Mark Vonnegut on Just Like Someone Without Mental Illness Only More SoI wrote Just Like Someone Without Mental Illness Only More So because I was increasingly annoyed with my younger self, who had wrapped up everything with a bow. You can try but you don’t just get to get over mental illness at age twenty-five, go to medical school, write a book, get married and call it a wrap.
In the seventies I was in so in love with the medical model I almost thought I had invented it. "No shame. No blame." I was thrilled to not have my health be dependent on the sanity of society or the wellness of those around me. I was magnanimous about not wanting to credit insight or hard work or circumstances like the kindness of others. Now, the medical model has morphed into "Shut up and take your pills." What passes for care is medication, medication, and more medication, the purpose of which is only incidentally and occasionally to help the patient get a life.
Much of mental illness is genetic, but I’m now quite sure there are people with more or less the same genetics I have who never go crazy and others who never get well. As a kid who wrote a little and painted a little and played a little music, I certainly didn’t want my mental health riding on anything as flimsy as my creative abilities but, among other things, I’ve come to see that a willingness to write, paint and play music is more than a little important to progress and just trying to keep my feet under me.
It was the feeling that good things had happened to me in spite of myself, that I had a rich life that showed itself in my house and how I practiced pediatrics and how we lived as a family that made me want to write Just Like Someone Without Mental Illness Only More So. I’m grateful to the gritty clench-jawed kid who wrote The Eden Express, I think it’s an excellent book, but I’m glad I’m not him anymore.
Afflicted with bipolar disorder, Vonnegut penned an account about his mental illness (The Eden Express, 1975) when in his twenties. He then forsook letters for a stethoscope; his occupation as pediatric physician backgrounds Vonnegut’s new memoir, which relays how he has coped with his condition while holding an important job and raising a family. Amid criticisms of red tape in medical practice, Vonnegut recounts the activities, such as painting and softball, that absorbed his nonwork energies, as well as his bibulous habits. Personal crisis arrived in 1985, when he decided he was an alcoholic, suffered “crack-up number four,” and was put in a straitjacket and hospitalized. He describes the episode psychically as being beset with voices and a torrent of thought that all seemed as though they were actually happening. Reentering the real world, Vonnegut resumed pediatrics, fondly recalling a brief stint at a free clinic in Honduras but also reporting a divorce and remarriage. Of intrinsic interest to readers involved in mental health, Vonnegut’s candid recollections will also attract the literati because, yes, his father was that Vonnegut. --Gilbert Taylor
Review
"Mr. Vonnegut's book surpasses all expectations--his heartfelt effort to enlighten us about mental illness is a gift. I read in awe and recognition, to say nothing of how many times I laughed out loud. People with mental illness, their families, friends and caretakers in the world of psychiatry will learn so much and continue to be fascinated by this remarkable man."
--Patty Duke
"Mark and I both started communes in 1971, and reading his new book I feel like a hippie brother. Sharing so vulnerably his woundedness and his family’s and society's woundedness, he shows you can step out of it all, into a celebration of imperfection and a life of meaning."
--Patch Adams, M.D.
"The man who wanted to bite R.D. Laing has grown into the doctor who helps us understand how compassionate healthcare has given way to mindless bureaucracy. As a psychiatric patient and a pediatrician, he lucidly conveys his experience of psychosis, as well as the maddening effects of today's health insurance and big pharma collusions. He is uniquely qualified and positioned to show us both sides of the insanity."
-- Julie Holland, M.D., author of Weekends at Bellevue: Nine Years on the Nightshift at the Psych E.R.
About the Author
Mark Vonnegutis the only son of the late Kurt Vonnegut and Jane Cox Vonnegut and the author of The Eden Express: A Memoir of Insanity, an ALA Notable Book. A full-time practicing pediatrician, he lives in Massachusetts with his wife and son.
Excerpt. © Reprinted by permission. All rights reserved.
Chapter One
A Brief Family History
It's good to have a sixth gear, but watch out for
the seventh one. If you think too well outside the box,
you might find yourself in a little room without much in it.
The arts are not extracurricular.
One hundred thirty-nine years ago, my great-grandfather Bernard Vonnegut, fifteen years old, described as less physically robust than his two older brothers, probably asthmatic, started crying while doing inventory at the family hardware store. When his parents asked what was wrong, he said he didn't know but he thought he wanted to be an artist.
"I don't want to sell nails," he sobbed.
Maybe his parents should have beaten him for being ungrateful, but they wanted their son to be happy and the business was successful enough that they could hire someone else to do inventory. He became an apprentice stonecutter and then went to Europe to study art and architecture. He designed many buildings in Indianapolis that still stand today. He drew beautifully, made sculptures and furniture. He was also happily
married and had three children, one of whom was Kurt senior, my grandfather, who was known as "Doc" and who also became an architect. Doc could also draw and paint and make furniture. He made wonderful chessboards, one of which he gave to me when I was nine.
When he was sixty, Doc was pulled over for not stopping at a stop sign. The cop was astonished to notice that his driver's license had expired twenty years earlier.
"So shoot me," said Doc.
At the end of his life, which had included financial ruin in the Great Depression, his wife's barbiturate addiction and death by overdose, and then his own lung cancer, Doc said, "It was enough to have been a unicorn." What he meant was that he got to do art. It was magic to him that his hands and mind got to make wonderful things, that he didn't have to be just another goat or horse.
When I worked on the Harvard Medical School admissions committee, artistic achievements were referred to as "extras." The arts are not extra.
If my great-grandfather Bernard Vonnegut hadn't started crying while doing inventory at Vonnegut Hardware and hadn't told his parents that he wanted to be an artist instead of selling nails and if his parents hadn't figured out how to help him make that happen, there are many buildings in and around Indianapolis that wouldn't have gotten built. Kurt senior wouldn't have created paintings or furniture or carvings or stained glass. And Kurt junior, if he existed at all, would have been just another guy with PTSD-no stories, no novels, no paintings. And I, if I existed at all, would have been just another broken young man without a clue how to get up off the floor.
Art is lunging forward without certainty about where you are going or how to get there, being open to and dependent on what luck, the paint, the typo, the dissonance, give you. Without art you're stuck with yourself as you are and life as you think life is.
Craziness also runs in the family. I can trace manic depression back several generations. We have episodes of hearing voices, delusions, hyper-religiosity, and periods of not being able to eat or sleep. These episodes are remarkably similar across generations and between individuals. It's like an apocalyptic disintegration sequence that might be useful if the world really is ending, but if the world is not ending, you just end up in a nuthouse. If we're lucky enough to get better, we have to deal with people who seem unaware of our heroism and who treat us as if we are just mentally ill.
My great-grandfather on my mother's side drank to keep the voices away and ended up the town drunk in the middle of Indiana. My maternal grandmother wrote textbooks on teaching Greek and Latin and had several bouts of illness that resulted in long hospitalizations. When my mother, Jane, was in college the family resources were exhausted after my grandmother spent over two years in a private hospital. With great shame and embarrassment her husband transferred her to a state hospital, where she became well enough to go home a few weeks later. She remained mostly well and never had to be hospitalized again, but she had spent roughly seven years of my mother's childhood institutionalized.
There was no acknowledgment of or conversation about my grandmother's illness either between my mother and her father or my mother and her brother, who would also be in and out of hospitals most of his life. He emerged normal enough to marry three times in his fifties and sixties, hold a job as a librarian, and be the Indiana State senior Ping-Pong champion.
This same maternal grandmother warned my mother not to marry my father because she was convinced there was mental instability in the Vonnegut family. My father's mother, a barbiturate addict who didn't come out of her room let alone the house for weeks at a time, told my father to stay away from my mother because there was mental illness in the Cox family. My father's mother famously (some say it was an accident, but does it really make a difference?) overdosed and killed herself on Mother's Day. Barbiturates had been prescribed to my grandmother as a wonderful new nonaddictive medicine for headaches and insomnia.
If you want to pick out the people who go crazy from time to time in my family, find the ones in the photos who look ten or more years younger than they actually are. Maybe it's because we laugh and cry a lot and have a hard time figuring out what to do next. It keeps the facial muscles toned up.
It's the agitation and the need to do something about the voices that get you into trouble. If you could just lie there and watch it all go by like a movie, there would be no problem. My mother, who was radiant, young, and beautiful even as she lay dying, heard voices and saw visions, but she always managed to make friends with them and was much too charming to hospitalize even at her craziest.
If you don't have flights of ideas, why bother to think at all? I don't see how people without loose associations and flights of ideas get much done.
The reason creativity and craziness go together is that if you're just plain crazy without being able to sing or dance or write good poems, no one is going to want to have babies with you. Your genes will fall by the wayside. Who but a brazen crazy person would go one- on-one with blank paper or canvas armed with nothing but ideas?
The psychotic state is a destructive process. A fire can't burn that brightly without melting circuits. Making allowances for individual tolerances and intensity and duration of the breaks, complete functional recovery becomes increasingly unlikely much beyond about eight or nine breaks. Fixed delusions, fears, loss of flexibility, loss of concrete thinking, and low stress tolerance make relationships, jobs, and family next to impossible and then impossible. The biggest risk factor in determining whether or not you have a nineteenth psychotic episode is having had the eighteenth.
Life for the unwell is discontinuous and unpredictable. Things just come out of nowhere. People try but mostly do a lousy job of taking care of you.
Chapter Two
Raised by Wolves
The biggest gift of being unambiguously mentally ill
is the time I've saved myself trying to be normal.
I grew up on Cape Cod. The vine forest a couple hundred yards from our house was two and a half acres of trees being wrestled down and killed by honeysuckle vines and wild grapes. There were flesh-tearing bull briars throughout the lower level. There was one path that got you into the vine forest and out the other side, where the abandoned apple orchard and old foundation were. I could hit that wall of green at a full run with a knife and fishing rod and disappear. I doubt anyone could have followed me even if they saw where I went in. I built wolf dens in the vine forest next to the pond and imagined I could live there if I had to. My mother was storing canned goods and water in the crawlspace under the house in case of nuclear war.
I was mostly left alone to figure things out. If I'd been raised by wolves, I would have known a little less, but not much less, about how normal people did things. My notions about how to brush my teeth, what could be left out of the refrigerator for how long, and where knives and forks and spoons went were odd. Having been raised by wolves would have given me an excuse. But I just had beautiful, slightly broken, self-absorbed parents like a lot of other people. One of the things I couldn't figure out was why I had such lousy handwriting and why I couldn't spell.
I fought at school almost every day during grades three, four, and five. I won most fights and was never mad or emotional about it. It was just the way it was.
What I liked best about the stories of children raised by wolves was that everyone snuggled in together in a nice warm den. And then there was the part when the people find you and teach you how to talk and wear clothes.
I had a rich, full, and seemingly complete world before I knew much. My father tried to explain about sex to me when I said "Fuck you" after a chess game. I said it in a perfectly cordial way; it was something I had heard and was trying to use in a sentence. Kurt told me something about going to the bathroom in the same toilet that sounded highly improbable.
When I knocked a few dozen bricks out of a partitioning half-wall under the barn and started making a bomb shelter, it was meant as a present to my father. It was something I thought he would have gotten around to eventually. I was surprised that he wasn't more pleased. He thought that knocking those bricks out made it more likely that the already wobbly barn would fall over.
At this time in my life, my father was a proudly antisocial man who spent most of his time at a typewriter, reflecting negatively on his neighbors and society, throwing in things like "Goddamn it, you've got to be kind." The emphasis was on the Godda...
