticed this, and had this existential dissociation with our reality. This led to them getting help.

Others around them were already attempting to 5150 this person. I consider this a drastic measure, one that carries far more problems, and ultimately may cause more problems than they cure. Keeping one’s autonomy is imperative if possible. It’s been almost 6 months now, and they have progressively gotten better, but it did require much of my own energy and time. I can see how easily the medical system (in the US) can make things worse as well. Quite literally, I hear someone mention schizophrenia, bipolar, etc. and instantly this is added to the case file as if it were true. I had a cooperative conversation with one older attending psychiatric doctor who himself was disgusted by the policies and procedure that forces him to label things in such a way. We spoke for almost an hour, at 3 am after he had tended to my friend. It was clear he was a deeply caring person, and wanted the best for his patients. We discussed how the nature of this area of care has changed on both sides. For their part on the patient side, drugs like Fentanyl literally destroying minds, and on the healthcare side, a lack of staff, training, and bandwidth, to deal with it all. Ultimately, it’s bad out there.

I moved my friend to Asia, specifically Thailand in this case., where one can get better care, and have a deeper relationship with doctors. This comes as a surprise to Westerners. But personally, I would do whatever it takes to not have medical done in America, unless it was specifically some extremely life/death situation where America had the only experts.

Doctors in Thailand will spend an hour just talking with you, sharing their knowledge, opinions, literally sharing their education with you, until you feel you can make a fully informed decision. That might cost you $50US, and the doctors will have done their residencies in America, Germany, England, etc.

Holistically, in but a few days, we could literally just walk from department to department, getting a blood test, meeting with a psychiatrist, ruling things out, or in, together. Unlike the US where every moment forces one to fill out papers, in Thailand, they already have all your information before you arrive at each location. The lack of redundant paperwork is joyous. They will check with you to confirm no mistakes, and you are welcome to all your own paperwork, of which it will be emailed to you while you are standing there. Again, a beautiful example of intelligent process.

You pay before you leave, freeing you 100% from follow-up paperwork endlessly mailed to you as is done in America. And when you do pay it, you may be confused and assume they left off a zero. No, this is the price of medicine without insanity.