Who’s to Blame?

“I need your help, Reb Yaakov,” said Rav Chayes. “You have to save a marriage.”

Rav Chayes was a special man — a rosh yeshivah who’d also earned a well-deserved reputation for excellence in shalom bayis counseling over the past few decades. “I’m in touch with a yungerman who was formerly a bochur at my yeshivah,” Rav Chayes explained. “Great guy, did some amazing personal avodah, and was blessed with a real winner of a wife. Soon after their marriage though, he experienced his first bipolar episode, but his wife stuck with him until he was stabilized. Frankly, things were going great up until a few months ago when he stopped his medication and ended up in the hospital for the second time in a decade.”

It was an all-too-common cause of rehospitalization, and Rav Chayes’s talmid was no different. It generally happens when the fellow is doing well, feels like he doesn’t need his mood stabilizers anymore, and then stops taking his meds. “Of course,” he tells himself, “the pros of taking those meds outweighed the cons when I was first getting back on my feet after the prior hospitalization, but now things are good and the medicine makes me tired,” or “the meds have a long-term risk for kidney problems” or any number of other good reasons. The ending is usually the same: Someone calls Hatzolah or 911, and the patient ends up back in a locked psychiatric ward.

“So how can I help you, Rav Chayes?”