Thursday, November 30, 2017

Mark Vonnegut, MD: Insanity. Managed Care. And Me!


I have written a review of this book on Amazon, which you can find here. Please do me a favor and mark the review as 'Helpful,' because I lost about 3000 points by not keeping my reviews up during the personal, family, and societal crisis of the past couple of months. 
In addition, if you don't WANT to read the supplemental personal commentary, go to the Amazon review and don't read this. Or, you can read the indented material below, which consists solely of the Amazon review.
Last preface comment: I'm trying to determine how many people are pleased to sign up for notification on the email gadget (top right). If that worked for you, could you send me an 'I got the email about your blog' message? My email address is PapaPatPatterson at gmail dot com.

Sometime in the past week, I posted in Sarah's Diner a note, saying that I was going to review, in the near future, two challenging books. Both of these were written by people with a first name beginning with the letter 'M,' and both of these people had parents who had been A-list science fiction authors. However, in a mostly impotent attempt to emphasize the value of the work itself, and not the 'child of Famous Author writes book,' as if that were the only value available and the progeny were limited to being a monkey on a chain, dancing to the organ grinder and collecting tips, I resolved NOT to mention the Famous Author.

Now, I must somewhat amend my position. In the first place, the author of THIS book bears the same rare last name as his father, so that's a dead giveaway. In the second place, SOME of the story (but not all)  is largely a function of the fame of the Famous Author Parent.

And in the third place, I eagerly purchased and read THIS book because I had read and purchased Mark's FIRST book, "The Eden Express," about forty years ago; and my initial interest  in that book was because I was, in fact, a huge fan of his father's works.

So, in this case, Famous Author Parent does have some bearing on the story, and thus, must be mentioned.

However, shortly into my perusal of Eden,  it didn't matter to me who Mark's father had been. His story was that of a semi-normal person, a part of the post WWII Baby Boom, who rejected the conventional society and tried something different. With friends, he started a self-sustaining subsistence farm, which was pretty much the ideal for drop-outs of that time. Things seemed to be going along beautifully, until he does not come down from an acid trip. It was the first of three psychotic breaks he experienced in a three month period in 1971.

 And that was a close enough parallel to my own experience that it was almost intimate; he was saying things that I had been thinking and feeling; however, he was doing it without shame, and with self-examination that I found to be impossible at the time. My difficulty, and his ability, to describe to others this cataclysmic interlude is likely due, at least in part, to the difference in our ages. Mark is six years older than I am, but I started using drugs earlier. Thus, I was 16 in 1969 when I had my first break; Mark was 24 in 1971 when he had his. He also had the structure and support (yes, I know that's a two-edged sword) of an inpatient hospitalization on each of the three occasions when the voices and delusions were overwhelming; I was given a shot of Thorazine and sent home.

And thus, our stories diverge a bit, but still hit some of the same high points. Mark accepted his insanity, took the medications he was prescribed, and talked to the professionals he was given to be his helpers. I, on the other hand, just stayed bughouse nuts for the next decade or so, but I hid it well. He and I both did some school; I did a hitch in the Army. We both got married (once for him, twice for me). We both started professional careers, him as a physician, me as a counselor. And, over a period of years, we both developed into alcoholics. And then, we both got sober.

That's why the book speaks to me so strongly.

Here is the review I posted on Amazon. If you already read that (and voted 'helpful') you can skip this.

Maybe forty years after reading his first book, 'The Eden Express,' I stumbled across this.
I had to have it, even though my budget doesn't really permit purchases, which is why I stick with Kindle Unlimited selections. This however, had to become an early Christmas gift I gave to myself.
His earlier book describes a somewhat confusing childhood, but then, it was a somewhat confusing time, and he had a somewhat confusing family. I've made myself a promise not to tout the name of his father, because the value of the story is not at all derived from any background views we get into the world of a Famous Author. Yes, those glimpses are there, and the book IS a must-read for fans of Mark's father, but this is MARK's story. The value comes from the compassionate self-observation of someone who has experienced a psychotic break, recovered, rebuilt a productive and professional life, and then gone freaken nuts one more time.
It may be a quote from 'The Eden Express:' "Insanity is a rational response to an insane world." No one who has experienced a psychotic break says anything like that. There is NOTHING as trivial as that statement when you are insane. He describes how a one-time acid trip triggered his psychotic break. I had a very similar experience, and it took over ten years for me to get completely free of some of the insane ideations that came out of that night. I was FUNCTIONAL for almost all of that time, but when I got fatigued, it was pretty easy for the bughouse-nuts thoughts to come creeping out. But, like Mark, I got better.
I started to say, there is nothing RATIONAL about losing your mind, but that's not true. It appears, from the inside, to be an extremely rational process. Mark addresses this as one of the most unsettling aspects of the break he experienced after a gap of 14 years. He found it rational, and he was utterly convinced of the logic and the pressing moral rightness and need to run down a hallway, and throw himself out of a third story window. He had been given the information, in his conversations with God, that this was a needful act if he were to prevent the death of his son. It was RATIONAL. It made perfect sense. And it did have a good outcome, in that he was finally hospitalized, where he could be medicated and helped through his own intentional self-induced withdrawal from alcohol and tranquilizers.
That's clearly what triggered the last break. Mark had gradually increased his tolerance to alcohol to the point that it took more to get him where he wanted to be, in a relaxed and comfortable state, and he had adopted a benzodiazepine as a supplement. When he realized his life was unmanageable, he stopped them both, cold turkey. It drove him nuts. That might very well have been me, too, had I terminated TWO psychoactive drugs at once. I never stopped more than one.
While the book is PRIMARILY linear, it's more like a grapevine than a pine tree. There is a bit of a kaleidoscope effect in his writing, which would not be the style to take, were he writing simply about his pediatric practice, or his problems with the state of medicine as is practiced today. However, the main story is how he struggled to put his life back together after having three psychotic breaks, and how he encountered his fourth, and what his life has been like since then. That is a story that accommodates some creativity in the prose.
I don't know if he could tell the story of his pediatric practice without including references to his mental health journey. I don't know if his passionate distaste for modern managed care would read so strongly, if he had not been a patient himself. However, I do know that if he wrote those books, I would want to read them. And I know that if he had been in my area, I definitely would have chosen him as my kids' pediatrician.

A message from Mark to writers and artists:

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?
Vonnegut Md, Mark. Just Like Someone Without Mental Illness Only More So: A Memoir (pp. 6-7). Random House Publishing Group. Kindle Edition.  

Peace be on your house.

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