Book Review: Just Like Someone Without Mental Illness Only More So by Mark Vonnegut

There are certain books you read during your life that stick with you. For me, one of those is one I first read while still in college, Mark Vonnegut’s The Eden Express: A Memoir of Insanity. First published in 1975 (and reissued in 2002), the book is a frank and compelling story of a young man’s descent into schizophrenia and his recovery from it.

In the introduction to that book, Vonnegut, the son of author Kurt Vonnegut, described himself as “a hippie, a son of a counterculture hero, a B.A. in religion [with a] a genetic biochemical predisposition to schizophrenia.” He and friends established a commune in a remote area of British Columbia but the mysticism he sensed he was experiencing led in 1971 to his hospitalization in a psychiatric hospital in Vancouver for what was diagnosed as paranoid schizophrenia. Eden Express details that journey, two subsequent hospitalizations and his efforts toward recovery.

Although Vonnegut has since come to believe what he really suffered from was a combination of what is now know as bipolar disorder and schizophrenia, his recovery has been equally remarkable. Not only did he return to “normal” life, he attended Harvard Medical School and has been a practicing pediatrician in the Boston area sine the early 1980s. With his follow-up memoir, Just Like Someone Without Mental Illness Only More So, he takes readers on that journey — and his fourth psychiatric breakdown “when the voices came back” more than 14 years after his last breakdown.

As a fan of Eden Express, I must admit I approached Just Like Someone Without Mental Illness Only More So with a bit of trepidation. I didn’t want anything to take away my favorable impression of the first book (although rereading it before the new book arguably may have increased that risk). Yet the new book drew me in as much as the first and I found it just as compelling. Not only does Vonnegut he again provide insight into the lives of those who confront mental illnesses, the book gives us a real glimpse of the type of person and doctor he is, his bout with alcoholism, and a look at how the practice of medicine has changed in the last 25 years. (“Every bright idea that was supposed to improve medical care has made care worse, usually by increasing costs and restricting access.”)

Eden Express was marked by its frank yet conversational tone. A similar approach helps make Just Like Someone Without Mental Illness Only More So as good as the predecessor. The two books, though, are different. The new one break the story into smaller segments as opposed to lengthier chapters. It also has more echoes of his father’s style and wit. For example, if he’s been doing so well, why does he continue to see a psychiatrist? His response is a simple, Vonnegutesque one: “Over the years I’ve come to care about Ned and, and I think I go mostly to make sure he’s okay.” This approach enhances the readability of a story that gives an idea of the life of a “regular” person dealing with existing or quiescent mental illness and how easy it can be to slip into a manic-depressive or schizophrenic state.

Still, Vonnegut never suggests he possesses some unique quality or strength that gave him advantages in recovering.

None of us are entirely well, and none of us are irrevocably sick. At my best I have islands of being sick entirely. At my worst I had islands of being well. Except for a reluctance to give up on myself there isn’t anything I can claim credit for that helped me recover from my breaks. Even that doesn’t count. You either have or don’t have a reluctance to give up on yourself. It helps a lot if others don’t give up on you.

Yet even that doesn’t ensure there will never be recurrences. In fact, Vonnegut’s fourth breakdown found him taken by police from his home in a straitjacket when he tried, unsuccessfully, to run through a third-floor window to prove to God that he was worthy of saving and “not just a selfish little shit.” Vonnegut says that when the voices he heard in the early 1970s came back, “it was like we picked up in the middle of a conversation that had been interrupted just a few minutes earlier.” The manic part of his bipolar disorder manic depression makes it that much more difficult. Vonnegut describes the slide into mental illness as a “grammatical shift. Thoughts come into the mind as firmly established truth. … The fantastic presents itself as fact.”

Once again, though, the hospitalization, together with medication and support, allowed Vonnegut to return to a normal life, including the practice of medicine. He forthrightly examines not only the role of medication but the treatment he underwent in the 1970s and explores the extent to which family heredity can play a role in a person’s psychiatric state.

Fortunately, Vonnegut did not just return to the practice of medicine but also to memoir. Taken together, Eden Express and Just Like Someone Without Mental Illness Only More So are an excellent survey of a life affected by mental illness. Yet with its style, tone and frank manner of addressing serious issues and events, Just Like Someone Without Mental Illness Only More So earns a place on anyone’s bookshelf on its own merits. It is the most insightful and enjoyable memoir I’ve read in a long time.

Mark Vonnegut, Just Like Someone Without Mental Illness Only More So