“all these ideas are swirling around inside your head at once, hurling through your mind, it is on fire, so when you speak it all comes out muddled and confused and no one can understand you.”
Like the other Wellcome-longlisted title I’ve highlighted so far, Freshwater by Akwaeke Emezi, Mind on Fire explores mental health. Its subtitle is “A Memoir of Madness and Recovery,” and Irish playwright Fanning focuses on the ten years or so in his twenties and thirties when he struggled to get on top of his bipolar disorder and was in and out of mental hospitals – and even homeless on the streets of London for a short time.
Fanning had suffered from periods of depression ever since his mother’s death from cancer when he was 20, but things got much worse when he was 28 and living in Dublin. It was the summer of 1997 and he’d quit a full-time job to write stories and film scripts. What with the wild swings in his moods and energy levels, though, he found it increasingly difficult to get along with his father, with whom he was living. He also got kicked out of an artists’ residency, and on the way home his car ran out of petrol – such that when he called the police for help, it was for a breakdown in more than one sense. This was the first time he was taken to a psychiatric unit, at the Tyrone and Fermanagh Hospital, where he stayed for 10 days.
In the years to come there would be many more hospital stays, delusions, medication regimes and odd behavior. There would also be time spent in America – an artists’ residency in Virginia, where he met Jennifer, and a fairly long-term relationship with her in New York City – and ups and downs in his writing career. For instance, he remembers that after reading Ulysses he was so despairingly convinced that he would never be a “real writer” like James Joyce that he burned hundreds of pages of work-in-progress.
This was a very hard book for me to rate. The prologue is a brilliant 6.5-page run-on sentence in the second person and present tense (I’ve quoted a fragment above) that puts you right into the author’s experience. It is a superb piece of writing. But nothing that comes after (a more standard first-person narrative, though still in the present tense for most of it) is nearly as good. As I’ve found in some other mental health memoirs, the cycle of hospitalizations and medications gets repetitive. It’s a whole lot of telling: this happened, then that happened. That’s also true of the flashbacks to his childhood and university years.
Due to his unreliable memory of his years lost to bipolar, Fanning has had to recreate his experiences from medical records, interviews with people who knew him, and so on. This insistence on documentary realism distances the reader from what should be intimate, terrifying events. I almost wondered if this would have worked better as a novel, allowing the author to invent more and thus better capture what it actually felt like to flirt with madness. There’s no denying the extremity of this period of his life, but I found myself unable to fully engage with the retelling. (Also, this is doomed to be mistaken for the superior Brain on Fire.)
A favorite passage:
St John of God’s carries associations for me. I attended primary school not far from here, and used to see denizens of the hospital on their day outings, conspicuous in the way they walked: hunched over, balled up, constricted, eyes down to the ground, visibly disturbed. We cruelly referred to these people as ‘mentallers’, though never to their faces or within earshot, as we were frightened of them.
Now I, too, am a mentaller.
My gut feeling: There are several stronger memoirs on the longlist, so I don’t see this one making it through.
- I’m about halfway through both The Trauma Cleaner by Sarah Krasnostein and My Year of Rest and Relaxation by Ottessa Moshfegh.
- I finally got hold of a library copy of Murmur by Will Eaves.
- The only two books I haven’t read and don’t have access to are Astroturf and Polio. I’ll only read these if they are on the shortlist. (Fingers crossed Astroturf doesn’t make it: it sounds awful!)
The Wellcome Book Prize shortlist will be announced on Tuesday, March 19th, and the winner will be revealed on Wednesday, May 1st.
We plan to choose our own shortlist to announce on Friday, March 15th. Follow along here and on Halfman, Halfbook, Annabookbel, A Little Blog of Books, and Dr. Laura Tisdall for reviews and predictions.
Yes, another memoir on a medical theme! I really do read a lot of them. My eye was drawn to The Family Gene: A Mission to Turn My Deadly Inheritance into a Hopeful Future by Joselin Linder because of the medical mystery aspect: 14 members of Linder’s Ashkenazi Jewish family are the only known exemplars of their particular genetic disease, so rare it doesn’t have a name or surefire treatment protocol, but now at least has a location on a chromosome.
Linder’s awareness of her family’s peculiar medical problems began when her father, William, himself a doctor near their home in Columbus, Ohio, started having a persistent build-up of lymph (also known as chyle) in his abdomen – usually a sign of heart or liver failure. At one point doctors tapped four liters of the stuff from his lungs. Her father’s illness threw Linder, then a junior in college, for a loop; drugs and music started to replace academics. After he died, aged 49, in September 1996, she became a nomad, moving from Prague to San Francisco to Brooklyn and dabbling in different careers.
Only gradually did they all realize that the same thing had happened to William’s uncle, Nathan, in the 1960s and his grandmother, Mae, before that. While Mae lived to age 54, Nathan died at 34, even after treatment at NIH. Along with the lymphedema, a heart murmur was a common factor. William’s brother, Norman; Linder and her older sister, Hilary; and various cousins of their generation were diagnosed in this way. The author’s own symptoms were initially easily to ignore – swollen ankles and a low platelet count – but escalated in her thirties: a blocked vein in her liver meant she was in danger of bleeding out if she vomited.
It’s rare to be able to trace a genetic disease from its founder through to the present. In Linder’s case, her great-great-grandmother, Ester Bloom, is the first known sufferer. Researchers eventually isolated their family’s gene on the X chromosome, near the location for asthma. This explained why, historically, female family members had a better prognosis than males – they have one normal X chromosome and one diseased one; men only get the defective X chromosome – and why asthma medication helped to an extent.
There are a couple of chapters here on the basics of genetics that felt a little condescending to me; for anyone with a high school or A level biology qualification, the simplistic metaphors explaining the workings of DNA may seem superfluous. I also had trouble relating to Linder’s immediate reaction to her father’s death. Although he’d been severely ill for years by then, her attitude still seems a little heartless. Of the decision to take him off dialysis, she writes, “I was on board. It was time to call it a day.” When the family went around expressing opinions, she said, “I think it’s time, Dad. You’ve been through so much,” to which he replied “F— you”! An ex-boyfriend’s suicide a couple years later affected her much more than her own father’s death. Grief affects people in strange and unpredictable ways, I guess.
What I most appreciated was how the book sensitively reveals the ways a genetic condition complicates life, especially in America: Linder had to do without health insurance for 10 years, having been denied it in Ohio on the grounds of a pre-existing condition. In addition, she and her sister faced a quandary common to those who carry genetic diseases: should they have children? While Hilary underwent pre-implantation genetic diagnosis, a form of IVF, to bear healthy twins, Linder ultimately decided against having children.
I enjoyed the earlier part of this genetic quest narrative a bit more than the later material about Linder’s symptoms. Still, I can recommend this to viewers of House and readers of Susannah Cahalan’s Brain on Fire and the like.
The Family Gene is released by Ecco today. With thanks to Beth Parker and James Faccinto for the electronic review copy via Edelweiss.