My Lobotomy: A Memoir, by Howard Dully and Charles Fleming

I expected to like this book. I have done a great deal of reading about mental illness and the horrors that pass as cures, including lobotomy. Seeing lobotomy from the patient’s perspective is a rarity.

The story is certainly compelling. The telling of it is not. I suspect that a combination of the natural talents of Howard Dully and his co-writer, along with the effects of the lobotomy, is why the book is not all it could be. The book is unnecessarily repetitious, which takes away a lot of its power. Much of it is also infused with an adolescent point of view. I had the disturbing feeling that Howard Dully is a 50-something teenager. Or perhaps now a young adult.

I have heard that alcoholics tend to be stuck chronologically where they first became alcoholics. So if they were teens, that’s where they stay until such time as they burst free of the addiction, insofar as one can. It seems to me that the same might be said for this particular lobotomy. It was performed on Howard as a 12-year-old and his thoughts and actions for years afterwards mirror the feelings and impressions of a 12-year-old.

I became impatient with the explanations. Howard, as a young teen in Agnews, the mental hospital, did not know when he would get out. His reaction, therefore, was to “have fun”. Because he did not know nor was he able to control his future, he felt his only option was to have fun. This attitude, along with the lack of any real training for the real world, is what got him into trouble year after year. It also was the reason I had trouble liking Howard as I listened to this CD version of the book.

He recognizes, late in the book, that it was the lack of preparation for work or life outside that got him in trouble so often. Is this a common experience for people in similar situations? Those who are young and placed in mental institutions for a relatively short time? It seems an astounding lack of foresight on the part of the caretakers. How can you expect somebody to do well on the outside without the necessary skills? Even in prison inmates get an opportunity to train for some work.

The part of the book that is especially disturbing is the treatment of Howard by his stepmother Lou. The unfortunate combination of a distant father (emotionally), who does not share significant information or thoughts with his son, and a distrusting, disapproving stepmother who singled Howard out, was bound to have a significant effect on Howard’s behavior as a young child. He was beaten daily by either or both parents, he was not told of his real mother’s death when it happened (she just “left”), and it seemed to make no difference what he did. It makes sense that he acted out, that he rebelled, he made good on what his parents accused him of. When Lou took it upon herself to press for the lobotomy, Howard had nobody in his corner.

As I listened to the CDs I was also affected by the manner in which the book was read. It is not read by Howard, but by a skilled reader, who reads an attitude into the words. I was not fond of the way he read it and wondered if I would feel differently about the book if I had read the paper version. Therefore, I sought out information online, and especially looked for the NPR program featuring Howard. It was easy to find: NPR program

In this radio program we get to hear Howard narrate and talk to lobotomy experts and others affected by lobotomy. We get to hear the real Howard speak. His voice has almost a monotone quality to it, which is something I might expect of a person who has undergone a lobotomy. When he is emotionally caught up we can tell by the hesitation and difficulty speaking, so his delivery is not actually “flat”. I wonder if I would have liked the book better if it had been actually read by Howard. I think it’s possible, because it would have felt more real.

I am glad I had the opportunity to listen to this book, which I had not even heard of before I saw it on the list of books in a virtual book box through bookcrossing. It gave me a lot to think about. I do wish it had been more skillfully written, yet it is hard to see how it could have been done without changing the character of Howard Dully.

The Cloud of Unknowing, by Thomas H. Cook

The Cloud of Unknowing was a book written in the 14th century, a "spiritual guide". It urges a young monk not to search for knowledge about God but to know God through love (I simplify, of course). There is nothing in this book, the one by Thomas Cook, that makes direct reference to the earlier work, except the way of knowing, of getting through that cloud, getting there through love.

We begin in the office of Detective Petrie. We begin with confusion: one death, two, three, four? And a promise to tell the whole story. This chapter is written in the second person, as if an unseen person is telling your story for you. The "you" in this case is David Sears.

The office conversation - or interrogation if you want to call it that - is intertwined with the story told in the first person by David Sears. The short detective chapters simply keep us in place, bring us back to the present.

Through this means Cook leads us gradually into the family of David, his sister Diana, and their father. He takes us through the drowning death of Diana's son Nathan, a child who was full of fear and who seemed to have inherited some kind of mental illness. The path then leads back to David's father, whose own struggle with what was diagnosed as "paranoid schizophrenia" escalated in later years.

I use the quotation marks only because my own knowledge of this condition tells me that there are no physical tests for it and there is, further, no proof of genetic descendency, however long such assumptions persist. Nevertheless, we have to assume in this book that, genetic or not, this family is somehow afflicted. That affliction may come as much from the cruel emotional cuts inflicted by David's father as by any kind of real illness.

We learn that Diana is not "getting over" her son's death. More, we learn that she is suspicious of the means of his death, yet her avenues of investigation defy normal categories. Instead of looking for physical or even circumstantial evidence, she looks backward thousands of years to ancient deaths, ancient myths, as well as more current stories. She tries to draw in her brother, his daughter, others.

Yet oddly nothing is every really overt. Nowhere do we have the direct conversation where people learn from each other. More, we see accusations and assumptions and an unwillingness to move in different directions. And thus I found myself at times frustrated, wondering why David does not consider other options, why Diana is not more specific. Yet isn't it often true that family members do not hear each other?

In the end we do have deaths, each one questionable - what made it happen? We don't have all the answers. We do have siblings torn by deaths but with a true loyalty to each other that survives the worst kinds of visions. Certainly this is less about the underlying mystery than it is about David and Diana and the bonds of childhood.

Blaming the Brain, by Elliot S. Valenstein, Ph.D.

If you believe that some mental disorders are caused by a "chemical imbalance" you need to read this book. Blaming the Brain: The Truth About Drugs and Mental Health is perhaps the most definitive, heavily-researched, and thoroughly-detailed book on how mental health professionals and the public came to believe in a biological basis for mental disorders and why this belief is ill-founded.

Valenstein, a professor emeritus of psychology and neuroscience at the University of Michigan, takes us through the history of mental illness treatment from the nineteenth century through the beginning of this one. He explains that his original intent when he began work on the book was to track how views about the basis of mental illness changed over the past fifty years plus. There have been many theories over the years that suggested a biological basis for mental illness, but in the 1940s and 1950s there was a strong belief in the power of psychotherapy alone. Valenstein was curious about how we have come to where we are now, to a commonly-held belief that depression and schizophrenia in particular are caused by chemical imbalances "similar to the imbalance of insulin for those who have diabetes".

The book evolved into more than a history. Valenstein discovered along the way that the basis for this common belief is shaky. What studies there are that seem to support the theory are flawed and can usually not be replicated. Further, too many persons with depression and schizophrenia do not respond to the current drugs. If these drugs actually corrected a problem present in all depressed or schizophrenic patients then we would expect them all to be helped.

Why, then, do so many patients - and doctors - honestly believe such an iffy theory?? Valenstein devotes much of the book to this question and answers it clearly.

Valenstein's research is exhaustive and his caution in interpreting what he learns is admirable. His writing is clear and comprehendible to laypersons but not simplistic. In the end he summarizes his findings and makes clear that he is not saying that nobody should use these drugs. But they should not be used without investigation into alternatives and certainly should not be considered the best option in all cases. His greatest concern - and it should also be ours - is that such a tunnel-visioned view of mental illness is dangerous and will not lead to improvements in care.