By Gian Ramos
How Anime brought me to Psychiatry
When I was in kindergarten I would pile up all the stuffed animals in school at the start of recess and I would perform physical exams on each one, effectively giving them a health screening before they could play with my other classmates. I realize now I was probably a very obnoxious kid. The point is, I’ve always wanted to be a doctor. Partly because I grew up looking up at my father who is a gynecologist/obstetrician. Simply put, I wanted to help people who were in pain. It wasn’t until my adolescent years that I began to shape what kind of doctor I wanted to be.
I was at a point in my life where I was exposed to a lot of mental health issues both in my family and friends, from suicidal behavior to drug use, to disabling anxiety. I saw the people around my life fall at the mercy of mental illness and I was ill-equipped to deal with it all. During this period I hated being at home and I was depressed enough that I couldn’t make any deep relationships at school. I remember a classmate telling me that they went to the school counselor with some emotional issues only to be told that the solution was to just “Get over it.” This, in turn, kept me from going to the school counselor with my own issues. I have no idea where my life would’ve gone if I didn’t get to the point where I asked for help. What happens in the alternate universe in which I kept believing that there was nowhere to turn to? I am glad that I did seek out help, it means that I’m in the universe where I lived.
What got me to the point where I could ask for help was, hilariously so, an anime about a family curse. At the time my brother had just started collecting anime DVDs and manga. He would skip out on lunch to save up money and on weekends we would go to the mall and buy DVDs to add to the collection. I still remember some of our first animes, Saber Marionette, Evangelion and Yu Yu Hakusho. To be honest, looking forward to watching the series unfold was partly something that kept me motivated on a day-to-day basis. After a time, I decided to try the collecting route myself and the first anime I bought was Natsuki Takaya’s Fruits Basket. On the surface, it’s about a family curse that turns its members into animals of the Chinese zodiac whenever they are hugged by someone of the opposite biological sex. But upon closer inspection, it is about a family cursed with the burden of mental illness. The anime revolves around the main character, Tohru Honda, an outsider who gets to meet each member of the family and have conversations about the psychological, sociological, and biological constructs that bring them down to the point of despair. That is to say, in the world of Fruits Basket, the real curse is rigid gender norms, or loneliness, or forbidden relationships, or the societal expectations that oppress us, and the way in which we keep those feelings hidden in shame. The solutions throughout the series to these universal problems are simply love and genuineness. Specifically, the love required to listen to each other and accept those feelings without judgment and reprehension; and the courage to live genuinely as you are an experiment with the emotions that life has to give.
This anime gave me the emotional toolbox to understand that what was happening around me was not ok, that it was ok however to feel sad about it and want to talk about it. It got me to the point where I could ask my mother to take me to a mental health professional and since then I have worked in mental health-related communities as a volunteer.
This was an experience that I carried throughout my life. It got me interested in the field of mental health and psychiatry (given my predilection for the medical field). I worked in a lot of communities that worked with substance use and reading psychology texts turned into a source of entertainment for me. When I went to college I did the best I could to balance STEM and psychology courses. Often in the open-ended end-of-year final project, I would look for ways to include themes of Geek culture into these works. I remember working hard on these projects, feeling motivated but then feeling a tinge of shame on presentation day because I felt judged. I would sometimes get looks during my presentations and at times I felt that maybe bringing the topic of Geek culture to an academic setting could be seen as a bit unprofessional. So I learned to keep my class projects on the topic of classic writers and things that are a bit more palatable for discussion in an academic setting. I didn’t stop playing games, watching anime, or reading comics, I just learned to keep those things apart from my academic career.
During my third year of medical school, I worked for some time in a child & adolescent wing of a psychiatric hospital. Throughout most of my life, I’d always thought my passion in Psychiatry was going to lead me into a career in substance use treatment. However, this experience changed my perspective. For many of the kids I worked with, being in a psychiatric ward was a very scary experience. As a student, my job was to talk to a subset of kids and learn their stories and provide recommendations for treatment. Here I found sharing geekdoms an indispensable tool for establishing a doctor-patient relationship. One of the kids, for example, was very reticent to speak to anyone until I sat down with him and asked him what he liked. Then a conversation about The Elder Scrolls: Skyrim took over, we talked about our favorite questlines, our playstyle, and eventually we talked about his strained relationship with his family as well as his struggles in school. I began to love working with kids because that part of me that was eagerly blending psychology and Geek culture in college felt recognized. Not necessarily by an academic institution at the time, but by a kid who was struggling with his emotions and needed someone to speak his language. It brought me back to my own experience with Fruits Basket and how anime, in general, tends to allow it’s characters to feel a wide range of emotions and express them prominently, which helped me in my time.
Far From Home: My GT Epiphany
During my fourth year of medical school, students usually send out their applications for residency. For context, four years of medical school make you a medical doctor. Four years of residency would make me a general adult psychiatrist. During this period of medical school, our curriculum consists mainly of elective courses which students usually take in institutions they plan to apply for in the hopes of leaving a good impression. I chose to apply for elective courses in hospitals outside of my hometown in Puerto Rico. Shortly after applying, I found myself in the wake of Hurricane Maria. It was one of the most difficult experiences of my life, living day-by-day with no water or electricity, at times spending a whole day in your car waiting in line for gasoline only for it to run out 8 hours later as your car is inching towards the gas station. I was however lucky because I had already booked a flight to another state for one of my elective courses, what’s more, it was in New York where my brother lived at the moment and I crashed on his sofa for the month. Focusing on my psychiatry rotation was going to be a challenge especially when my thoughts would wander back home frequently. How were my fiancée and family? Did they get enough to eat? Are they getting by?
Working in NYC was definitely an experience, I loved commuting. Back in Puerto Rico, the days are hot and you couldn’t get anywhere without a car. I longed to wake up early just take a walk and take the train and people watch whenever I could. Eventually, I started listening to podcasts. When I opened up my Podcast app I just looked up the words “Geek” and “Psychology” and lo and behold I met the Geek Therapy podcast and network.
It was a cosmic coincidence that at this period of time I began listening to the Geek Therapy podcast and I started watching the Cartoon Network show Steven Universe when I came back to my brother’s apartment from a long day of working in the hospital. The concept of Geek Therapy had been slowly planting a seed in my brain, which primed me for what was to come. At one point in my time in this hospital, I was assigned a Latino patient, whose entire family was strictly Spanish-speaking. I was the only one at the time who was a fluent Spanish speaker and my supervisor thought we could use that to our advantage. This was the case of a kid who was stuck in a catatonic state.
He had spent a whole year with a highly resistant H. Pylori infection. A bacteria that sticks to the lining of your stomach and creates ulcers which in turn result in severe pain and vomiting. This kid had been so sick for so long that his weight was less than 1% of what we should expect from him. Carlos (alias), had finally fought the bacterial infection that ravaged his body, but his mind had never recovered. In response to his severe malnutrition, Carlos’ brain switched his body into what we call a catatonic state. This is a state in which the person does not react to his environment. You could clap next to him and he wouldn’t blink. He couldn’t eat anything and was constantly being fed through a tube and even that was hard to keep down as he would frequently regurgitate his food. It seemed strange for me as a medical student who had frequently worked with kids whom I could talk to suddenly have a patient in a psychiatric setting that I couldn’t communicate with.
One day I sat with one of my peers who was supervising me on the case and I asked if there was anything I could do besides keep in touch with Carlos’ labs and his pediatricians. My peer told me to talk to him, to motivate him to interact with the outside world even if it seemed like he just couldn’t. We talked about how scary this situation was for the kid. Moving away from home, to a place where nobody speaks your language, surrounded by adults who draw your blood and talk technical terms with your mother, It must’ve been a nightmare. A shred of company would at least give him the motivation to reach out and give us a sign that he’s still there.
We started talking to him daily, I would often sit with him twice a day. I spent these moments awkwardly talking to him about the weather or asking his mom what his preferences were but nothing seemed to work. One day, the mother received a shipment of Carlos’ belongings. As I looked through his things, a single game popped into sight. A PS3 copy of Naruto Shippuden: Ultimate Ninja Storm 3. When I asked his mother about the game she mentioned he loved playing it with his brother.
I remember holding the back cover of the game that includes all the characters and asking him which was his favorite character. After a brief pause,I scanned for his reaction to no avail. I told him my favorite character is Shikamaru, that I’ve always admired him for his intelligence. In that very moment, I noticed something almost too tiny to notice. A twitch of his eyelids as if something within him had awakened. After his mother and I looked at each other with glee for a moment, I asked her what his favorite character was. She mentioned it was the one with the black hair. Immediately, I knew she meant Sasuke. ( I mean you will be hard pressed to find a kid that doesn’t admire his strength and overall coolness.) When I asked him what he liked most about Sasuke I saw him open his eyelids full-stop. No other movement was registered in his body, but that opening of his eyes meant the world to those of us who had been working on getting Carlos to respond to something for a whole month. All I could think about was “This is it, this is my way to contact him!”. As a native Latino, I could speak a language that he could understand, but as an anime geek, I found a language we could both speak in.
My Geek Therapy
When I approached my supervisor he immediately encouraged me to do what I thought would motivate the kid to interact with his environment. I was also lucky enough that the hospital in which I was working actually had dedicated child care specialists and a playroom that included a PS3. I decided to take a short time, a few days a week to take Carlos to the playroom and play Naruto in his presence. Over time I learned two things: First, that a fighting game is a wonderful way to sustain and release tension, something that made Carlos jump in his seat often. Second, I began to receive reports from Carlos’ psychologist in his home town and slowly, like audio logs in videogames, I began to have context on why Carlos identified so much with Sasuke. He had issues with his brother who often bullied him and had even convinced him at some point that the act of eating food would kill him. Something that contributed to Carlos’ current emaciated state. Perhaps this was me trying to make sense of many disparate threads and perhaps I might be biased,but I think the narrative of looking up to a brother who eventually betrays your trust was a theme both in Sasuke’s character arc and Carlos’ record. Even if I was making things up as I went, integrating these narratives into my conception of who Carlos was as a three-dimensional human being helped me continue bonding with him and learning to challenge him to do something new every day.
Eventually, Carlos got healthy enough to leave the hospital. He could walk himself to the bathroom without soiling himself. He could cry when he was upset and smile when he found something funny. He could still not swallow food normally but the nurses had adequately taught the mother how to manage his feeding tube and the hospital agreed that he was not in a sufficiently dire state to justify him staying at a hospital with the risk of infection. So I said goodbye to both Carlos and his mother almost a full month after I started working with him daily. It was a very emotional goodbye and one that I would remember from then on.
A few days later, my supervisor told me they were going to have a follow-up visit with Carlos and he invited me to join. I had wondered how much he was able to improve outside of the hospital. When we saw him he was shy, hiding behind his mother, but was otherwise acting as a child should. He wasn’t speaking throughout most of the visit so I thought he probably hadn’t jumped that hurdle yet, but on our way out we all had a moment to talk to him. I got down to his level and joked about how his mother had told me that I could keep him in the hospital and that we could play Ninja Storm together. At that moment he hid behind his mother smiling and said “no”. This was the first time I heard him speak since I met him a month ago and I find it hard to describe the emotions that were running through my mind. To this day, you might catch me with a lump in my throat when I talk about this moment.
Whether it is Carlos’ love of Naruto or me finding a path of introversion through Fruits Basket, it is made increasingly clear to me that media matters and that it can have a profound impact on us. There are little words I can use to describe how glad I am that I found the Geek Therapy Community when I did. I am fully committed to finding and discussing the ways each of us could use media as a catalyst for the discussion and promotion of mental health. That’s why shortly thereafter I joined my wonderful co-hosts Kat LaForgia and Marc Cuiriz in creating the Here Comes a Thought podcast in which we discuss Steven Universe and it’s many complex themes on family, psychology, and the human condition. I’ve been blessed with people who love me, but also I was lucky that at moments in my life when I did not find ways to discuss my inner turmoil, there were pieces of media providing me the language to discuss it. That’s why one of my hopes is that we spread the message of Geek Therapy far and wide. If I can be a Fruits Basket evangelist on my way there, so be it.
To you, dear reader, I would like you to know that you don’t need to be a mental health professional to grow and help others through the use of Geek culture. Just take two things that you are passionate about and experiment with them and see how they mix and you might find yourself making this world a better place in the process. This community is filled with wonderful passionate members who will support you along the path of your choosing.