Drive, he said

Psychiatry's view of schizophrenia has evolved since it was first described as an early form of dementia with a similarly grim prognosis, a Tufts doctor writes in today's New York Times.

Better treatments and a fuller understanding of its many forms have made remission and even recovery conceivable, Dr. Ronald Pies writes. But he was still nonplussed 20 years ago when a patient of his who was doing well asked him to sign off on a part of ordinary life.

"Hope is what Harry presented to me at his most recent appointment — along with a request that raised the hairs on the back of my neck. He wanted me to sign off on his application for a driver’s license," he writes. "Suddenly, I was caught between two conflicting visions: one of my patient obeying some malign voice behind the wheel, with who knows what consequences; and another of a young man yearning to get his life back."

They came up with a plan that chose hope over pessimism.

"After all, driving is what guys do — guys with a real life."