It’s 6:09 p.m. on Nov. 3.
Somewhere amidst winding hallways, there are voices behind the door of Stanford’s Department of Psychiatry & Behavioral Sciences inside Dr. Matthew Kendra’s office.
Kendra, a clinical psychologist in Stanford’s addiction medicine clinic, currently specializes in individual and group psychotherapy for drug addiction. But long before that, Kendra’s path to his current career started in the humble phone room of a suicide watch hotline, where he and his friend would sit, waiting for the phone to ring. When it finally did, neither knew what to expect from the person on the line.
“It could be anything, it could be anybody,” Kendra said. “It could be someone who just wants to talk to you about their day. It could be someone who is seriously thinking about a suicide attempt.”
He first found himself interested in psychotherapy and mental illness when he was at Miami University in Ohio while working at a suicide watch hotline. He recalls the experience fondly, remembering how he always felt a sense of anticipation in the unpredictability of the job. He knew it was an experience that most people didn’t have, so sticking to a career along those lines made sense to him.
As for addiction medicine in particular, he stumbled upon it accidentally when he needed a job in graduate school. He ended up working in the Veterans Affairs (VA) with veterans that had serious mental illnesses like schizophrenia. He found that many of them had drug related addictions and used various addictive substances, particularly tobacco. It was there that he was first exposed to the link between mental illnesses and substance abuse.
After graduating and getting his Ph.D., he moved to Stanford for his post-doctoral fellowship, where he worked in a clinic with Dr. Anna Lembke, the director of the Stanford Addiction Medicine Clinic, for a year. He’s been working at Stanford for about three years and recently, just received funding from the Stanford Cancer Center to develop a Smoking Cessation Program to help individuals stop smoking.
“Even in [the] group today… we have people that even at 65, 70 years old, this is their first quit attempt in their whole lives, which is crazy to think about,” Kendra said. “But it feels like such a privilege to be [with] someone in that point in their lives where they’re like ‘I’m really ready to tackle this.’”
Yet there’s this stigma in the industry, not only around drug use itself, but in the expectation that drug users should have the ability to overcome their own addictions.
“There’s this whole thing about ‘I need to do this on my own.’ Like we wouldn’t tell a diabetic patient ‘oh, you have to do that on your own,’” Kendra said. “Isn’t that crazy? We wouldn’t tell a cancer patient ‘oh, no don’t get support from your family around this… you can do this on your own, you need to be strong.’
That isn’t to say it’s impossible to make it through an addiction without any help – but Kendra says it’s undeniably harder.
When Kendra went to an addiction health services conference in Seattle, Wash. with other experts in his field, he could feel the excitement of those around him. To Kendra, the media’s increasing awareness of the nation’s opioid crisis has beckoned the entire industry of addiction medicine into the public eye – an industry that he feels has been in the dark for much too long.
“It’s a bad thing, this whole opioid crisis, and people are overdosing and getting pills from physicians... But now, god, this is being talked about in public,” Kendra said. “It’s out there and the problem is finally out… that’s a great thing for us because we’ve been in the shadows for too long.”
But evidently most of his time isn’t spent at conferences in Seattle. From day to day, his work consists of a combination of emotional highs and lows. Even if it may be difficult for him to hear about his patients’ reasons for substance use and their struggles with the usage itself, there are always the happy stories that help make his day go by faster.
“A work day can be a big rollercoaster because one patient you’ll see for 55 minutes and it’s like ‘oh man, I’m really struggling’ and then the next one comes in and it’s like ‘Dr. Kendra! That thing you talked about? I did that, I said ‘no’ to that’ and...it’s great. It’s like ‘oh we’re down, we’re up, we’re down,’” Kendra said. “So it has this excitement throughout the day and my day goes fast, which I really like.”
Although his job takes him on an emotional rollercoaster each day, it’s a job that has largely impacted him. It has taught him to take care of himself so that he can assist others, and it has taught him to remain optimistic, even if he doesn’t feel like a certain patient will get better. But, his job has changed far more lives than just his own. To him, it’s a job that has the opportunity to fight society’s perception of drugs while helping the lives of those that are addicted to it, but only if they seek the guidance needed to overcome it.
“We often see people at some of the worst points in their lives over the course of their lives,” Kendra said. “To see someone come out of that is really powerful.”