For the 2014 Cannonball Read, 50 of my 52 reviews will be of books written by women. I am doing this as part of the #ReadWomen2014 campaign and as a way to mark my upcoming 50th birthday. Among the books to be reviewed, I have decided to include a book written by a woman in the year I was born (1964), as well as for each subsequent 10 year anniversary of my birth. First up: 1964.
I came upon this novel while searching for something written by a woman in 1964. I started by scouring the New York Times bestseller lists for that year, which was quite an eye opener. Women writers were terribly underrepresented there, as they were on lists for literary prizes. I eventually found my way to a wikipedia list of fiction published in 1964, where I discovered Joanne Greenberg’s semi-autobiographical novel, written under the pen name Hannah Green. This novel, which has also been made into a movie and a play, is the story of Deborah Blau, a teenager in post WWII Chicago who suffers from schizophrenia. The story opens with her parents Esther and Jacob visiting the remote hospital where Deborah is about to be placed — a grim institution with locked wings and screams from beyond their doors. This hospital, however, also has Dr. Fried, a German woman who is renowned for her work with those who suffer the worst cases of schizophrenia. Deborah will spend several years at the hospital with Dr. Fried, and the novel takes us into Deborah’s mind, the doctor’s office, ward D — where the extreme cases of mental illness are treated, and the Blau family’s history.
Let’s start with one criticism that has been raised about the novel — did the character (and author) really have schizophrenia? Deborah’s symptoms begin to emerge in early childhood, as the result of a traumatic surgical experience as well as family pressures and the stigma of being Jewish in an anti-semitic environment. Generally, schizophrenia presents itself later, during adolescence and early adulthood, and while trauma can play a role, current understanding is that most likely the person is born with the condition, i.e., it is not environmentally caused. It’s possible that Deborah (and Joanne Greenberg) today would not receive a diagnosis of schizophrenia, but in a way that doesn’t really matter. Back in the 1940s through the 1960s, the term schizophrenia was broadly defined (one source refers to it as being a “trashcan” term) and a person showing Deborah’s symptoms (hallucinations, hearing voices, distancing herself from the real world and engaging in self harm) would have been given the diagnosis and sent to an institution. So whether it would be considered schizophrenia today doesn’t really matter, as far as I’m concerned. It’s not really the point of the book. The character has a mental illness, deep rooted and harmful to herself and others. The question is whether it’s possible for her and those like her to recover.
What Greenberg reveals regarding treatment of the disorder as well as the workings of her (and Deborah’s) mind is well worth reading. Deborah has created an alternate reality that once comforted her and made her feel loved and valued (albeit by gods she created herself), but that has come to torment her and hold her hostage. The descriptions of this world called Yri, its language and rules, is fascinating, and it’s hard to walk away from Deborah’s battle against Yri and for her own sanity. I think the reader gains some understanding of how very terrifying it must be for someone who has created this protective shell to turn around and destroy it, and then try to reintegrate into the real world that was so hurtful. Equally disturbing is the portrayal of life in the hospital, particularly ward D, where the worst cases (those who are violent, catatonic, “insane”) reside. Greenberg demonstrates great compassion not just for the women in the ward, but also their families and caretakers at the institution. We see the effect that Deborah’s institutionalization has on her younger sister, who loves her sister but also resents her for getting so much attention. We see the stigma and shame that Deborah’s parents experience as well as the division between the parent who sees the value of the treatment and the one who does not. We see what happens to the nurses who work on the ward. Some are kind, but of course, some are frightened, abusive and dangerously close to commitment themselves. I learned from this novel that conscientious objectors were sent to work at institutions such as this in place of their military service.
The dynamic among the women in ward D is a large part (maybe the best part) of this narrative, and each of the women is shown to have strengths as well as the obvious weakness. Miss Coral is especially interesting as she is a small wiry older woman who possesses great physical strength (capable of throwing a bed or holding off 5 attendants at once) as well as formidable intellect. She and Deborah develop a mutually nurturing relationship. The patients in this ward, in their own unusual ways, help Deborah rediscover compassion and friendship. There is also an unofficial code of conduct among the patients that is very interesting. They can help each other get away with small acts of defiance but they also have certain expectations of conduct from each other. This was particularly interesting whenever a patient was sent down to a less restrictive ward or released, but then returned to ward D. While these patients engage in dangerous and extraordinarily challenging behaviors, Greenberg shows the great fear that motivates so much of what they do.
I found this to be a deeply moving story that is still worth reading. I wish I could say that the treatment of mental health issues and those who suffer from them has changed dramatically since this book was written, but sadly that is not true. I’m not sure if “cold packs” are used when patients experience psychotic breaks, but restraints are, and the stigma attached to mental illness is very real and a formidable obstacle to treatment and reintegration. For those who would like to learn more, I recommend a couple of TED talks given by successful women who also have schizophrenia: Eleanor Longden and Elyn Saks. Andrew Solomon’s Far From the Tree has an excellent chapter on schizophrenia as well. Schizophrenia and mental illness seem to make the news a lot these days, so I think it’s worth our while to read about them from those who have direct experience. I wish more people would.