Just Like Someone Without Mental Illness Only More So_ A Memoir - Mark Vonnegut [1]
And if you’re lucky enough to survive going crazy and get back to the point where you can pass for normal, it builds a question into the rest of your life. You have to forgive people for wondering, “How all right can he be?”
After my fourth break, fourteen years after the first three, when everything was supposed to be okay because I had graduated from medical school and was a respected physician in the so-called real world but I fell apart anyway, my task was, once again, to get my sorry, sick, humiliated self back together as quickly as possible. Because if I didn’t stand up and do a credible job of walking and talking, my license and job would have been up for grabs, and then how would I be able to tell if I was okay?
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My psychotic episodes start out great. As a reward for diligence, patience, and the refusal to accept lesser gods, I am set free. We’re all one, really and truly one, free at last, blissfully overwhelmed by God’s boundless love. There’s peace and universal brotherhood. There’s no need to wait for the other shoe to drop.
And then, a few weeks later, ten or twenty pounds lighter, I’m foggily embarrassed in a cold world with things that need doing, like figuring out if I can still be a doctor and how to explain mental illness to my young children.
There were crazy people in my family, but I had figured out good and sound reasons why I wouldn’t go that way. I was stronger than that. But then there were three breaks in quick succession in 1971. I was diagnosed as suffering from schizophrenia. With the publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorder (DSM III) in 1980, the diagnosis of schizophrenia was made more standard and required continual symptoms for at least five years. What I had and have is more consistent with what is now called bipolar disorder, which used to be called manic depression. The name change was an effort to get away from the stigma around the diagnosis of manic depression. Good luck.
Until we come up with an unequivocal blood test or the equivalent, we’re all blowing smoke and don’t know if what we call schizophrenia and bipolar disorder are one disorder or a dozen.
Break number four, in 1985, came as a complete surprise and taught me once and for all that what I think is and isn’t going to happen doesn’t count for much. My friends and family and psychiatrist all think I’m doing well and won’t go crazy again, and I appreciate their optimism.
In the middle of break number one, I made a lot of promises. When I promised to try to remember to tell the truth, it seemed to help.
It’s now been almost twenty-five years since my last break. It was a matter of faith that I could go to medical school and do a pediatric internship and residency and that it would turn out okay. I’ve had a good run as a pediatrician. I’m happily married and have three healthy sons, but I’ll never fully shake the feeling that I’m being tracked by the voices and a parallel psychotic life.
“You didn’t really think you could lose us, did you?”
PRACTICE, PRACTICE, PRACTICE
Most adults have forgotten what they had to do to survive childhood.
I’ve spent most of my professional life thinking about how to improve and safeguard the health of children, studying what others have figured out about their major and minor ailments and trying to cram this knowledge into the day-to-day work of a pediatric practice. It’s been a privilege to watch my patients and their parents closely to see what works and what doesn’t work.
If you had told me ten years ago that today my patients