Interview with Belgian psychiatrist Dirk de Wachter

Dutch political, societal debate program Buitenhof, 18 December 2022. Interviewer: Pieter Jan Hagens

Pieter Jan Hagens introduces Dirk De Wachter to the viewer: “The well-known Flemish psychiatrist Dirk De Wachter helped hundreds of patients and also countless readers with his books. But how does a psychiatrist himself find solace when disaster strikes.” 

Pieter Jan Hagens addresses Dirk De Wachter: “A warm welcome. Nice to have you here. You were diagnosed with metastatic cancer in the summer of 2021 and then you wrote this book “Consolations”. How are you doing now?”

Dirk De Wachter (laughing): “Yes, that’s the classic question. I usually answer quoting, from Gerard Reve’s book “De Avonden”. At one point, when asked how things are going, Frits van Egters says: “Things are bad, but otherwise things are going well.” That’s a nice summary isn’t it? Of course, my situation is not so rosy, but actually my life is good. I have a […] very strange to say hear […] I have actually had a happy year despite all the misery. That’s weird isn’t it? So I write about that too. How that a person can still do well in the face of death, with the inconveniences.” 

Pieter Jan Hagens: “I would like to talk to you about it. Before we do, let’s go back to the day you noticed something was thoroughly wrong. You also write about that. You found out at the Centre Pompidou in Paris, a city you love dearly. Can you talk a bit about that moment?”

Dirk De Wachter: “Yes, I am often and gladly in Paris. I write that too. So it’s also a bit paradoxical that I have to discover such awkwardness precisely in that beautiful place. Anyway, I was at the Centre Pompidou museum. I was looking at a nice number of artworks. Suddenly I got a really bad pain in my stomach. I had to go to the toilet and I saw a whole bloody condition. That was actually very unsettling. Now, I am a doctor and my wife is also a doctor. So we kind of knew, “This is not good.” Then we immediately contacted the doctors we know well in Flanders to make an appointment. Then the ball started rolling. Within weeks, I knew that this was indeed a colon carcinoma with distant metastases. So in terms of prognosis, that’s not very good. Anyway, it is what it is.”

Pieter Jan Hagens: “A big blow at that time?”

Dirk De Wachter: “Yes, of course it was. But one doesn’t know in advance how one will deal with that. That all went rather reasonably well. I was able to stay relatively calm in that. I did what had to be done. I followed my handlers well.”

Pieter Jan Hagens: “What happens then is that you, the doctor, the psychiatrist, becomes the patient.”

Dirk De Wachter: “That’s how it is. Indeed, that’s how it goes in life. There are so many people going through it. Surely I want to stress that a lot, that what I write is a very individual story but what I hope is that it can mean something to the many people who go through this…. Sometimes a little less bad, but often much worse, right? I am still alive. I’m living well. I still possess my sanity, hopefully, which is very important to me. I would rather dispose of my mind than the feeling in my legs. Yes, because I don’t have that.”

Pieter Jan Hagens: “You write about your time in hospital. That is actually hell. But at the same time, you also meet people there, or people appear at your bedside who also offer comfort.”

Dirk De Wachter: “Certainly, that is the basic premise of the book. The greatest comfort comes from fellow human beings. From a person’s contact. Especially in difficult times. I used to write a lot about that, from my profession, about all those things. And now I have indeed experienced that myself, experienced it first-hand. Really. In person. I mean it literally. The human touching you. The skin contact. Pursuing the caress, I call it, is truly life-giving. It’s like that.”

Pieter Jan Hagens: “Even after it became known in the media. You announced that yourself., the comfort actually came in by mail loads.”

Dirk De Wachter (laughing): “Yes, it’s very crazy actually. Such a semi-familiarity I have. I’m not a footballer, of course. But still a bit famous in my profession. That does indeed make for a lot of reactions from people who then say; `doctor, you don’t know me, but I do know you a bit, and I wish you well. From all over the world. That was very special. I was able to enjoy a bit of the benefit of that status. Anyway, that’s all well and good. Of course, the most important thing was my small circle of loved ones, my wife, my children, my close friends. Those are there then aren’t they? That is so essential. Knowing that there are people who don’t have that. In the same way, I have also received reactions from people who reported, “I am sitting here alone. I am dying and there is no one.” That’s hell, I think.” 

Pieter Jan Hagens: “At the same time. You write that the chance of you being alive in four years is 40 per cent. How do you deal with that knowledge?”

Dirk De Wachter: “That’s a frightening figure. I am a doctor. My wife is a doctor, so we know what that means. Of course, that is an epidemiological figure that cannot be substantiated individually. We will see. I am going full steam ahead with the 40 per cent. I will be sitting here again in a few years’ time to talk about yet more new books. One must also keep courage, and look ahead. Anyway. From another side, I have my feet on the ground and know, “this is also precarious. This is a reality. So we also have some issues, such as financial issues, also a little bit ahead. That is so, yes.”

Pieter Jan Hagens: “What you also write is that it is very important to you that you have helped so many people, as a psychiatrist.”

Dirk De Wachter: “Yes, that is for me, my profession, my vocation, my mission. For me, it is crucial in life to be meaningful to others. I write a lot about that. It’s not the fun and happiness that gives meaning to life, but being there for someone. And now, in this misery […] I haven’t worked for a while […] I’m working again, as best I can. But that through those interviews, and through that book, I also hope that I can still be meaningful to people. Apparently, the testimony of such a person who then says how things are going is recognisable and comforting for many people. The special thing is, the comforting thing, my comfort is, to be able to comfort those people. So it’s double, actually. It gives me great pleasure that I get lots of messages from people who say, yes, I went through that too, or my partner, or my child, my parents. So many stories. People who write, I recognise myself in that and thank you for the words. While they are very ordinary words. It is my individual story, which is also a bit […] yes, I don’t know if that everyone has a story about art and about philosophy and about music and all those things. Maybe some people say, I don’t like Bach much at all, I listen to the city bather, or whatever, or other figures. Or, I don’t watch Francis Bacon’s art but I’d rather watch football. That’s ok too, of course isn’t it? That’s ok too.”

Pieter Jan Hagens: “Is it that your powers of observation, to be able to appreciate beautiful things as well, that maybe that becomes greater the moment you experience something like that?”

Dirk De Wachter: “I haven’t changed. I didn’t know that beforehand. But I see that now. Nothing has changed. Nothing substantial in my life. For many people say in the face of death, “Now I see what is important.” Well, very haughtily I dare say, I already knew what is important. I still have the same ideas about life and death. I still have the same wife, the same house, the same children, the same profession, and I still like it all.”

Pieter Jan Hagens: “Nothing has changed?”

Dirk De Wachter: “Nothing substantial. I did experience something very bad. But my opinions on life are the same. I don’t have a bucket list. I don’t suddenly want to do this or this. I have been able to do a lot in this life. I am a very grateful person. Should it stop, I should be very grateful for all that has been so good. My children are also grown up and have their own lives. That is very nice. But I would still love to live. I also enjoy life to the fullest, very bulimic. Life is beautiful, actually.”

Pieter Jan Hagens: “You don’t need to do new things, no bucket list, you say. But you would like to go back to, I also liked what you described, to things you have been to before. To Paris, for example.”

Dirk De Wachter: “Yes,for example. That’s described in detail in the book, of course. Paris is the city where I like to come, where I also studied. I like to come back there. So, yes, precisely because a lot of people in my field also very often say, one has to stay in the now. A lot of meditative techniques even, are about the now. I can understand that. I also often refer people for mindfulness etc. But I myself also like to dwell in the beautiful past. Looking back in a grateful way at all that has been so good, I actually find pleasant. It’s weird.”

Pieter Jan Hagens: “Well, I don’t find that weird at all.”

Dirk De Wachter: “I have had a very good life, actually. I have been able to experience a lot of loveliness and still do. I like to dwell in that. Recently I looked in a photo album of my grandparents, from a long time ago. That did move me, to see. Look, these people have gone before me and have also made my path. I am a little bit in their lives. That is also my understanding of death. If I can tell you that?”

Pieter Jan Hagens: “Gladly!”

Dirk De Wachter: “I don’t actually believe, to the disappointment of very religious Christian people, I don’t believe that we go to Heaven and then see each other again there. I actually believe, not in a concrete way, but in a metaphysical way that we still meet each other here. That our parents and grandparents are good friends who have gone before us. That those who are dead are still among us, still defining us to some extent. I still dialogue with them. The curious thing is, in the hospital I had a hallucinatory experience where I experienced the same, where a good colleague, who died, came to see me. Of course, the anaesthesia and the misery had made me a bit confused all over, but that still says something about my conception of death. That we continue to live in the memory of the past for a bit. I like to cherish that, actually. In a manner of speaking, my mother is sitting here now, saying, “But boy, what are you saying?” She used to say that too. She keeps saying that. And my father also sits there but he remains silent and he smiles a little. He was a sweet man who was silent. So those people are still in me. And I actually hope too and I think so too, that I still…I hope to live for a long time. But I also hope, that when I’m no longer physically here in my children and in my little grandchildren, to still be there. To be of significance. That’s my wish, actually. That’s what I’m convinced of anyway.”

Pieter Jan Hagens: “At the same time the book “Consolations”, there are all kinds of things that comfort you. You write about that. It could be Bacon’s art. It could be the city of Paris. But you also write about Bach. The music of Bach.”

Dirk De Wachter (smiling): “”Not a day without Bach”, I always say.”

Pieter Jan Hagens: “There is one special performance. I would still like to show and hear that one here. Namely, a cantata by Bach, “Gottes Zeit wist die allerbeste Zeit”, played by an elderly couple. I may say, a very elderly couple. “”

Dirk De Wachter: “György and Márta Kurtág, who are both in their nineties in that excerpt. Márta, the lady, has since died. They play piano four-hands. A piano version of that cantata that he himself wrote so much. It’s incredibly haunting, I think, beautiful, loving and comforting”

Excerpt is shown => https://www.youtube.com/watch?v=Z8lTh58jhA8   

Pieter Jan Hagens: “Yes, this is actually what your book is about.”

Dirk De Wachter: “Absolutely. That’s beautifully said. It absolutely is. Yes, it’s better hey! There are some more of those videos. It’s really worth seeing that, how those two people intertwine too, that piano. Their hands going through each other. Very beautiful is that. That is loveliness itself.”

Pieter Jan Hagens: “There is one thing I mentioned that I would like to continue with you a little bit more. That is that you said, you are actually there for the other person. You talk in your book about the small good. Kindness as actually the most important thing you can do. You mention a philosopher in this. Emmanuel Levinas.”

Dirk De Wachter: “Yes, that’s the philosopher I refer to the most, even before, in my work yes.”

Pieter Jan Hagens: “Who actually says, you exist by the grace of the other, sort of?”

Dirk De Wachter: “No, much more. You exist in the gaze of the other. Look, I am here because you are speaking to me. Otherwise I wouldn’t be here. Then I might be here as a piece of meat, but not as a human being. So the humanity, the true existence arises because the other speaks to you. That is the essence of it. The essence of human existence, consists in caring, in responding to the need for care. Being able to assist someone in need. In a kind of mercy. To express that biblically. That’s what it’s really about. I have, really, I can only write and say that, of course. I have experienced that very much. A nurse coming to my bedside, as I lay there writhing in pain, to put it that way, grabbing me and saying of: “Come, we are going to give you something.” Very small things, small gestures that actually bring in humanity and in that sense are also fundamentally comforting in the gaze of the other and also the touch. La caresse, says Levinas. It is the philosopher I know best,” and in which I could now once again recognise and comfort myself very much in this whole state.

Pieter Jan Hagens: “The gaze of another and what you were just talking about, the deceased who are still in your life actually, still intertwined in your existence, those are of course also the others.”

Dirk De Wachter: “Yes indeed, who are also again comforting presence. The fact that one is surrounded, that one is not alone. I always paraphrase Sartre lol. “L’enfer c’est les autres” said Sartre in “Huis clos”. I say, no, l’enfer c’est le manque de l’autre. It is having no one, being alone. Hell is having no one. The fact that there is no one present in you in trouble. There is not even much need to speak. Being there, being there in an authentic way is, I think. Anyway, I don’t think so. I’ve experienced it that way myself. Actually, yes.”

Pieter Jan Hagens: “I hope that with a new book, at some point, healthy and well, you will be back here at the table. I am already looking forward to that.”

Dirk De Wachter: “With pleasure.”

Pieter Jan Hagens: “Thanks.”

Dirk De Wachter, nods in mutual agreement to Pieter jan Hagens.