The Beauty in Breaking

Harper, Michele

Last Updated: Sep-18-2020

Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The Beauty in Breaking is the memoir of an African American physician who, in her own words, has “been broken many times” (p. xiii).

Despite maintaining a veneer of affluence, the author, her mother and siblings live in constant fear of being battered by her father. Following one particularly vicious attack, she accompanies her injured brother to the local emergency room. That day she serendipitously discovers her calling: “As my brother and I left the ER, I marveled at the place, one of bright lights and dark hallways, a place so quiet and yet so throbbing with life. I marveled at how a little girl could be carried in cut and crying and then skip out laughing” (p. 18).

Much later, the author (Michele Harper) undergoes a shattering breakup and divorce. She endures disappointments at work, some of which, regrettably, can only be explained by the color of her skin.

As she picks herself up time and time again, Harper discovers her inner resilience: “The previously broken object is considered more beautiful for its imperfections” (p. xiii). She learns from the experience of her own suffering to develop compassion in her clinical work. The bulk of the Beauty in Breaking is devoted to case studies of the author’s clinical encounters with patients in the emergency room.

View full annotation

Hidden Valley Road

Kolker, Robert

Last Updated: Jun-15-2020

Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

The Galvins of Hidden Valley Road, just outside Colorado Springs, appear to be the kind of wholesome, all-American family that others might envy. The tragic fact is that six of the twelve children go on to develop schizophrenia, a situation that is practically unprecedented. In Hidden Valley Road, journalist Robert Kolker gives us the tale of the deterioration of six afflicted children and the traumatization of six healthy ones in an improbable, bucolic setting. As one after the other reaches young adulthood in this “funhouse-mirror reflection of the American dream” (p. xxi) and inexorably succumbs to madness, the family struggles to cope.

In their search for answers, the Galvins’s extraordinary circumstances come to the attention of researchers. Ultimately, although there is no cure, the family makes a contribution through their genes to our understanding of schizophrenia, as a mutation is discovered that is shared by the afflicted children.

Hidden Valley Road follows the travails of this “multiplex schizophrenia” family over so many years that there is a sea change in our understanding of the disease’s origins. At first, it is taken for granted to be the result of a faulty upbringing at the hands of “schizophrenogenic” parents. Later, biological explanations prevail. Finally, a more balanced view is attained, with nature and nurture each thought to play a role.

View full annotation

The Edge of Every Day

Sardy, Marin

Last Updated: Jan-25-2020

Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The Edge of Every Day is the memoir of a woman who comes from a “multiplex” family, in which schizophrenia is manifested in successive generations.

The book consists of a series of essays. Some, on topics ranging from gymnastics to building altars, were first published independently and do not appear (at least at first glance) to be linked. The choppy effect this produces speaks to the disorganized thinking that psychotic persons experience. Other essays propel the tragic narrative of family members slipping into psychosis. At the age of ten, the author Marin Sardy, watches as the “shapeless thief” of schizophrenia steals her mother’s personality away. Later, as she reaches her thirties, she witnesses her younger brother succumb to an even more pernicious illness.

Despite Sardy’s mother’s conspicuous symptoms, (she advises her daughter to move to Pluto and informs her that her father has been swept away in a tsunami and replaced by another man), she functions just well enough to avoid being compelled to accept treatment. Thus, no one can stop her from going through a large inheritance and becoming destitute.

Sardy’s brother Tom suffers his first psychotic break in his 20’s and then rapidly deteriorates. He repeatedly “cheeks” his meds and falls through the cracks of Anchorage’s mental health system. The author and her family scour the streets, hoping to lure him inside for a shower or hot meal. As the weather worsens, they can only hope he will land in prison if it means not being exposed to the Alaskan elements. Ultimately, the young man, who once sailed through college with A’s, commits suicide in the bathroom of a psychiatric facility.

View full annotation

The Collected Schizophrenias

Weijun Wang, Esme

Last Updated: Apr-08-2019

Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Esmé Weijun Wang is a novelist who has been diagnosed with Schizoaffective Disorder. The Collected Schizophrenias is a book of personal essays that was the 2016 winner of the Graywolf Press Nonfiction Prize.

A precocious young person on a track to success, Wang experiences a manic episode at Yale that leads to her first hospitalization. After a second hospitalization, her college washes its hands of her. Hitting roadblocks time and time again requires her to rebuild her life over and over. This is not a conventional chronological autobiography but rather essays that provide different approaches to the author’s experience of mental illness. The plural “schizophrenias” of the title encompasses the whole schizophrenic spectrum of disorders. As Wang explains, her own diagnosis is “the fucked-up offspring of manic depression and schizophrenia” (p. 10).

In an essay entitled “High-Functioning” we learn how the author, having been a fashion editor, knows how to pass for normal: “My makeup routine is minimal and consistent. I can dress and daub when psychotic and when not psychotic. I do it with zeal when manic. If I’m depressed, I skip everything but the lipstick. If I skip the lipstick, that means I haven’t even made it to the bathroom mirror” (p.44).

Later, in “The Choice of Children,” volunteering at a camp for bipolar children makes Wang think about what it would be like to inflict her diagnosis on her own offspring. In “Reality, On-Screen” she attempts to convey the sensation of decompensating to psychosis. And in “Yale Will Not Save You” she considers the failure of universities to accommodate mentally ill students.

View full annotation

That Jealous Demon, My Wretched Health

Noble, Jonathan

Last Updated: Feb-19-2019

Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

In That Jealous Demon, My Wretched Health (subtitled “Disease, Death and Composers”), Jonathan Noble, a retired surgeon gives us the medical and psychiatric history of seventy classical music composers. Chapters are organized by illness, ranging from cancer to syphilis to alcoholism. Famous composers such as Schubert and Shostakovich predominate, but many lesser-known composers, ranging from Jeremiah Clarke to Gerald Finzi, are also included.

Mozart is one composer whose cause of death has long been the subject of controversy, and the various theories are comprehensively explored here. However, the author goes even further, developing a detailed medical case study of the composer beginning in childhood. He examines the toll that Leopold Mozart’s exploitation took on his prodigy son’s constitution, what Wolfgang’s appearance in the surviving portraits has to say about his general health, and even whether he may have had Tourette’s Syndrome. Finally, the author ties all of this together, methodically refuting or confirming each diagnosis, offering far deeper analysis than one would expect to find in a standard biography.

Another example, the case of Tchaikovsky, reads like a veritable whodunit. The composer’s activities during the last two months of his life are scrutinized, with the likely causes of death systematically disproven or confirmed.

A list of composers who suffered accidental or violent deaths provides some surprises. You will learn that Lully accidentally stabbed himself with his conductor’s baton, and that Alkan may have been crushed to death by a bookcase upon pulling his Talmud off a shelf.

View full annotation

The Center Cannot Hold

Wells, Kenneth

Last Updated: Jul-31-2018

Glass, Guy

Primary Category: Performing Arts / Theater

Genre: Theater

Summary:

This is an opera based on Elyn R. Saks’s best-selling book The Center Cannot Hold. Subtitled “My Journey Through Madness,” the memoir recounts the author’s struggle with schizophrenia. Here, Saks has collaborated with composer/psychiatrist Kenneth B. Wells on the opera’s libretto.

The librettists utilize the device of having three different singers portray Elyn. One manifestation, the “Lady of the Charts,” represents her when psychotic. The others are Elyn as a law student and the present day Professor Saks as a law professor. Another dramatic device involves the use of a chorus to embody the protagonist’s schizophrenic delusions. At the height of her paranoia, as Elyn sings Beethoven’s 5th Symphony in an effort to keep herself together, the chorus recalls the Symphony’s opening notes by singing “Elyn must die.”

The opera opens with Elyn as Professor Saks reflecting on her childhood. Even then there were signs of the illness that, to quote a famous poem by William Butler Yeats, ensures “the center cannot hold” in Elyn’s life. During the first act, Elyn, a Yale law student, becomes psychotic in front of her friends and is hospitalized. In a Connecticut hospital she is put in restraints and treated by various mental health professionals. She imagines she hears demons threatening to kill her. Elyn’s diagnosis and condition overwhelm her parents, who have been called by the hospital.

In the second act, Elyn works to reintegrate her fragmented mind. She is determined to get back to law school. She is released from the hospital. She finds an antipsychotic medication, with fewer side effects, that she can live with. She resolves to devote her career to mental health law. At the conclusion of the opera, Elyn anticipates graduation. She has been instrumental in winning a class action suit against the use of restraints in psychiatric patients. Her parents, friends and doctors proclaim their pride in her accomplishments.

View full annotation

Victorians Undone: Tales of the Flesh in the Age of Decorum

Hughes, Kathryn

Last Updated: May-03-2018

Glass, Guy

Primary Category: Literature / Nonfiction

Genre: History

Summary:

Victorians Undone is no ordinary history book. If you have ever felt dissatisfied by a sterile biography, wondering if its subject actually possessed bodily functions, look no further. Here, British historian Kathryn Hughes undoes centuries of sheltering the reader from the unseemly by putting it on full display. While the very term “Victorian” evokes an image of propriety, it was also a time of population displacement from the country to cities where “other people’s sneezes, bums, elbows, smells, snores, farts and breathy whistles were, quite literally, in your face” (p. xi). The author seeks to rectify the imbalance by creating a history that puts “mouths, bellies and beards back into the nineteenth century“ (p. xiv), which she hopes will “add something to our understanding of what it meant to be a human animal“ (p. xv) during the Victorian Era.

The book consists of five essays, each following a part of the body of an historical figure. In the first, entitled “Lady Flora’s Belly,” we learn about the tragic saga of Queen Victoria’s lady-in-waiting. Did Flora’s protuberant abdomen conceal a tumor or a baby? It was harder to find out than one might think. Most women went through their lives without ever exposing their private parts to anyone but their husband. Medical consultation when unavoidable might be conducted discretely, by post.

Other essays focus on George Eliot’s hands, Fanny Cornforth’s (the lover of Dante Gabriel Rossetti, the Pre-Raphaelite painter) sensual mouth, and the beard that Charles Darwin’s grew to hide his eczema. The book concludes with the gruesome tale of the dismemberment of Fanny Adams, an early case study in forensic pathology. The term "Fanny Adams" soon came, in navy slang, to mean unpleasant meat rations.

View full annotation

The Black Monk

Tibaldo-Bongiorno, Marylou

Last Updated: Feb-20-2018

Glass, Guy

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

As the film opens, George Anderson tells us he has been advised to treat his anxiety by going “to some island to rest.” We see him arrive by ferry in Staten Island where he has arranged to spend several weeks at the beautiful home of his father’s best friend. There, he renews his friendship with the friend’s daughter, Maggie. We discover that George, a filmmaker, dropped out of medical school, and that Maggie is now a doctor. We learn from the start that, though they have not seen each other for ten years, there is a longstanding mutual romantic attraction.

One day, while walking around the house’s lush gardens, George suddenly and improbably sees a monk. We are made to understand this is not the first time this has occurred, although at this stage George still recognizes it as a “mirage.” However, when the monk foretells a “grand brilliant future” for George and entrusts him with a divine mission, George is inspired. He becomes obsessed with attending church, and we learn he has not been sleeping. In his religious fervor he calls Maggie “disgusting” because she performs abortions.

Maggie becomes aware that something is not quite right. We learn too that George enlisted in the army and resigned under suspicious circumstances. Other details about his past are mysterious. The relationship between George and Maggie intensifies. Meanwhile, a friend warns Maggie that she has witnessed George saying peculiar things about a monk and smiling inappropriately. Finally, in Maggie’s bedroom, George has a full-fledged psychotic episode as he hallucinates the monk in front of her. She accuses him of “becoming schizophrenic,” and begs him to see a psychiatrist. He responds by accusing her of trying to drain him of his inspiration, packs up his belongings, and, despite her entreaties, leaves.

View full annotation

Spy of the First Person

Shepard, Sam

Last Updated: Jan-30-2018

Glass, Guy

Primary Category: Literature / Fiction

Genre: Memoir

Summary:

Spy of the First Person is a short semi-autobiographical narrative about a man with a debilitating condition. He spends most of his time sitting in a wheelchair on his porch, goes for tests to the Arizona campus of the Mayo Clinic, and has a “handicapped sign hanging from the rearview mirror of his car” (p. 15). The man’s illness is unnamed, but we learn that his motor skills are grossly impaired: “His hands and arms don’t work much. He uses his legs, his knees, his thighs, to bring his arms and hands to his face in order to be able to eat his cheese and crackers” (ibid).

The story is told from various, shifting points of view. At times we are in the head of the protagonist. At other times, the perspective is that of a nosy neighbor who peers at the sick man through binoculars, hence the book’s title. There is a parallel narrative about an elderly couple and the wife’s gradual decline in health. The Southwest plays such an important role here one might even say that it too is a character.

There are also frequent shifts of tense. It is not always clear whether we are in the past or present. We alternate between the central character’s fantasies, memories, and observations. The effect of intertwining voices and tenses is reinforced by the brevity of the chapters, many no longer than a paragraph. The overall impression is that while he may no longer have full control over his body, the man has retained an active (one might say overactive) mind.

Spy of the First Person concludes as the man’s children take him to a Mexican restaurant. The vivid description of a meal shared with his loved ones provides a sharp contrast to the inner thoughts that provide the bulk of this book.

View full annotation

This Way Madness Lies

Jay, Mike

Last Updated: Oct-17-2017

Glass, Guy

Primary Category: Literature / Nonfiction — Secondary Category: Visual Arts / Visual Arts

Genre: History

Summary:

This Way Madness Lies was published in partnership with London’s Wellcome Collection for the exhibition “Bedlam: The Asylum and Beyond,” which ran from September 2016 - January 2017 and was curated by Mike Jay and Bárbara Rodriguez Muñoz. It is a book that was meant to accompany the exhibition, yet which, by virtue of the substantial text and reproductions, can stand alone.

The book traces the history of treatment of the mentally ill by following the colorful story of Bethlem Royal Hospital from its antecedents in the Middle Ages up to the present. Its sway over the public imagination evidenced by its appearance in everything from Jacobean Drama to “Sweeney Todd,” Bedlam has truly attained archetypal status. An archetype, yet also a real functioning hospital. Sections of the book entitled “Madhouse,” Lunatic Asylum,” and “Mental Hospital” chronicle the facilities designed respectively during the 17th/18th, 19th, and 20th centuries, and explain how they reflect changing notions of madness in each era.

The first structure was visually grand but lacked a foundation, a metaphor for what was going on inside: “a façade of care concealing a black hole of neglect” (p. 39). It became a tourist attraction along the lines of the zoo, with nothing preventing the public from gawking at and taunting the inmates. While its replacement gave the impression of being more functional, conditions proved equally squalid. On the other hand, 19th-century Europe and the United States saw asylum reforms, as well as the medicalization of madness as an “illness” and the ascent of psychiatry as a branch of medicine. Finally, in 1930, the buildings still in use in Monks Orchard, a suburb of London, were constructed.

By contrast, we learn about treatments elsewhere, most notably Geel, Belgium. There, for centuries, as an alternative to being warehoused in psychiatric hospitals, the mentally ill have been successfully boarding with townspeople.

View full annotation