Life, Death, and Mind-Body Medicine Across the Lifespan

On June 6, 2015, an African American man from the Bronx hanged himself in his bedroom while his mother rested quietly downstairs. He concocted a rope from strips of bed sheets, a technique honed during five previous suicide attempts as an inmate at Rikers Island, the adult penitentiary in New York City where he was detained for 3 years. Two of those years were spent in solitary confinement, where he tried to take his life several times.

Wrongfully imprisoned at age 16, exonerated at 20, and dead at 22 by suicide, Kalief Browder's story is a tragedy of epic proportions.

His death reverberates with the unifying theme of this issue of the Residents' Journal: the inextricable bond between mind and body in children and adolescents. In each article, the false dichotomy of mind and body is undermined in its own way, effacing the ersatz distinction between the physical and mental. The mind, as psychiatrists know, can suffer mightily from insults to the body. And our bodies, of course, are vulnerable to the torment of mental illness.

But some minds and bodies are more vulnerable than others. Browder's case is so troublesome, in part, because a constellation of bodily and mental attributes and insults conspired to take his life too soon. Imprisoned as an adolescent at Rikers, he was one of the 6,000 minors detained in adult facilities that are inappropriate for youths and devastating to development (1). As an African American male, he was among the 1 in 3 black men that can expect to be incarcerated at some point in their lives, a rate six times higher than their white counterparts (2). As a body that was placed in “solitary confinement”—a euphemism for the barbaric practice of limiting social contact by isolating individuals in closed cells for 22 to 24 hours per day, for days to years on end—Browder endured the effects of a draconian method of cruel and unusual punishment. And of course, Browder suffered from mental illness. During and after his solitary confinement, he began to experience severe depression and debilitating paranoia; all of these factors ultimately culminated in his suicide. His race, age, isolation, and mental illness were all wielded against him to end his life too soon.

“Mind-body medicine,” the subtext of this issue on child medical conditions and psychopathology, has become a moniker for the frivolous pursuit of happiness by the worried well. Browder's story reminds us, however, that mind and body are not yoked exclusively in privileged circles. Oppressed bodies beget oppressed minds, and vice versa.

It is time we as psychiatrists take a closer look at the forces that colluded to end Browder's life, including the terrible ways in which the mistreatment of the body can produce disastrous and unconscionable effects on the mind.