Quiet Room - Lori Schiller [3]
—Lori Schiller and Amanda Bennett
March 1, 1994
Foreword
I first met Lori Schiller when she was a patient and I was a staff psychiatrist at New York Hospital. I was her case administrator while she was in the throes of the worst of her illness. I followed her through her depths into recovery. Today I am her therapist.
Even knowing Lori as well as I do, I was both surprised and moved by her account of her battle with schizophrenia. For, in this very personal book, Lori Schiller becomes our eyes and ears into a strange and terrifying world. Hers is one of the most compelling looks inside that world we have ever been able to take.
Back in the early parts of the century, such personal accounts of mental illness were more common in medical literature. Back when psychiatrists knew little about the workings of the brain or about the causes of mental illness, they pored over case studies looking for clues. Back then the anguished accounts of mental patients were an important window—if only for medical professionals—into what the subjective experience of mental illness was like.
Today, the whole psychiatric field has become much more scientific. Our focus has shifted to the study of the biological causes of mental illnesses like schizophrenia. Our treatments today turn increasingly to medications. Our hope for the future of many mentally ill patients lies largely in a whole range of new drugs now under development.
These new drugs have already changed the lives of hundreds of thousands—if not millions—of people who suffer from mental illness. Lori herself received her final, major push back into the real world from a then-experimental drug, clozapine. In the years since Lori first took the drug, we have learned that the dangers we had at first feared are much more controllable than we had understood. The benefits of clozapine can thus be made available to a much wider range of patients than we had initially expected. Other, newer drugs will expand that range even further.
Physicians, families, friends and the mentally ill themselves can only be grateful for these enormous medical developments. But Lori Schiller's story helps remind us of something we may have lost in our rush to embrace science: Mental illness is not just about drugs and biology. It is about people. It is clozapine that made Lori's final recovery possible. What made her recovery so successful is Lori herself.
I believe that the turning point for Lori occurred long before clozapine came on the scene. It happened during the early months of her final hospitalization when she finally began to face the illness head-on, when she finally became able to say: “I'm very sick. I need help.” It was only then that she was able to take the risk of becoming truly involved in her treatment, of opening up to others about what she was feeling, and of beginning to connect with other people.
Lori's experiences with schizophrenia are at the same time very typical and very unusual. The course the illness took was extremely typical: The onset in late adolescence after an apparently normal childhood; the initial difficulty in finding a correct diagnosis; her own denial, and that of her parents, and their refusal at first to recognize her illness for what it was. The initial failure of treatment is also, unfortunately, fairly typical. The average young person with schizophrenia has, as did Lori, repeated hospitalizations, numerous medication trials and several separate courses of treatment with several different doctors before the illness is finally correctly identified and treated appropriately. Like Lori, many of these people turn in the meantime to illicit drug use in an effort to manage the frightening symptoms.
Her story is unusual, however, in the enormous personal courage she brought to her illness. She didn't fall victim to the prison of repeated substance