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My Knees, Anthony Bourdain and Depression

“The anger of Bourdain – tears of a clown.”

By Dr. Rich Furman, Ph.D.

I was, to say the least, at loose ends. By “loose ends” I mean aimless and regularly suicidal. . . . like a lot of things in my life, there’s no making it prettier just ‘cause time’s passed. It happened. It was bad. There it is. 

—Anthony Bourdain

Anthony Bourdain hung himself.

As I dragged my family around the country from one academic job to another, No Reservations, Bourdain’s culinary travel and adventure series was a constant—a comforting event once a week in our hectic lives. I developed a weekly ritual of experimenting with popcorn toppings inspired by each country Bourdain would feature. My creations were a bit unorthodox: extra-thick, fermented Japanese tamari with organic sesame oil; Poblano peppers from Central Mexico infused in artisanal avocado oil; and extra-aged parmesan cheese mixed with Scottish yeast, normally reserved for distilling single-malt scotch. As the start of the show approached, and the last moments (refrains?) of the introduction played, I cranked the volume so loud that my dogs ran from the room, and the thin century-old windowpanes of our North Tacoma bungalow rattled. Seconds before the show was to start, above the music and Bourdain’s voice-over introduction, I called to my family using Bourdain’s very words, which signaled the start of our special time together. I accentuated each syllable so even a straggler would know that it was time to quickly join together. It was as close to a family prayer as I would ever recite, almost like a Jewish nigun, a ritualized chant which resonates deep within your bones.

NOOOOOOOO RESERVATIONS.

No Reservations brought Bourdain considerable notoriety, and his wonderfully funky series ran for nine seasons. He left the show at a time of personal crisis precipitated by his divorce and joined CNN for a new globetrotting culinary adventure, Parts Unknown. CNN brought him a far larger audience, considerable celebrity and wealth.  He did not always wear his newfound status, along with its perks and responsibilities, well. An introvert with outstanding extroverted skills, Bourdain seemed to thrive in his new role but was frequently worn-out.

Shortly following his death, several essays attributed Bourdain’s downfall to drugs or alcohol, but this does not appear to be the case. It is true that he had a significant history of substance abuse. Bourdain had long struggled with cocaine and heroin addictions, but finally quit both. For many years, he drank a great deal, seemingly alcoholically or addictively, but by all reports he had learned to drink moderately by the time of his death.

I never met Bourdain. My opinion comes from reading his books and essay and watching many of interviews of him and those who knew him. I believe that drugs and alcohol were probably not Bourdain’s most significant problems. In his first book, Kitchen Confidential, he more than alluded to battles with hopelessness, despair and a struggle to find hope and meaning. He hinted at his struggles during various episodes of Parts Unknown. His adventures were always tempered with – and usually made richer, more profound and, frequently, more human – by his acute sensitivity to the pain, struggles, despair and tragedy of others’ lives. Parts Unknown was as much a story of human struggle –  his struggle – as it was a food-and-travel show.

My family watched Bourdain with laughter and tears, joy and heartache, longing and a humble reverence for the human condition over the span of many years. My wife and I relished and resonated with his talent for portraying the bittersweet nature of life, of existence itself. We certainly had our share of loss. Each of my wife’s parents died tragically. My oldest daughter struggled with substance abuse and behavior that had become increasingly out of control: cloaked as a science experiment, she grew psilocybin mushrooms in our attic and was lucky to survive multiple car crashes driving with druggy friends. My wife and our two daughters frequently developed strange, difficult-to-diagnose medical conditions—they were masters at confounding the medical community with disorders that defied clear diagnostic criteria that often appeared to be far worse than they were. Finally, the blow that shattered so much of the world we had constructed: my wife became disabled and wheelchair bound from a paradoxical neurological response to pain medication following surgeries and a life-threatening infection. During those three years, No Reservations became a needed escape from a life of chronic pain and disability and the witnessing of a life of chronic pain and disability.

I have always loved to travel. When I was seventeen I walked across the US-Mexico border at Chula Vista, California—thank you fake ID and borders far more open, friendly, and less contested than they are today—and hitchhiked from Tijuana to Mexicali, where I hopped aboard a six-dollar, second-class train that sliced through the northern Mexican deserts and high plains for twenty-six hours until I arrived in Mexico City.

I longed to understand that sprawling, pastel-and-soot ancient megalopolis the Aztecs once called home. So, instead of riding the subway, I traced its path above ground, stop to subway stop, crisscrossing the largest city in the world by foot for over eight hours. On my second night, I drank beer and ate pancakes at midnight with college students from UNAM, the largest university in the world and the nexus of decades of Modernist art and poetry and protest in that vibrant and turbulent capital. They brought me to house parties and raves. We danced all night until nearly noon when we would drink a hot spiced corn drink, atole, before passing out from exhaustion in the flat of a gay artist couple in the La Condesa neighborhood.

Against recommendations, I hiked the shanty-covered hills, ate street tacos with locals who called my green eyes ojos del diablo–devils eyes – but made I found my way back to safety. Outside of the capital, I explored the colonial town of Guanajuato and slept in a dingy, three-dollar-a-night room beside the bus station for a few days. When I was almost out of money, I tried to book a ticket on another twenty-four-hour, second-class bus, but it was oversold. Luckily, the conductor allowed me conveyance on the roof with a few others who were either too late or too poor to buy a ticket yet absolutely needed to travel north.

On that roof, I soaked up views of the yellow-and-brown desert that collected red hues just like my sunburn-blistered face. Despite the throb at the base of my spine from being jostled up and down onto the metal roof and not having nearly enough food or water, I discovered that no matter how miserable I might have been at any particular moment, I possessed a love for travel, a need for travel. This need would become one of the central themes of my life.

I can sum up this joy clearly – and in the Bourdainian voice I have attempted (inadequately, I am sure) to infuse into this essay – by saying: It was good, it was all very good, and I was happy.

I binged watched Parts Unknown while I recovered from back-to-back total knee replacements. My emotions were all over the place as I watched Bourdain’s adventures: I feared that my knees would never heal enough to allow me to ever travel again, to hike another set of hills, to have my perspective transformed, once again, by travel. Nearly every new project I had ever developed, whether research or writing or teaching, had come to me while traveling. For a while, I didn’t even know if I would be able to walk again without intense pain, no less travel. Yet travel had been such an essential part of my life, personal and professionally for over thirty years–life without travel would be devastating.

My arthritis disabled me within the span of a year, and while my surgeries themselves went well, the second total knee replacement was not without, what was euphemistically referred to as post-surgical complications–immobility, stiffness, muscles that often refused to function and when they did were so tight that they felt as if they were going to snap. I feared the worst, that arthritis had won and my body was ruined. There were moments when watching Bourdain travel the world gave me some sort of strange, irrational hope that I would return to my pre-arthritic state of several years ago–I would be able to travel again too, just like him. Bourdain’s irreverent, evocative, snaky yet still deeply and hopeful-for-humanity style somehow helped me feel connected to the places and people that he encountered. I was, it felt, part of his world. Yet all the while another part of me knew that if my recovery did not progress, Parts Unknown would be the closest I would ever get to traveling to Burma or Bali, at least without a wheelchair.

Over the last few weeks, my range of motion in my right knee has improved enough to give me some hope, some confidence that I will return to something close to “normal.” Yesterday I bought plane tickets to travel with my lover to Guatemala. When I was twenty-one years old, I volunteered in Guatemala for several months to help children and adults with physical and psychiatric disabilities. I really did not do much more than sing songs to and feed the children, play soccer with a few of the teens, and cards with a man who had lost his legs. I was not much use to them, but through singing and laughing and playing with them, I decided that when I returned home, I would finish my undergraduate degree and would apply for graduate school in social work.

Years later, I had written a memoir about my ten-month travels through Central America. Most of the manuscript chronicles my time in Antigua. So, booking the flights and making hotel reservations in Antigua yesterday was an affirmation, a hope, part recognition of my improving health and part trust that I would continue to improve. I hoped to return to a semblance of the life that arthritis had taken from me. I had lost the sense of myself as a fit and strong man, having a body that listened to my brain and that followed my will. I had lost a great deal of my desire to connect with the world outside my home. For over a year I had minimized how bad my knees really were. It was not intentional. I was not conscious of attempting to be macho, tough, or even brave. It seemed to me that disability had crept up on me. I was, perhaps, out of touch with how wrecked my knees were and how this impacted the rest of my body. It is only through retrospection that I can see that the internalization of stoicism, self-reliance, autonomy and invincibility—core elements of what has been termed toxic masculinity–each contributed to me underestimating the severity of my condition. It was not that I resisted seeing a doctor: it simply had not entered my mind until I could barely walk. My obliviousness, I should add, is rendered fairly ironic by my having spent the last twenty years studying, writing, and teaching about how various aspects of masculinity contribute to men’s poor physical and mental health. I pride myself, typically, on being rather self-aware. Clearly, my personal capacity for self-reflection has serious limitations.

It was during a trip to Cuba that I was forced to come to grips with how disabled I really had become. I had walked a few blocks up the hill from my apartment to a large tourist hotel for breakfast and quality internet–a rarity in Havana. The walk there was difficult but manageable. The walk back, however, was a different story–my knees were so inflamed and brittle I felt like my torso was becoming kindling and splinters–the three blocks took over an hour to walk, if my slow rocking from side to side in fracturing agony could actually count as walking. For a couple of days after, I only left my room to eat and to buy more ice to try to sooth my inflamed knees, which now throbbed even when I was not walking. I was in one of the places on the planet that I most wanted to explore, and I was unable to even walk. I began to feel depressed. It was becoming clear that whatever was happening to my body, I would not be able to ice, stretch, or anti-inflammatory my way to health. A part of me intuited that I would need knew knees, and sooner rather than later.

Lying in my room, I considered a life of disability. I had so avoided acknowledging that I had a significant problem that I did not even know if they even give new knees to otherwise healthy fifty-one-year-old men. If they did not, would I have to adjust to a life of chronic pain and disability? Would I wind up in a wheelchair? Would I have to tolerate pain this intense on a daily basis? Was my life as I had known it over? A few days later, my condition improved enough to allow me to walk a few blocks, but I could not shake an accelerating, deep sense of hopelessness and despair during my final week in Havana.

When I returned, I made an appointment to see an orthopedist. I had x-rays that confirmed what my pain had already assured me: I did not process nearly enough cartilage to prevent my femur and tibia from grinding into, and destroying, each other.

From reading the Twitter hashtag #RIPBourdain, it seems thousands of people wanted to be Anthony Bourdain, or at least wanted his seemingly idyllic life: traveling anywhere in the world he wished to go; eating exotic meals with movie producers and artists, punk rock icons and, billionaires, writers and presidents (he drank beer with Obama in Vietnam!). Bourdain had achieved fame and wealth from doing what he loved, what millions of us love. 

When Bourdain explored his addiction in his book of essays, Medium Raw, he admitted that his compulsions functioned to fill empty and injured places within himself. He wrote of his self-loathing, his assessment of his mediocrity as a chief, his belief that he did not deserve his success, and he often intimated that his highly social career was exceedingly painful given his introverted personality. He described a trip to the Caribbean in which he frequently drove around the island drunk while frequently considering driving off a cliff in order end his sadness and pain. He felt despair over perceived failures, which included two divorces for which he usually blamed himself. 

While it is impossible to really diagnose someone with a clinical disorder without formally assessing them, I strongly believe that Anthony Bourdain was depressed. Clinically depressed. Even some clinicians—most are not trained to assess and treat men—might not have considered Bourdain depressed had they spoken with him: he was too angry, bitter, and snarky. Yet, increases in and the inability to control anger are often signs of depression in men. Those who don’t understand these gender differences in the expression of mental illness often view anger simply as a character defect, or often as part and parcel of addiction. I believe this lack of understanding is what lead to talk show hosts and others believing that Bourdain died as a result of addiction. Yet, he was depressed. The anger of Bourdain–tears of a clown.

The orthopedic physician assistant looked at my x-rays on the computer screen for less than a minute before he began asking me questions about my pain, mobility and current activities. To help him understand, I told him about my trip to Cuba. After I finished, he sighed, gave me a quizzical smile, and gently tapped me on my left knee, and then the right, and asked: “You traveled on those things?”

You traveled on those things.

It is what I remember most clearly about my orthopedic evaluation. Those words, and that my osteoarthritis was so advanced that total knee replacement–on both knee–was really my only meaningful treatment option.

After an appointment with the orthopedic surgeon, my surgery was set for late November. I was grateful for such a quick surgical date. Given that I was teaching online in January, I would not have to take leave from my faculty position to have my simultaneous, bilateral knee replacements. However, two weeks out from surgery, I was informed that my surgeon had developed some health concerns of his own and would not be able to perform my surgery. For the next four or five days I found myself lost in the bureaucratic hell-maze that is Kaiser HMO, trying to find some way to have my surgery so I would not have to take a medical leave. 

After a great deal of advocacy–read, I threatened hospital administrators with handcuffing myself to the front door of Kaiser Permanente Tacoma while calling the local television station and informing them about the nature of my protest–I had a January surgery date, and while I would have to take paid medical leave, I knew I was privileged to have a job that afforded me this option.

During the pre-operative exam on the morning of my first surgery, the surgeon noticed a small scratch just below my right knee, and informed me that he would not be willing to operate on that leg–as small as the scratch was, its position represented too great a risk for infection. I was gobsmacked and was instantaneously overcome with despair. I wave of horror came over me, fearing that I would have to wait until summer for my second surgery due to my teaching schedule and how much leave I am allowed each academic year. The surgeon assured me that he would be able to operate on my right knee in six weeks, which would hopefully allow plenty of time for me to recover from the first surgery and still have enough time after the second surgery in order to be ready for the spring quarter. 

I had been so beaten down by the pain of my arthritis, the disappointment and stress of losing my first surgical date, along with my fear of dying on the operating table that I panicked, and nearly cancelled the operation. Somehow, I was able to get my pull myself together, perhaps with help from the first phase of anesthesia which had already been administered prior to his finding my scratch. I consented to surgery, they gave me the rest of my anesthesia, and I felt asleep. I had my first total knee replacement.

When I woke up in the operating room, the surgeon informed me that the surgery was “textbook.” I had felt no pain whatsoever, which was sort of shocking. The anesthesiologist told me that I was one of the lucky ones for whom nerve blocks work extremely well. Along with the narcotic pain killers I given, I really was only conscious of a little discomfort. The nerve block, in fact, worked so well that I felt very little pain even five days after surgery, and so I stopped using the opiates I was prescribed–I hated the way they made me feel. After a day and a half off of the medication, I thought I was free and clear from pain.

However, in the middle of the night, I was awoken by pain. Not just pain, but an agony the likes of which I have never felt before. Within seconds, my whole body was overcome by a depth of physical anguish that literally took my breath away–I wanted to scream, but nothing came out. I lied there alone trying to figure out how to call for help. It should have been obvious that I just needed to holler for my girlfriend who was sleeping upstairs or that I could throw something across the room to make a large bang, but the pain was so acute that I literally felt myself unable to act. I was reduced to having to experience a throb and burn that pulsated between each layer of my flesh. I experienced this pain as, how can I say, sinister, an evil of sorts that did not seem real, this horrible movement of fiery sensation that pulsated from skin to fatty tissue, through my ligaments and tendons, and finally to my recently sawed bones. I was shocked, in awe even, that my body could produce an experience so intense. It did not seem plausible that such a feeling was congruent with living. I quickly became certain that I was going to die. It was then that I screamed.

The dogs ran down the stairs with Sandy remarkably close behind them. As soon as I saw her, I choked out the words “pain medicine.” She quickly disappeared into the kitchen and returned with the oxycodone I had stopped taking two days before. While the pain decreased a bit after an hour or so, it took two days on opiates for the pain to mostly abate. Over the next couple of days all I did was lie by in my chair trying simultaneously to understand and forgot that initial, unmedicated pain, and how it traveled between various layers of my body. I had experienced firsthand, I told myself, something someone should never have to feel.

After my brush with unmedicated pain, my recovery went exceptionally smoothly. My physical therapy progressed quickly; by the end of the second week the range of motion in my left knee was so good that I began peddling on the exercycle. I progressed from walker to cane to walking without assisted devices a week after that. Everything was going as well as could be expected, with the exception of some pretty serious insomnia, a common side effect from major surgery and opiate use.

Despite getting better, the insomnia began to impact my thinking and emotions. I started having a hard time remaining optimistic. A week after starting the pain medication I stopped feeling pleasure, hope or joy. My mood began to suffer greatly four weeks out from my surgery, and I found myself, for the first time in my life, having thoughts that were not about ending my life, but about wishing I were no longer around. These increasingly persistent and hard to suppress thoughts scared me, but I felt too prideful to share my nearly automatic, not-consciously-entertained ruminations. I knew I should have. In the knee replacement class that was part of my pre-operative preparations, I learned how common depression was following total knee replacement surgery. My significant other–my designated knee replacement-recovery coach, Sandy­–and I developed a plan that included me sharing any depressogenic thinking with her. I believed, however, that I would be able to handle my increasingly dire mood myself.  I did not follow the plan. I was weeks away from my second total knee replacement, and I was in trouble.

The week prior to my second surgery I become increasingly fearful and anxious, and, perhaps for the first time in my life, truly clinically depressed. I have had extended bouts of loss and grief before. My divorce two and a half years before, for example, marked the start of a very intense, loss-filled several months. This, however, was different. I slipped into a darkness and hopelessness that felt bottomless. I had no joy or meaning and saw little reason why my feelings would change. This dysphoria was trigger by my growing fear about my upcoming second surgery. I started to believe that I would prefer to remain chronically disabled and in constant pain rather than going through with a second recovery. While the pain that I experienced from my arthritis was debilitating, it was a wade-pool ripple compared to the tropical tsunami of pain that I experienced the night my nerve-block wore off. While the pain was only at its most intense for an hour or so, I was truly traumatized by the experience. Suddenly, all my options seemed equally horrible. I started to believe that it would be much better off if I were dead.

The fog of depression seems to have blocked a good deal of my memory about the days leading up to my second surgery. I know that I stuck close to my dogs, wrote a morbid, informal will, and clung to the little hope that I had. I am not sure exactly how I dragged myself to the second surgery, but I did. The fact that my physical therapy was also going well certainly helped. Everyone was telling me that I would soon be walking again, that I would soon be traveling.

The first thing I remember after my second surgery is still being on in the operating room and my doctor telling me that everything went “like clockwork.” I felt relieved, and fell back asleep. However, as soon as I woke up in recovery room, I felt a tightness and constriction around my surgical leg that I did not experience after my first surgery—something felt wrong. I flagged down a nurse, and in my groggy state, told her that something with my leg was wrong, that it felt like my leg “could not breath.” She told me it was fine and walked away without so much as looking at it. Another nurse walked by, and the same thing happened again. It took me raising my voice and becoming angry with a third nurse before I was taken seriously: the cellophane wrap that was wrapped around my leg after surgery was far too tight.

This was not the only early mishap. A few hours later in my room, the drain that was placed in my wound to clear out blood and fluid popped out. A nurse tried to put it back in but was not successful in spite of stabbing my leg multiple times with the sharp end of the drain. He called another nurse who also struggled to put in the drain. After ten minutes of cursing and pushing on my knee, a physician assistant fit a new drain into my leg and cleaned up the small puncture marks caused by the slightly panicked nurses.

Perhaps precipitated by these two misfortunes, or just bad luck, my leg was far more swollen compared to my first surgery. Nothing about my recovery from my second surgery went smoothly. The day after my first operation, I was able to achieve a ninety-degree range of motion, but I came nowhere close with my right leg even after a week. It felt stiff and tight, and no matter what we tried in physical therapy, not much was changing. I could barely bend myself into the car to get there. My therapist began to look concerned during our sessions.

For two weeks, I barely moved from the couch, believing I had made a horrible mistake by having the second surgery. I missed my natural, original, presurgical knees–those diseased, brittle, rapidly disintegrating hinges. I feared that I allowed myself to become a willing pawn in the for-profit machine of corporate medicine. I started to see myself as a dupe, a fool that let a butcher mutilate my body for the good of corporate profits. As my insomnia returned and my paranoia increased, I started to wonder if my lover had colluded with my surgeon to disable me so she could take my house and dogs away from me. This level of paranoia shook me. Part of me knew it was not true, but I had lost control of my own mind.

Fortunately, I started to recognize the irrationality of my thinking and began to taper off oxycodone in spite of how disconsolate I was feeling. After several days off the opiates, nearly three weeks after my second surgery, I began to feel less paranoid, but I was in still in battle for my life. I had a plan in place for how I would want my possessions to be distributed. I started to plan for a trust to pay for my youngest daughter’s college, and I would leave Sandy enough money to get her through her master’s program. I wanted her to take care of the dogs, in what once was my house, what I had referred to as my forever home.

I do not want to make it seems as if I had an active plan to kill myself. I did not. Nor was I preoccupied with my death during the majority of this time. That I even entertained thoughts of my own non-existence, that they automatically demanded the attention of my consciousness when they never had before, that I had begun to make plans for what I wished would transpire after my demise, terrified me. It showed I was close to, and perhaps as close as anyone can be, to the edge. It gave me personal insight into how various physical and emotional pains can interact with depressive states to distort one’s thinking. I have been a mental health professional for nearly half of my life, but never had I truly understood the nature of depression, not in this visceral, lived, deadly way.

Whether I met the diagnostic criteria for any of the major depressive disorders is not the point of this essay. What is, however, is that no one is immune from depression, a disease that can diminish our desire to live. I was lucky that for whatever reason, I have a history of cognitive/emotional resilience that somehow allowed me to quickly move beyond my depression.

It is not easy to explore the needs and vulnerabilities of men at this moment in history, and for good reason. The national #MeToo movement has brought to light how men abuse the power they hold over women in order to sexually abuse them and then get away with it. Brett Kavanaugh, accused of sexually assaulting several women, was quickly confirmed to the Supreme Court despite the protests of millions of women and men alike. Women who have been victimized are claiming their space as survivors and advocates for social justice, calling out men for their sexism, misogyny, and abuse. Every day women are subjected to a President who was caught on tape admitting to sexually assaulting women. And of course, sexual assaults are not limited to politics or Hollywood–1in 6 women will be raped in their lifetime and over 300,000 women are raped each year.

In this context, why should we concern ourselves with men, even those who are depressed? How can we have public discussions about the pain of men at a time when we, as a nation, are pausing to care for the needs of women? How do we create this space without making women feel invalidated, unsupported, and uncared for?

I really don’t know the answers to these questions, and I have been working with, teaching about, and writing about men and masculinity for twenty-five years. What I do know is this: men become depressed, and not attending to the needs of depressed men is killing many, fathers, sons, brothers, friends, lovers, partners. More than six million adult men, or seven percent, suffer from depression. While depression is more prevalent in women than men, men are far less likely to seek treatment for their depression and other mental health disorders. Men are not socialized to attune to their feelings, and many men fail to recognize or admit to sadness, melancholia, and loss. As such, men often do not recognize, or admit to themselves, that they are depressed. That depression looks different in many men than in women only complicates matters. Many helping professionals don’t understand how to assess depression in men and fewer specialize in treating men. While women are more likely than men to attempt suicide, men are far more likely to successfully kill themselves.

Bourdain’s second book, Medium Raw, was published eight years ago, when he was fifty-three-years old, the age I am now. In many of these essays he adopts his angry-at-the-world persona, a persona filled with a palpable, judgmental righteous indignation. Yet, his harshness is not only reserved for others. He is also self-critical, self-effacing, and less than empathetic toward himself. He never seemed to feel fully worthy of his success. He continued to view himself as a low wage-earning chef who lacked the creativity, talent and social skills to become truly great. He seemed to believe that, at least in part, he lucked into his success and fame. He often experienced himself as a fraud, and suffered from what is sometimes glibly and too easily referred to as “imposter syndrome,” the dread that who you are does not really match your achievements, and someday this will be discovered, and you will lose all that you have. For Bourdain, this seemed to be a real and pervasive fear.

Some of his essays are less bitter and angry, and are in fact circumspect, reflective and wise. At times, he is gentle and vulnerable. In the best of his work he turns his considerable power of analysis onto himself. We read a Bourdain that continues to struggles with self-acceptance, yet who is far less judgmental and more tender with others. We rediscover the Bourdain that we fell in love, the one most frequently encountered during his summative reflections at the end of each Parts Unknown episode, in which he honors and thanks the people who touched him.

In 2011, I published the book, Social Work Practice with Men at Risk, with Colombia University Press. After the book began to receive some attention, some colleagues, and a book reviewer or two, challenged the notion of men at-risk. Are men, in particular white men, not the cause of many of the social problems that we face? How could they, as a group, be at risk? Men commit the vast majority of violence against women, against children, and against each other. Men are responsible for most sexual violence, domestic violence, homicide, robbery and even war. Men still earn far more than women for preforming the same jobs and have access to positions of power and leadership that are far harder for women to obtain. Most men continue to be privileged in subtle and invisible ways, including the ability to walk through life without constantly worrying if they are going to be victimized or harmed.

These are truths, and the onus needs to fall upon men to change things. Men that care about women must work to dismantle patriarchy and transform the oppressive institutions that leave women far more at-risk than men for many psychosocial challenges. Men must take ownership for the deleterious effects of most forms of masculinity and work to transform the ways that masculinity is performed. We must hold each other accountable for violence and other transgressions against women.

Men must change, but, or perhaps and, men also deserve care and support. As a social worker, my code of ethics requires that I value the dignity and worth of all people–all who suffer from emotional and mental distress deserve help. Many men are in pain. Even if they to understand their experiences, they are suffering, and they deserve help.

Bourdain was a man at-risk. I am not sure anyone would argue with this ascertain now, but what if, weeks before he killed himself, I explored the psychosocial risks of men and masculinity on social media or in an op-ed piece and used Bourdain as a potential example? Perhaps I am wrong, but I think there is a significant likelihood that I would have been lambasted. Bourdain was white. Bourdain was wealthy and possessed a dream-of-a-career. He dined with marvelous, fascinating people in three-star Micheline restaurants with tasting menus and immaculately selected wine pairings, was gifted his own private shelf (filled, of course) in a billionaire’s wine cellar in Shanghai, met his heroes and anyone else he wished to know. He was able to engineer nearly any experience or adventure he could conjure. His life was charmed. I believe that if Bourdain himself went onto social media and wrote about feeling down, he might have been scorned. He might have been called out for his wealth and power and privilege, been chastised for concerns that were “first world problems.” Perhaps he would have been told to suck it up. A few might have simply responded with one of the flippant, dismissives of the day: Womp womp. Who knows, I might have even forgotten my own depression, the years I provided therapy to men in pain, and joined the cacophonous dogpile.

Having white, male privilege certainly inoculates against some of the risk factors associated with negative mental health outcomes–poor health, poverty, and a lack of access to, and inability to afford, quality care. However, anyone can become depressed. Privilege does not prevent depression from changing how we feel about ourselves, our lives, and our futures, nor does it prevent someone from slipping into the darkness of depression, that downward opaque spiral that leads some to consider killing themselves. Leads some to kill themselves. Anthony Bourdain was probably depressed, and like many men depressed men, he probably believed he could handle it by himself. He probably thought he could grit and bear the agony of depression. I also thought I could handle the despair I experienced before and after my second total knee replacement. Frankly, I caught a break. I somehow pulled out of it. I don’t even know how. I am still healing from my surgeries eight months later, but I am ok. I am no longer depressed. Lucky, lucky me.

Bourdain probably thought he would be OK as well. And he was.

Until he wasn’t.


Rich Furman, MFA, MSW, PhD, is the author or editor of over 15 books, including a collection of flash nonfiction/prose poems, Compañero (Main Street Rag, 2007). His work has been published in Another Chicago Magazine, Bluestem, Chiron Review, Sweet, Hawai’i Review, Pearl, Coe Review, The Evergreen Review, Black Bear Review, Red Rock Review, Sierra Nevada Review, New Hampshire Review, Penn Review and many others. He is professor of social work at University of Washington Tacoma. A qualitative researcher whose work is situated on the boundary between the expressive arts and the social sciences, he is one of the pioneers of poetic inquiry. He received his MFA in creative nonfiction from Queens University Charlotte’s MFA-Latin America program.

Image: “Floral Interpretation of Antelope Canyon,” digital photography, 2019, Jury S. Judge

Jury S. Judge is an internationally published artist, writer, poet, photographer, and political cartoonist. Her Astronomy Comedy cartoons are also published in The Lowell Observer. Her artwork has been featured in literary magazines such as Dodging The Rain, The New Plains Review, The Ignatian Literary Magazine and Fearsome Critters. She graduated Magna Cum Laude with a BFA from the University of Houston-Clear Lake in 2014.