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I have not seen a breakdown of salary data in BLS reports.According to Radiologist Salary | Salary.com, the average Radiologist salary in the United States is $415,590 as of June 28, 2020, but the range typically falls between $361,290 and $480,790. Salary ranges can vary widely depending on many important factors, including education, certifications, additional skills, the number of years you have spent in your profession, reputation, number of direct reports, and location.The Radiologist consults with patients to determine the appropriate course of treatment. Examines and diagnoses disorders and diseases of the human body using x-ray and radioactive materials. Being a Radiologist requires a degree in medicine from an accredited school and is licensed to practice. Treats benign and malignant growths with exposure to x-rays and radioisotopes. In addition, Radiologist may require at least 2-4 years of radiology experience. May report to a medical director. Radiologist's years of experience requirement may be unspecified. Certification and/or licensing in the position's specialty is the main requirement. (Copyright 2020 Salary.com – Unlock the Power of Pay)Radiologists earn 6% less than similar careers in the United States. On average, they make less than oral and maxillofacial surgeons but more than dermatologists.According to Radiologist salary Radiology retains its spot among the three highest paid medical specialties, according to the annual Medscape Physician Compensation Report. Topping the list were orthopedists, cardiologists, radiologists, gastroenterologists, and urologists. A radiologist salary is even higher for those who choose a subspecialty like radiation oncology or ultrasonography. About 16% of radiologists earn $500,000 or more; about 8% earn $100,000 or less.The following are the steps an aspiring Radiologist must cross to achieve the high salaries, according to CareerExplorer :High SchoolTake advanced science classes in anatomy, biology, chemistry, physiology, and physicsTake math classes to facilitate the calculation the reading of graphsStudy Latin to help you understand unfamiliar medical terms that often have Latin rootsStudy a foreign language to increase your capacity to communicate with the segment of the population that does not speak EnglishInterview a practising radiologistAsk simple, but pointed questions:• What got you interested in radiology?• Can you tell me about an average day at your job, from beginning to end?• What do you like about your job? What do you dislike?• What is the most challenging part of being a radiologist?• What advice would you give to someone who wants to become a radiologist?• If you could start over, would you still choose to be a radiologist? Why?Research which colleges offer the best radiology programsBachelor’s DegreeWhile there is not a specific degree required for undergraduate study, aspiring radiologists tend to concentrate their coursework in advanced biological sciences to meet admission requirements for medical school. They must graduate from an accredited Bachelor's degree program with pre-med prerequisite courses, such as microbiology, biochemistry, and human anatomy. Also recommended are classes in English, advanced mathematics, and statistics. Most medical schools require a grade point average of at least 3.5 and may choose only those candidates who rank at the top of their graduating class.During undergraduate study it is also important for students to gain experience that will set them apart from other medical school applicants and prepare them for their chosen career. This experience may include volunteering at a hospital, performing community service, and research work. Especially valuable are job shadowing programs, which allow students to follow plastic radiologists and other doctors throughout a workday. All of these activities demonstrate work ethic and dedication to the medical field. Whenever possible, these experiences should be documented on letters of recommendation, which can be submitted with medical school applications.Medical College Admissions TestProspective radiologists must sit for the Medical College Admissions Test (MCAT) administered by the Association of American Medical Colleges (AAMC) and the American Association of Colleges of Osteopathic Medicine (AACOM). Through a set of multiple-choice questions, this standardized exam allows medical schools to evaluate a candidate’s training and skill set. Many schools share their incoming student MCAT score average on their website to inform undergraduates of how well they need to score to compete with other applicants. Most students take the MCAT at least a year before they wish to begin medical http://school.To achieve their highest possible MCAT score, students are encouraged to take advantage of assistance available to them. This includes study materials, pre-tests, practice tests, and online and in-person tutoring. These resources are designed to ensure that students attain the best possible score, which will open doors to medical schools.Medical School & National LicensingRadiologists obtain either a Doctor of Medicine (MD) degree or a Doctor of Osteopathic Medicine (DO) degree.Medical school is a very challenging four years of study that is divided into two parts. The first part, comprising the first two years of the schooling, is focused on course and lab work that prepares students intellectually for patient interaction. This training is in the biological and natural sciences, physiology, chemistry, medical ethics, and the art and practice of medicine. To test their grasp of this portion of training, in the second year of medical school students pursuing an MD must take and pass the United States Medical Licensing Examination (USMLE) – Step 1. Those pursuing a DO must take and pass the United States Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) – Level 1. A passing score on the USMLE or COMLEX-USA indicates that students are ready to begin supervised patient visits and gain clinical experience.The second part of medical school, the second two years, is called Rotations. During this time, students have the opportunity to experience a variety of medical specialties and a variety of medical settings under the supervision of experienced physicians. Rotations further students’ understanding of patient care, situations, scenarios, and the teams that come together to help those that are sick. As they complete rotations, students tend to find out that they gravitate towards certain specialties or environments that fit their particular interests and skill sets. It is important that this time inform their decision of specialty or subspecialty, so that they find complete satisfaction as a physician.After part two of medical school, students take the United States Medical Licensing Exam (USMLE) – Step 2 or the United States Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) – Level 2. The objective of these exams is to test whether or not students have developed the clinical knowledge and skills that they will need to transition into unsupervised medical practice.Internship / ResidencyAfter completing medical school, postgraduates begin a five- to seven- year radiological internship (year one of residency)/residency accredited by the Accreditation Council for Graduate Medical Education. During this time, radiology residents spend many hours, both day and night, in the hospital interpreting imaging studies, counseling patients on their results, consulting with other clinicians, and performing image-guided procedures and interventions.Fellowship (optional)A ‘fellow’ is a physician who elects to complete further training or a ‘fellowship’ in a specialty or subspecialty, after or near the end of residency.Some radiologists choose to focus their practice in one of the two areas of radiology: diagnostic radiology or interventional radiology (also known as ‘vascular and interventional’ radiology). Others opt for a dual diagnostic/interventional concentration.Diagnostic Radiology (DR)Diagnostic radiology allows health care professionals to see structures inside the body. Diagnostic radiologists specialize in the interpretation of these images, allowing them to diagnose the cause of symptoms, monitor how the body is responding to a treatment, and screen for different illnesses such as breast cancer, colon cancer, or heart disease.The most common types of diagnostic radiology exams include:• Computed tomography (CT)• Fluoroscopy• Magnetic resonance imaging (MRI)• Magnetic resonance angiography (MRA)• Mammography• Nuclear medicine, which includes such tests as bone scan, thyroid scan, and thallium cardiac stress test• X-rays• Positron emission topography (PET)• UltrasoundInterventional Radiology (IR)Once considered a subspecialty, interventional radiology is now a specialty with its own distinct residency program. Interventional radiologists use imaging techniques to help with medical procedures. The imaging guides doctors when inserting catheters, wires, and other small instruments into the body. The technology facilitates smaller incisions and allows doctors to diagnose or treat conditions in almost any part of the body without performing open surgery. It is used in treating cancers, tumors, blockages in the arteries and veins, fibroids in the uterus, back pain, liver problems, and kidney problems.These are examples of interventional radiology procedures:• Angiography, angioplasty, and stent placement• Embolization to control bleeding• Cancer treatments including tumor embolization• Tumor ablation with radiofrequency ablation, cryoablation, or microwave ablation• Vertebroplasty Kyphoplasty• Needle biopsies of different organs, such as the lungs and thyroid gland• Breast biopsy, guided either by stereotactic or ultrasound techniques• Uterine artery embolization• Feeding tube placement• Venous access catheter placementThe American Board of Radiology (ABR) lists the following as the primary radiology subspecialties. Although included in this list, vascular and interventional radiology – as noted above – has been elevated to ‘specialty’ level.• Hospice and Palliative Medicine• Neuroradiology• Nuclear Radiology• Pain Medicine• Pediatric Radiology• Vascular and Interventional RadiologyState LicensingAll physicians in the U.S. need to be state licensed. Licensing requirements may vary from state to state. Generally, candidates must have earned an undergraduate degree, graduated from medical school, completed a residency, and passed all necessary examinations. Often, the examination component is satisfied by passing the USMLE or the COMLEX-USA exam. States may further require periodic license renewal and mandate continuing education.Board Certification & Continuing EducationThough not mandatory, most employers seek certified candidates. Board certification is offered by the **American Board of Radiology (ABR)**. Passing Board examinations and earning ABR credentials establishes a radiologist’s commitment to excellence in the field and increases credibility and marketability in the medical community.Additional Resources• American Association for Women Radiologists• American College of Radiology• American College of Nuclear Medicine• American College of Nuclear PhysiciansDue to the complexity and the demands of radiology, as well as to the ongoing advances made in the field, radiologists undergo training and learn throughout their career. This continuing education takes place at annual meetings and conferences; through research; and via study of scientific journals.Consider the cost of all these steps…Now does the salary seem so large?Finally, when CT, ultrasound, and later MRI appeared, all of a sudden the radiologist was able to provide unprecedented information with each study, to the point where certain time-consuming and invasive (i.e. risky) x-ray procedures are no longer performed, and certain surgeries are either not done or done much less frequently.This shifted a lot of expenditure to radiology, because the Radiologist could provide answers which were much more accurate - and provide them faster, safer, and yes, cheaper. Everyone talks about the proliferation of CT scans and the associated costs, but few people also point out that "unnecessary" surgery has become much less common as a result. Avoiding a major surgical procedure can pay for quite a few CT scans; shorter hospital stays, made possible by faster diagnosis and treatment, also save a lot of money, but the connection between those savings and "costly" CT scans is often overlooked. The Emergency Room physician routinely relies on CT for rapid diagnosis and treatment, and oncology relies on CT (and MRI and PET) to assess whether they should stick with the current treatment or try something else.So you have an additive effect. Radiologists get paid for each procedure, but a whole lot more procedures are being done, and the most clinically valuable ones (like CT) are among the most expensive.Additionally, the profession has also decreased "turn-around time" - how long it takes to get one study done and the next one started - which benefits the patients because the Radiologists are better able to keep up with demand, but also has the consequence of bringing in a lot more revenue.

Here's an interview with Jane Chin (陳盈錦). She discusses her journey in helping STEM career professionals. She addresses issues of gender, race and finding ways to reinvent yourself.What does it mean to be smart? From Socrates to Howard Gardner there are thousands who have addressed this topic. The wise words that follow come from Jane Chin, an expert not just on being smart, but on the ways smart differs, changes, and applies not just to our work but also to our lives. She not only has published books which address ways people need to learn certain ‘smart’ skills but she has been a keynote speaker who has given advice to some of what many of us might think are the smartest people on the planet.For those who want to learn from her personal journey while at the same time learning how to apply her “talent compass” to education and jobs I think you will be schooled to think differently and more effectively than you were before you read her words. I count myself lucky to be able to say I have learned from her to approach ‘smarts’ in ways that will help me.***********************************************************************First of all can you give us a little bit of historical background? Where did you grow up, perhaps could you add a bit about your family too?My childhood spanned 3 continents: Far East (Taiwan), where I was born and went through 2 years of elementary education; Middle East (Saudi Arabia), where I went to the British section of Saudi Arabian International Schools; the West, where I came to the U.S. as a first generation immigrant for middle school through secondary and post-secondary education.What were you like growing up? How did you like high school and how did you decide where to go to university and what to study?I was extremely compliant and obedient growing up; a tiger mother's dream, you might say. Then I turned 13 and rebelliousness switched on. My parents moved a few times, I went to a different high school each year. I left home as part of that rebellious phase. High school was a very difficult time. But no matter what was happening in my life, school was one constant I could rely on.As college applications approached, I faced unfavorable odds. My high school record was inconsistent because of frequent moves and personal problems. I enjoyed my sophomore biology class at high school #2 and logically chose to study biological sciences. I was "pre-med" as I thought I was expected to become a doctor. Ironic that I rebelled against authority yet I have internalized the expectations that programmed my decisions.The guidance counselor at high school #4 knew about my personal problems and my spotty academic record. He explicitly discouraged me from applying to Cornell. I did not disagree with him, but I applied anyway. I knew he was only trying to help me make good use of what little funds I had to apply for college.The first acceptance letter came from a small liberal arts college in Pennsylvania that offered scholarship assistance. I will be forever grateful to that school for accepting me and renewing my confidence about the future.Then I received the acceptance letter from Cornell. The admissions committee may have seen through my tumultuous high school career, and believed I had either grit or gut to survive Cornell's hyper-competitive academic environment. Once I got over the shock of getting into my dream school, I was very happy.Looking back on your university education are there things you would change and if so what are they and why?I wished I had sought help for (un-diagnosed severe) depression, and that I had learned about Cornell's Tae Kwon Do club earlier. I'd written a creative nonfiction essay called "Martial Art of Life: Way of Foot and Fist" (http://www.janechin.com/martial-...) that described how depression and learning tae kwon do shaped my experience at Cornell. If I'd learned about depression symptoms sooner and gotten help, I could have had a deeper, richer experience at Cornell. I would have opted out of the pre-med track sooner. I'd have taken more writing and communication classes. I would have spent more time exploring the beautiful campus beyond rushing from one class to the next. I would have enjoyed Cornell much more.Your by line on your profile on the website Quora.com is that you “eat tiger moms for lunch”. Aside from demonstrating your sense of humor why did you choose to highlight this on your profile? Do you think Asian moms are stereotyped because of Amy Chua’s Book "Battle Hymn of the Tiger Mother"? What would you say to Ms. Chua is you had a chance to chat with her?"Eating tiger mothers for lunch" is my stance against forced compliance and emotional manipulation on children. I have grown up in dens of tiger mothers. Even though my rebellious side overrode my compliant side, I experienced enormous emotional suffering, and in the process have also inflicted suffering on my parents. Our household was strictly authoritarian and shame-based, there were no bedside mother-daughter snuggles or hugs and "I Love You"'s. I don't believe Chua's portrayal of her motherhood experience claimed to represent Chinese mothers in general but the media made blanket statements for shock value. Nevertheless, the book opened up crucial conversations we parents must have about how we exert will and power on children, and at what personal costs are we willing to pay to gain the highest levels of performance from children.Does it surprise you that Asians face greater challenges than anyone else? Does it bother you at all that there seems to be discrimination (I think this is the correct word) against Asians because they are “over-represented’?No, it does not surprise me. When I was young, my mother constantly reminded us that because we were Asian, we needed to work "3 times as hard to get the same result" (as a Caucasian person). What bothers me about this so-called Asian representation is the myth that somehow Asians garner top performance as if equipped with higher IQs. What we see is a logical outcome of a culture that exalts education as the highest virtue. We revere education, and so we consistently invest hard work and effort in education.I am concerned that as colleges and universities increase "diversity", Asians are excluded as a minority, and instead assigned the questionable status as "the model minority". I look at my elementary school-aged child and I wonder how much tougher it will be for him to compete for college admission because we aren't "the target minority" in the admissions market. The broader societal impact of this "model minority" myth is that we ignore Asian Americans who right now live in poverty and are disadvantaged but are not afforded the same opportunities through affirmative action.Do you feel that in your own career you have been held back in any way either because of your background or gender?I have been fortunate to have mentors who recognized my ability to contribute. Gender did not frame my career experiences, but I tend to focus on the "cause or mission" versus "a gender equality issue". I tend to look through obstacles to find what opportunities or paths I may not have considered.On the other hand, there have been times when my doctorate degree was a real obstacle, because I was relegated to the "overqualified but under-experienced" group; men and women PhD holders experience this obstacle when competing in non-academic job markets.Another recent piece that came out in the NY Times recently showed that women are drawn to specific areas of engineering but do not respond in large numbers to outreach that is specifically targeted to women. Any comments about this?I can only speak for myself: I'm interested in the problem, the mission, or the specific contribution versus "women-targeted" efforts. What may need checking are pervasive subtle forms of discrimination, like "You code well.... for a girl" or making fundamental attribution errors where you assign gender for a behavior (like "Calm down and be a man!" suggesting that only women get to be emotional) versus looking at the situation that has caused a behavior.One of your Quora answers that addressed the way students should approach developing a passion was so good that I asked you if I could post it on my blog and you kindly agreed. There were a few comments on LinkedIn about your advice. Do you think you would now add any more qualities that student should develop to prepare for future success?I'd suggest students cultivate longer-horizon thinking. Their decision-making may change if they start looking at the bigger (longer) picture and consider their lives unfolding 10-20 years hence. Today's young people face more pressure than ever. You lose perspective when you put all possible trajectories of your life into one single event, like getting into THE dream school or landing THE dream job.Life does not unfold as crisp lines and clean parabolas. Life is a messy spaghetti diagram. You may veer off track or fall or fail, and it will not be the end of the world even if it feels that way sometimes. Failures can push you on a path you did not consider and that path may turn out to be a fulfilling one, or offer new lessons and skills to better prepare you for the journey.I often tell students, if my life unfolded exactly as I'd originally planned, I'd probably be wearing a white lab coat, working in the basement of a research institution, hating my life. Thank goodness for all the ways I have failed, and fell into the work(s) and life I have now.Jane taking on the climbing wallOne of my favorite answers you have posted on Quora has to do with what you do now as a featured motivational speaker. Before I ask anything specific about this could you talk a bit about what you do and how you reached these heights?I am invited to give career seminars or keynotes to predominantly STEM audience, because I have had many "alternative" careers as a PhD. I say that my job is a pie-chart: I speak, I write, I teach, I advise, I parent. I've been an employee, a contractor, a hands-on consultant, a "behind-the-scenes" advisor. I can speak from a wealth of first-person experiences, as opposed to an observer speaking "about" a topic.I have heard from a number of executives in STEM fields say a version of the following: “Anyone graduating from college these days without knowing coding is functionally illiterate. Schools should let students take coding instead of a regular foreign language. It is much better skill to have and most who study foreign language in high school don’t become close to fluent?” How would you respond?Then I need to disclose that I am functionally illiterate. Coding may be a foreign language, but why view foreign language only through pragmatic lens? Languages serve a function and transcend function to embody history, culture, and consciousness of a civilization.My native tongue was Mandarin Chinese and now I dream in American English. I have read classical Chinese poetry that cannot be perfectly translated to English because the rhythm, structure, and sound of the original language are lost in translation. A language's sound, rhythm, and structure collectively "make" poetry, not just the meaning in its words. Thus I advocate for learning languages as much for personal enrichment as pragmatism -- this goes for coding too.Do you think students in high school and college should be taking MOOCs? What do you think of them? And what about people who are now in careers? Should they be supplementing their education too?I have taken several MOOCs and have enjoyed the few classes I had completed. I think MOOCs are useful for students to review or broaden their horizons about a subject. Career professionals can use MOOCs as a resource for continuing education. MOOCs introduce newer technology and massive scale, but online learning has been around for longer than MOOCs. I don't see MOOCs "replacing" brick and mortar institutions for the time being. I'd like to see disruption in the pricing (return on investment or value) of higher education in the United States, but I doubt MOOCs can achieve this for the time being.Can you share a few of the things you make sure to say to groups like this? Have you seen an increase in the past few years in these stars questioning what it is they really want to do with their lives? If yes why do you think this is?My focus has been PhDs because I went through the same struggles as a PhD professional. There are fewer academic positions available today relative to the number of new PhD graduates. By necessity PhDs have to look outside academia. PhD professionals may look at subject matter expertise and overlook transferable skills they have acquired in the process of earning their doctorates. I urge all STEM professionals to identify specific skills that can apply in non-research contexts.Some stigmas remain toward those who work outside the ivory towers, such as accusing us of "going over to the dark side" or labeling us as "lesser" scientists. Many of us want to use our degrees in practical ways; some of us prefer to communicate science beyond publishing in journals or presenting at scientific meetings. If we want to talk about dark sides, I believe there is a version of Sayre's Law that states, "Competition in academia is so vicious because the stakes are so small." In many ways, industry is forced to be more transparent about hiring practices, equal opportunity measures, and labor laws, because regulators are watching.Another message I give is the "long horizon" thinking I mentioned previously. Life is messy and we cannot always expect to map out our careers the way we map out directions to a restaurant. Instead, learn what our strengths and talents are (I use the term "Talent Compass") and how to use these strengths, so that no matter what terrain we face, we can navigate our way through.How important do you think it is that people need to have a presence on LinkedIn? You have founded an active group for STEM leaders that has been successful in raising important issues. Many in leadership positions think everyone from students to senior executives should have, at the very least a profile. Some are now saying this is the way student might get selected to colleges. Do you agree?If you are looking for a job, then you need to have a presence where potential employers gather. If you know that hiring managers are on LinkedIn, then you want to be visible to them, or at least searchable. Now that LinkedIn allows you to share multimedia files and volunteer activities and projects, the service may be useful to both students and executives alike.What do you like most about what you do and what do least like?What I like the most and least is the same: the variety in what I do means I cannot answer "What do you do?" in 15 seconds. This freedom is at once intoxicating and infuriating. I like it this way."***********************************************************************Given the push and rush of what happens to us daily, developing a “long horizon” on a career and life often gets lost. Jane’s words demonstrate that the paths we take seldom follow a straight line no matter how hard parents push or how we plan. Stuff happens over which we have control and there are things that come our way, be it depression or some sort of tragedy that will effect us. And change us, perhaps over the long term in ways that might actually help.Jane gives great advice not just to STEM leaders, but to all of us. One thing she embodies rather than talks about is "grit", something another smart person,Angela Lee Duckworth, has emphasized as a quality that we should all try to add to our mental toolkit. Jane has overcome challenges to become a leader in her field but it came through a willingness to being open to new things and new directions. She is a risk-taker, not just because she climbs literal walls, but because she climbs past the limitations some have about the value of working for companies instead of universities and past some of her own self doubts. Her honesty in sharing her story is inspiring in personal and professional ways.

Dear Mike, this article answers your question completely.Bipolar Disorder & Genetics: Passed Down Through The Family TreeBY Sara SolovitchGeneration to generation, family members observe and reflect on patterns of bipolar.For some families, bipolar disorder runs through the generations as invariably as freckles or cleft chins appear in other family trees. Even so, looking for your family’s source of bipolar disorder can be a little like searching for the headwaters of the Nile. You start backtracking through the generations and suddenly realize that the quirky behavior you once brushed aside as your grandmother’s eccentricity was really a signpost.If only you had recognized her outlandishness or rage for what it was—the genetic source of your own bipolar disorder. You might have been more tolerant of her. Perhaps you wouldn’t have distanced yourself so much. At the very least, you might have asked some questions.Unfortunately, many people never think to connect the dots in their family’s history of wellness until the day a family member is diagnosed with bipolar. Suddenly, it hits like a ton of bricks—everything falls into place. As one mother describes it, it wasn’t until her son was diagnosed that she recognized her own illness. “Oh my gosh, that’s what’s the matter with me!”This experience was related in one way or another by several individuals interviewed for this story. Jolted by the diagnosis of a child or a grandchild, an older family member may reluctantly acknowledge the symptoms as his or her own. Sometimes, it comes as a bolt of self-recognition; other times, it’s a case of reluctant consent, a muttered admission, “Yes, that’s me.”Scientists don’t know how many or which genes are involved in bipolar. But there is no way at pre- sent to determine whether someone will inherit the disorder. Nevertheless, according to a study published in the March 2009 issue of Archives of General Psychiatry, having family members with bipolar disorder is the best predictor of whether an individual will go on to develop the illness. (See sidebar below.)Here, we relate the stories of three families: one in Ohio, one in California, the third in Quebec and Alberta. Though each is unique, the similarities among them are often striking. In each case, the individuals interviewed, whose real names have not been used in this story, have begun to unravel their bipolar family tree. They are looking for the genetic source and observing patterns from one generation to the next.In the Canadian family, a young man shares an unhealthy obsession with military history with a grandfather he’s never met. In California, the son doesn’t have much insight into his own illness, but he’s great at giving advice. “Just like his grandfather,” his mother wearily observes. “And he likes to talk, talk, talk—just like my dad.”Several of the people who spoke with bp Magazine lamented that their brothers and sisters were unwilling to acknowledge the illness that seems to run between the generations. Buck up! they say. Meanwhile, some members of the next generation—now in their 20s and 30s—are self-medicating with alcohol and drugs.At the same time, the parents whose children have not been diagnosed watch guardedly, looking for any behavior that may signify bipolar.When Emma of San Diego scrutinizes her family tree for bipolar disorder, she traces it back to her paternal grandfather—a charismatic fellow who could never hold down a job. Even during the Depression, when jobs were scarce, he repeatedly quit his in a huff, only to let his wife, Emma’s grandmother, beg the boss to take him back.But it was Emma’s father, Larry, whom she considers the real link. A brilliant man with a long line of academic degrees following his name, Larry insisted on giving his wife an IQ test before he would take her out on a date.Just like his own father, Larry had trouble holding on to a job. He did, however, keep his kids in check through a combination of fear and play: “The way he played with us was very manic, tickling and chasing, or locking us out of the house ’til someone got hurt,” Emma recalls.Once, when she was 5 years old, he donned a bug-eyed gas mask from World War I and hid himself in the hallway. When she walked by unsuspecting, he leaped out and roared at her. Her terror made him laugh—that was his idea of fun.Larry was a man of passions. He grew dozens of epiphyllums (cacti that put out an annual flower) in each room of the house and took thousands of photographs of them. He had 10 fish tanks and stayed up until the wee hours of the morning, feeding them.Whenever he was home, Emma went on high-alert. He could lose his temper without warning, screaming, throwing objects, tossing his kids across the room. Like the time her brother, who was about 8 years old, received a letter from a foreign country and ripped the stamp in opening it. Her father was enraged and showed it. Why? “Because he was a stamp collector.” She pauses. “And a gun collector. And a camera collector. And a coin collector.”Many years later, when Emma’s son, Patrick, was diagnosed with bipolar disorder at age 13, her father—who had consistently refused to see a psychologist or psychiatrist —read over the list of symptoms and nodded. “Yeah, that’s me,” he said.Patrick had been an unhappy child from the start. “When he was two weeks old, he started screaming and turning purple ’til he vomited,” Emma says. His parents got a brief reprieve the year he signed up for Little League, when all his obsessive energies went into making sure his baseball uniform looked just right.A couple years later, the stresses start-ed piling up again, and when Patrick was 11, Emma’s psychiatrist diagnosed him, sight unseen, with panic disorder. “He knew the history,” she says in the doctor’s defense. “I saw him for 10 years and he was a wonderful man, but not the best psychiatrist.”For a while, a common antidepressant seemed to help. But then the boy couldn’t sleep, prompting the psychiatrist to prescribe a sedative.“And that sent him over the edge,” says Emma. “So here I had a child who was just unable to function. He just lay on the floor of his room, asking ‘What’s the matter with me, mom?’”Emma says she feels neither guilty nor responsible for bequeathing the “bipolar gene” to her son.After the difficult high school years—during which he was diagnosed—Patrick quit school at 18, discovered cocaine, and began stealing. “He just went completely over the edge with cocaine and meth and alcohol,” says Emma. “We finally got him into a treatment program in 2007 after he had two drug possession charges.”Although Patrick was the first in the family diagnosed with bipolar disorder, Emma was the first to be diagnosed with a mental illness. Twenty years ago, she learned she had anxiety disorder.In the past year, her younger sister, like Patrick, has been diagnosed with bipolar. “My sister really struggles,” Emma says. “She has four grown children and two of them are diagnosed with bipolar and are on and off their meds.”Emma says she feels neither guilty nor responsible for bequeathing the “bipolar gene” to her son.“I’m sure there was a point I felt guilty but that’s long past,” she says. “When he was diagnosed we did a lot to educate ourselves. We got on the Internet, we read a lot of books, and we took a Family-to-Family course through NAMI.”It has been a unique education, Emma says—one that has brought her tremendous rewards. Most recently, she and her husband underwent training to become teachers in the 12-week course for family caregivers. Today, they work with families in the San Diego area, teaching them about the disorder, offering strategies on how to cope, and providing techniques for problem solving and communication.“If I can’t help my son, at least I can help someone else,” she says.For years, Karen of Ohio, regarded her grandmother as just plain mean. The old woman was shunned within her family for making unreasonable demands and refusing to talk to one or more of her children for weeks at a time. Once, she even declined to break a self-imposed speech ban long enough to wish her teenage daughter a happy birthday. She refused to seek medical help, insisting that a doctor would make her “go crazy.”Karen’s mother was also abusive. “I was petrified of her,” says Karen, recalling a childhood being chased around the house with rubber spatulas, belts, and wooden spoons. “You could just watch the mood swings.” Up and down. When she was up, her mother went on “super duper spending sprees.” When she was down, everyone steered clear.In 1988, her mother was diagnosed with bipolar. Thirteen years later, Karen’s son, then 8 years old, received the same diagnosis. A few years later, it was Karen’s turn.Then, in 1995, Karen’s sister was diagnosed with depression, as was Karen’s then-9-year-old daughter in 2006 and a niece in 2009. “It’s obviously a family affair,” she says.These days, Karen works four days a week at her job as a customer support specialist. She reserves the fifth day for doctors’ appointments—for herself, her son, and her daughter. She also attends counseling sessions with her mother and is working on anger management.“Unfortunately, I see a lot of my mother in me,” she says. “I think her anger comes from the way she was raised…. A lot of what I’m angry about is having to pass it on to my son.”Karen has wrestled with depression ever since she was a teenager. When she gets manic, she can be just like her mother. She goes on frenzied shopping sprees, sometimes plunking down $10,000 in a single afternoon. She has already pushed her family into bankruptcy and they’re close to it again.“All the credit cards are maxed out,” she says tautly. “My daughter and I just went on a three-day cruise to Mexico. Everything was paid for, and I ended up spending another $1,000 in Ensenada. The worst thing is, I can’t even remember what I bought.”Karen suddenly recognized the… symptoms as her own: Like, oh my gosh! That’s what’s the matter with me.The biggest challenge, however, has been her son, Nate. He was a difficult child from birth, crying almost nonstop, sleeping little, and demanding such constant attention that for the first two years Karen and her husband traded off nights sitting up with him.At age 4, he told his parents that he was unhappy to be alive, an announcement that sent them in a tailspin searching for counseling. One psychiatrist told them that Nate wasn’t getting adequate stimulation; another informed them that they were failing his basic needs. Eventually, the family doctor observed the boy’s tics and referred the family to a psychiatrist at Ohio State University, where Nate was soon diagnosed with bipolar.It was there, while attending an educational program for families of bipolar patients, that Karen suddenly recognized the criteria of symptoms as her own: “Like, oh my gosh! That’s what’s the matter with me.”Now 16 and a high school sophomore, Nate regularly sees four separate therapists and doctors and is on nine different medications. He has been hospitalized nine times—the first time for throwing a chair at his schoolteacher. He has been placed in foster care following a violent outbreak against his sister and mother. He has been committed to an inpatient treatment center for five months, and placed in a behavioral program on a ranch in Idaho for seven weeks that cost his parents $25,000—an expense that Karen says, “We’ll be paying for the rest of our lives.” For now, he’s living at home.“Even though I know it’s not my fault, I still blame myself for giving it to him,” says Karen. “The one good thing is it’s something that the two of us can joke about. Because we know what’s going on in our heads. And no one else can understand it.”Rebecca grew up just outside Moncton in New Brunswick, on a large property surrounded by orchards and maple trees for tapping, berry-picking, and a river over- flowing with trout. The way Rebecca remembers it, it was an idyllic childhood—that is, until the time she turned 14 and her father lost his job. Then began his fast descent into alcoholism, during which time the family farm was transformed into a “kind of World War II barracks,” complete with guns, dogs, and a copy of Mein Kampf.“His depressions hung over the house and the house lost all its joy and light,” she says.Rebecca, who was diagnosed with bipolar disorder at 24 (she is now 59), lives in Montreal on a limited budget. She has never worked, although she holds two university degrees, one in education, the other in translation.Teaching is out of the question, since school buildings are far too stressful and stimulating environments: “Too many lights, too much noise,” she says, ruling them out. And though she is a talented French-English translator, she can’t endure the pressure of deadlines.Instead, she manages to live within the limitations of a modest disability pension and considers herself an excellent money manager.Although her family is prominent and successful, many of its members—from the Maritimes to the prairies—have variously struggled with mental illness. During one hospitalization in Nova Scotia, Rebecca recalls, she ran into a second cousin who also happened to be a patient. She counts off cousins, nieces, and nephews across Canada—all of whom have been diagnosed with bipolar, depression, or anxiety.One of them is her brother’s son, a bright, 28-year-old history student named Matthew, who lives with his mother, Meg —Rebecca’s former sister-in-law—about a hundred miles outside Calgary, on the other side of the country. Meg, long divorced, reached out to her former husband’s family–and specifically Rebecca —after Matthew’s first psychotic episode five years ago.Matthew had borrowed her car and when it broke down on a country road he jogged for a few miles, arriving at a stranger’s property during a bonfire party in the middle of the night. The partygoers grew queasy after Matthew started bragging that he had a brother in Al Qaeda. Someone called the Royal Canadian Mounted Police (RCMP); a couple hours later a helicopter was circling overhead.“I got a phone call around midnight that he was at a party somewhere,” recalls Meg. “I picked him up right before the RCMP arrived.”After two days of his waking her every half hour, jabbering nonstop, and refusing to eat, Meg knew that she had to get him to a hospital. So she called Matthew’s aunt by marriage, Rebecca, a woman she hadn’t seen or talked to in more than 20 years. Meg could not forget the first time they met, when Rebecca came to visit the family at their cabin in the woods. She remembered Rebecca’s bizarre behavior during the visit, writing over Meg’s sketches with her poetry, feeding her psychiatric medication to the houseplants in order to kill them, and generally impressing her new sister-in-law as someone who was larger than life—beautiful, talented, and “off the wall,” as Meg puts it.Still, it never occurred to Meg at that time that her sister-in-law’s illness held any special significance down the road.After Matthew was diagnosed with bipolar, however, she began thinking about the family’s genetic history. She and Rebecca renewed their acquaintance and began steeping themselves in the language and literature of bipolar disorder.Today, Meg sees her son as someone who will probably struggle all his life to balance mania and depression. Like his paternal grandfather, he has an obsession with military thoughts. Also like his grandfather, he has a predilection for alcohol and drugs.Moreover, Meg has known her son to fantasize about being Attila the Hun. After a motorcycle tour of France’s war-time bunkers, he visited the University of Calgary’s library and told people that he had a bomb. The police were called and he was hospitalized.Mostly, his mother is concerned for his safety. She hopes that he will be able to complete his university studies, but she also hopes that he will find some peace of mind—like his Aunt Rebecca who, after 25 years of struggle, knows enough to appreciate the good days when they come.“I’m so grateful each morning when I get up and my mind is in order,” says Rebecca. “Whether I feel a mania coming on or a psychosis, I don’t care anymore —as long as I can put my two feet on the ground.”Meg isn’t quite as sanguine. The newly acquired knowledge has left her with worries that she never would have considered previously. Mostly, they have to do with her daughter, a healthy, happy 33-year-old, who last year married a wonderful young man. It was a happy wedding and Meg thinks the world of her new son-in-law.There’s just one problem—his mother has bipolar disorder.“I’m not going to be the one to say, ‘Oh my God, have you looked at the gene pool?’ Hopefully, they’re thinking about it. But life’s a crapshoot. I look at it and I think, hmm, that ups the odds.”* * * * *Understanding the family tiesBipolar disorder is a complex condition involving untold genes, and family history does not necessarily mean a person will inherit the illness. But it does play a strong role. According to NARSAD (the previously named National Alliance for Research on Schizophrenia and Depression), children of one parent with bipolar carry a 15 percent to 30 percent risk of themselves developing the illness. Those with two parents with bipolar have a 50 percent to 75 percent risk of getting it.“Bipolar disorder is one of the most clearly heritable disorders there is,” says Samuel H. Barondes, MD, director of the Center for Neurobiology and Psychiatry at the University of California, San Francisco. “The evidence is absolutely overwhelming, and there is not much evidence that nurture has any influence at all.”Although the genetic component is undeniable, the relationship is far from straightforward, he continues. There are an untold number of genes responsible for bipolar disorder, many of them overlapping with schizophrenia.Roger McIntyre, MD and associate professor of psychiatry and pharmacology at the University of Toronto says this about the genetic component: “Most individuals who have bipolar disorder can identify someone else in their family who also has a psychiatric disorder. As a point of fact, the other psychiatric disorder is not always bipolar disorder,” he says. “Major Depression, anxiety disorders, substance abuse disorders and ADHD are more commonly encountered than is bipolar. People need to think not only about bipolar, but other conditions as well.”“Let’s say your wife is bipolar and you worry that your child is acting a little weird,” Barondes says. “I would say don’t. Just chill. Although the risk is greater, the odds are still that your kid is not going to get it.”Still, it’s enough to make you wonder.* * * * *Printed as “Unraveling the Family Tree”, Spring 2010ABOUT THE AUTHORSara SolovitchCanadian-born Sara Solovitch is a freelance writer based in Santa Cruz, California.