Bioethics Research at The Hastings Center

Sherwin Nuland on Living through Depression

Sherwin Nuland does not need to read about depression. "I have never read a single textbook paragraph on the subject of depression," he growled, reading from his most recent book, Lost in America: A Journey with My Father (Knopf, 2003). "I have never read a sentence written in later tranquility by a recovered sufferer. I do not need to learn about depression from the pages of a book. I've had my own."

Speaking at The Hastings Center's Bioethics Seminar in May 2004, before about 90 riveted listeners, Sherwin ("Shep") Nuland told the story of his struggles with a mind-shattering, nearly intractable depression that forced him into a mental institute for over a year. Lost in America is primarily about the fraught relationship Nuland had with his father, but it begins with his struggles with depression in his late 30s, portraying depression as the embattled analogue to living with, hating, and eventually understanding his father.

Like Dante, Nuland found himself, in the middle of life's journey, thrown into a dark wood. Though a successful surgeon, he was wracked by distorted, ritualistic thinking, obsessive, superstitious worries, and overwhelming fear. His walk with "the black dog," as Samuel Johnson referred to his own bouts of depression, led Nuland down a lonely road. "I lost everything." For a graduate of Yale Medical School, clinical professor of surgery at Yale, and father, there was much to lose.

As Nuland tells it, he checked himself into The Institute of Living in Hartford, Connecticut, in an attempt to recover. Nothing, no amount of medication or psychotherapy, seemed to help. If not for the intervention of Vittorio Ferrero, a young Italian-born psychiatrist, Nuland might not have gone on to win the National Book Award (1994) and rank as a finalist for the Pulitzer Prize (1995) and to be a regular and prolific contributor to such publications as The New Yorker and The New York Review of Books. Instead, he might have agreed to a lobotomy and lost much more than just his depression. In his best Italian accent, Dr. Nuland described how Ferrero, whom he refers to as a brother, in effect saved his mental life by recommending electroshock therapy.

So he did. At first the treatments did not work, but eventually he began to feel that the spirit of the man he had been before reasserted itself. "After the sixteenth treatment I was feeling better, and by the 20th I felt well." Dr. Ferrero was the first to see that his symptoms were a function of the depression, and that there was a way out of the wood that would not have to involve radical surgery. After thirteen months of hospitalization, Nuland was ready to leave. He returned directly to his profession as a surgeon in Connecticut. "It was as though I'd never left the OR," he remembered.

His depression has made Nuland, by his own admission, a stronger and wiser man. He went through hell to emerge again to see the stars. He places himself in the tradition of the "wounded healer"; that is, he is a better healer of wounds, psychic and bodily, because he himself has suffered, and he can empathize with others' pain.

Perhaps this intense empathy led him to bioethics (he is a founding member of Yale's Bioethics Committee), though, as he notes with humility that he himself finds incongruous in a surgeon, "I'm not a bioethicist. I'm just a doctor who worries." This worry is in part what brought him to The Hastings Center. Though he never wanted to become a poster boy for depression, he realized, after speaking to a crowd at Yale about depression, that his struggle was not isolated. "These people had not come to be entertained. They had a personal involvement in depression, and they had all sort of questions." He now speaks and writes about his depression because he wants to help people, and through the particulars of his experience he believes he is on the path to treating universals of human life.

Nuland lives in part by the words of Philo of Alexandria, which form the epigraph to Lost in America: "Be kind, for everyone you meet is fighting a great battle." Sherwin Nuland has fought at least one great battle against depression and come out wounded but stronger. A portion of his kindness toward others is in unflinchingly telling his own story.

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Last Updated: 11 July 2006