No One Cares About Crazy People Page 4
Kevin Berkeley Powers rocketed into the world on July 21, 1984, emerging with such velocity that for an instant it looked as though he might shoot right through the obstetrician’s gloved hands. He was ivory-skinned, whereas Dean was darker; and his hair, when it appeared, grew long and yellow and curly above his blue eyes. Velocity was his modus. Dean, more laconic, observed this rollicking new arrival with amusement and tolerance. Two years and eight months separated them in age; they became amiable playmates and, later, friends; and, later still, a dynamic guitar duo.
By the time of Kevin’s birth we had moved from West Side Manhattan to a little two-story brick house in Yonkers, just north of the city.
Ever the one to find an excuse to worry, I fretted for a while that this incomprehensible little being could pry his way into a family that already seemed entirely complete in its bonds. I need not have worried. Kevin came supplied with his own built-in dynamo. Crowing lustily from the seat of his Jolly Jumper affixed to a doorway, the baby made himself right at home, bouncing and cackling, his arms in motion, riveting all our attention. Dean didn’t seem to mind.
In fact, Dean took his role as big brother seriously. It seemed to give him gravitas. He liked to be in on important adult doings in the household. I recall coming home one afternoon to find him and Honoree in the kitchen, Dean with crumbs on his fingers and chin. He looked up and greeted me and announced in Important tones: “We’re making chicken in fancy style!”
One mud-puddly autumn day before the Yonkers move, Dean and I were alone at the tiny playground in Riverside Park. Dean was on a swing, and I was standing a few yards away, watching him. Something made me shift my gaze and take in a shape on the playground’s far border. A thin young stranger, rainwater dripping from his black, oily hair, stood watching my son. His hands were in the pockets of his mouse-colored raincoat. After a while he shifted his attention from Dean to me. The two of us stood motionless, our eyes locked onto each other’s. No other human being was visible except for Dean, who swung happily.
I tried to calculate whether, if I broke into a sprint, I could reach my son before the stranger did. I was maybe three long paces closer than he. I bent my knees a little and tensed for my lunge, but otherwise I did not move; not yet. I was waiting for motion from him. Our eyes remained interlocked. After perhaps half a minute, the stranger gave a brief half-smile, then he turned his back and walked away. I quickly closed the distance between my son and me.
After that, my delusions of invulnerability went away. The stranger would return, in a different shape. And I would never reach my son in time.
For several years I had been lecturing in nonfiction every August at the Bread Loaf Writers’ Conference near the Green Mountain National Forest above Middlebury, Vermont. Dean’s first visit to Bread Loaf occurred three months before he was born: Honoree, her hair still down to her waist and braided then, was radiant in a violet paisley ankle-length maternity dress. Through a stroke of good luck, our assigned lodging for the sixteen summers of visits there was the Homer Noble farmhouse, a nineteenth-century white wood-frame that sat atop a hillock less than a mile from the Bread Loaf campus. A dirt road bordered by blackberry bushes connected the farmhouse to the main road. Behind it, to the north, stretched a rising meadow, and beyond the meadow lay woods. Robert Frost purchased that farmhouse in 1939 as a summer residence, and he wrote there, and in the smaller log cabin near the woods, until his death in 1963. In 1968 the homestead was designated a national landmark.
The boys experienced Bread Loaf as a kind of Brigadoon, a nonesuch kingdom that swept into view every August around a mountain-road curve at the end of a five-hour car ride: a permanent summery little realm of right-angled wood-framed buildings (the residence dorms) painted in bright yellow with green roofs and shutters, and ringed in the distance by fog-crowned mountains. The dominating structure is the Inn (more dorm rooms, the long dining hall, the administrative office, a fragrant fireplace), whose original construction traces to the 1860s. In back of the Inn rises a grand old three-story structure with gigantic Alice-in-Wonderland doors. This was the Barn. Down the hill behind the Barn, which contains classrooms and a spacious main floor where participants go to read, and talk, and eat, and dance on Friday nights, is a final unexpected wonder: a small pond with a miniature island crowning its center, and a wooden raft for getting there.
Many grown-ups, alighting at the campus from their airport shuttles, are stunned to silence by the intensity of this abrupt transition to what seems a palpable, perfect past. For an urban child open to enchantment, it can seize the soul and never let go. Dean and Kevin were such children. They gave themselves to this kingdom populated by a couple hundred grown-ups of mysterious provenance to them: mellow, friendly, strolling people who tended to disappear en masse inside the Barn and the other outbuildings from time to time, only to emerge about an hour later, stroll some more, and then vanish back into the buildings. Some of these people had children of their own, and so a kind of kingdom-within-a-kingdom existed, with kids poking their heads out of the alfalfa fields, waiting their turn for a ride to the island on the raft piloted by a Bread Loaf staffer, or sharing a long table in the clattering laughing dining hall.
Our sons loved the Frost farmhouse as well—the “Hobo Nobo” as they called it—prowling its small upstairs rooms and letting its lace curtains billow through their fingers, and inhaling its ancient aromas of charred firewood and the petrified glue of old books. In the evenings, as the grown-ups sat in the Little Theater listening to, say, Paul Mariani rumble forth his poems of working-class grace in his Long Island workingman’s baritone, or to Linda Pastan’s piercing epigrammatic lines (“I made a list of things I have / to remember and a list / of things I want to forget, / but I see they are the same list”), the children frolicked in the safe Vermont night.
Within a few years we started to entertain thoughts of moving to Vermont. The conference director, a professor of English at Middlebury College, recommended Honoree to the department of chemistry, which immediately recognized her credentials and offered her an appointment as a visiting professor of biochemistry, with the strong possibility of a tenure-track position. Our idle dream was now at the threshold of reality.
Yet we hesitated. Honoree was a lifelong New Yorker. My livelihood was tied to the city. We had previously moved to Yonkers for greater residential space within proximity to the city. Then one night, running late for a chamber music performance at Alice Tully Hall and finding parking garages filled, we took a chance in leaving our car parked on Tenth Avenue. The resulting vandalism was not drastic—a broken window, some audiocassettes looted. But in the time-honored spirit of mugged urban liberals everywhere, Honoree and I looked at each other, and one of us said: “Let’s go to Vermont.”
We went to Vermont. Where it was safe, for us and for our sons.
Years later, after our time in Middlebury, after our sons each encountered his particular dark shadow, after Honoree and I had been thrust into darkness with them, the Homer Noble Farm itself was vandalized, young invaders stopping by its woods on a snowy evening. Where my sons had explored and slept and had their dreams and games, other people partied, leaving behind broken windows, broken chairs, broken dishes, beer and rum bottles, pools of vomit, spittle, and piss—ten thousand dollars in damages. No place is safe, but by then we had already learned that.
2
What Is Schizophrenia?
What if we are all potential schizophrenics? What if our ancestors were schizophrenic as a matter of course?
What if schizophrenia were the foundational state of human consciousness?
What if vestiges of this preconscious state remain embedded in the human brain, in all newborns’ brains—dormant but viable, awaiting a collision with some random circumstance to be hurt into poetry—Yeats’s phrase—if only the dark poetry of destruction and self-destruction? Or, perhaps equally disturbing, what if that spurred state gave us the luminous poetry of art? Or the poetry of God?
> Such questions can seem outlandish, yet they have been posed by serious, scholarly men and women in modern times in attempts to answer an unanswerable question: What is schizophrenia?
So little is known about schizophrenia that neuropsychiatrists and researchers hesitate to offer a definitive theory of causation. Of its origins and causes, the writer and professor of psychology Richard Noll has suggested that “contemporary readers would do well to be humbled by our current state of scientific knowledge.” He points out that more than thirty thousand articles on the disease were published between 1998 and 2007, and that the output since then has increased to about five thousand articles per year. This illness shares with cancer, its partner in catastrophic affliction, an almost otherworldly imperviousness to definitive understanding and cure.
Neuropsychiatrists and allied professionals have only recently moved toward agreement on several fundamental likelihoods. Among them:
What we call “schizophrenia” is not a single disease, or a “categorical illness,” but a rare clustering of several distinct malfunctions in the brain.
These malfunctions are genetic in nature, yet in a far more complex way than direct genetic inheritances like hair or eye color.
These genetic malfunctions are unlikely to produce schizophrenia in an individual unless they are stimulated by environmental conditions. By far the most causative environmental factor is stress, especially during gestation in the womb, early childhood, and adolescence—stages in which the brain is continually reshaping itself, and thus vulnerable to disruption. Stress can take the form of a person’s enduring sustained anger, fear, or anxiety, or a combination of these. Stress works its damage by prompting an oversupply of cortisol, the normally life-sustaining “stress hormone” that converts high-energy glycogen to glucose in liver and in muscle tissue. Yet when it is called upon to contain a rush of glycogen, cortisol can transform itself into “Public Enemy Number One,” as one health advocate put it. The steroid hormone swells to flood levels and triggers weight gain, high blood pressure, heart disease, damage to the immune system, and an overflow of cholesterol. Stress is a likely trigger for schizophrenia.
Many scientists believe that stress is especially destructive during the natural adolescent process of “pruning”—a critical and necessary period of cell destruction that can leave the prefrontal cortex open to disruption. I will explain pruning in greater detail later.
Scientists generally agree that the disease produces three sets of symptoms: positive, negative, and cognitive. Positive symptoms of schizophrenia are the most dramatic. They beckon the sufferer into an imaginary world, a world of shapes and presences and, most commonly, voices. Some people with schizophrenia can construct those voices and hallucinations into an alternate identity that either speaks to them or that they inhabit, as when they come to believe themselves a great leader from history, or even a god. In extreme cases, the patient acts out these delusions, sometimes with violent, deadly, and self-destructive results.
Negative symptoms embrace a range of responses that manifest as generalized withdrawal. They can take the form of decreased motivation, cauterized emotions, a passive turning away from friends, and listlessness—symptoms that are distinct from symptoms of clinical depression. Cognitive symptoms can include a loss of memory, a lack of focus on what is happening or being said, and a diminished ability to process information and take useful action based on it.
Despite such increasingly authoritative theories, I cannot put aside my layman’s fascination with a book that appeared at the dawn of neuropsychiatric discovery, an era that would strongly interrogate the book’s assumptions. Despite the perceptions of obsolescence, it remains a book that, as many of its critics concede, offers richly provocative speculation on the origin of madness within its larger theme: an exploration into what the author calls “the consciousness of consciousness.”
The Origin of Consciousness in the Breakdown of the Bicameral Mind was written by the late psychologist Julian Jaynes and published in 1976. Despite the portentous tone of the title, it is an unusually audacious, original, and eloquently written speculation on why and how human beings think, especially about themselves. It probes the question of why people sometimes hallucinate images, hear disembodied voices, express fantastical thoughts, and behave in ways that make no sense to “ordinary” people.
Jaynes, the son of a Unitarian minister, drew upon the extraclinical viewpoints he gathered as a playwright and actor before he turned to psychology. He proposed that until as recently as three thousand years ago, human beings were not “conscious” in the way that consciousness is understood today. That is, they were not conscious of being conscious, with all the introspection that state implies. We were instead a largely instinctual species, according to Jaynes, subject to “the authority of sound.” We believed and obeyed without skepticism the seemingly autonomous voices that came into our thoughts.
To oversimplify Jaynes’s theory (and oversimplification is virtually the only way to discuss his arguments without quoting the 469-page book entire), three millennia ago the two halves of our brain, though connected by millions of fibers, functioned almost autonomously in a sharp division of labor. The left hemisphere contained (as it still does) three “speech areas” that enabled our understanding of language. This left half was what Jaynes called the “man (human) part.” The ununified right hemisphere was the repository of something far more complex: the seedbed, perhaps, of mysticism and religion. Here lay Jaynes’s “god” part: the received sounds, most importantly human speech, actual and imagined. The bicameral mind did not distinguish between the actual and the imagined. Remembered voices bore the same authenticity as voices of other people in the moment. They often were admonitory—the voices of the father, the village elder—and thus commanded obedience. Hence: voices as gods.
The halves of the bicameral brain functioned almost independently through the epochs of subsistence agriculture and nomadic exploring, epochs of scattered populations and relatively little social complexity. It was the increase in population density and intense social interactions—divisions of labor, inventions, warfare—that obliged the brain to evolve into self-awareness, and to recognize internal thoughts as internal thoughts, not messages from on high. Yet the voices of our thoughts still echoed in us as if they came from other entities. In fact, Jaynes argues, in our own times, even everyday voices command us to a kind of obedience. To understand someone speaking to us, “we have to become the other person; or rather, we let him become part of us for a brief second. We suspend our own identities.” What also has survived even in our evolved time is “a vestigial godlike function in the right hemisphere,” according to Jaynes. “If [my] model is correct,” he writes, “there might be some residual indication, no matter how small, of the ancient divine function of the right hemisphere.”1 Later in the book he writes: “What we now call schizophrenia… begins in human history as a relationship to the divine, and only around 400 B.C.”2
The nascent shift in awareness from the bicameral to the integrated brain, Jaynes believes, can be located in certain distinctions between the two great epics commonly attributed to Homer, the Iliad and the Odyssey. The two poems—passed along orally at first—were composed probably a century apart between 750 and 650 BC. (Some scholars place the creations farther back.) As the science writer Veronique Greenwood explained in a profile of Jaynes, the characters in the Iliad have no ability to look inside themselves: “They do only what is suggested by the gods.” But in the Odyssey, “the characters are capable of something like interior thought… The modern mind, with its internal narrative and longing for direction from a higher power, appears.”3
Jaynes’s assertions have struck neurologically trained readers as eccentric or, at best, fatally compromised by his unawareness of the discoveries just then commencing. For instance, he writes, “Whatever brain areas are utilized, it is absolutely certain that such voices do exist,” adding that they are experienced exactly like actual s
ound. “They are heard by many completely normal people to varying degrees.” He seems a bit suspiciously sure of himself at times. The bicameral voices of antiquity, he averred, “were in quality very much like auditory hallucinations in contemporary people.”4 Yet readers of Jaynes who have lived out some of these assertions remain a bit more open-minded. I have experienced such voices on perhaps half a dozen very brief occasions that I can only dimly recall. I do remember that they sounded real. Most of these, I think, occurred while I was slipping into sleep or emerging from it, but they were not dreams. I cannot, however, vouch for being what Jaynes called “completely normal.”
A century after naming this multiheaded beast, science is beginning to understand the biological mechanisms underlying the symptoms of schizophrenia and the psychosocial factors that influence their expression. Yet a vast and tragic gulf still separates scientific understanding from the incomprehension of people in general, including relatives of the afflicted, taxpayers, and the chain-link network of law enforcement, the courts, and jails. This mass public confusion has resulted in uncounted millions of wasted resources, much of it vaporized due to lost economic production, but more of it expended on maintaining punitive institutions such as jails, which have become the country’s largest de facto mental institutions and which specialize, however unwittingly, in making an inmate’s mental illness worse. Enlightened systems of care would cost Americans far less than the thoughtless incarceration and the resultant recidivism among those who must struggle to manage their actions. America, it seems, is not yet ready for enlightenment.