Author: Joseph J. Sivak M.D.
ISBN: 978-0-615-31489-1
Publisher: Niagara Press

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Today, Norm Goldman Publisher & Editor of Bookpleasures.com is pleased to have as our guest, Joseph J. Sivak M.D author of When Can I Go Home.

Dr. Sivak is a psychiatrist with a busy practice in Duluth, MN. He is a graduate of Hahnemann University School of Medicine and completed his residency in Psychiatry at the University of Rochester.

Good day Dr. Sivak and thanks for participating in our interview

Norm:

How did you decide you were ready to write When Can I go Home? As a follow up, whom do you believe will benefit from your book and why? Is there a message that you want your readers to grasp?

Dr. Sivak:

It really started back in 1988, about a year after my mother died. The events were very fresh in my mind, and I wanted to let the world know what it is like to have a parent with Alzheimer's disease.

After that I got busy with residency and work. The original manuscript got set aside for many years. In the 1990's I had a very short story, a brief version of the struggle, that I used to read when I presented at Alzheimer's conferences. It was published in 1993 in the Journal of Bereavement. I never lost sight of the goal to finish the book but never had the time with work and family.

In the early 2000's I went back to it. One of the motivating factors is my son was growing up, and I wanted to have something finished, sort of a legacy of some sort that would be in the written word and withstand the test of time.

My son was starting to grow up, I wanted something other than the stories I could verbally tell him, that would help him know the story, the legacy, something that would be timeless. That is what motivated me to get back and finish the book. The fact that the number of Alzheimer's victims continues to grow, and there is still no cure or significantly effective treatments and the aging population also motivated me. There is still very little voice for the victims and caregivers. I wanted to be a voice, if only in some small way, to bring attention to this devastating disease.

I believe the book can benefit the family members of an Alzheimer's victim, and certainly the general population at large. We are an aging population and we have many baby boomers coming of age. We don't really what to know about Alzheimer's till it touches us in some personally. We have our conceptual impressions of the disease, but since it is now a household word, we know it is a terrible thing, but we don't really want to think about it or say the word till it affects us. It is almost magical thinking.

The book teaches in a basic human way, what the devastation is like, what it does to a person, and the family. In addition, there is plenty of clinical information presented in a human and understandable way that would benefit family members. Younger persons would also benefit from the book and even identify with some of the basic struggles presented from the perspective of an adolescent and young person.

I also think it would benefit young people going into medicine and the health care field, as we still need more books on the trials and tribulations it still takes to become a physician.

There are many messages in the book, and every reader will take something different from it. I didn't want to present only hopelessness and despair, but also the resiliency of the human spirit. Specifically I wanted to present the fact, that although there are very few medical and social problems that are more isolating to a person than Alzheimer's, we are all connected by this devastation.

At the rate we are going it will touch most people's lives in one way or another. In this day and age, we don't have to be isolated. It is a common bridge, and affects us all. I really wanted to send the message also that we need to treat our aging population with more respect and dignity than we generally do in our society today.

Norm:

What was the most difficult part of writing your book?

Dr. Sivak:

I would say finishing the book. The ending was difficult. It would be great if we had a cure but we don't. Somehow, offering a degree of hope for people. My mother's memory will always live on, so will the love and the pain and the struggle we all went through, there is no ending to that. It is frustrating how far we have not come in 100 years with treating Alzheimer's, and I wish I had something more to offer people.

Norm:

What was one of the most surprising things you learned in writing your book? 

Dr. Sivak:

How hard it is to write a book- something like this. We start out really excited, to let the world know, to cry out about this terrible disease, but then when it comes down to it, it is hard to remember all the details, to make it interesting for the reader and cover the truth. You don't want to make it all hopeless and moribund, but that is what the disease is like. I wanted to take care of the reader, but in the end, you have to tell the truth, no matter how ugly it may be.

Norm:

What did your family and siblings think of your writing your book? How did they react? Were there any surprising comments?

Dr. Sivak:

I think initially there was some concern about sharing such a deeply intimate story about our mother with the world. My niece, a writer, actually said this is a book to finish and put away in a drawer. I almost did that, but then I decided there was nothing to be embarrassed or ashamed about, it does not disparage my mother, it pays tribute to her. I felt, if it just helped one person going through the devastating process, then the whole effort of writing and publishing the book was worth it. As it was written over many years, I also gained personal insight across the time line, of what my siblings pain must have been like and not just my own.

My sister said, it must have taken so much emotional energy and a person would have to be going through a lot to actually get this all down in words.

Norm:

How has the feedback been so far?

Dr. Sivak:

It is a bit early to tell yet, since the book will be released in June 2010.

I have been told it is really three books in one: my mother's struggle with Alzheimer's, the struggle to become a doctor, and an underlying social commentary on many of the issues and problems we face in society, health care, our aging population and mental health.

I have been told it presents a wealth of good clinical information and anecdotes, while still being a book about my mother.

I have been told by others, who have been effected by the illness that essentially: "I got it right" in the depiction of the disease. A lot of feelings seldom covered are discussed.

Another interesting piece of feedback involved people's perceptions of physicians. There are many stereotypes about physicians. This book brings the human side of the physician into the readers consciousness. We assume a lot of things about doctors. We have to trust them with our lives. For people that already trust their doctors, this work probably brings some degree of comfort and relief to those individuals. For people that inherently have a basic mistrust of physicians, there could be a paradigm shift in their thinking. They may start to understand the universal emotions and makeup common to all physicians in our world today, the book is so revealing in the way, it may increase trust in the doctor-patient relationship. On the other hand, some people may find that disquieting, knowing that their doctor is just a person with thoughts and feelings like theirs, and really not be reassured by that, if they already have been conditioned not to place any positive regard or trust in that physician-patient relationship. We will have to see how that goes.

Norm:

It is said that writers should write what they know. Were there any elements of the book that forced you to step out of your comfort zone, and if so, how did you approach this part of the writing?

Dr. Sivak:

It is really about what I do know. It is a narrative, a memoir. There are some things in the book people don't like to think or talk about, I didn't leave much out, trying to interpret my thoughts and feelings for the reader at large was sometimes tedious. It was not just a self-indulgent purging of my feelings,  I wanted to make it something the reader did not want to put down. Trying to think outside of my own psychological box, and the impact this would have on the potential reader, when the book became a reality, was definitely a bit disquieting, and out of my comfort zone.

Norm:

What advice would you give to individuals, who are the primary caretakers of loved ones, concerning controlling their anger and frustration, particularly if there are other siblings, who are not as involved in the caretaker process?

Dr. Sivak:

Don't let the disease divide and conquer you. That is what it tries to do, by its very nature. Get outside of yourself and the isolation. There are many support groups and organizations available, utilize them. Don't cut off communication. We have busy lives, even if you are a sibling, geographically far away from the everyday care giving, you are still emotionally very connected. One great thing about the Internet, which was not around when my mother was afflicted, is that there is an abundance of information and resources out there. Utilize that.

Isolation leads to more negative emotions and disconnect. That really is not necessary in this day and age. There is more awareness and attention now on the plight of the caregiver and the emotional and physical toll it take on them. Getting as much information as possible, really learning about the disease, connecting with others in similar situations or those who have lived through the process is a healthy thing. It leads to better outcomes for the family. This is true for all family members, regardless of age or geographical context, whether you are the primary caregiver or not. Everyone is deeply affected. Everyone's experience shares common themes, yet every family members experience is unique. Connect with one another, the disease is a common bridge, use it to build more cohesiveness and support for each other. The disease does not have to increase isolation. It only does if you let it.

Norm:

In the last fifty years, what would you say is the most important advance in the field of psychiatry?

Dr. Sivak:

Certainly the de-institutionalization of chronic psychiatric patients. Psychiatric patients don't have to live their lives in a state hospital anymore. This has been possible from a clinical standpoint because of the development of clinical effective psychiatric medications. Each decade there has been more development of better, cleaner and safer psychiatric medications. We have a long way to go, but fifty years ago, I don't think we could have imagined how far we would have advanced at this point. There is a tremendously long way to go. Half the problem in this day and age, is teaching the patient and the public about the expectations  and limitations of modern psycho-pharmacology. In the end, it is still about the human connection and the trust in your doctor, no matter how far psycho-pharmacology advances I am not sure that will ever change. That part is the true healing component.

From a research standpoint, there are many exciting things on the forefront that have not made their way into the mainstream of everyday clinical psychiatry yet. Mapping the human genome is one area, understanding the genetic implications of various mental illnesses and testing for this, will eventually, over the decades to come, become more of a part of mainstream psychiatry. The area of neuro-imaging, and understanding what parts of the brain influences specific behaviors and affects mental illness is continuing to develop. Basically understanding genetic predispositions, coupled with the influence of environment on neurobiology and the brain, throughout the life-cycle, is the new frontier. 

Norm:

Where can our readers find out more about you and When Can I Go Home?

Dr. Sivak:

You can find information on the Book's Website

The book will be available for mass distribution in June 2010. It will be available at all major on line book retailers, like Amazon, Barnes and Noble, Powell's Books. You can pre-order the book now at Amazon.com or the publishers website www.niagarapress.net.

In June the book will be available at your local bookstore, however you may have to have them order it for you. The book's ISBN is 978-0-615-31489-1. If you give that to you local book store, or the title they will be able to locate it pretty easily and order it for you. It should only take a few days for the book to come in to your local bookstore for you.

One other place on the web, where you can get a lot of information about the book, Alzheimer's disease, and a host of related issues, is  MY BLOG,  It is titled- CAREGIVER SURVIVAL:I HATE ALZHEIMER'S.   You can also follow me on TWITTER
You can also find me on Facebook, my profile name is: Joe J. Sivak. Another site where you will find information about the book is Goodreads.com.
Norm:

Is there anything else you wish to add that we have not covered?

Dr. Sivak:

It is my sincere hope that in some way, any way, that this work benefits those families who are struggling with this devastating disease.

Norm

Thanks once again and good luck with your book and all of your future endeavors.

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