I have never read the letters sent to "Cary" but the headline on this one caught my attention. For me it is easy to relate to "Dad". Having been sick with a nasty prostate infection for several months eventually I was diagnosed with cancer and had surgery early this year. I had not been sick for years and even then never as badly as the period prior to surgery. Subsequent to surgery I found a nasty side effect, mood swings. Yes, I have been near tears and sometimes difficult to deal with but it is slowly moderating as the healing progresses.

Our family is one that laughs a lot and we all give each other a "hard time". This helps through the rough patches.

I think the whole thing is related to a realization of the fragility of, and a reconing with your life, accomplishments and the eventual finality. Someone said you need to find something beyond youself and focus on it to give your life meaning at times like "Dad" is going through. Some choose religion or hobbies, travel, gardening or volunteer work, something that gives a sense of accomplishment and for which you can see a positive result.

Our family laughs and we all give each other a "hard time". This helps through the rough patches, our family won't let me sink but they do it through laughter and a sort of contrary love. So my advice to your reader is to step up to the situation, it make take some sort of confrontation to snap Dad out of his deepening hole. If they don't Dad could slip into a decision that has very negative consequences.

I'm taking it that the Dad wasn't always like this before the operation.

Now he's the absolute bane of the family. All you really need to consider is this -

He wasn't this like before, and he's like this now. What was changed?

It sounds simple, but it's a very important question. It's the question I ask customers when they have a server down, and they can't fix it or figure out why. Again: *What's been changed*? In the IT world once you've got that figured out, half the battle is over, and you can thus take quick measures to fix the problem, either by reversing the change, or finding other ways to counter the change and restore everything back to the way it was - UP AND RUNNING, for the users.

Now this is a human being we're dealing with here, and a botched operation. Chances are, what's been done to him is permanent damage and thus irreversible. Sad to say, IMO there's really very little, if anything - you can do. You can't change him. You can only change yourself or the circumstances revolving around yourself. It sads heartless and selfish but if it's the only way to gain back your life, then you do what you must. Move away, distance yourself little by little, and get back to life.

Check with the pharmacist. They have a lot of drugs today for heart patients. SOme of those drugs have been linked to depression and personality change. It might be do to the meds.

Good luck LW.

Just a few ideas:

1) certainly for anybody who's had a life-threatening health event -- there may be physical aftereffects, or drugs they're taking, that impact mental health. So yeah, finding a qualified MD for mental-health advice is a good idea.

2) Nearly dying freaks most people out, and being chronically ill is depressing to almost everybody. So regular (non drugs) counseling / therapy might help.

3) it can be easy to fall into the "illness as identity" trap, where the illness is treated as the most important thing in that person's life.

For example, the person isn't held accountable to basic norms of polite behavior "because they're sick;" they get excused from all chores and household tasks; all conversations revolve around the illness -- talk about it, don't talk about it, don't upset the person, etc.

The only way to stop this, is for people to stop allowing the illness to be a trump card. Treat the person as normally as possible. Talk about the illness when necessary -- don't avoid it, and don't dwell or obsess on it. Don't let the illness dominate everyone's lives to the exclusion of everything else.

4) Many men have a hard time adjusting to a health crisis. It's humiliating to be a sick old dependent aging person, and it's doubly humiliating when you're used to being self-sufficient *and* you're a guy (masculine stereotypes around being strong etc.).

5) Finances. Even with insurance, this has gotta be expensive -- and the father may not be able to resume work again. So there may be a $$ crunch -- and Dad the traditional wage-earner can't fix it, cause he's the one that's ill. Money is a big stressor. Financial advisor for the family might help -- restructure their finances in light of recent events.

6) Letter says the father is late 50s. So he's had a debilitating health event relatively in life. That's a big issue. People often feel bitter -- "I worked so hard all these years, I had all these plans for the rest of my life, my retirement golden years -- and now I may die early, dammit." Again no easy solution -- maybe look for an early retirement planning group, they might have resources or counseling services.

With due respect to people who find the Bowen theory very relevant to this topic, I found it to be full of generalizations, and not much better than any self-help book that tells you how to fix yourself complete with generic examples.

Particularly all purpose self rising white flour was the family example used to illustrate the dynamics described.

Understanding the psychological reasons for one's problems neither ends the pain, nor cures the person having the famous AHA! moment about the past.

Great suggestions from readers on checking the dad's possibly altered biochemistry due to drugs given post surgery. Steroid psychosis is common and unsuspected.

It's not uncommon for open heart surgery to be followed by depression and memory loss. Some of it is due to the procedure (especially if a heart/lung machine was used) and some due to the meds, and some due to the fact that (especially if you're relatively young--such as in your 50's)you are faced with the fact, rather than an abstract theory, that you will die. You can get over most of it, but it takes time. It also can take treatment.

After I had unexpected open heart surgery when I was in my mid-fifties, I'm afraid I was a bit of a pain in the ass for several months. Fortunately, my family and friends were able to deal with me until I pulled through. I did keep my sense of humor though, which helped everyone.