The haunting memory of friendship lost – I Refuse by Per Petterson

April 7, 2016: The post below was composed when I was debating the extent to which I wanted to turn toward reviewing books. As a result it is primarily personal and reflective in nature. Since writing it my reviews rapidly moved to more serious and critical efforts, many of which now appear on other sites.

I recently wrote a piece for the Three Percent blog on why this book should win the Best Translated Book Award for 2016. It offers a more critical view of this work.

23626238The novel opens with the chance meeting of Jim and Tommy, two childhood friends, now in their mid-50’s on a bridge at the break of dawn. More than 30 years have passed since they last saw each other. Jim, the sensitive and more intellectually inclined of the two, has struggled with mental illness and, as we meet him, he has exhausted a year of sick leave after a brief and unsuccessful attempt to return to work. Tommy, who dropped out of school at 16 to work at a mill, has benefited from some shrewd investments and a head for numbers, to find himself in a high level financial position in the city. But his life, with his fancy clothing and new Mercedes, is hollow. Both men have failed marriages behind them and over the course of the day that follows this early morning encounter each one finds himself facing a deep sense of grief and loss over the close friendship they shared growing up in semi-rural Norway.

As spare and luminous as the northern landscape that grounds this exploration of time, friendship, family and dysfunctional parents – themes Petterson has returned to continuously – I Refuse follows a winding chronology and employs a variety of perspectives and characters to frame the peculiar circumstances that helped forge the original bond between Jim and Tommy, and the fractured pathways that each has followed after Jim’s attempted suicide at 18 initiates events that drive them apart. Brought to life through the blistering translation from the Norwegian by Don Bartlett (of Knuasgaard, Loe and Nesbo fame) this is simply Petterson’s broadest, darkest and most complex work to date. If his brilliant Out Stealing Horses has long occupied a space in my top ten all time favourite books, this new work is even more striking and mature.

Or maybe I am simply more mature myself.

At this moment in time, at roughly the same age as the men at the core of this novel, and currently engaged in my own pursuit of disability supports following an unexpected return of a mental health disorder after more than a decade of stability, I could relate to the essential theme of the slowly eroding and distorting impact of the passage of time on our selves and our relationships with friends and family. Apart from a failed marriage and a childhood in a similarly semi-rural setting; my life and circumstances are different than those portrayed here. But the true power of this work lies in the author’s skill and confidence in the reader to leave the space for ambiguity and hint at the possible dynamics that drive the characters without feeling the need to answer all the questions or resolve all the mysteries.

Kind of like the way we have to navigate life itself.

Reading and anxiety: Proceed with caution

“Then the anxiety set in. If someone told me I had to be depressed for the next month, I would say that as long as I knew it was temporary, I could do it. But if someone told me I had to have acute anxiety for the next month, I would kill myself, because every second of it is intolerably awful. It is the constant feeling of being terrified and not knowing what you’re afraid of. [Anxiety] resembles the sensation you have if you slip or trip, that experience you have when the ground is rushing up at you before you land. That feeling lasts about a second and-a-half. The anxiety phase of my first depression lasted six months. It was incredibly paralyzing.”            – Andrew Solomon

The above passage from a PBS interview with Andrew Solomon, the author of The Noonday Demon: An Atlas of Depression and Far From the Tree, describes the reality of living with anxiety better than any I have heard. I had a bad stretch earlier this year but once it passed I let the memory of this crippling sensation fade. Until now. Anxiety has returned.

Sometimes it helps to get out but that is not an option today. The temperature outside has climbed from the -34C wind chills that settled in late last week to a comparably balmy -7C. But my car sits on the street with a flat tire that cannot be replaced until Friday and a chest cold has left me feeling too ill to walk to the nearby shopping centre to pick up a few necessary items. With my daughter’s 22nd birthday on Wednesday and Christmas on the horizon with no indication that I will even have enough income to pay my bills at the end of the month I can expect to feel a little down. But the anxiety that has coiled its way around my heart is much more devastating.

The worst aspect of anxiety is that it seems to ignite the fears, the loneliness and the paranoia that are already entertaining me during this prolonged mixed hypomanic state. It seems to be impossible to distract myself in any truly functional way – even reading is only a temporary respite.

HungryI have recently emerged from a book, both glorious and heartbreaking, that I would strongly recommend but should come with a warning for the mood sensitive. This book is sad. The book in question is The Hungry Ghosts by Sri Lankan-Canadian author Shyam Selvadurai. This richly sensuous novel begins in Sri Lanka and explores a young man’s complicated and difficult relationship with his grandmother, follows him as he immigrates to Canada with his mother and sister where he struggles to find himself in the gay community of 1980s Toronto. A return to visit his grandmother is marked by a tragedy that will seal his fate, binding him in his own bitterness and pain, to ultimately threaten everything he builds and holds dear in Canada. Buddhist mythology is woven throughout this tale of family, wealth, warfare, race and love. The resulting huge tapestry of life pulls at the very threads of the human heart. But, be warned, this book is sad. Bravely so, something I find missing in much of the Canadian literature I ready today.

The other night I braved the brutal cold, probably the last thing my emerging seasonal illness needed, to attend a reading by the author, the final event of his week-long residency with the University of Calgary’s Distinguished Visiting Writers Program. As positive and rewarding as this opportunity was it served to remind me that my own accomplishments seem to have been stalled by the cards fate (or karma?) has dealt.  I awoke the next morning feeling saddened, empty and anxious.

Adrift in mid-life.

Manic Implosion: Venturing into the third section of Damon Galgut’s In a Strange Room without warning

About a month ago I had an opportunity to talk briefly with Damon Galgut following his appearance at Wordfest here in Calgary. He published his first novel at 18 and I shared that I had wanted to write when I was younger but wanted to live first, completely unprepared for the messy and complicated path my life would take. So we spoke about the challenge of winnowing out a story that runs close to bone from the detritus of life lived. He pointed to my newly signed copy of In a Strange Room, his 2010 Booker short-listed novel, and admitted that in this, of all his works, he felt that he had most closely captured the essence of his self. And he achieved it, I later learned, by telling three tales which recount actual events from his life and feature a character named Damon from perspectives that often shift from first to third person to a detached observer, sometimes within the same sentence or paragraph.

So far so good.

7199962The first two sections involve travel and more or less unresolved interactions and attractions between the remembered Damon character and people he meets while he frets and wanders through parts of Europe and Africa with a restless inablity to settle himself. The prose is tight and evocative with the open ended reflections and ambiguity that feature in my favourite of his writings. But I was sucker punched by Part Three: The Guardian. Not only is it harrowing in its intensity, but the devastating action centres around a woman in the throws of a full-blown suicidal manic pychosis. I could not help but relate as a caregiver but more critically as someone who has experienced the full impact of manic psychosis from the inside. My blessing, if there is one, is that I have never been especially suicidal or inclined to self-harm, nor do I drink or use drugs. All of those factors are added to the mix in this account.

And it takes place in India.

It is not a secret that his close friend Anna is not in a good way, when Damon agrees to allow her to accompany him on the first part of a trip to India. He has been before and intends to stay and write for several months, but it is thought that the change of scenery might be a positive and healing experience for Anna. Her life is beginning to unravel around her and the creative, vivacious woman he has known for many years is tipping dangerously close to the edge. With a stock of mood stabilizers, tranquilizers and sleeping pills she promises not to drink or indulge in recreational drugs on this excursion – a vow sullenly defied as soon as they take flight. Her mood escalates, and behaviour becomes increasingly frenzied and unpredictable from there, culminating in an intentional overdose while her already weary guardian is close at hand but not paying close attention.

Throughout this process and the weeks that follow, Damon’s concern is stretched beyond affection to annoyance to guilt and back again. While Anna fights for her life in ICU, a British nurse and another couple from the village where they are staying are co-opted into a tag team to provide support and relief for Damon at the hospital where cockroaches and rats scurry about and, although care is free, all supplies from bandages to drugs to all other medical items much be purchased by friends or relatives who trek back and forth to the pharmacy with lists. As Anna begins to recover and relocate to more crowded and unattended wards, she not only becomes increasingly volatile and unpredictable, but her erstwhile crew of attendants have to attend to all her care including propping her over the bedpan and cleaning up the splashing mess afterwards.

Care for her actual mental health concerns is not part of the treatment plan.

To make matters worse, attempted suicide is a criminal offense in India and the police are awaiting Anna’s release so they can detain her. An escape must be planned and executed. Finally she is safely returned to South Africa, but she and her support network are shattered and strained at both ends. Sadly her successful suicide is only delayed, not avoided. And her traumatic spiral leaves those who love her and even those who get caught up in her whirlwind of self destruction, with wounds that will take their own time to heal long after she finally achieves the rest, or self martyrdom, that her illness drives her to desire.

No one wins.

My own manic psychosis was maintained to my home where the refrigerator filled with inedible meals and my children destroyed the yard while I struggled to make it through the days. As my grasp on reality slipped and the long standing issues I had been fighting off for years bubbled and distorted in my mind, a month of growing horror ended in a morning of escalating fear and violence before the ambulance finally arrived. Diagnosis and treatment of my bipolar disorder helped explain much, but in the end the very real issues of identity that had haunted me for most my life still existed. The difficult years that followed would see the end of a long marriage and, the beginning of a new authentic existence for me.

Anna was committed to death in her madness. In mine I found life.

I finished reading this book late this afternoon at a cafe where I frequently go to clear my mind and write. I could not put it down until I reached the final pages. As I stumbled out of the cafe into the biting cold and snow of this premature winter evening, I felt devastated and emotionally wrung out. As painful as it was to read, for those of us who live with manic depression or care for someone who does (and I do both), the third part of In a Strange Room is essential reading.

But consider yourself warned.

Further reflections on the void left by suicide: deeper appreciation for Miriam Toews

Miriam Toews is one of Canada’s most celebrated novelists. She has drawn heavily on her Mennonite heritage filtered through the ability to explore the messiness of ordinary life with a wonderful sense of humour. Recently I reviewed her Giller nominated All My Puny Sorrows, a novel which is deeply inspired her sister’s suicide. The novel itself, while wicked funny in places, left me wanting more of a connection to Elf, the deeply depressed character. Her “healthy” sister, the narrator, never really seemed to understand but rather struggled with her own reactions – the practical and the reckless.

Tonight I had the good fortune to attend a panel called “Darkness Visible” in which Miriam participated. The theme explored by the three somewhat diverse novelists was focused on looking at whether dark themes, personal or political, can be fully examined in literature. The consensus I suppose was that despite the challenges and limitations, the ambition is valid and important.

swing lowBecause I already own a digital copy of All My Puny Sorrows I purchased a copy of Swing Low: A Life for this event. Written in memory of her father, a well loved teacher and pillar of the community who took his own life about a decade before his daughter followed suit, this slim volume deals more explicitly with manic depression and suicide. I only recently became aware of it. Given my own recovery process I am thinking this is more the story I was looking for with All My Puny Sorrows. Coincidentally, an audience member at the event had grown up in the same Manitoba community as Toews. Her father had been his teacher and he began to cry as he shared his shock when he had learned how much pain and sadness the family was going through. Miriam had to dry her eyes as well.

That is the true impact of suicide and it spreads beyond families.

When I had the pleasure to speak to Miriam after the event I confessed my experience with All My Puny Sorrows, explaining that I was reading it in the aftermath of my own breakdown and, sadly, in the light of Robin William’s suicide. I told her I suspect that the book I was hoping for probably lies in part in this earlier, more serious volume. But then we both admitted that unless we are ourselves are burdened with the desperate desire to let go of this life, we can only ever observe from the outside. We also shared our mutual fears for our children inheriting the same genetic disorder.

I am deeply impressed with Miriam Toews’ desire to speak about mental illness and with her wide appeal in this country, hopefully her message will reach an audience that needs to hear it. I am looking forward to finding out how she explores the bipolar disorder in her family through her father’s story, unaware at the time of course, that the same event would strike her family again.

She told the audience that if writing her most recent book taught her one thing it is to hold tight to the joy in life.

A worthy goal for us all.

When even a sibling’s love is not enough – All My Puny Sorrows by Miriam Toews

The title and binding imagery that fuses the latest novel from Canadian author Miriam Toews comes from a poem by Samuel Taylor Coleridge to his friend, the poet Charles Lamb. Both men had their own struggles with mental illness but Lamb’s beloved sister Mary had an especially prolonged and devastating battle. Coleridge commiserates with his friend’s tireless care for his sister, reflecting that he, Coleridge had had a dear sister upon whom he “pour’d forth all his puny sorrows”. Elfreida (Elf) the suicidally depressed character at the centre of this novel drew her signature theme from this line , but it is her sister Yolandi (Yoli) who brings her to life and devotes herself to trying to keep her alive as she narrates this funny, heartbreaking tale. As such, All My Puny Sorrows is well named.

all my puny sorrowsColeridge was the first poet who caught my adolescent attention, much to the shock of my high school English teacher. However I confess it was the rugged adventure of “The Rime of the Ancient Mariner” and “Kubla Khan” that sparked my enthusiasm. The Romantic poets, so many of whom seem to have suffered from mental illnesses seemed kindred spirits ( although this would have been long before my own diagnosis). They loved passionately, often tragically, and became addicted to opiates. For the teenager falling well short of cool, the appeal is not hard to imagine.

SamuelTaylorColeridgeFor Elf and her sister growing up in the confines of a small Mennonite town, the arts were an acceptable outlet. Elfreida channels her energy into the piano eventually taking to concert stages around the world and winning the love of a man so patient he’s surely destined for sainthood. Yolandi opts for a less glamorous route, including a couple of failed marriages, children, meaningless affairs and a career pumping out rodeo themed YA novels.

I was attracted to this book when I heard Toews on the radio explaining that this novel began from a deeply personal space. Her father, a respected teacher despite a lifelong battle with depression, took his own life in 1998. Almost 12 years to the day later, her only sister followed suit in the same very way and location. Having already memorialized her father in non-fiction, Toews felt that fiction would free her up to address this very real and difficult subject more openly. But that is also where it falls apart for this reader.

She is able to make some very astute observations about the failings of the mental health system and sadly demonstrates that, in the end, there is no way that anyone or any system can ever do more than delay the efforts of someone truly committed to stepping off this mortal coil. However I never felt that Elf was more than a tragic figure in a hospital bed. Yoli’s childhood memories and the accounts of her sister’s glorious career rang hollow. The real strength of this book for me lies in the the indomitable spirit of the characters who survive against all the odds and resist the despair that mounts around them.

And maybe that is the point. It is not for us – friends, family, observers or readers to judge. In a few weeks I will be able to see Miriam Toews take part in a panel exploring the ability – or limitations – in being able to make sense of the darkness in life through literature. I will be interested to hear what she has to say.

Inhale deeply : Reflections on Breath by Tim Winton

Take a deep breath and hold it as long as you can… I imagine there are few children who have not engaged in some variation of that form of super hero training. I am aware that some push it to an extreme, driving for the physiological high induced by oxygen deprivation, but in my day it was an exercise in imagining oneself capable of surviving one of the daring challenges we set up for ourselves. Where I grew up that generally involved challenging one another to crawl through one of the long corrugated metal culverts under the rural road ways. I never heard of any unfortunate incidents resulting from such an activity but my overactive childhood imagination manufactured many. Either way, being able to hold one’s breath for at least 60 seconds seemed to be skill worth developing.

At this end of life I no longer maintain this practice, but despite the fact that tests have assured me that I actually have very good lung capacity, panic and anxiety attacks can leave me struggling to fell like I am getting enough air. Breath deep, stay calm, focus on your breath.

1414720The arrival at the scene of an apparent suicide is the impetus for paramedic Bruce Pike, the narrator of Tim Winton’s novel Breath, to return on the pivotal events of a summer many years earlier and the struggle to relieve himself of the baggage he believed he carried on well into adulthood. What follows is a gripping coming of age tale featuring the young Pike (or Pikelet), a slightly bookish, awkward outsider, growing up in an unremarkable mill town on the edge of western Australia. His encounter and ensuing friendship with Ivan Loon (Loonie), the restless and reckless son of the local publican, leads him away from the safe an predictable confines of life with his reserved parents and into the aura of a former champion surfer who becomes their surfing coach, hero and guru.

Under Sando’s fickle attention the boys are introduced to the thrills of confronting nature in one of her most dangerous and unpredictable forums. Even if you have never fancied that you have an interest in surfing, Winton’s spare, confident writing pulls you right into the swell, creating vivid and heart stopping scenes that leave you gasping for air. Under the equally reckless attention of the aging surfer’s bitter and damaged young wife, our narrator is left with emotional scars that are even slower to heal than any physical beating inflicted by the surf.

This is my first encounter with the work of Tim Winton, chosen at the fine recommendation of whisperinggums as a suitable (i.e. shorter) introduction to his work in advance of his visit to Wordfest next month. It will definitely not be my last. I reveled in the exotic setting, a sharp contrast to my own landlocked prairie childhood, yet I fully related to the awe with which Pikelet and Loonie held their flawed hippie heroes. As a teenager in the 1970s myself I can remember clearly how the hippie movement of the 60s still held this magical allure that had not yet faded. On an even more personal level I was moved by the sadness and regret that drives the narrative on into the complications of adulthood. Pike’s adjustment is not easy. He has a breakdown, makes a mess of his life and has to find his own way to pull it together.

This wonderful book is more than a classic Bildungsroman. Youth and adolescence are never the full picture. When has anyone truly come of age? And by what measure of ordinariness are the true heroes assessed? Ask someone trying to live well with a mental illness.

The right book at the right time: Just Like Someone Without Mental Illness Only More So

“There are no people anywhere who don’t have some mental illness. It all depends on where you set the bar and how hard you look. What is a myth is that we are mostly mentally well most of the time.”
– Mark Vonnegut, MD 

A couple of years ago I happened to hear an interview on CBC radio, as part of a series on mental illness. I was, at the time, of the mind that my own issues with mental illness were well managed. A present fact but a distant reality. However, something about this conversation stayed with me.

The guest was Mark Vonnegut, son of the late author Kurt Vonnegut Jr. Mark grew up in Cape Cod, in the years before his father’s writing brought fame and fortune. I listened with interest to his very personal account of how, despite diagnosis with a serious mental illness, he applied and was accepted to Harvard Medical School. He went on to become a respected pediatrician. After my breakdown this summer I debated returning to the the fine accounts, like An Unquiet Mind, that had originally guided me to an understanding of my newly acquired label. Then I remembered Mark’s memoir Just Like Someone Without a Mental Illness Only More So and within minutes it was on my Kindle. But I only decided that I really needed to read it this weekend as my symptoms and anxieties continue to persist.

7816284Mark writes in an honest and matter of fact way about the trail madness has left through his family, tracing a legacy of depression, suicide and alcoholism going back generations. His mother heard voices and received message from license plates but once the episode passed she was able to rationalize it. When Mark’s aunt and uncle died within a month of one another leaving four troubled orphans, his parents took them in even though they had neither the money nor the capacity to manage. His oddly prescient mother had been stockpiling supplies for their arrival in advance, as her helpful voices had advised.

Mark was a loner spending a lot of time fishing and playing imaginary games in the woods around his home in Cape Cod. The oldest child of the family he grew up poor in the fallout of the the Depression. His father was a ineffectual used car salesman for many years. Mark was 21 before his father became a rich and famous author seemingly overnight.

Caught up in the hippie movement of the 60s, Mark followed many of his peers to Canada to join a commune in BC. He lived off the land, contemplated the meaning of life and experimented with drugs. And that is where he first encountered his own voices. In 1971, at the age of 23 he experienced three major psychotic breaks that landed him behind the locked doors and plexiglass windows of a Vancouver hospital.

“Among the things I grew up thinking about mental illness was that it was caused by other people or society treating you badly.I also knew that once people were broken they didn’t usually get better and the ones least likely to get better were paranoid schizophrenics, which is what I seemed to be.”

Retrieved by his father, Mark returned to the US where, with ongoing treatment, he continued to recover. The voices faded to the background. He published a book about his experiences and articles advocating for an understanding of mental illness as a biochemical condition, in strong opposition to the RD Laing inspired philosophy that was popular at the time (and has recently resurfaced). Somewhere along the way he decided that he wanted to go to medical school himself. Against all odds, and with pathetic math and science marks, he applied to one school after another. Incredibly Harvard gave him a chance.

Over the years that followed, Mark dedicated himself to his studies and his internship. By this point he had recognized that he was bipolar (not a schizophrenic who responds to lithium as he had been told), but even then, the schedule of an intern is grueling. During these years he also married, bought a house and started a family. The model of normal and healthy he figured his mental health issues were history.

Then 14 years after his third psychotic break, several years into a successful pediatric practice, the voices returned to taunt him. The trigger was his realization that he was fueling his high stress schedule with a two pack a day smoking habit along with 5 or 6 beers, half a bottle of wine, a few shots of bourbon and a sleeping medication to round off the day! Hardly a surprise then that his effort to quit cold turkey should trigger a psychotic break.

Although he sensed things were falling apart he resisted seeking help in a hospital. Driven by an absolutely irrational fear planted in his head by his voices he attempted to throw himself through a third story window. The window smashed but he fell back into the room. Unfortunately he ended up in a straightjacket on a gurney in the hallway of the very hospital where he had completed his internship and taught a course.

Although my own manic resurgence following an extensive period of wellness was somewhat less dramatic than Mark Vonnegut’s, it is only a matter of degree. Yet in time he was able to return to work and it has now been more than 25 years since his last manic break. His ability to rebuild his life and career even in the face of abject humiliation is an inspiration. And I am fortunate that I have neither smoking or alcoholism to contend with. But his story stands as stark reminder that with bipolar you must take the medication that keeps you stable and monitor your own level of energy. If we become complacent we risk an unwanted replay, no matter how long we have been well.

This book was published in 2010, so It was not available when I was first coming to terms with my diagnosis. Perhaps if I had read it when I first heard the interview I might have been able to head off my more recent experience. But then again, a manic person is a slow learner because that high just feel so good. Especially in contrast to the draining and  despondent opposite end of the cycle.

I would recommend this memoir to anyone interested in mental illness, especially those who understand what it is like to experience psychosis. Its casual, relaxed style makes for an easy read but, as a practicing physician, Vonnegut has some depressing observations about the decline of health care in his own country. Most importantly though, he leaves those of us who live with mental illness with a sense that we can get better, we can stay better and if we fall, we can get up and move forward.

That is exactly what I need to remember right now.