In the March 25 edition of Muses – the arts blog from BJPsych International – Ayeyemi Obabire, Pictures Editor, BJPsych International introduces John Offenbach, the photographer whose work is on the cover of the latest edition of BJPsych International.

This month’s edition of Muses features a lucid review of Dr. Benji Waterhouse’s You Don’t Have to Be Mad to Work Here, written by Nigerian psychiatrist, Ayeyemi Obabire. Waterhouse’s book is the portal for Obabire’s musings on becoming an International Medical Graduate (IMG) psychiatrist. Obabire’s passion for the mentally ill and disillusion with his natal country’s mental healthcare triggered his relocation to England’s NHS where he imagined better outcomes for the mentally ill.

You Don’t Have to Be Mad to Work Here by Dr. Benji Waterhouse is an engaging and thought-provoking book about mental health and the human experience. Retelling his psychiatry training experience, he shares snapshots of both his personal and professional journey, weaving stories of patients, colleagues, and his life into a compelling narrative. 

It is divided into three parts—prodrome, illness, and recovery—mirroring the process of growing up and losing one’s innocence and highlighting the challenges faced by mental health professionals. Each section is a potent metaphor for his transformation, that of his colleagues, and, hopefully, that of his patients. 

I was gently introduced to the conflicts in Dr Waterhouse’s professional life that were similar to mine. These conflicts include those between the psychiatrist and patient, the trainee and the trainer, and the doctor and bureaucracy within the NHS.

These stories demand the reader to reflect on the power dynamics between the psychiatrist and the patient. They highlight its nuanced nature while inviting contemplation of the professionals’ struggle to maintain optimism amid systemic pressures and burnout. We see the blurred line separating sanity and madness, contrasting with the thick, restrictive, impenetrable walls that stereotypes tend to be. 

As a Nigerian-trained psychiatrist working in the UK, I found these stories relatable, reflecting conflicts, uncertainties, and risks I have become accustomed to. I worked in a resource-constrained setting, where misleading stereotypes of insanity run deep, and mental illness is systematically stigmatised. I found comfort in fantasies of a setting where the mentally ill were valued and empowered members of society, and healthcare access was universal and need-based. These fantasies fuelled the restlessness to relocate to the UK and acquire that rather ambiguous label, ‘International Medical Graduate’. 

I identified with Dr. Waterhouse’s experience of starting psychiatry training with a healthy measure of faith in the system. He struggled to maintain that faith, remain empathetic, and retain one’s identity when confronted with the reality of a seemingly well-resourced system that still frequently appeared incapable, with patients who often do not exactly match established guidelines/pathways/criteria—a common occurrence in mental health. 

I transitioned into psychiatry practice in the UK, excited about working in a ‘less resource-constrained’ health system within a more accepting society. However, navigating the disillusionment that follows the acknowledgement of this system’s limitations has been humbling. 

Ultimately, You Don’t Have to Be Mad to Work Here is a brave and insightful exploration of mental health, personal and professional identity, and the human condition. Dr. Waterhouse’s incisive and humorous style makes this book engaging for mental health professionals and the public.

Welcome to Muses – the arts blog from BJPsych International. This new blog aims to highlight international art and artists, particularly from low-and-middle-income countries, with a focus on mental health. We welcome submissions for consideration, such as, comments on artwork, visual arts, literature, drama, films, podcasts, and videos. Do have a look at the instructions for blog authors for details on how to submit. General enquiries about the blog: BJPInternational@rcpsych.ac.uk

Dr Marinos Kyriakopoulos, Editor-in-Chief, BJPsych International.