Two health-related points struck me in this disturbing but exceedingly smart piece in the current New Yorker about the “darker side” of Aaron Swartz, the gifted young Internet activist who hanged himself in his Brooklyn apartment in January. (The “dark” health aspects of the story were so powerful that I called an expert to find out more about the potent connection between disorders of the gut and the brain. See below.)
First, the depth of Swartz’ physical distress and heightened sensitivity to everything from food to music is astounding. Reporter Larissa MacFarquhar writes:
He disliked all vegetables and refused to eat them except in extremely expensive restaurants, such as Thomas Keller restaurants. He had ulcerative colitis, a serious digestive disorder similar to Crohn’s disease; he also thought that he was a “supertaster,” experiencing sensations of taste more intensely than regular people. Partly for these reasons, he ate only foods that were white or yellow. He ate pasta, tofu, cheese, bread, rice, eggs, and cheese pizza. He was phobic about fruit and wouldn’t touch it. He rarely drank alcohol and was careful to stay hydrated. He went through four humidifiers in his apartment in Brooklyn. He said that he left San Francisco because the air-conditioning was bad. He was a supertaster in matters other than food: things always seemed much better or worse to him than they did to other people.
[From Swartz’ own writing]: I recently had to sit through a performance of Bach’s Well-Tempered Clavier at the Chicago Symphony Orchestra. . . . At first it was simply boring, but as I listened more carefully, it grew increasingly painful, until it became excruciatingly so. I literally began tearing my hair out and trying to cut my skin with my nails (there were large red marks when the performance was finally over). (2006)
The second issue that seemed particularly relevant to the entire tragedy is the severity of Swartz’ ulcerative colitis, a type of inflammatory bowel disease that affects the colon and rectum, with symptoms that can range from highly uncomfortable to seriously painful. In the piece, MacFarquhar quotes one of Swartz’ friends discussing the link between ulcerative colitis, depression and suicide:
A doctor relative last night told me that he’d had some very painful experiences with patients with ulcerative colitis committing suicide. Apparently co-morbidity with depression is common. I’ve been thinking about it a lot for the last twelve hours. I know during the scare in 2007 he had gotten very, very sick from his U.C. He definitely didn’t seem depressed right before his death, nor for a long time previously. He wasn’t doing normal depressed-people things (like withdrawing from friends and family), let alone suicidal-people things (like giving away his stuff). However, he did commit suicide, which weighs pretty heavily on the other side of the scale. My doctor relative told me that some of his ulcerative-colitis patients seemed to be doing much better until the moment when they suddenly committed suicide, and that there’s some speculation that U.C. can alter liver functioning, which in turn can cause other medicine to cause impulsive behavior like suicide.
Ben Wikler, a friend
I spoke with Suzanne Bender, a psychiatrist at Massachusetts General Hospital and the psychiatric liaison to the pediatric gastro-intestinal service at MGH. Every Thursday, Dr. Bender sees children and adolescents with GI problems that have not responded to typical treatments, and have also caused emotional distress. She says many of these patients only get relief from their GI symptoms once coordinated care is provided, between GI and Psychiatry.
“In general, the gut and the brain talk to each other quite a bit,” Continue reading