He's called "Mr. Education" in an upcoming profile in the April issue of Canadian Psychiatry, – cited as "one of the main pillars of Canadian psychiatry, particularly in postgraduate education."
He's also described as a "renaissance man of psychiatry, a superb negotiator. Patient. Quietly respectful. Charming."
Yesterday, in his small, simply appointed, windowless office at Markham Stouffville Hospital, Dr. Persad and I spent an hour together, our first shared-hour since he had a much larger, windowed, plant-filled office on the eighth floor of the Clarke Institute of Psychiatry.
Our appointment, yesterday, was at 3 p.m. and at precisely that moment, Dr. Persad approached me as I wandered a little dubiously in the busy lobby of this suburban Toronto hospital. I recognized him instantly. He has hardly changed, especially in his humility, his concern that I might lose my way to his office on a subterranean level of the hospital. That caring gesture was a clue to the kind of person, Dr. Persad is.
This was our first reunion in about 25 years.
The last time we met, in his Clarke Institute office in the early 1980s, he said, "We're very proud of you, Sandy." I was a full-time feature writer at The Toronto Sun and Women's Editor at CHFI. Doing well, apparently, on the mood stabilizer Lithium Carbonate.
That meeting was a far cry from the previous time we'd shared an hour, a decade earlier.
I met Dr. Persad in 1975 when he was a professor of psychiatry at The University of Toronto and a newly-minted senior psychiatrist at The Clarke, now part of The Centre for Addiction of Mental Health,
And I was seriously troubled.
Following my graduation from Queen's University and the break-up of my short-lived first marriage, I was psychotic. Again.
Hospitalized for the fifth or sixth time since the early 1960s. Delusional. Delusions of Grandeur, actually. My thoughts racing. "Flight of Ideas," it's called. Talkative. Sleepless. Irritable. Hallucinating.
I remember how Dr. Emmanuel Persad listened to me. Very carefully. Intensely. With respect. I've never forgotten the way he listened.
"What transpires here, in the work I do, is having the person I am with know that they're being listened to and that it's safe enough with me for them to come back," he explained yesterday.
I remembered that feeling of being intensely listened to. You never forget it. Dr. Bob listens the same way. Why wasn't I surprised that Dr. Persad and Dr. Bob are professional friends. Colleagues who share the same psychiatric spirit and vision.
"There is something sacred about the interaction between a psychiatrist and a patient. Trust. Autonomy," Dr. Persad continued. "It takes courage to come into this office.
"And I avoid labels – which have a way of dismissing the person."
During that 1975 hospitalization, Dr. Persad changed the course of my life.
From 1960 to 1975, my psychiatric diagnosis was schizophrenia. At one time, in the late 1960s, catatonic schizophrenia. I was, in the words of many psychiatrists, "a revolving door case" – in other words, "doomed" to a life in and out of mental institutions. My mother recalls being told that "there was no hope for me."
Somehow, Dr. Persad saw something in me that eluded all those other psychiatrists.
I did not have schizophrenia. Manic Depression, as it was known then – Bipolar Disorders, today, a spectrum of disorders – was a more apt way to describe my behaviour back then. But it was a difficult diagnosis. I do not get clinically depressed. Ever. Just high. Ultimately psychotic.
Today, my diagnosis is Psychosis in Mania – and it's rare. I don't think about it much. It's just a label. I prefer "in recovery." Most of the time I'm simply exuberant. Hypomanic, with medication and therapy.
The point is, as Dr. Persad explained yesterday, "no label aptly describes a person's unique life experience." Furthermore, he strongly endorses the practice that whatever treatment is prescribed must be managed by the person in partnership with their therapist. "It's a joint-event."
In the 39 years since Dr. Persad more accurately understood what was troubling me, he has continued to educate several generations of medical students and psychiatrists at the University of Toronto, the University of Western Ontario and now Queen's University, while practicing his profession.
(Coincidentally, I will be delivering the keynote to the students at the Queen's Faculty of Medicine next week during their "Mental Health Awareness Week.")
Today, he continued, the tensions between the neurosciences and the mental health issues pose serious problems for psychiatrists. "The "biopsychosocialspiritual model" is almost invisible behind pressures of Big Pharma and the push to prescribe, prescribe, and prescribe.
The reasons are too complex to deal with here.
"We're part of the problem," Dr. Persad admitted. "We perpetuate the undesirable nature of our profession. We treat the person as less than a person."
He envisions a re-introduction of psychotherapy – talking therapies – into the treatment of serious mental illnesses, like schizophrenia. He's completing a text on this subject right now, stressing instead the far more powerful impact of listening and respecting the integrity of the person who needs and/or seeks help.
"As psychiatrists, we seem to have lost the intellectual rigor, to be comfortable with the ambiguities of people, and this needs to be resuscitated," he says referring to this return of "talking therapies" and a re-examination of the overemphasis on medications-only as therapy – the all too ubiquitous "15-minute appointment and prescription" which plagues the practice of psychiatry today.
"I've always felt there's a kind of giftedness to people with mental illnesses – not just moments of insight," he said. "But people are often frightened by that kind of expansiveness."
Dr. Persald, now 72, is committed to changing the way psychiatry is practiced and perceived. For his entire career, which began in the mid-1960s, he has actively involved himself in the academic world, in teaching young medical students – stressing the inherent humanity of psychiatry. Teaching is learning.
His humanity – in a word – is hope for all of us.