The Letters After My Name

Laura P. Schulman, MD, MA, FAAP.  What do these letters mean, of themselves, and what do they mean to me?  Why do I use them, here on Bipolar For Life?  What, if anything, do they have to do with bipolar-ness?  And most importantly, why do I insist upon using them when the professional qualifications they symbolize are now meaningless?

MD: Medical Doctor.  A passion since childhood, hard-won.  I put myself through college (oh yes, another set of letters: BA, Bachelor of Arts) by holding down three jobs while taking a full course load.  I know, I know, hypomania.  But it was fun, and I would have graduated with honors except that the required Honors Seminar conflicted with one of my jobs.  Oh well.

The MD turned into a combined degree program in Medicine and Medical Anthropology, six years.  Graduated with a perfect grade point average, 5.0.  Number One in my class (actually shared with my then-husband, who also had a 5.0), inducted into the Alpha Omega Alpha Medical Honor Society.

My first year in practice as a Pediatric Emergency Physician, I was inducted as a Fellow of the American Association of Pediatrics, and added FAAP to the collection.

All that stuff, including the wisdom garnered while cocktail waitressing as an undergraduate:  I used it until that very bad day, April 4, 2000, when I locked my office door for the last time, drove home, and went into a catatonic depression that resulted in my permanent disability.

All those letters, lost.

OK, yes, I did earn them, every one of them.  And it could be argued that in so doing, I earned the right to keep them after my name, forever.  No one can ever take them from me.

On the other hand, I feel lost when I look at them.  It’s as if–no, it isn’t as if–it’s the reality, cold and hard, that I am no longer who I once was.  I no longer go to the ER or the office every day.  I no longer practice Pediatrics, or anything else.  I live moment to moment.  My energy goes into keeping my mind in a reasonably healthy trajectory, and it takes every once of energy I have just to keep living from one moment to the next.

For a long time I used the letters after my name as a reminder of what I have achieved in this life.  But now I feel that they have become a burden.  I look at them and cringe.  This is not what I wanted for a life.  This is not what I worked 20 hours a day during my undergraduate years, who knows how much during my Medical and Graduate School years, 120 hours a week during internship and residency–I did not work all those hours to be sitting around like a bump on a log just trying to keep my shit together so I don’t start screaming and scare the dog.

I look at those letters, and I start to cry.  I think about the people who read this blog, or my comments, and think I am a practicing physician with oodles of money, knowledge, and perhaps power.  And I think I am misleading them.  In fact, I know that’s the case sometimes, from comments I’ve received.

Those letters weigh upon my soul.  They sit on me like an elephant.

It’s not that I don’t want them anymore.  I earned them with my sweat, blood, and tears, dammit.  They’re mine.

It’s just that right now I’m feeling the grief of my lost life, and I don’t want them staring me in the face every time I look at my blog or my email signature.

So I think you will see the letters after my name disappear.  Not today; I don’t have the energy for it.  But soon.  Maybe tomorrow.

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58 Comments

  1. I feel really sad having read this and partly it is the enormity of your loss but also my own unrecognised grief at a similar but much less journey. I think those letters are yours, and you should use them as you wish. If you don’t want to see them there, take them down but know that they are still yours. Always.

    Reply
  2. they are yours, to do with as you please. you can use them when and where and for as long or short as you want. they are still a part of you. your knowledge cannot be taken away because you don’t practice. you are still all these things.

    but i do know exactly how you feel right now, how you feel as if they are a lie, as if they belong to and describe someone who is not you now. and that may be true also. but it is only one thing that you can choose to define you or, or not.

    i do know how you feel you have lost something, how you are not the person you studied and trained to be, how the person you made yourself into is no longer the person you find yourself to be now. i have a degree and i look at it and wonder, what good is it now? what good did it ever do (i became ill shortly after obtaining it)? yes, i see it can and does still represent a part of me, of who i was, and wanted to be….but now, it is like a pair of jeans my son has outgrown. it no longer fits the person i now am, and yet, it does still define a certain part of me at times.

    but, the issue is not the focusing on what was, on who i was, but on who i am now. i could choose to see only my disability as my current self. but i think instead i need to find new adjectives, new concepts to define me. (when i come up with some, ill let you know! guess im still struggling with this too.)

    Reply
    • Well, your struggle seems to be in the right direction. My sense of identify, sense of self was wrapped up in those titles and roles, which WERE my identity. I too struggle with being who I am now, but it’s a bitter struggle.

      Reply
  3. I remember when I finally accepted that these illnesses were here to stay because I remember when I, too, grieved over my lost life — what it was and what it could have/should have been. Everyone has a right to grieve over loss, no matter who or what that loss might be.

    Reply
  4. Letting go is the hardest thing to do to something you love, and you are so right those letters are your past life. But you don’t completely lose the knowledge gained or the wisdom received from the experiences those letters gave you. I can understand getting rid of them if they are no longer part of your life and useful to your mental health.

    Reply
  5. I’m so sorry, Laura, and can’t even imagine how sad this all makes you feel. Those letters will always be yours, you earned them as you say. You are a warm, caring, intelligent, beautiful person with or without all those titles and I hope someday the loss of what you once had won’t hurt so much.

    Reply
  6. Paul Albert

     /  February 17, 2014

    Keep the letters after your name. It is not about your past but about your present and future. Every time you look at your letters what you should see and be reminded of is your
    tenacity in life. The reality is that you are still here and moving forward in life. That is what the letters tell you.

    Reply
  7. I wondered about the FAAP…sounded like something one might say if something goes wrong. Example: “Oh faap, this can’t be happening to me.”

    Reply
  8. D'Alta

     /  February 17, 2014

    Hi Laura,
    Here is my take on the letters that we earn in this lifetime. In ministry, we seldom include the MDiv following our names unless presenting ourselves academically, which I seldom do because, well, there would be a lot of letters and certifications that seemingly have little to do with each other, and all this changes how people perceive me…

    However, I have a title that signifies my ordination, Reverend. There are times that I use that title, and those are the times that I want people to know that I am speaking as a holy person, as a religious person, experienced and trained in matters of faith, that I speak with authority. Most often I use my title when contacting others who have authority about matters of injustice. While I no longer serve as a pastor, nor do I anticipate ever doing so again, the bishop who officiated at my ordination was very adamant that once one was ordained, one was always ordained. It was an act in which G-d was active, from calling through service in ministry. It was a holy act, a sacred moment that could not be undone.

    I liken my ordination and service as a pastor as akin to graduating from medical school and taking the Hippocratic Oath. It is culmination and affirmation of one’s calling to medically care, to be doctor, physician for and with others. It is a holy moment, sacred in its weight, meaning, and impact in and on one’s life. It is an act which cannot be undone. Yes, you may no longer practice medicine. I know longer practice ministry, well, not as a pastor assigned to a parish…Yet, Bishop Joseph Yeakel told me ordination never goes away. That moment when you became a doctor, when you promised to do no harm, never goes away…because it is part of who you are, every fiber of your being… So whether you practice, can practice or not, you are doctor, with all the accomplishments those letters after your name signify. You fulfill a sacred calling. That sacredness goes with you wherever you are. And if those letters after your name start screaming at you, tell them to shut the f*#k up! What you are, who you are, what you have accomplished can never be taken from you. Once a doctor, always a doctor.

    Reply
  9. You are still a beautiful and wonderful woman. i think more so because you are willing to not hide behind the accolades of letters.
    You are courageous enough to show your heart, even when it is broken.
    You are honest, raw and exquisitely brave, much more so than those who hide behind the letters that follow their name.
    Don’t think that just because you are not on the mountain anymore that your worth is any less, valleys are as important as mountains and just as beautiful in their reflection of life. (Maybe more so)
    You keep acting like you have failed. i don’t understand that because you are still brilliant but in a different way.
    It is like you were a precious gem when you were a doctor but through your difficulties you were chiseled to reflect brilliant prisms of light.
    You are much more than those letters could have ever defined you to be.
    I doubt that I would have noticed you much as a doctor but I can not pass by you now without turning my head with admiration as i watch you lumbar down the path of life.

    Reply
  10. You are a honest soul and that is what matters. Degrees, money, positions are labels that we put on people as per our perception.

    Take care.

    Reply
  11. Love you, Laura. Exactly as you are.

    Reply
  12. teddymear

     /  February 18, 2014

    I’ve read all the comments and was going to write my own but Gracielynne said it much better than I ever could. Gentle hugs~Mear 🙂

    Reply
  13. You are perfect, exactly as you are. After all we are all flawed. I’m not being facetious, I know how you feel. I have letters I could use, should use, if only because they have added to the sum total of the person I am. You have given me much to think about, Thank You.
    Be at Peace Laura,
    Blessings
    Susan x

    Reply
    • I understand what you’re saying, and I appreciate your support….but what really hurts is that I’m a better doctor than most I’ve encountered in the years since I stopped practicing. I love medicine, I’m good at it, and now I’m good at just trying to stay alive. I guess that’s something, but it’s not satisfying….
      Blessings back xoxoxo
      Laura

      Reply
      • But you’ve helped me also… there are many of us who appreciate your kind words and helpful suggestions.. I know I may not have pushed further until you commented about my medication…. I see my doctor on Monday and I don’t think I have Lyme disease so the antibiotics have been ‘killing’ me for no good reason. I have to wait til then for the showdown – thanks to you.
        Blessings
        Susan x

        Reply
        • Good luck with the doc…most of them are robots these days, unfortunately….

          Reply
          • Uhuh – and this one may just end up as scrap metal 😉
            I have a PhD is Metaphysics – never added the initials because I thought people might think I was pretentious. What do you think? I spent a long time earning those letters when things were tough and they do mean something to me. I would value your opinion.
            Blessings
            Susan x

            Reply
            • WOW! A Ph.D. in Metaphysics! Can I come be your student? (I’m not kidding.) Always, when people ask me what kind of doctor I am, I joke, “Metaphysician.” But you’re a real one! I say, go for it with the letters! What was your dissertation about?

              Reply
              • Oh dear – It was during my very idealistic phase but many things have not changed. It was, “Is there a need for true Spirituality in a world of religious confusion.” All my materials have been filed away carefully as we are in the process of trying to move again. My brain fog has been excessive lately so I may have the title slightly wrong. I remember how thrilled I was knowing I could call myself a “Doctor” or add “PhD” after my name and then stepped back and wondered if everyone would think I was making it all up. After all, most people look blankly at you if you mention metaphysics.
                I was thinking I should become your student! I was at a point where I needed to search for answers, in many ways I all still searching. (the reason I went to Israel and the Middle East 🙂 ) Have I really earned the right to say I have a PhD – apart from passing all the criteria?
                Your post made me think about it again add whether I should add those three little letters. I had the same type of argument with myself. Do they make me who I am? Do they add anything to my life? If I consider the struggle I had to go through to do the study – in a very negative environment, then yes they are important – a symbol of my triumph over my surroundings, and personal growth gained through that time.
                Life is strange – I have as many questions now as i had then so it didn’t fulfill my quest for answers 🙂 There are always going to be questions – they are a sign of continued growth. – Now I’m on my soapbox….lol
                I hope I can teach through words, ideas, sharing the life lessons which we all face in one way or another. I always thought the lessons hidden in plain sight were the ones people absorbed the most easily as opposed to the formal strictures of teaching,
                What do you think?

                – I hope things are a little easier with your father, and he is still in the nursing home and getting the care he deserves. I have been sending love and prayers to you both.
                Blessings,
                Susan

                Reply
  14. I think that the letters can seem like ghosts at times, a former self, a lost life evidence of major achievements past when today’s achivements come with no plaudits at all. But to others – to me certainly – all those other letters, the ones you wrote above, are medals evey one.

    Reply
  15. Losing the ability to work (even though it was a short 3 years) was traumatic and grieving to me too, I understand the conflict. I had to take my Associates Degree in Early Childhood Education off the wall, because of the distress it caused. Anyways, you are in my thoughts.

    Reply
  16. I read your blog and recognized your grief for your lost past. I too have a similar story though not as many initials. I was once a successful business woman working in Corporate America breaking through the glass ceiling…I had an M.A. after my name. The illness took me down and made it impossible for me to return to the positions I had worked hard to achieve. I understand your pain and your sorrow. The initials seem to represent a person from your past, someone you can no longer be…but the initials also represent someone you once were and that can never be taken away. The illness steals enough don’t give it anymore of you than you need too! Thanks for writing you made a difference to me!

    Reply
    • Amy, I’m so sorry that you’ve suffered that loss and that daily struggle with identity. Thanks for your insight–it gives me a framework in which to think about this. Take good care!

      Reply
  17. Laura, you are wonderful in and of yourself, letters or no letters.

    I’d like to tell you what those letters meant to me, when I first began reading your blog because I didn’t see it in your list of things they might say to people. “Bipolar for Life” told me that bipolar is one label you carry. “MD, MA, FAAP” told me that you have both education and practical experience. I was really excited by that, because what had originally drawn me to look for mental health blogs was my desire to better understand my son’s situation. (He’s “bipolar for life,” too, doing OK as far as I can tell right now.)

    The combination of the title and the letters told me that you had inside knowledge of BPD, medical training, medical experience, and that you had at some time in the past loved school as much as I. (If I were to use my letters, they’d be MA, MAHL, plus the “Rabbi” on the front.) I felt a certain kinship (love of education) and trust (expectation of low levels of baloney and pseudo-science.) That’s all.

    The person I am getting to know is much, much more than titles or letters, as people always are. I’m sorry the letters give you pain, but I am glad they were up there a few months ago for me to see. Do what you need to do to take care of yourself; I’m just glad to have encountered you. You have become someone whose messages I anticipate gladly.

    Reply
  18. Dear Friends,

    It’s taken me a day or two or something to get back here and answer your wonderful comments. Writing this post triggered me so badly that I basically couldn’t function al all.

    Everyone’s insightful comments are helping me to look at this situation from many different perspectives. Your help is invaluable.

    Much love to everybody,

    Laura

    Reply
  19. Reblogged this on Shedding Light on Mental Illness and commented:
    Laura’s post is so powerful and through her words I found a kindred spirit, one who could understand exactly how I feel.

    Reply
  20. This is so touching! I’ve read it a few times and it kept me thinking. No one but you will know what is right for you. You earned those letters and they are yours whether you use them or not. Your B.A., M.A., M.D., FAAP. will always belong to you…they do not define all of you as a person, Bi-Polar does not define you either…you are always changing …maybe not on a path you had planned but you are still you…we are always reinventing ourselves and I think that is what keeps us alive, interesting…not stagnate. Perhaps it is not only your letters you feel you need to let go…but grieving some dreams you had…it is too personal for me to even dare to know…you are one of the first blogs I started following when I started Stop the Stigma. You have much to offer…more than you know. I hope you work it out and find what you are looking for. Blessings, Cheryl-Lynn

    Reply
    • You’re so kind, Cheryl-Lynn. I’m glad you take away from this something that speaks to you. You’re right, it’s what’s behind the letters that I’m grieving for. There are some wounds that heal with a deep scar. I know that what I’m doing right now is exactly what I’m supposed to be doing. It just wasn’t on my agenda.

      Blessings,
      Laura

      Reply
      • Yep, I hear you and I must say my growing professionally, personally and spiritually in the past years has been volunteering at an agency that support those diagnosed with a mental health condition as well as their friends and family. I wish more professionals learned from the experts…those aflicted with this “interesting’ condition. We are all interesting in our own way, right? Sending you hugs and good vibes, Cheryl-Lynn

        Reply
        • I think that’s great. I think about volunteering, and I hope I will after this family thing has passed. Or maybe it would give me more joy and energy to deal with the family thing, if I could give back to our fellow “interesting” people!

          Reply
          • It is always easier helping people NOT in the family or too close. I have found that personally. The emotional connection is difficult but when helping/volunteering, you see the positive results and it gives you confidence to give it a try with significant others. It’s always a dance…a real tango.

            Reply
  21. Reblogged this on Stop the Stigma and commented:
    This truly made me think and the post is moving, real and the support in the comments also made me think.

    Reply
  22. Your letters are yours. You said no one can take them away from you, well, you can’t take them away as well.
    Let them be,

    Reply
  23. Laura, after taking the time to read your blog and these comments, I can say that I empathize: I, too was diagnosed with bipolar 15 years ago. This is only the second time I have admitted it, and only my best friend knows. I have kept it hidden out of shame, yet I also had to leave a beloved profession; I was a teacher for over 20 years.

    Thankfully, my newfound faith prepared me for the grieving process. I knew that God had a plan for me. I began a writing project and started blogging. He expands my comfort zone daily. And maybe – just maybe – after reading your blog and a few others like it (Amy Gamble’s), I might begin to write about how I live and thrive with my illness, too.

    The one thing I have learned through my own struggle is that I am not my illness. Yes, it is a part of who I am; I must manage it just as I manage being a cancer survivor. But who I am at the core of my being is my character, is the love I pour out on others, is the way I cherish God. And perhaps now, I can add courage to my character as I write about this illness.

    Thank you for your honesty and vulnerability in writing this. You have reached inside me, and have caused a change for the better.

    Reply
    • Susan Irene, thank you so much for your kind words. It helps me so much to know that the risks I take by pouring out my heart on this blog might help someone in their own journey. Interesting that you are a cancer survivor who lives with bipolar. I have at least three Christian bipolar cancer survivors who follow and comment here. I wonder what the connection is?

      Be well,

      Laura

      Reply
      • I don’t know if there is a connection between the two, but both are genetic. My mother and her aunt both had breast cancer; my father had bipolar – undiagnosed.

        I’m 63 now. He was born in 1911, died in Jan. ’82. It wasn’t being diagnosed back then, but I can look back and see the symptoms. I walked on eggshells as a child, never knowing what would set off his manic rages. There was never an in between; he was either in a manic stage, or depressed. Thankfully, I have a milder version than he did, and medication has saved my life.

        Reply

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