I mentioned this story a few weeks ago after reading this article in the Atlantic. It’s by Jonathan Rosen, the author of the book The Best Minds, and a very (relatively) brief summary of the story he tells in the book.
When the Rosens moved to New Rochelle in 1973, Jonathan Rosen and Michael Laudor became inseparable. Both children of college professors, the boys were best friends and keen competitors, and, when they both got into Yale University, seemed set to join the American meritocratic elite.
Michael blazed through college in three years, graduating summa cum laude and landing a top-flight consulting job. But all wasn’t as it seemed. One day, Jonathan received the call: Michael had suffered a serious psychotic break and was in the locked ward of a psychiatric hospital.
I snagged the book from the library and read it last week. Six hundred pages long but well worth the time, not only for the individual stories it tells about the tragedy of mental illness and the fraught nature of friendship, but for the questions Rosen raises about the treatment of the mentally ill in the United States in particular.
There are countless failed aspects of contemporary American life – in fact, it’s hard to think of a success at times – but one of the most tragic and frustrating is the way in which mental illness has been understood – or not – and treated over the past century.
Of course mental illnesses are challenging to comprehend and treat, to say the least. What we don’t understand far outstrips what we do, and the throw-mud-at-a-wall nature of decades of treatment makes this very clear.
But the purpose of this post is not to unwrap all of that. The purpose of it is to look at what Rosen does in The Best Minds as an example of what healthy, open-minded discussion of contentious subjects could look like, but mostly doesn’t.
I’m going to quote liberally from this review in the New York Sun – which I think gives an excellent sense of the book’s strengths, captured in the review’s subtitle: Jonathan Rosen gives us a tale of madness told with humility and charts the good intentions on the path to hell.
The book’s spine is a friendship — that word seems both too small and too large for the relationship — between Mr. Rosen and Michael Laudor. They grew up in the same New Rochelle hamlet shadowed by the Holocaust but sunlit by America’s postwar promises to the smart and ambitious. Their fathers were characters who could have been written by Saul Bellow, street-smart scholars and angsty academics. This is the golden age of Jewish America.
Mr. Laudor ascends to New Haven from New Rochelle, and then to Bain Capital, and then the wheels come off, in the form of a florid schizophrenia. Mr. Laudor nevertheless makes it to Yale Law School, buoyed and protected by professors taken by both his brilliance and his brokenness. His persistence is lauded in the New York Times. Leonardo DiCaprio, and then Brad Pitt, contemplate playing him in a movie. Millions of dollars are on the table.
That Times profile describes Mr. Laudor as “by all accounts a genius” and a “schizophrenic who emerged from eight months in a psychiatric unit at Columbia-Presbyterian Medical Center to go to Yale Law School.” The school’s dean, Guido Calabresi, reflected that Mr. Laudor is a “brilliant young person who has conquered what is always difficult — an illness — but has conquered it extraordinarily well.”
Then it all goes wrong.
Rosen’s friendship with Michael Laudor gave him a prism through which to examine the definition and treatment of mental illness. He looks at the age of the asylum, the dismantling of the asylums, the trust put into community-based care, the changing views of medical interventions from lobotomies to pharmaceuticals, and the collapse of basically everything in our present day. He takes a good look at the various political and ideological pressures that were brought to bear: the horror at the conditions of asylums and the trust that funding of community-based care plus management of illness through drugs would lead to far superior and dignified outcomes for everyone. What no one could – because they never can – take into account were unintended consequences: bureaucratic regulations related to funding, the exploitation of funding mechanisms by those who had no interest in helping anyone, the limited value of pharmaceuticals and not insignificantly, the role of the matter of the individual civil rights of the person suffering from mental illness himself: his right to take or not take his medicine, as well as his right to not be forcibly institutionalized.
Rosen also gives attention to the philosophies and ideologies prevailing in both the particular culture of Yale and post-war American in general. Philosophies that deconstructed everything, that gave those who imbued it a world stripped of meaning. Philosophies that celebrated mental illness as the only realistic response to an insane world, that romanticized it, that saw the experience of psychosis as an opportunity for gaining deeper insight into life, the world, the cosmos.
From the Sun:
“The Best Minds” charts how everything from the counterculture to post-structural theory of the kind espoused by Jacques Derrida and Michel Foucault to the legacy of Kennedy-era liberalism conspired to shift the paradigm on madness. The asylum was out, confinement was barbaric, and the crazy ones had it right all along. Mr. Rosen calls the resulting void — filled only with “checks and pills” — a “mental healthcare system that had never been baked.”
This is a book about the long 1960s. Mr. Rosen notes that “Woodstock was already part of the mythic past” and that “the distance between 1969 and 1973 was unbridgeable.” Nevertheless, “the idealism of the sixties lived in our classrooms” and “our teachers were the products and protectors of its dreams.” Mr. Rosen talks about “sailing into the late twentieth century” on the narrow bed of a college girlfriend.
Mr. Rosen observes that even by the end of the 1970s, “our conventional world was still green, however watered with subterranean streams of music, conspiracy theory, and our dreams of radical liberation.” He quotes Pete Hamill’s description of the doctors and nurses attending the slain Robert Kennedy: “Behind them, in a refrigerator, lay the sixties.” Mr. Rosen adds his own postscript; “oddly, the sixties had also pulled the trigger.”
From The Best Minds:
What hope was there for Michael in this inverted world where causes were cures, madness bestowed mental health, and murder restored innocence?…The curse of Greek tragedy, ‘whom the gods would destroy the first make mad,’ was erased. Now, madness was the first step to recovery, even if it sounded more like philosopher-assisted suicide. (223)
On Thomas Szasz, whose work was instrumental in remaking the post-war interpretation of mental illness, and positioning the civil rights of the mentally ill at the center of his discourse, but in a way that ignored the “illness” part of the matter:
It was hard to believe that someone who seemed so indifferent to the plight of people with severe mental illness had helped shape laws governing the treatment of the most vulnerable members of society. But Dr. Szasz’s indifference was pat of the argument he’d made twenty years before in The Myth of Mental Illness. He did not simply deny the existence of Rebecca Smith’s illness, or the legitimacy of the state stepping in to help her if her family could not, but insisted on turning the most impaired subset of people suffering from untreated psychotic disorders into a test case of individual liberty. Denying the exceptional nature of Rebecca Smith’s illness, he made her autonomy essential to his own, even if she died on the sidewalk to preserve it. (308)
Rosen is deeply critical, but measured. He lays out the events and points of view clearly and fairly dispassionately. This is important – he tries, every time he critiques a government action or fad among these helping professions to put everything in a broader context. This is, if you’re paying attention, hinted at in the title of his book. The Best Minds has a thought-provoking double meaning: it’s the often the best minds that are afflicted with mental illness, the brilliant Michael Laudor being an example – and it was the best minds that always propose solving these problems and – also important – invoking (sometimes demanding) our trust because they are, of course, the best minds.
Since we do so much religion and Catholic talk in this place, of course you know I’m going there. Well, I already did, but here’s a bit more. The conversations about Church – especially the history of the Church over the past century – are endless, fraught, contentious and exhaustingly circular. It’s also, most of the time, conducted in extremely bad faith – lots of strawmanning, hardly any steelmanning – and a refusal to sit down and look at the events of the past – all of the events – with the most objectivity we can muster.
Maybe, before I die, I’ll see it. But probably not.
In writing this out – especially the quote up there about Thomas Szasz – I was put in mind of another problematic aspect of Catholic public discourse – and that is standing on some hill, defending a particular process, procedure and policy just to prove a point or maintain one’s dominance and position (or, quite often to just not let them win) – no matter the cost to real human beings along the way.
Anyway, there’s also lots of just plain good writing in The Best Minds (Rosen is a novelist, so go figure), some of it wry.
About the father of a neighborhood family:
Still, life had grown tumultuous after Josh’s father had donned orange clothes, hung a mala around his neck, and run off to Poona, India, where he was learning to let go of the things of this world, including his wife and children….the guru offered middle-class professionals a way out of the dulling bond of sexual, spiritual and economic convention, asking only for their assets and total obedience in return…(83)
Having gone around smashing things up like Tom and Daisy, the experts retreated back into private practice, government agencies, or where it was they had tenure….(150)
So sad, so frustrating, and such a sense that a solution is very, very near . . . and then you walk into incidents that leave you feeling dropped in the middle of a vast trackless plain with night falling fast. Next door to this is how we handle cognitive impairment & dementia: the Columbus Dispatch had a long story with a nine minute video about legendary Jungle Jack Hanna & his wife Suzy, about his descent into Alzheimer’s and how she’s trying to cope. I’m sitting here now with a fellow twenty years older than Jack (and not on a porch in northern Montana overlooking a lake), and he isn’t Alzheimer’s diagnosed, but reading the story and watching Jack in the video I was struck by just how similar it all is. And no good solutions for any of us in how to best care for and deal with this stage of life.
Here’s the link, but Gannett is pretty harsh with links, so apologies if you can’t get to it: https://www.dispatch.com/story/news/nation-world/2023/06/21/jack-hanna-illness-sick-alzheimers-columbus-zoo-david-letterman-animal-guy-good-morning-america/70293207007/