At the family physician’s office, he filled out a questionnaire. Inside the exam room, the doctor sat across from him and said, “First, know that what you’re experiencing is very common. Depression affects people of all ages, all races, and at every socio-economic level. Sometimes it’s temporary, sometimes it’s a chronic medical condition that must be managed throughout a person’s life. And it is that: a medical condition. I’m going to prescribe a medication: a selective serotonin reuptake inhibitor, or SSRI. Many patients improve on SSRIs. In your case, with the severity of your symptoms, I would also strongly encourage you to see a psychotherapist who can identify other underlying issues that could be at play and help you identify triggers in your life that you can manage. I’ve seen many patients improve on medicine alone, but many more benefit from a combination of medicine and therapy.”

The psychotherapist the doctor recommended was named Thomas Janson. He was in his sixties, with short gray hair and a kind smile. He listened as Desmond recounted his childhood and every major event up until he had walked in Dr. Janson’s door. The man took copious notes, and when Desmond had finished, Dr. Janson told him that he believed he could help him. He just needed a few days to consider what he’d said.

When Desmond returned, the man sat in a club chair, a notebook in his lap, and spoke slowly, his voice even.

“I believe you have a disorder we call post-traumatic stress disorder. Or PTSD.”

That surprised Desmond.

“I suspect you developed the condition after the bushfire that killed your family and very nearly you as well. I believe you never recovered from that event. You never came to grips with that severe trauma. In fact, you were placed in a new environment with its own dangers and hostility: your uncle’s care. Those first years were spent in near-constant fear of starvation or verbal abuse from your uncle. In your work on the rigs, you were in physical danger; your injuries attest to how real that threat was. And in the days after, when you and your uncle were,” he glanced at the notebook, “blowing off steam, that is, drinking and fighting, the danger and fear never went away.

“You also never got to mourn your uncle’s death—or frankly to unpack your feelings about him at all. You were in danger the instant he passed, even having to fight for your life, to kill a man, which is in itself an incredibly traumatic event. The fact that you processed it with little emotion at all is evidence of the vast amount of pre-existing emotional scar tissue.