Patient in Phitsanulok

“How happy is the blameless vestal’s lot!

The world forgetting, by the world forgot.

Eternal sunshine of the spotless mind!

Each prayer accepted, and each wish resigned.”

-Alexander Pope, Eloisa to Abelard

As I finished rereading Brave New World by Aldous Huxley, I was reminded of Eternal Sunshine of the Spotless Mind, one of my favorite movies, the title of which was borrowed from Alexander Pope.

Is the spotless mind really eternally sunny? Can we have happiness without sadness, without the contrast of more trying times?

Brave New World‘s Mustapha Mond certainly believes so – “What fun it would be if one didn’t have to think about happiness!”

But what about the potential to grow from meeting unhappiness head-on rather than denying its existence in order to achieve more happiness? Can beauty only be found in beautiful things?

“I don’t want comfort. I want God, I want poetry, I want real danger, I want freedom, I want goodness. I want sin.”

– The Savage, Brave New World

Even putting the external aside, it’s known by many who have overcome adversity that the lower you are, the higher your mind will want to soar. It requires a balance, like everything else. It requires gentleness with oneself, to accept everything in our journey, whether or not it’s what we thought we wanted. It’s about understanding that your best is always enough and finding peace within any outcome.

So, this is when I tell you – I’m coming out of the antidepressants closet.

There’s such a stigma, such strong divisiveness surrounding this word and medicinal concept that it almost feels like something I should keep very personal. But why?

Upon disclosing this “private matter,” I’ve even had people tell me that they wouldn’t expect ‘someone like me’ to take antidepressants rather than find holistic treatment or focus on healing through my yoga and meditative practice.

With how rural of a town I am living in, finding a doctor who could continue my treatment and prescribe my medication was much more difficult than the impression OEG gave me prior to my move. I was told that the majority of prescription meds can be easily found in Thai clinics and most for a cheaper price than America, so I didn’t make any arrangements to have my medications sent from the US.

My town is small, old, and so rural that in some ways, particularly socially, it can feel like we’ve gone back in time a few too many years. The sexism was the first backwards thing I noticed, and now, it’s the lack of mental health care availability and common knowledge.

I visited a clinic in Phetchabun with a female doctor who spoke English fairly well. I was in the clinic for a general physical for my work visa, but I showed her my paperwork for my medication to see if she could help me. She reviewed my treatment history and the type of medication I need, looked up at me and said, “You have already been taking this medication for six months?” Yes, I said.

“Are you better now?”

As if I had a chest cold.

I’ve read countless arguments both for and against the use of antidepressants. As a libertarian who strongly disapproves of the government’s heavy involvement in and influence on prescription medication in the United States, it’s difficult to trust much research that is published on the topic. All significant research, of course, requires a substantial financial backing, and with the government’s hands in the pockets of American health care and pharmacology, is what I’m reading truly objective?

What I do know is this: at the time that I began taking medication, I was consistently eating a clean vegan diet with a full infantry of nutritional supplements. I cooked all my own meals, was conscious of my sleep habits, drank plenty of water, did yoga and meditated every day. And yet whenever I went through bouts of grief or experienced stress at work, I would immediately experience stomach sickness – in the months following Swayze’s passing, the episodes were so frequent that it was interfering with my job.

What I also know is that one week after starting medicinal treatment with my primary care doctor, I could finally breathe easy without the added stress of my stomach health.

I will always advocate for holistic treatment first – and what’s most important to note is that I’m not saying medication is for everyone working to improve their own mental health. I experienced firsthand that antidepressants were not the solution for my brother. I am simply recounting my own experience.

And by talking about my own experience I hope to encourage others to talk about this subject openly. If mental health continues to be a hush-hush type of dialogue, if antidepressants continue to be a taboo subject, how can we expect suicide rates to go down and mental health to improve?

After being unable to find a clinic that could fill my mediation within an hour radius of my location, I went to Pee Som.

Pee Som might as well be nicknamed Thai Mom – any time I have a problem or need advice, no matter how minute or overwhelming, she’s there to help. She made calls to different clinics in our surrounding area until she found a doctor who could help me in Phitsanulok, a city two hours away from our town by car and three by bus..

It just so happens that Pee Som had a professional conference in Phitsanulok scheduled for the following Saturday.  She and her husband, Pee Art, drove me to Phitsanulok to visit a tiny, private psychiatric clinic.

When I first arrived to Thailand, I remembered hearing some prathom teachers (primary school) talking about the lack of individual attention that students with learning disabilities or autistic tendencies receive at their school. They explained that the school essentially does not provide, or recognize the need for, any accommodations for these students.

I’ve confirmed this firsthand with a student of mine named Bon. Bon is a student in my mattayhom 3.2 class and, without a doubt in my mind, he has Aspberger’s. Sometimes in class, Bon will do something that practically screams Aspberger’s and my mind will immediately jump to a Swayze flashback of a similar obsessive-compulsive, high-functioning or unusual social behavior.

Bon is extremely intelligent – his English is the best out of all 800 students I teach. He frequently approaches me around campus to ask me questions like, “What do you think of Donald Trump?” or, “Have you ever used a floppy disc?” or, the most charismatic series of questions, “Why do you go by Sam and not Samantha? What is your middle name? Oh, Varie – Why not go by Varie? I think it is much more fitting.”

For some reason, I did not proactively connect the dots between the lack of support students like Bon receive and the inaccessibility of mental health care in Thailand – in rural areas like mine, at least. It was not until I was dealing with the issue from the driver’s seat that I realized just how arduous the road to treatment would be.

The doctor was much more knowledgable at this clinic and extremely helpful: I was able to work out a treatment plan with her that is practical and will help me stop taking my medication in due time. The problem? Because I could only find the care I needed at a private clinic and not a government clinic, I am paying an absurd amount of money for my medication – about one fifth of my monthly salary in Baht, and about twelve times the cost I would pay for the same medication in the United States (with insurance coverage, which I do not have here).

I will be okay – I am fortunate enough to be in a situation that I can afford these costs, but the implications are upsetting. Is mental health care a luxury, reserved for the wealthy? My salary is considered high compared to that of many living near my school, and yet with the cost of this medication, I am living paycheck to paycheck. It seems impossible to imagine that Bon’s family, for example, could afford respective care.

While Pee Som attended her conference, Pee Art gave me a quick tour of Phitsanulok before helping me to the bus station back to Lomkao. First, we went to Wat Phra Si Rattana Mahathat, a temple dating to the 14th century that lies in the center of Phitsanulok on the banks of the Nan River.

Wat Phra Si Rattana Mahathat is best known for its enormous shining gold Buddha, named Phra Buddha Chinnarat, and is one of the most highly revered Buddha images in the country.

While at the temple, we ran into a group of mattayhom five students from a Phitsanulok secondary school who had an assignment for their English class to speak with a native English speaker. I helped them for five minutes or so with their interview questions while Pee Art played photographer. How oddly coincidental, I thought, that these students are the same grade I teach in Lomkao.

My favorite part of Wat Phra Si Rattana Mahathat was the standing Buddha, called Phra Attharos, in front of the Ayutthaya-style prang, a conical tower common in temple architecture. The Phra Attharos overlooks the ruins of a large chapel and invites you toward the 36-meter high prang with 4 rows of niches enshrining images of the Buddha.

The prang is said to contain relics of the Buddha. A steep but stunning white staircase leads you to the apex where you can give merit to a small resting Buddha.

After seeing the beautiful temple, Pee Art took me to the Nan River to feed the birds and “release fish.” After visiting the temple, it’s considered an act of merit to purchase fish from a vendor and release them into the river. Funny enough, if you walked twenty feet down the sidewalk, you’d find the same vendor’s employee fishing out of the river. I guess it’s the thought that counts.


In many cases – like Phitsanulok’s prang, Tiger Cave Temple in Krabi, Wat Charlerm Phrakiatit in Lampang – it is not until you have climbed the stairs that you can offer merit to the Buddha. The “Zen of stair-climbing” can be thought of as committing your whole mind, body and spirit to the activity as a moving meditation.

Indeed, many times, climbing steep stairs, climbing seemingly endless, onerous stairs, I have had to remind myself why I should keep going. Because the view will be exceptional. Because you have done this before, and you can do it now. Because you can overcome anything you put your mind to.

I hesitated a lot while writing this post. What if I offend people? Mental health treatment is such a slippery subject. Is it too personal? 

But when I asked myself why I wanted to write about my mental health experience in the first place, I remembered: If we do not start TALKING about mental health, the situation will NOT improve.

My words are the stairs. By putting myself out there, by speaking out about my own experience, I’m starting to climb the stairs. By reading my words, so are you. The difference between climbing these metaphorical stairs and climbing the stairs of a temple? I can climb to a temple on my own, but to build awareness of and bring change to mental healthcare, we must come together.

We must share our stories. We must support each other. We must be willing to speak openly about mental health – the difference truly can mean life or death.

On October 20th, my mom will be walking in the Out of the Darkness St. Petersburg Walk to fight suicide and support the American Foundation for Suicide Prevention’s bold goal to reduce the suicide rate 20% by 2025. She is walking in memory of my brother, who we lost in July 2017, and a high school classmate of hers, Randy Gentzler, who left us in June 2018. To join my mom in her walk, or to support her fundraising goal, please visit


7 thoughts on “Patient in Phitsanulok

  1. As always… I’m blown away by your writing. And once again… your words have deeply resonated with me. Thanks for sharing.
    First, comfortability breeds ignorance. Also, I cannot tell you how often I have said that mental health needs to be an ongoing conversation. It’s true, medication isn’t for everyone and it’s also true that holistic approaches should always be explored. However, medication is sometimes needed and THAT IS OKAY! I’m a firm believer that medication in conjunction with other things like counseling, yoga, or whatever it is that suits you is the true best way to go, but medication is not something to be ashamed of nor ignored and good for you for not letting society to continue to tell you should hide.
    Can’t wait to have some more deep convos with you in the future. You’re truly amazing 🌸😊

    Liked by 2 people

  2. I love the fish story.😎🐟🎣

    When I moved to Montana 10 years ago my Doctors warned me in advance that I’d be in for culture shock with the medical community here. They were sooo right. The list of meds that I was on from when I stepped off the plane were as follows, and these were all maximum allowed dosages:

    Morphine tablets
    ‘Just finished a year on chemo
    …and various OTC stuff

    So with my first visit to a new doctor here I was told flat out that, and despite having a “suitcase” full of medical history documents that I wouldn’t be getting one refill and that I’d have to go cold turkey off of everything. They suggested that I get my medical pot card, which I did, though.

    I went through 2 seizures in the first 6 months. My hands trembled to the point where I couldn’t write, draw or paint up until about a year or so ago.

    I’ve since been doing fantastic, much of that I owe to Carrie’s nutrition advice. I insisted to the new doctor that I wanted to stay on a low dose of both an anti depressant and a mild narcotic pain med’ just for good measure, which he eventually obliged to.

    A drop of pure THC each evening does wonders for things including sleep. ‘Never really drank much over the years on account of my work drivin’ the rigs. On occasion I might at times now.

    But be careful not to go cold turkey off your anti depressant if you can help it. Try to taper off if you can, and you’ll be ok. Either way I think you’ll be ok if it’s not a high dose.

    I enjoyed your writing as always Sam!📝📖

    Liked by 2 people

  3. I agree with MonkeysProjet – first read it in 1957 as a freshman in college and really didn’t get it. Now I do. It just takes time and experiences. It may even prove to be the best medicine – and the prescription doesn’t need to be refilled by a physician . PapPaw

    Liked by 1 person

  4. I just love your blogs! You are a wonderful writer! This particular blog was an eyeopener as to what’s going on in other countries with mental health. Amazing and very sad that other health care and scripts are so easily available, yet mental health care, and scripts, are not. I would have never imagined this. So many people still are unaware that there isn’t any quick fix, such as a cold. It is lifelong.
    Beautiful photos and experiences! The temples are amazing! Keep enjoying! Thank you for sharing with us! 🤗

    Liked by 1 person

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