Book Review  |   June 2011
Dancing With Medusa, A Life in Psychiatry: A Memoir
Author Affiliations
  • R. Gregory Lande, DO
    Silver Spring, Maryland
Article Information
Book Review   |   June 2011
Dancing With Medusa, A Life in Psychiatry: A Memoir
The Journal of the American Osteopathic Association, June 2011, Vol. 111, 410-411. doi:
The Journal of the American Osteopathic Association, June 2011, Vol. 111, 410-411. doi:
What motivates a person to pursue an occupation in osteopathic medicine? Several possible answers immediately spring to mind—perhaps chief among these is a basic humanitarian interest. This shining ideal serves as a guiding light, helping young osteopathic physicians navigate rigors of an osteopathic medical curriculum. However, the ideal soon gives way to practical realities of a demanding profession. Somewhere along this path, dullness sometimes develops. Pressures of clinical practice become a predictable burden, always vying for the osteopathic physician's attention and often taking a toll on the DO's private life. Youthful idealism is slowly chipped away, leaving a more rounded, self-confident, and balanced outlook on life. 
This journey to professional maturation is taken by all physicians. For the greater part of the journey, the osteopathic physician is forward-focused with a career map routed to all sorts of educational pursuits, examinations, appointments, and positions. At some point in his or her travels, the osteopathic physician will look in the rearview mirror and reflect on the passage. This backward glance can set a cascade of memories in motion, as in Dancing With Medusa, A Life in Psychiatry: A Memoir, an autobiography by H. Michael Zal, DO. Dr Zal is a longtime psychiatrist who is currently in private practice and serving as a clinical professor at the Philadelphia College of Osteopathic Medicine in Pennsylvania. 
In slightly fewer than 200 pages and 21 brief chapters, Dr Zal poignantly exposes his various personal triumphs and tragedies. By doing so, he creates a time capsule filled with 4 decades of memories. Readers witness a bygone era of psychiatric training, visit a relic of institutional mental healthcare, and see erosion of physician authority with a corresponding growth in the government regulation of medicine. 
The author takes justifiable pride in overcoming prominent prejudices directed toward osteopathic physicians. He recounts a decade-long effort to join the staff of a well-known hospital—Haverford State Hospital in suburban Philadelphia. With a mixture of pluck and pride, he succeeds in this effort and eventually ascends to a leadership role in the institution. 
Up to this point in the present review, the prospective reader may be dismissive. After all, many osteopathic physicians can recount similar experiences. The difference, at least in terms of Dancing With Medusa, is the author's willingness to share intimate moments of his life with complete strangers. The means by which he does this ends up provoking almost equal measures of empathy, compassion, and a disquieting sense of discord. In a paradoxical manner, this juxtaposition of competing sentiments actually draws in the reader. 
Dancing With Medusa weaves 3 story lines together. The primary story line involves Bella, a young woman with a serious mental illness. In Dr Zal's first encounter with Bella, a remarkable patient-physician link is forged—a link that endures for the next 30 years. At pivotal points in her life, Bella seeks the author's guidance in matters of marriage, child-rearing, and family disputes. Perhaps the most impressive evidence of Bella's growth and development comes when she is diagnosed with lung cancer. She remained focused on her daughter's wedding while waging an ultimately unsuccessful battle with the metastatic cancer. Throughout this ordeal, she repeatedly shared her worries and hopes with Dr Zal. 
A particular moving example from the book about Bella's struggle follows: 

In spite of her distress, she was only mildly depressed. When I questioned her about thoughts of suicide, she denied it. However, she revealed to me, for the first time, that she tried to commit suicide in 1970. “My brother had been killed and my Grandfather died. A priest had tried to sexually assault me. I took an overdose of pills.”... I knew so much about Bella and yet apparently, there were layers and layers yet that I would have to peel back to understand her more fully.

The author ponders factors that supported this close patient-physician relationship before finally settling on dysfunctional childhood experiences that they both endured. This revelation leads to the second plotline—the author's rather critical analysis of his parents. Most of his lamentations are turned toward his father, an inscrutable and unreachable man. An example follows: 

I could relate to the abuse that Bella suffered as a child. In spite of his gift with others, my father had no patience with me. When I was in elementary school, he punished me for minor infractions (I was a good kid) by hitting me with a strap. After he hit me, he made me stand in the corner with my hands straight down at my side...

Interspersed between these 2 tales is the third plotline, which documents the author's professional career. Part of this narrative includes his experiences with the move from state institutional mental healthcare to community-based mental health centers. 
This book is not perfect. Readers may find it jarring when the author abruptly moves from one plot to another. The storyline does not always proceed in a sequential manner, presenting an unnecessary element of disorganization. Certain grammatical rules, such as the proper use of capital letters, seem oddly employed, and misspelled words appear in several places. 
Despite shortcomings in style and grammar, osteopathic physicians will find Dancing With Medusa to be a rather sentimental and engaging story worthy of a quick read. Experienced psychiatrists, in particular, will find many opportunities to reminisce. For younger psychiatrists and other physicians, the book provides an opportunity to learn about earlier days of psychiatric care in the United States. 
An unstated but obvious theme in Dancing With Medusa is the therapeutic benefit that patients derive from professional relationships with physicians. In the 4-decade span covered in the book, substantial advances occurred in pharmacologic management of mental disorders. Advocates of biologic theories of mental illness competed with, and many times eclipsed, proponents of more balanced treatments who still valued psychotherapy. The author acknowledges the benefits of medications in Bella's lengthy treatment, but he makes it clear that drugs were not the glue that bonded this particular patient-physician dyad. 
Bella used Dr Zal as her touchstone, returning repeatedly over the years for the stabilizing support that an empathic physician provided. Osteopathic medicine emphasizes an approach that celebrates the whole person, not merely objective signs and symptoms divorced from that person. That timeless message is inspirational, and when readers finally set Dancing With Medusa aside, perhaps the message will encourage a moment of self-reflection. For osteopathic physicians, this reflection will most likely rekindle the sense of selflessness that launched their careers. 
 By H. Michael Zal. 188 pp, $20.99 (softback). ISBN: 978-1-4490-7116-5. Bloomington, IN: Authorhouse; 2010.