Psychosis Fails to Block Psychiatrist’s Career Path

Elizabeth Baxter, M.D., has come a long way since the days when her life was clouded by psychosis, agitation, and confusion, and when psychiatrists desperately—and often unsuccessfully—sought treatments to stabilize her illness.

Now she is fighting this battle for others. A psychiatrist herself, Baxter advocates, writes, teaches, and treats patients who are in some ways very much like her.

Baxter was diagnosed with schizoaffective disorder shortly after medical school, but emerged triumphant.

Last October, Baxter won the Public Eye category of the 2001 Lilly Reintegration Award for her outstanding contributions as an advocate and health care professional in helping people with schizophrenia reintegrate into society.

“It means a great deal to me that I won this award,” Baxter told Psychiatric News. “I support psychiatric rehabilitation and everything that means, including placing people with serious mental illness into new social and occupational roles.”

Baxter’s debilitating, year-long episodes of depression began in her sophomore year at Rhodes College in Memphis, Tenn. Despite the anguish these depressions caused her, Baxter led several campus organizations and was elected student-body president her senior year. “I was able to hide my illness because I was so prominent on campus,” said Baxter.

In the fall of 1985, Baxter began medical school at Vanderbilt University in Nashville. The rigorous course load wasn’t easy. “I spent so much time taking care of my illness that it was like holding down a full-time job aside from my medical training.”

At Vanderbilt her illness became harder to mask, and during freshman-year final exams, Baxter said she sat staring at her exam for four hours, doing nothing. She then knew that she needed help, and she was able to see a psychiatric resident in the hospital that night. “The resident was very insistent that I get help for my illness,” she recalled.

Baxter took a medical leave of absence halfway through her sophomore year to spend some downtime with her grandparents on their Texas ranch. Six weeks after arriving there, Baxter had her first psychotic break and ended up in the hospital.

She returned to medical school the next fall, and with medication, psychotherapy, and the support of friends, she was able to continue her studies. She told those around her that she had a mental illness. At that point, she noted, psychiatrists told her that she had bipolar disorder, but she would later be diagnosed more accurately with schizoaffective disorder.

“I decided to be honest and open [about my illness], and although it made things difficult sometimes, in the end that decision has helped me a great deal.”

For her honesty, Baxter was often awarded with discrimination and stigma.

“I had trouble getting out of medical school,” recalled Baxter, “because people weren’t too excited about a person with mental illness graduating.”

Baxter’s honesty also became a liability when she applied to residency training programs in psychiatry. She said she fell through in the residency match, which meant that no program ranked her in the list of applicants they wanted. “Residency training directors told me that the training wouldn’t be good for me and that I’d never be able to survive it.”

Looking back at those years, Baxter said, “It is interesting to see how stigmatizing the field of psychiatry has been.”

After an internship in internal medicine in Memphis, Tenn., Baxter began her residency training in psychiatry in Rochester, N.Y. She was receiving medications and psychotherapy during her training.

“At times, my colleagues treated me differently, but most saw how hard I was trying to take care of my illness—that I was being responsible about it,” she said.

Baxter completed her residency training on schedule, but became ill afterward. She had become a staff psychiatrist at a state hospital in Rochester, but her days were filled with despair and feelings of self-doubt. She wondered how she could be a doctor when she couldn’t help herself.

Learning to Function Again

In November 1994 Baxter decided to end her misery. “I was afraid that if I failed at my suicide attempt, I would never be able to practice medicine again,” she said, explaining the seriousness of her attempt.

“I took a knife to my throat and tried to sever my carotid arteries. I had been at this a half hour or so, and it is very much a miracle that I didn’t succeed.”

It was a long recovery process.

“I was ill, very psychotic, and had to start from the beginning again,” said Baxter. “Learning to get up, take a shower, eat three meals a day.”

“I was in the hospital for six to eight months after the suicide attempt, in about four different hospitals,” she said, as doctors searched for the right combination of medications to help her.

Once she was started on clozapine, her psychosis lessened each day. In addition, while she was recovering, Baxter had a spiritual awakening. “God brought me through the suicide attempt alive. . . . He wanted me to live, and I decided that I wanted to serve God in whatever I did.”

Baxter said that each step of the way, she tried to use her life to help other people.

Soon she became a medical writer for the Bridges Program, run by the Tennessee Mental Health Consumers Association. Bridges is a psychoeducational program developed to educate mental health care consumers about mental illnesses and to help them cope with their emotions and circumstances.

Advocacy Efforts

Baxter also became an advocate. She has traveled the nation speaking about her life and experiences both with mental illness and recovery.

She emphasized that as an advocate she reinforces one point—that people with mental illness don’t have to recover completely in order to get on with life. “Despite the fact that medicine and psychotherapy may not take away all of the symptoms of a person’s mental illness, it is still important to set personal goals and try to meet those goals.” Baxter also said that one crucial reason people with serious mental illnesses recover is because they find someone who believes in them and their recovery.

In 1998 Baxter began seeing patients and now works in Nashville with a continuous-treatment team. The team includes case managers who go out into the community to identify people with treatment-resistant mental illness. Many, said Baxter, have been in and out of hospitals and jails, and the program attempts to keep them from returning to those institutions.

Baxter said she has been able to integrate her experiences with mental illness and recovery into her work with patients in an objective way. “My experiences have helped me to understand my patients better,” said Baxter. “My work is very meaningful.” ▪