Saturday, October 7, 2017

The Touch of Madness - Pacific Standard

By the time Nev Jones entered DePaul University's esteemed doctoral program in philosophy, she had aced virtually every course she ever took, studied five languages and become proficient in three, and seemed to have read and memorized pretty much everything. Small and slightly built, with a commanding presence that emerged when she talked, she was the sort of student that sharp teachers quickly notice and long remember: intellectually voracious, relentlessly curious, endlessly capable, and, as one of her high school teachers put it, "magnificently intense." Her mind drew on a well-stocked, seemingly flawless memory with a probing, synthesizing intelligence. With astounding frequency she produced what one doctoral classmate called "genius-level reflections."

So Jones grew alarmed when, soon after starting at DePaul in the fall of 2007, at age 27, she began having trouble retaining things she had just read. She also struggled to memorize the new characters she was learning in her advanced Chinese class. She had experienced milder versions of these cognitive and memory blips a couple times before, most recently as she'd finished her undergraduate studies earlier that year. These new mental glitches were worse. She would study and draw the new logograms one night, then come up short when she tried to draw them again the next morning.

These failures felt vaguely neurological. As if her synapses had clogged. She initially blamed them on the sleepless, near-manic excitement of finally being where she wanted to be. She had wished for exactly this, serious philosophy and nothing but, for half her life. Now her mind seemed to be failing. Words started to look strange. She began experiencing "inarticulable atmospheric changes," as she put it—not hallucinations, really, but alterations of temporality, spatiality, depth perception, kinesthetics. Shimmerings in reality's fabric. Sidewalks would feel soft and porous. Audio and visual input would fall out of sync, creating a lag between the movement of a speaker's lips and the words' arrival at Jones' ears. Something was off.

More ...

https://psmag.com/magazine/the-touch-of-madness-mental-health-schizophrenia?

We Need to Talk About Madness: A Reading List

When I was 15, a teacher I was very close with killed himself over winter break. I found out about it in an AOL chatroom the night before school resumed. My friends were talking about how the elementary school science teacher had died. "The one from when we were kids?" I typed into the chatroom, sitting on the couch between my parents, as the Jennifer Garner show Alias played on our television. "Shit," one of my classmates typed. "We weren't supposed to tell her," another wrote.

John Wake was my little brothers' science teacher, and my after-school photography teacher. I leapt from the couch and called my homeroom teacher at his home. In a quiet, heavy voice, he confirmed what my friends had let slip. I screamed. My parents hovered around me, trying to understand what was happening. Eventually one of them took the phone. I was sobbing, incoherent, and couldn't breathe. I needed air. I ran to the elevator and my father followed me. He walked me down and back up our Manhattan block in pouring January rain, his arm tight around me as I sobbed, tucked into his armpit. The next day in school I was crying at my locker and the guidance counselor walked by. He stopped and turned around after passing me, and asked if I was okay. I looked at him and said with all the raw teenage emotion in my body, "No. My favorite teacher killed himself." The guidance counselor looked back at me, said he hoped I'd feel better, and walked away.

My own mental illness had made itself known a few years earlier. Mr. Wake and I had a special bond, maybe because something in each of us recognized itself in the other person. I had always been a Good Kid — didn't smoke, didn't drink, had never kissed a boy. But when Mr. Wake died, I became angry at the adults in my school. I needed them to talk about this monster that lived inside some of us, sometimes quiet for years at a time, occasionally rousing to try to kill us. When they wouldn't, I punished them the only way my teenage self knew how: I became Bad. I smoked cigarettes in school, cut class to get stoned, threw tantrums at teachers and stormed out, showed up drunk to a school dance with the valedictorian. The adults in charge ignored my acting out, for the most part. I transferred to a new school at the end of the year, in large part because the adults who interviewed me there didn't look away when I confronted them with my sad, ugly, unwieldy pain.

I try now, as an adult, to be sympathetic to those adults at my old school, who shied away from the conversation I so badly wanted to have. They were probably ill-equipped for it. They were probably dealing with their own pain. They probably worried that I wanted answers they didn't have, that simply didn't exist.

More ...

https://longreads.com/2017/10/04/we-need-to-talk-about-madness-a-reading-list/?

A Surgeon Not Afraid to Face His Mistakes, In and Out of the Operating Room - The New York Times

In 2003, The Washington Post columnist Marjorie Williams, struggling with liver cancer, wrote that she had finally figured out what bothered her so much about then-presidential candidate Howard Dean: His doctorly arrogance. "Where else but in medicine," she asked, "do you find men and women who never admit a mistake?"

Actually, this happens quite frequently in politics too. But point taken.

Henry Marsh is in the business of admitting his mistakes. It's right there in the title of his second memoir — "Admissions: Life as a Brain Surgeon" — and it was the central theme of his first, "Do No Harm," published in his native England to wide acclaim, in 2014, and then here a year later.

One of the reasons patients find condescension from doctors especially loathsome is that it diminishes them — if you're gravely ill, the last thing you need is further diminishment. But the desires of patients, Marsh notes, are often paradoxical. They also pine for supreme confidence in their physicians, surgeons especially, because they've left their futures — the very possibility of one at all, in some cases — in their doctors' custody. "So we quickly learn to deceive," Marsh writes, "to pretend to a greater level of competence and knowledge than we know to be the case, and try to shield our patients a little from the frightening reality they often face."

More ...

https://www.nytimes.com/2017/10/05/books/review-admissions-life-as-brain-surgeon-henry-marsh.html?