Theories of Mind, Medicine, and Jenny McCarthy

I am humbled. I couldn’t possibly have anticipated the response to my first blog. There was a tremendous amount of support from close friends, from distant friends I hadn’t spoken to in years, and from new friends. I went to bed awed, and a little nervous, because I had no idea how to follow it up.

Then, I had a dream.

The dream didn’t tell me what to do. It was about a friend buying 10 kilos of cocaine as a performance enhancer for poker/back-up plan if poker didn’t work out, because apparently he had never seen a movie and had no idea that that was a lot. Then the cops raided the place. We all got taken to the station and everyone was looking at me like I was going to snitch. I called my dad (a lawyer) and he mentioned over the phone, while the police were listening in, about some run-in with the police I had had in New York. I dreamt about visiting cousins in New York a while back, so my brain added some police to that dream.

I never used to dream.


I started dreaming when I started on the drug Cipralex (escitalopram). I also get night terrors. Yesterday I woke up screaming at 5:30 am. I thought I was awake, and could vaguely see, over the rumples of the covers, a hand. I knew it was coming to get me.

Cipralex also causes me to feel blunted, like my nervous system has a hangover. I’m not as sharp mentally. I don’t really get joy from anything. My skin isn’t sensitive to the touch. Anywhere.

In the spring, I felt amazing. I had a new dog, a new girlfriend. The sun was shining, the plants were in bloom. But I was blunted. So I started taking half the dosage. I was fine for a bit. I was a little edgy at times, but I didn’t feel like I was being suppressed, either. Then we went on vacation.


My vacations aren’t usually vacations. Normally, I spend two thirds of my time in a casino and a third in a hotel room. Sometimes I will actually venture all the way to the closest place I can buy food. Very occasionally, I am inspired to walk around.

Travelling with a significant other is different. You do things that you don’t quite feel up to. A relationship is a unit of two; Giving a little to someone you love so they can get a lot is a no-brainer.

I left my comfort zone in Barcelona. We walked a lot. Even when I’m at my best psychologically, walking a lot is hard on me physically. That’s a story for another time. At the end of a particularly long walk, she said something to me. Truthfully, I can’t remember what. I started to pace the hotel room uncontrollably.

When I got home, I went to see my doctor.


I am phenomenally lucky to have a mother who is a doctor (she is one of the three I thanked). I have someone I can call 24 hours a day who I trust and who cares about me. I have someone who can refer me to people who I know will take good care of me, because my mother wouldn’t send me to them if they wouldn’t.

I am phenomenally lucky, too, to have control of when I play poker. When I need to see my doctor, there’s no hoops to jump through. No rationing out sick days, no anxiety-inducing conversations with bosses who don’t understand mental illnesses.

And I stopped taking my medicine.


An ex-girlfriend of mine dealt with serious anxiety. She had to go through all the hoop-jumping at work, but instead of seeing someone she trusted to give her the best care possible, she had to bounce between walk-in clinics. She had bad experience with doctors she didn’t trust.

Her friends told her she was fine. She stopped taking her medicine.


What chance do most people have?


Until this very moment, I’ve been mystified from people who take their health advice from Jenny McCarthy. They’ve seemed like easy target for mockery. But thinking about my ex, who trusted her friends more than her doctor, it doesn’t seem like such a huge leap that some people will feel more connected to celebrities than their doctors. Add the desire to make sense of things that don’t, to create an ordered, reasonable explanation for something as complex and unfair as why your child has autism and others don’t, and the desire to have someone or something to cast blame on and to focus your anger on. It’s hard not to feel compassion for these misguided people.


I had my mother refer my ex to a doctor in her office. She explained my ex that there could be a chemical imbalance in her brain, that she needed the medicine to correct, and that no amount of positivism was going to correct it. This had never occurred to my ex.


It’s easy to fall into the trap of thinking people who make bad decisions are just bad decision-makers. It’s fits a simple, ordered, reasonable explanation, in much the same way “inoculations cause autism” does. Different fallacy, same result.

Human beings develop theory of mind around age 5. We all understand that we all understand the same things differently. The value of openness, of listening compassionately and discussing without prejudice, is that more people are more likely to come across a source of good information that they trust. The more they spread that good information, the fewer people will be providing bad information to people like my ex.

And that means fewer people will stop taking their medicine.


After I got back from Barcelona, my doctor and I came up with a plan to try another drug, Wellbutrin (bupropion) and, if it worked for me, to gradually phase out the Cipralex. It’s working so far, and I trust us to work together to make good decisions in the future. It’s not that easy for some.

But it should be.


Two years ago, I was staying in Sweden with a good friend of mine. I had come to Europe because I won a satellite to WPT London (for those of you who are not fluent poker lingo, a satellite is a tournament where the prize is an entry to a more expensive tournament. It’s kind of like a game of drink the beer, if you won a keg and had to get on a plane to claim it). I had to do some paper work before the tournament, so I trotted off in the rain towards a business centre where I could scan some documents. On the way there, I passed a girl sobbing in the rain. I asked if I could help. She shook her head. She didn’t stop crying.

That short encounter moved me to write a poem. It was the first time I had written since the death of my grandfather. I only write poetry when something bothers me deeply.

I originally started with the intention of writing a poker blog where I share thoughts on other things sometimes. This is very clearly not that. It is about something much more important. It is about whatever made me stop that day and realize that I spend most of my time playing a silly card game that can’t help anyone else.

I may talk about poker from time to time, when the notion strikes me. It still presents interesting puzzles to solve, even when they aren’t important ones.

You can support my quest for mental health and make it a topic we can discuss openly here


The Girl Under the Umbrella

I passed you on a bridge

raindrops shaking free from the tips

of your



four steps forward

five steps back

a clumsy dance

set to soft sobbing

I asked if I could help.

You were scarred underneath

your umbrella

great twisting things

snaking down your arm

telling stories

some callous thief

had stolen away

the light from the day there

like so many rainclouds

My steps had seemed

so purposeful that day

so direct and full of meaning

my gait confidant in its importance

we did not speak

the same language

standing on that bridge

your body wracking

teardrops shaking free from the tips

of your



There was nothing I could do.


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