 pediatrician and he is also the son of my favorite author from when I was in junior high school. His memoir is a poignant and candid account of his struggles with...well... life in general, and life with a psychotic illness in particular. Schizophrenia, bipolar disorder---who knows (I'll vote for bipolar disorder)? Some illness where he had three episodes in his twenties, then another episode 14 years later. Thorazine and lithium and megavitamins and psych wards. Xanax and alcohol and how humiliating it is to be psychotic on a stretcher in the ER hallway of the hospital where he works. Divorce and remarriage. First and second families. Childhood as the son of a financially struggling, not-yet-famous, eccentric writer, and adulthood as the son of an icon. Vonnegut is a hippy, a mainstream doctor, a middle-aged softball player, then finally a guy who accidentally poisons himself with wild mushrooms.
Dr. Vonnegut's struggles are those of vulnerability, fragility, hope, and resilience. He comes back from these life-altering episodes of psychosis and applies to 20 medical schools. He gets in to Harvard, and only Harvard. If you're going to apply to med school with a 1.8 science GPA from college, then I imagine it's helpful to have a very famous dad who teaches at Harvard. Vonnegut does well enough that he stays for residency and teaches there after. His illness and the possibility of its return hang on him--once you've heard voices, he says, you're never like someone who hasn't. As serious as the topic is, the author is able to make light of himself and the writing is funny and tragic all at once. It's a quick and engrossing read.
In case I didn't like this memoir enough, Vonnegut makes intermittent jabs about the tedious things that weigh down life as a doctor-- paperwork (my favorite rant), the influence of big pharma, and insurance companies.
So would I like Mark Vonnegut in real life? I liked him in his book. And so it goes.
In Treatment: Adele, Week 3.
Paul is upset that Adele doesn't have any Motrin to treat his headache. Adele doesn't recall his son's name fast enough. On the scoreboard, Adele is losing.
Paul gets up and walks around the room. Adele wants him to sit. He doesn't, at least not at first. He tells her a little about his patient, "You know what's going on here, it's perfectly obvious." But she doesn't. He wants her suggestions and Adele doesn't want to be both therapist and supervisor.
Paul talks about Max (his son, not my dog). He makes a lot of assumptions about....everything. Adele sums up the session by telling Paul that he has been pushing her to take care of him. She cites the evidence to prove her case.
Would Sigmund Freud or Carl Jung read Shrink Rap? Somehow, I'm not so sure. Tracey Cleantis seems a bit more certain. Check out her article on Blog.com of Top 10 Psychoanalysis Blogs (Jung and Freud would read).
Thanks for the should out, Tracey, and we're always happy to be deemed accessible!
Why is Paul always chasing people?
Jesse brings his mother to the session, but he doesn't want it known that he wanted her to come. Jesse continues to alternate between being a gentle, vulnerable boy and being a provocative, hurtful monster. He tells his mother about the sexual event, in all it's glorious detail, that got him beaten up and suspended from school, and just in case that's not enough, he announces that his birth mother wants him back. Mom gets upset and leaves the room. Paul asks her to stay. Why does he do that? When someone says "enough" or "I need space," maybe it makes sense to listen.
Paul tells Jesse he's creative, an artist. I like that, he's saying something to build the kid up. He tells Jesse that his own son is an artist and that sometimes he doesn't understand him and feels distant. Is this the right thing to do? At first it seemed kind, like an attempt to connect with Jesse, but for a moment I wondered who was the patient. The revelation doesn't seem to have an impact on Jesse, who is drowning in his own complicated life and problems. He wants so much to be loved and valued as he pushes the world away.
Paul asks Jesse if he's heard from, or contacted his birth mother, and Jesse abruptly stands and leaves. Paul follows him to the door, not just to say goodbye, but to continue the session as Jesse is trying to end. And Mom, who Jesse had believed would leave, is still in the waiting room.
Meet Edgar. He's Roy's dog. My best bet is that Edgar secretly watches In Treatment.
Paul asks his girlfriend if he has 'happiness deficit.' She hasn't seemed to notice what a miserable creature he is.
Frances is a hurricane of stories about her mother, her daughter, and her sister. The sister, you'll recall, was once a patient of Paul's and the entire session is a play of who is having a relationship with whom and of competing jealousies. Mom liked sister more, even from infancy, and now daughter likes her dying sister more. Frances is always on the outside, always the one abandoned by everyone else, and on cue, Paul recalls how the patient used to put lipstick on her dying mother until the very end. Oops, Paul got the wrong patient, it's a story that the sister had told him 18 years ago! One more jealousy. And Frances wants Paul to help rehearse her lines, like her ex-husband used to do. He refuses and she storms out. Somehow, he feels more like the patient in this episode as he fumbles to apologize and cover his mistakes. Ah, the episode started that way when he fell asleep and the patient's knocking woke him--and he lied to conceal that he'd been asleep.
Usually, I find it easy to criticize Paul as a therapist. In this episode, however, I felt like I could relate to his mistakes. We all have moments where we slip--forget the name of a patient's spouse, confuse a story with one another patient told...he's put on the spot, and somehow I know how he feels. Yes, Clink, I know, it's just a TV show and they're not real.
So last week, I took my kid to the doctor. He knows I'm a psychiatrist and greeted me with "Have you ever watched In Treatment?" Oy. He wanted to talk about Sunil.
Sunil continues to develop as a character. He and Paul have tea. They talk about dignity and passion and living a principled life. Sunil is animated when he talks about Survivor and about his daughter-in-law as she exercises. He's overheard his son having sex with her, he thinks she's having an affair, and we learn that Sunil was secretly in love briefly, before he met his wife in an arranged marriage. Maybe he is jealous of his son, Paul suggests, or maybe he feels the daughter-in-law is betraying Sunil personally.
Who is Sunil?  Is he wise or is he insane? There is a mystery to him--- he wants to know exactly what might cause Paul to break his confidence, and as Paul tells him that the circumstances would have to be extreme, that someone would have to be in danger, it's hard not to wonder if someone might be. Sunil is compelling, yet creepy, and one might wonder if he's attracted to his daughter-in-law, or if he's thinking of killing her? Did anyone else wonder this?
The Sunday Morning Shrink Rapper Update.
I've decided to start reading the Sunday New York Times in bed--- no electronic distractions and I actually sort of read. I love the internet, but I think it makes me crazy.
The NY Times has a feature on Debra Winger and talks about her acting come back in the role of Frances on In Treatment. Click here if you'd like to read it.
I'm reading a wonderful book, a memoir by Dr. Mark Vonnegut called Just Like Someone With Mental Illness Only More So. When I was a kid, I loved Kurt Vonnegut's novels. Unusual family with lots of genius and mental illness. I will write more about the book when I finish it, maybe later today?
Tried a great new pizza place last night. Trouble parking and I thought I'd never go there again, and then we ordered a boring pizza because we have topping-issues in my marriage. Great spinach salad, and as we waited for the pie, I coveted the pizza's around us with sausage, veggies, mushrooms, oh.... but then our Four Cheese Pizza arrived and it was amazing. We didn't even mind that we were by far the oldest people in the place, and I will definitely go again, maybe on a weekday. So here's a plug for Iggy's.
As for the rest of my day? Roy wanted me to go to lunch with him so he could convert me into someone who fully understands the details of an issue that has come up in our state with hospital reimbursements. The restaurant he chose isn't open on Sundays. Oh, and he's decided he's busy with one of his many other projects. Clink wanted to work on posting another podcast with me, but got a last minute invite to a birthday party and has blown me off. I've pointed out to her that she was on my "A" list as a first-choice friend