Summary:

In this sequel to his earlier seem-autobiographical novel, House of God, Shem (this time using both his pseudonym and his real name) describes the experience of a physician in the first year of a psychiatry residency in a prestigious private psychiatric hospital. In this first hand account it is assumed that the author is the resident, Dr. Roy Basch; he describes not only his experiences with a variety of patients but also with the other doctors and the staff members of the institution. It is not a happy place and in the telling of the story there is a biting irony and a sense of the absurd.

It is obvious from the first that Dr. Basch is very serious about becoming a psychiatrist but that he is also searching for meaning and connections. He finds that colleagues may often hurt you more than your patients. Another issue addressed is that of competing psychiatric theories, particularly the competition between pharmacologic treatment and psychoanalysis. Issues about drug treatment trials and the questionable way in which they are conducted also receive attention, as does the problem of insurance coverage for hospitalization.

The fact that psychiatrists often specialize in their own defects becomes a reality to Dr. Basch. There are not many exemplary people in this book--hopefully it exaggerates the real situation. There is, surprisingly, a sort of poignant positive ending.

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The spirit of St. Francis of Assisi presides over the garden in spring. Hyacinths bloom, and abandoned bird nests are tucked away in the nooks and crannies. Young couples embrace: "St. Francis forgive them / and all lovers / whoever they may be." The scene then fast forwards to summer, when the lovers find themselves bewildered and "incredulous / of their own cure / and half minded / to escape . . . "

The idyllic garden has turned menacing, yet St. Francis continues to have compassion for the lovers who "resemble children / roused from a long sleep." One lover stands up unafraid in the sunlight "as her heart / beats wildly / and her mind / drinks up / the full meaning / of it." [139 lines]

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Ten months after being burned over 68% of his body, Dax Cowart was interviewed on videotape at the University of Texas Medical Branch in Galveston by Dr. Robert B. White. Blind, disfigured and helpless, Dax had consistently asserted his right to refuse medical treatment, including further corrective surgery on his hands (useless, unsightly stumps) as well as the daily, excruciatingly painful baths in the Hubbard tank.

At the time of his admission to UTMB, he had become adamant that he be allowed to leave the hospital and return home to die--a certain outcome since only daily tankings would prevent overwhelming infection. Dr. White had been called in as a psychiatric consultant, and much of the twenty-nine minute documentary is a conversation between patient and psychiatrist.

Calm and coherent, Dax states his wishes clearly and presents his case compellingly. He does not "want to go through the pain"; he does not "want to go on as a blind and a crippled person"; and he does not understand or accept any physician’s "right to keep alive a patient who wants to die."

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Will Farnaby, reporter and underground agent for an oil magnate, is shipwrecked on the island of Pala, where for 120 years an ideal society has flourished. In the mid 19th century, a Scottish doctor successfully treated the enlightened Raja of Pala and settled on the island. These two men then designed a perfect society in which (according to the book jacket's description), "sex lives are unabashed; children are carefully conditioned from infancy and none is at the mercy of one set of parents; jobs are assigned according to physique and temperament," and everyone uses "moksha medicine," a drug that sharpens and deepens powers of consciousness.

The Palinese also practice hypnosis, eugenics, and a form of sexual yoga that leads to virtually perfect sexual experience. While Pala has enormous oil reserves, the people are uninterested in developing them because they are happy with their way of life and do not feel the need to become wealthier or more Westernized. Pala's companion island of Rendang is ruled by a ruthless dictator, Colonel Dipa, who plans to develop its oil resources and industrialize the island, while, at the same time, enriching himself.

After his shipwreck, Farnaby is injured climbing a cliff from the beach. He spends time recuperating, during which he meets a number of Palinese people, including Dr. MacPhail (descended from the original Scottish physician) and Murugan, the young man who will soon become the new Raja of Pala. As he learns more about the society, Farnaby comes to respect it and turns away from his plans to promote oil development on the island.

However, Murugan (who was raised largely in Switzerland by a fanatic mother who runs a fundamentalist Christian movement) frowns upon the sexual freedom, drug use, and general lack of "ambition" among his countrymen. He secretly conspires with Colonel Dipa to sell-out Pala. At the end of the book, the army of Rendang has invaded Pala and declared a joint kingdom of Rendang and Pala with Murugan as king and Colonel Dipa as Prime Minister.

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Ashdown, a beautiful but bleak manor on the English coast, is the main setting of this story. Initially, a group of university students including Sarah Tudor, Gregory Dudden, Robert, and Terry reside at Ashdown. Some of these same students return there years later as either patients or staff when the building is converted into the Dudden Clinic where individuals with all sorts of sleep disorders are treated.

Sarah is a disturbed young woman suffering from narcolepsy. She is sometimes unable to differentiate her dreams from the experiences of real life. Robert is infatuated with her and will do literally anything to please her. Gregory is Sarah’s first lover, later a psychiatrist in charge of the sleep clinic, and finally a man gone mad who decides to self-experiment. Dr. Cleo Madison is a sleep psychologist whose true identity is a surprise. In this novel, reality appears more surrealistic than most dreams.

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I used to be able to think. My brain’s circuits were all connected . . . I had a memory and an intuition that I could trust. So begins Floyd Skloot’s memoir of living his life with "a scatter of white spots like bubbles" in his brain, as a result of a viral illness in 1988 that led to chronic fatigue syndrome and persistent brain damage. The first section ("Gray Area") consists of essays that re-create a texture of mistaken words and memory lapses, as well as the author’s creativity in discovering ways to minimize or bypass disability in his daily life. The temporal vector of this section begins with the onset of illness; continues through his marriage to Beverly and their settling on a hilltop in Oregon; and ends with an idyllic stay on Achill Island off the western coast of Ireland.

The second section draws us back in time to "The Family Story," a series of stories about childhood. In "Kismet," which begins section 3, the author returns to a description of his post-illness experience, in this case to his fateful final visit with an older brother, who is dying of diabetes and kidney failure. Later, in "A Measure of Acceptance," he tells of his encounter with a Social Security psychiatrist, whose task is to determine whether Floyd Skloot is "really" sick. The Social Security Administration provides one measure of acceptance; but the author creates a more important measure of acceptance for himself: "I can say that I’ve become adept at being brain damaged. It’s not that my symptoms have gone away: I still try to dice a stalk of celery with a carrot instead of a knife . . . Along the way, though, I’ve learned to manage my encounters with the world." (p. 196)

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The story opens with the protagonist, identified only as the "Patient," being forcibly carried into the insane asylum. Once there, he no longer protests, but seems to accept his incarceration in the huge, overcrowded hospital. The doctor and other staff members seem particularly kind. Because the Patient rapidly loses weight, despite his good appetite, he receives a special diet.

The Patient notices a single scarlet flower among the many beautiful flowers in the hospital garden. He suddenly realizes that all the evil in the world is condensed into the scarlet flower. His mission is to destroy it. But when he attempts to pick the flower, hospital personnel prevent him from doing so, since picking flowers is prohibited. Eventually, he manages to destroy the flower, but notices a second scarlet blossom in the garden. He destroys that one as well, but a third scarlet flower appears. Finally, the Patient sneaks out at night to deal with the third flower, and then is found dead in the garden the next morning, clutching the remains of the scarlet blossom.

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This film is biographical, based on the life of the actress Frances Farmer (1914-1970), who was briefly successful in Hollywood in the early 1940’s and was then institutionalized for mental illness. She was "cured" by a transorbital prefrontal lobotomy.

The film begins with Frances (Jessica Lange) winning a high school writing competition with an essay criticizing God. This outspoken intelligence characterizes her. As a young actress, she wins a trip to Russia in a competition run by a Communist newspaper, performs on Broadway, and ends up in Hollywood. Quickly, however, it becomes clear that her unconventional behavior and attitudes make her vulnerable to people, including her overbearing and vicariously ambitious mother (Kim Stanley), who demand that she conform to more passive forms of femininity.

When Frances is arrested for drunk driving, her mother puts her in a "convalescent home," where she is given insulin injections in the guise of "vitamins." She escapes and, deciding that the pressures of the film industry are causing her drinking problem, tells her mother that she won’t be returning to Hollywood. Her starstruck mother, appalled, has her committed.

After undergoing the closely filmed experiences of the strait jacket, the padded cell, and shock treatment, all in the frighteningly bedlam-like atmosphere of the asylum, Frances submits to psychiatric surgery. This is perhaps the most disturbing part of the film. She is lobotomized in front of an audience by a mallet-wielding surgeon who boasts he can do ten patients per hour because "lobotomy gets ’em home."

Sure enough, Frances is allowed to go home. The film ends several years later in 1958, when Frances Farmer really did appear on the television show, "This is Your Life." We watch the show through the eyes of Harry York (Sam Shepard), the journalist who has always loved her, and he goes to meet her afterwards.

She has been transformed: composed and seemingly serene, but fundamentally blank, she has become a chilling shadow of herself. Early on in the film, she refuses to cooperate with a psychotherapist, saying "I don’t want to be what you want to make me: dull, average, normal." By the end of the film she has been reduced to the hollow appearance of all these things--and is grateful for it.

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Summary:

This documentary presents a pastiche of illness narratives, the stories of seven women (including the filmmaker and the associate producer) who have struggled with mental illness, including depression, bipolar disorder, and multiple personality disorder. Intercut with the interviews are reenactments of key events in the women? lives; vivid depictions of sometimes frightening, sometimes exhilarating mental states experienced by the women; films and still photographs from the womens' childhoods, and archival film footage. In the process of exploring their illnesses and recoveries, the women discuss experiences that hurt them (rape, misdiagnoses, racism) as well as those that helped them heal (creativity, caring, therapists, and spirituality).

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Written with controlled elegance, this is an absorbing autobiographical account of psychiatric hospitalization. Twenty-five years after the fact, the author describes the two years during her late adolescence in which she "slip[ped] into a parallel universe." The surreal nature of the experience is reflected in darkly comedic recollections of her inner life, the other patients, their families, the staff, and of forays into the outside world.

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