While You Were Out

[Jaunty Guitar Music]

Mike: Welcome, everybody. This is Avoiding the Addiction Affliction brought to you by Westwords Consulting and the Kenosha County Substance Abuse Coalition. I'm Mike McGowan.

Mike: What happens when mental health collides with substance abuse? In a family that grew up in an era of silence. Our guest today has written a fantastic book that addresses those issues from a very personal point of view.

Mike: Meg Kissinger is the author of the incredible book, While You Were Out. A memoir of a family besieged by mental illness. It is also an incisive exploration of the systems that failed them, and a testament to the love that sustained them. Meg spent more than two decades traveling across the country writing about America's mental health system for the Milwaukee Journal Sentinel.

Mike: Meg is a Pulitzer Prize finalist. She has won dozens of accolades, including two George Polk Awards, Robert F. Kennedy Award, Investigative Reporters and Editors, and two National Journalism Awards. Meg is also teaches investigative reporting at Columbia University's Graduate School of Journalism and was a visiting professor at DePauw University, her alma mater.

Mike: She's consulted for projects for Frontline, The New York Times, Wall Street Journal, Seattle Times. I could keep going. I'll just stop there. Welcome, Meg.

Meg: Thank you, Mike. I'm so happy to be with you.

Mike: Yeah, and I should say before we start, Meg is an old friend as well, so this is a real treat to be able to do this with you.

Mike: Meg, your book chronicles growing up in a large family in the suburbs of Chicago. All right, let's start there. Tell us about your family.

Meg: Yeah, I'm so happy to talk about my family, which sounds a little counterintuitive when you consider that this is a book, you know, about the ravages of mental illness and the heartbreak of suicides of both my brother and sister.

Meg: But I will tell you, Mike, like, I think of my childhood as a happy one. And I think of my... I know my, my mom and dad and my brothers and sisters, they're, they were good, loving people. So we had a lot of fun. We had a lot of, as I said, sorrow as well, but it, I just don't want people to think that this is just a big, like slog through [inaudible]...

Mike: it's not.

Meg: Sadness after another.

Meg: I mean, there was a lot of, a lot of love, a lot of warmth, a lot of shenanigans, a lot of monkey shines. I mean, we had a good time, but very early it was apparent to me, I'm the fourth of eight kids. So, and, and my mom and dad had eight kids in 12 years, which is a challenge for anybody.

Mike: Oh my!

Meg: Yeah. But as I would come to learn, you know, throughout my life and certainly, especially in making this book you know, they both came into the marriage with pretty substantial mental health deficits.

Meg: So, you know, my dad was ultimately diagnosed as bipolar, and these are all labels, you know, so I could tell you stories all day long about what a funny, engaging guy my dad was, and he was, but he'd also struggled with, you know, his ability to manage his emotions. And so that was his profile and then my mom who was brilliant and lovely and thoughtful and she was pretty funny herself. But she had really I would call it crippling at times depression and anxiety. So as I say in the book, you know and then on top of that they treated all of that the way people a lot of people did. Then and sadly now and that's with alcohol.

Mike: Yup.

Meg: So they were never far from a martini glass and or you know, whatever whatever concoction of the day, but alcohol was definitely prevalent in our family. And so as I say in the book, you know, you take two people with depression, bipolar and have them be alcoholics and let them have eight kids in 12 years, you know, what could possibly go wrong?

Mike: I, I have this argument with people all the time, and I know in your work, you must have ran across this, how much do you think the alcohol usage was made worse by their medicating their mental illness or vice versa. I mean, chicken and egg.

Meg: Yeah. Well, I also had the privilege. I mean, I wish I had the answer to that, Mike.

Meg: I don't, obviously. I no doubt a fair amount of that was self medication and numbing the tensions that filled their days. And you know, a martini for my mother making dinner for the 10 of us every night, softened that I know, right. (chuckle) Oh, or not, not even getting into the laundry, you know, God forbid. I know my mother's in heaven because she did so much laundry in her life.

Meg: She deserves a Barcalounger at the right hand of the father. But anyway, that aside I'm sure that a lot of that was numbing the pain and self medication. But I also had the privilege of watching both of them get sober. You know, my dad quit drinking in the mid seventies. He lived the last 35 years of his life, sober, stone cold sober.

Meg: Now he was still, he still had mental illness. He still had big challenges to, again, controlling his emotions. And my mother got sober. My mom died pretty young. She died the same age that I am right now, 66. So she was sober for the last maybe five years of her life. But that was really quite amazing to watch both of them give it up.

Meg: My dad was a lot more faithful and he, I think he fell off the wagon once. My mom struggled for years to finally get sober, but she did. And that was, that's such a testimony to them and such a lesson for us. And I think it's a real lesson in strength and endurance. Now I say that, you know, knowing that not everybody can do that.

Meg: So I don't mean to be judgmental like that because you know, it's a disease for sure. So that was one of their diseases was alcoholism.

Mike: Well, and you and I share a generation. So that previous generation, which would be our parents, you know, that silence uh, right? So none of that was addressed.

Meg: Right. And this is so amazing to me, Mike. I, in fact, I had to call my brothers and sisters multiple times when I was writing this book, because I thought it just can't be possible that we never really sat down as a family and talked about these deaths. So let's just talk about my sister, Nancy, who died in 1978.

Meg: So I was 20 years old. I was going into my senior year of college. Nancy was 24. So she died on a Friday night. this was after years of agony and many, many suicide attempts. So she dies at, like, 8:30 on a Friday night. Sunday at 4 p. m. is her wake. So I'm talking about, like, you know, 40 hours later, there's a wake, then is the funeral and then on Monday, then the next day, boom, we just all go back to our business at hand back to summer jobs and whatever else we were doing, never talking about it.

Meg: And so never processing it. And it wasn't again, that we weren't a loving, warm family. We just didn't have a language for it. But not a small factor also was the fact that we were afraid, you know, and I blame the Catholic church for this. You know, my dad, we, they were afraid that my sister would not be allowed to have a funeral.

Meg: Funeral mass, nor would she be allowed to be buried in the Catholic cemetery where our family had plots. Now the Catholic church has improved its position. And since those days, I'm happy to say, but it was not a small worry on my mom and dad's part. So the institution of the Catholic church added to the silence, you know, really, as did our education system, you know really all the kind of in culture, you know, in society.

Meg: We didn't have Google. We didn't have any way to know about how to talk about these things. So, it was just all kind of swept away.

Mike: Well, I don't think it was just your family. My guess is your friends, everybody who attended the funeral, your extended family. You know, nobody broached the subject.

Meg: Yeah. I understand that they felt that that would make us feel sad to talk about it.

Meg: And of course the opposite is true.

Mike: Right.

Meg: You know, you need to talk about it. And when you don't, it's in your head anyway. And it consumes your day really thinking about this. A trauma like that, a shock like that, you need to talk about it. You need to process it and make sense of it, and we didn't do that in healthy ways, which as I say in the book, I think really laid the foundation for more mental illness down the road. And then here we are, you know, fast forward to 1997. And my brother, Danny also dies by suicide and he was the second youngest. So Nancy was the second oldest and Danny was the second youngest.

Meg: So that was just crushing, you know, and then to think about how much did we set him up for that. That sounds very sinister, but I mean, how much did our silence contribute to the climate that led to his death. So these are questions that can't be answered, but they're questions that I needed to ask.

Mike: Okay. So that's 20 years later. How was that experience or was it the same? Was the wake and funeral?

Meg: Yeah, very different. So, you know, by then the Catholic church had embraced helping people who have suffered the blow of suicide in their family so no problem, you know, having a funeral for Danny, but and, and people at Danny's wake very forthcoming about what their families went through. So whereas at Nancy's, it felt like just like it was, we weren't talking about it. At Danny's people were very much into sharing their stories.

Mike: Which is amazing, right?

Meg: Yeah. And we've evolved and we've evolved further still, you know, I mean, you cannot turn on a baseball game without hearing an ad for, you know, do you need, are you feeling depressed? Are you feeling anxious? Get help. If you know, don't be too proud, get help. It's on the sides of buses. It's on billboards on the highway. That's wonderful. I mean, so I teach young people, you know, people in their twenties, I teach at a graduate school. And my students are so generous about sharing their mental health struggles, which is fantastic.

Meg: That's a great start. The problem is Mike, and you know this more than anybody, it's the supply of mental health providers such as yourself. You need to go out and clone yourself, sir.

Mike: (laugh)

Meg: And we need, we need. 10,000 Mike McGowans. (chuckle)

Mike: Oh, that's a scary thought. I'll tell you that. Well, all right. So let's get into it then because you spent your series, you know, I didn't look this up before we did this.

Mike: I should have done that. Your series, I would assume, for the journal Sentinel, is available somewhere, right?

Meg: Yeah. Yeah. Well, what series, Mike, I wrote literally, I think I I spent, you know, the better part of 25 years all over writing about the Milwaukee system, which is not a system, as you know. So starting with that, you know, we always talk about the mental health system.

Meg: It's not a system. It's a sieve, you know, it's a, it's full of holes and people fall through those holes because how do you get somebody in your family? At the very basic level, somebody in your family is starting to really show signs of great wear, great concern and is struggling, struggling, struggling with their mental health.

Meg: You're frantic to help them. Where do you turn? We still don't have a smooth system that allows that person to get into care. So, you know, where do you find a doctor? Where do you find a mental health provider? How do you get that? Sometimes you'll find a call and sometimes the wait is a month or more. You know, it can be, it could be six months or, or they don't take private insurance.

Meg: You know, insurance is, there's all these barriers. Insurance is another barrier to care. So, yeah, so that I mean I could again talk all day about the the barriers to care.

Mike: Well and when I heard you talked the last time you were talking about what's available. You know, we're lucky in a way.

Mike: We live in a relatively urban place so you have some mental health available. There are a lot of therapists near where I live. They're all over work to the max or schedules are off, but that's not indicative of the entire country

Meg: No, right so half, more than half of all counties in the United States do not have a psychiatrist.

Meg: That's just stunning. Now, I know there's a lot of very rural counties, but nonetheless, people live in those counties. (chuckle)

Mike: Yes.

Meg: And people have to drive long distances to access care. In New York City, where I live, when I teach, you know, most Psychiatrists will not take insurance of any kind. It's, it's purely out of pocket because the reimbursement rate is so awful.

Meg: So that's, you know, New York has the highest concentration of mental health providers, probably in the world, but certainly in the country. And still, it's not that easy to find care there, care that's affordable. So, you know, if you can shell out $500 or whatever a visit. You can find somebody in, you know, but here in Milwaukee or, you know, in Wisconsin it's not easy still, and it's not necessarily affordable.

Meg: And then you have to stand on your head to prove yourself to your insurance company that this is something that should be covered. So you know, can you imagine Mike doing that if you had, you know, a lump on your breast or shortness of breath or chest pains? I mean, those are urgent medical conditions.

Meg: Well, so is depression.

Mike: Uh huh.

Mike: And Meg, I go to places where the only mental health available is the County Human Service Department. And speaking of a group that is overworked and with all due respect, because I work with them, under trained to deal with some of this and you just mentioned a huge one for me is I know a lot of professionals now that aren't taking insurance.

Mike: So it's all out of pocket. Well, who does that mean? Cannot access the

Mike: system, right?

Meg: Definitely. Yeah. Right. And so what happens to those folks who, again, fall through those holes in that sieve that we call the system and they end up homeless, you know, on the streets, really a lot of them end up in jail and prison.

Meg: And that is, those are our new mental health facilities, our new asylums are the prisons and the jails.

Mike: When people ask me where they can get help, oftentimes I say corrections offers help. And I don't mean that cynically.

Meg: Right. And that isn't that sad that your default is calling the cops.

Meg: So like a phone calls that I got all the time in the newsroom at the Milwaukee Journal Sentinel were from these frantic family members from mothers and fathers just desperate to find help for their kids. And I always thought, how sad is that? That they're calling a newspaper reporter, you know like that's how dense or how labyrinth.

Meg: Our quote system is that there's no obvious way to access care. But you know, it's when I start talking about this, Mike, I feel like I start to just feel helpless a bit that you know, what can we do? It just seems so overwhelming, but I really think there are things that very concrete, specific things that we can do to improve lives of people who suffer from mental illness.

Meg: And that's why I wrote this book. You know, I wanted people to know, first of all, they're more than their diagnoses. They're, they're human beings who are complicated and yes, they might be very irritable to live with, or in some cases, the case of my sister, you know, menacing and scary. I mean, she used to chase me around the house with a knife every once in a while, but she was also loving and funny and could be, and she was smart. Anyway, we need to find ways to look at people with mental illness as human beings and have conversations with them and just give them the space, the time to talk about what's bothering them.

Meg: I had somebody say to me recently How do you think your sister would have done if instead of people at asking her What's the matter with you? They said what happened to you?

Mike: Uh Huh.

Meg: I love that question. That's like it's so it's so thoughtful it really takes the emphasis off of somebody doing something bad, as somebody being sick and in need of help.

Mike: You know, I'm allergic to certain things. And if I, if I eat them, if I eat strawberries, I have these hives that I break out in.

Mike: I didn't do anything about that. I mean, that's just the way it is. If you grow up in a family that isn't as functional as it should be, you also might end up having hives of a sort.

Meg: Right.

Mike: So how does your family then, the six of you, right?

Meg: Right.

Mike: Right. So how do you talk about it? And do you ever feel like, well, look in the mirror, what am I missing?

Meg: (chuckle) You know, we have really evolved. I am so stinking proud of my brothers and sisters. It's not even funny. I mean, first of all, can you imagine that they let me write this book? I mean, Mike, really? Like if somebody, if one of them, as I said, the very first sentence of the book, if one of them came to me and said that they were writing a book about my family.

Meg: Oh, my God, I would like file a restraining order against them. I mean, I'm kind of teasing.

Mike: (laugh)

Meg: But I do. It's a scary undertaking. I mean, I knew I was going to be unveiling a lot of scary things. Anyway, they were very brave and very generous to share their story. So what we have learned in the process of. Of this book is that these are conversations that we have to have with each other. This is in many ways and it's not too dramatic. I think to say they're life saving conversations. I mean two of us are gone because we didn't didn't have anybody to talk to each other, so we better learn for self preservation sake, if nothing else, we better learn how to talk to one another, so that brings me to my brother, Jake. So Jake is the next guy up for me, he's the third in line, and Jake, I've written about Jake for the paper, and he gets pretty big profile in the book as well because he's a superstar.

Meg: He is a hero. So Jake lives in a group home for people with serious mental illness. I guess if you had to slap a diagnosis on him, you would say he has anxiety and depression and maybe a bit on the spectrum. So he's a little unable. He's, he is unable and more than a little unable to kind of manage his daily chores. So he kind of can't prioritize. Anyway, he enjoys living in a group home. That's, that was his, he doesn't want to live alone in an apartment. Jake also has the grace and the courage when he is not feeling well to reach out to us. So he'll send us a text and say, I'm, I don't know how to get ready for this vacation that we're going to go on. Can somebody help me figure out what to pack? So we are happy to step up and help him and that is I think it's a great model. It's like know when to ask for help because guess what we all need help. We're all human beings. We are have we all have our moments of weakness and our our times when we need to lean on somebody else.

Meg: Don't be too, don't be afraid to say that, you know, just have the, have the humility to reach out and ask for help. I really think that asking for help is one of the, is a hard lesson to learn.

Mike: Well, and on the flip side of it, you told a great story when I heard you speak last about your friend who wasn't a friend at the time, the lady who introduced you, who reached out to you. Tell that story.

Meg: Yeah. So the great Nancy. So after Danny died and I was just deer in the headlights, you know, I was just so crushed to think, I can't believe this has happened to our family a second time. And we've got to bury another sibling. And it was just, I was just bereft anyway. The phone rings and it's a lady who I barely knew.

Meg: I mean, she's so funny. I knew her from a distance. Her kids went to school with my kids and she, and anyway, her name is Nancy Barnett. And she's, Nancy said I'm so sorry to hear about your brother. Let's go for a walk. And so. Sure. So off, off we went and it turns out her sister had died by suicide some years earlier and she just was there to walk with me and I wanted to talk about it.

Meg: I could, if I didn't want to, you know, I didn't have to, but just the simple act of walking side by side with somebody who knew what I was going through, it was so powerful to me and just a great witness. And yeah. Yeah, I came across this great poem or a prayer that they say a lot at Jewish camps about do not walk in front of me, I may not follow, do not walk behind me, I may not lead, just walk beside me and be my friend.

Meg: And I think that that is such a beautiful lesson. And, and really. In that case, it was two sisters stung by these deaths, suicide deaths of their siblings. But you could really apply that to anything. You know somebody having, being depressed, a friend who's depressed, or a family member who is anxious.

Meg: You know, just to be with them and be at their side and listen to them.

Mike: Not that it's not appreciated, but that beats a casserole.

Meg: Yeah. Yeah, casserole would have been nice to though.

Mike: (laugh)

Meg: (laugh)

Meg: I mean, you know that, yeah, I think it's when we elevate, you know, the community support for people who are going through difficulties with their family members with mental illness, I know that we'll have really arrived, which is why I love these like NAMI walks and these now public manifestations.

Meg: You know, we're, we're out of the shadows and out of the darkness and talking about it. So we're, we're making progress, Mike, through people like you, but we just need more people like you. We need many more mental health providers and we need... So it's not just, it's money of course. So tell your legislator, you know, give more, more funding for mental health care and make sure and again, insurance companies are really giving true parity but just yeah, it's the illness that befell my family could have been cystic fibrosis or Hodgkin's, you know, but it's, it was a different kind of illness and, and we grew up in a time when these were illnesses that we didn't discuss. And we now are, so I'm very grateful for that.

Mike: Yeah, the current buzzword is mental health is health, and if it is health, then let's treat it that way, right? So, I'll let you get out of here, but I gotta ask you, being six siblings and whatnot, and you writing the book there had to be " No, Meg, that's not what happened!" Or, or there had to be those right or no?

Meg: Well, I was, I was really careful to whatever, you know, because memory is very fungible.

Mike: Yes.

Meg: Trauma. So what I did was I, I, you know, put it all on a Google doc and I told them they could access. So I told them, please read this book before I sent it to the editor. If there's anything in there that is, you can't live with, or that's wrong, let me know.

Meg: There wasn't, there was nobody said any, nobody maybe take anything out and there's some pretty juicy or also embarrassing and also heartbreaking and also hilarious stuff in there. So that was good, but really you know, it was, I don't... They didn't call out anything a hundred percent wrong that I know of.

Mike: That's cause, that's cause you're brilliant at what you do.

Meg: Well, I don't know about that, but that's because I worked hard to get the records. You know, I had to, I got my sister's, my brother and sister's medical files. I got the police records. So I quoted from documents and I interviewed people and I, yeah, it wasn't just me sitting on the hammock in the backyard.

Meg: You know, remembering things. I did my investigative reporter diligence.

Mike: Well, Meg, it's an absolutely phenomenal book, and, you know, for those of you listening, you know there's links to Meg's work here. She's an amazing writer she won't say this, I will, but, and the book is an incredible read, and, I'm this person for those of you who prefer to listen to your books rather than read them.

Mike: You've just had a sampling of Meg's terrific speaking voice. So you get that additional layer of emotion in there. Yeah. I listened. It was a great listen to.

Meg: Thanks Mike. It was, it was a chore to read it, but then it was kind of fun to read it too you know.

Mike: How long did that take you?

Meg: It took me four days sitting in the radio station at Marquette University.

Meg: They were generous enough to let me use that. But you know, my mom who used to say these very scary things like "Come here or I'll beat you to a bloody pulp!" She said it in such a cute way. It was, she'll say, "Come here so I can beat you to a bloody pulp." [said in a charming tone] And it was like, it was not menacing at all. We just thought it was adorable.

Meg: So I was afraid to let anybody else read that line because I felt like they would make her sound scary. And she wasn't. She was charming.

Mike: That's what I loved about it. I mean, there's parts where you think, if I read this, I'd be shaking my head and instead I'm laughing.

Meg: Oh, great.

Mike: Well, Meg, thanks again for your work, for being with us today. And it's been a treat to see you again and to talk to you.

Mike: And for those of you listening, we invite you to please listen in next time. Until next time, stay safe. And even if it's hard to do, talk to your family.