A Niece Explores the Intricacies of the Schizophrenic Mind.
by Candace Mittel
Note: This is Aunt and the Brain: Part 3, and is the final installment in this series. We previously published Part 1 and Part 2, and will feature the longform piece in its entirety in our print issue coming June 6th.
VI. Never-ending Carousel
Voicemail:
Just want to know how your tooth surgery went, is everything alright? We could watch you live, too. Bye, we knew this was gonna be corn, too, bye, it’s your Aunt, bye Candace.
My dad says he has only seen his sister normal and functioning for periods of no more than six months at a time. She’s caught in a relentless, cyclical whirl, strapped onto one of those pink plastic horses, drifting around on the carousel. Her feet dangle about; they cannot find the ground. Maybe it’s too high to jump down, or maybe the bells, flutes and chimes of the tinkling tune have bewitched her. Whatever the reason, she seems unable to hop off.
Aunt will be normal and functioning because she is taking her medicine in proper doses, supervised by a psychiatrist. The anti-psychotic medicine in proper doses acts like a brake for Aunt, a deceleration — she slows down, and so do the words and thoughts; she can talk to you and listen. She can stand still, sit at the table through a meal and eat. The medicine always makes her gain weight, a clear indication to me that by starving herself, she directly activates her schizophrenia, and thus I think that full healing must be contingent on her eating correctly.
Aunt will be taking the pills and taking the pills until she doesn’t anymore. It’ll take a few months, but soon she’ll smack a low, and my dad will drag her to the doctor’s office, and he will order her hospitalization. One time the psychiatrist, Dr. Uribi, called the police after she wouldn’t go to the hospital voluntarily. The policemen came and took her away with a medic, and she was screaming for my dad to release her. There was nothing my father could do except watch from the sidelines as the men put his sister in a restraint and then strapped her to the gurney.
Aunt has been hospitalized like this half a dozen times since her first diagnosis, and each time she goes into the hospital they forcibly give her the medicine, and she’ll gain weight and start functioning like a normal woman again. Then right back to the start of the pony ride—gliding up and down, up and down, around and around and around.
One time in her 30’s after a short hospitalization, Aunt was moved to a halfway house in Atlanta, and she lived there for about six weeks while my grandmother took care of her two-year-old son. My dad says the staff trained and taught her how to deal with the real world and explained to her the importance of medicine. At the graduation ceremony from the halfway house, she gave a three-minute speech about her experience, how nice it was and how grateful she felt for her time there. My dad, my mom, and my grandmother all attended to celebrate.
Ten years later, Aunt’s teenage stepson is watching TV in the living room at their home in Atlanta. Aunt, entirely naked with a cigarette in hand, walks down the stairs, through the living room, right past her stepson, and out to the porch, engaged in a serious conversation with herself. Her husband, after what I assume was a concerning howl from his son, slides the porch door open and calmly asks her why she is naked. She says that it is hot outside.
She was hospitalized shortly thereafter. Again.
Examining non-biological factors that serve as catalysts and aggravations to the disease, research in the last 15 years has fallen on the rather dispiriting conclusion that schizophrenia is caused by a genetic vulnerability coupled with non-determinable environmental, neurobiological, and psychosocial stressors. The classic “chicken or the egg” question is planted deep in debate, a tiresome and exhausting matter to investigate.
Declaring causation is impossible as of now. But if we could know, would it help? Or is it dangerous to know?
No one can be sure what started first for Aunt. We know she started smoking marijuana in London, which can be a trigger for schizophrenia, but was that what did it? Was it just the pot, causing intense paranoia, that induced the genetically predisposed schizophrenia, which then caused delusional body image thoughts, which resulted in her anorexia? Or was she first anorexic, then started smoking, which had strange effects on a young woman suffering from malnutrition, which then ultimately lead to the development of schizophrenia? Or was the schizophrenia the first thing to come about, and marijuana merely exacerbated the situation?
Declaring causation is impossible as of now. But if we could know, would it help? Or is it dangerous to know? New Yorker writer Andrew Solomon also ponders this question: “It’s a circular argument that conflates what describes a phenomenon and what causes it. Everything in our minds is encoded in neural architecture, and if scanning technologies advance far enough we’ll see physiological evidence of a college education, a failed love affair, religious faith. Will such knowledge also bring deeper understanding?”
Even though it’s an unknown, I have been commanded by my father, “do not smoke marijuana.” The correlation is too great. Marijuana spawns asinine thought and spontaneous laughter, uncalled for and often inappropriate, while the rest of the outside world moves in a blistering speed, and your limbs cannot catch up for they are dragging slowly and taking their time and bathing in the air—
But if I do, a thudding ignites inside my chest from a cavernous place, echoing throughout my ribs and arms and finally my head, and then the clunking, nervous spirit begins to run as fast as it can, as if on fire, and it keeps running and running and my fingernails twitch and tremble like they’re nodding, “Yes, yes, you were right, you were right, dad, I’ll never smoke again!”
And then, I’ll smoke just one more time. Am I asking to hop on the carousal ride?
VII. Value
Voicemail:
Hi honey, it’s 6:30. Um, I just want to know how your Nana’s doing. You were here last Friday to Monday? You called when Daddy was picking you in the car. Okay. Okay, bye. Wondering how you’re doing, too. Did you also go to Memphis to Nana’s back and her blood clot in her brain? Bye. Bye, honey. Do well on your finals. You must be ready to get out of there and go back to Israel. You must be paid for. Bye, honey. We could watch you live, too. I’m still with the idiot phone. Bye, honey.
Consider a person: There is mind and there is body, and they are inescapably linked. There are things, metaphysical things some call spirit or soul. There are veins, and there is breath, and there are lots of other jelly parts in there, too. We comfort ourselves by asserting that a person is made up of all of these parts, and that an essence of a person lies in the lumping together of everything somewhere near the center of our chest, the core we call the heart. You have a heart of gold. Speak from your heart. I believe it with all my heart. Wholeheartedly, heartfelt! The heart of the matter. The heart of an issue. The heart of the city. The heart of a person.
But to speak exclusively of the celebrated heart is nonsensical and deceptive, even in metaphor. What good is the heart when all we value is the brain! We should be giving each other chocolate brains on Valentine’s Day, filling up jars of sugary little candy brains for our spouses, giving our loved ones marshmallow brains and special blueberry brain pancakes made with our brain shaped cookie cutter, signing our Mother’s Day cards with “Love, from my brain to yours,” with a squiggly mess inside an oval beside it.
Yes, the heart pumps our blood 72 beats per minute, and without it we would be dead, but the heart is not a person. If all we cared about is Aunt’s heart, she would be a fruitful and welcomed member of society. One Sunday afternoon around 4 p.m., the doorbell rang and there was Aunt, clunky shoes and a pack of cigarettes tucked into her belt. She had driven 30 minutes from her home to hand me a bouquet of flowers. Just because. So, tell me, is that brain or is that heart?
Sally Satel, psychiatrist and co-author of Brainwashed: The Seductive Appeal of Mindless Neuroscience, explains our obsessiveness with the brain: “Understanding the brain is of course essential to developing treatments for devastating illnesses like schizophrenia and Parkinson’s. More abstract but no less compelling, the functioning of the brain is intimately tied to our sense of self, our identity, our memories and aspirations. But the excitement to explore the brain has spawned a new fixation that my colleague Scott Lilienfeld and I call neurocentrism—the view that human behavior can be best explained by looking solely or primarily at the brain.”
She reveals that this neurocentric view that is coming to dominate almost all disciplines and venues is often misleading: “The study of the brain is said to be the final scientific frontier. Will we lose sight of the mind, though, in the age of brain science?”
Why are we only concerned with fixing what’s wrong with Aunt’s physical brain? Why doesn’t anyone ever talk about Aunt’s mind?
Some time after Aunt’s first stay at the halfway house, she married her current husband. When they met, she was at the very start of a carousel ride, taking the medicine and continuing to see her psychiatrist. Then one day, as predicted, she began taking her pills less and less, until eventually she wouldn’t take them at all. Her husband didn’t know about her schizophrenia until my dad told him. My dad pulled him aside some time when they were dating and asked if Aunt had told him about “her issues.” He calmly replied, “Yes, she told me she had a chemical imbalance.” Aunt never told her fiancé she had schizophrenia. She never told anyone she had schizophrenia. Because she doesn’t believe she has schizophrenia. She thinks it’s all a hoax.
Aunt got married quickly. They were in their early 40s, and it was both of their second marriages. She already had one son; he had three. The first time her new husband saw her “bad,” as my dad calls it, was about six months after their wedding. It’s not as if she went downhill all at once—it took a long time for her to lose all the weight, to go from 130 pounds to a skimpy 80. But her husband, a compassionate man, stuck around. Fifteen years later, he’s still there. Most telling, my dad always marvels, is how he doesn’t even treat her like someone with schizophrenia.
I don’t know where deep emotions like love come from. Maybe it’s the ability to understand, to feel, to connect with other humans, which comes only from experience, and the ability to experience comes from consciousness, and this all stems from the brain. Or maybe it comes from somewhere much more puzzling and ghostly, far away from the cerebral matter. “We can always keep our bearings by remembering that the brain and the mind are two different frameworks,” Satel concludes.
Why are we only concerned with fixing what’s wrong with Aunt’s physical brain? Why doesn’t anyone ever talk about Aunt’s mind? Aunt is conscious and aware. She feels. She makes decisions, acts intentionally. She thinks, perceives the world. The mind enables memory — Aunt’s is flawless.
VIII. Freedom Revisited
It is remarkable that at age 12, when my father sat me down in the living room to tell me about Aunt, I had no idea she had schizophrenia. I was naive in the most coveted, enchanting way—the simple innocence only children hold that genuinely allows barriers and labels of otherness to collapse and invites a natural acceptance of all humankind. Children innately over-include, like my aunt does, thoughts jumping from one to the next, too harmless and unknowing to hold back certain comments and questions. Too open-minded and permissive to reject oddity. Children see curiosity, not freakishness. I knew my aunt was a little strange, but embracing her was easy—my quirky, goofy, maybe a bit crazy Aunt.
I know now that these descriptions underemphasize the severity of Aunt’s condition. She suffers severely from malnutrition as a result of both anorexia and bulimia. Her teeth, the ones that haven’t been pulled, are rotten. Aunt mostly stays at home, a small, cluttered house, and I do not know what she does there. She sometimes bakes, although my mom tells me not to eat her cakes, and she often takes long walks and makes phone calls and leaves voicemails. She is disintegrating, as far as I can tell, sinking far into a bottomless isolation and bewildering mess.
I cannot help but crave my childish self, the one who saw a funny person, not an off-the-wall lunatic and a schizophrenic. Before knowing there was a bad name and a technical label, a disease, a condition, a disorder to the eccentricity of Aunt, I tried to listen and decipher, to connect the dots between sentences. I was sincere in my conversations with her because that’s all I knew to do when talking to another human.
I don’t answer my phone very often now when Aunt calls. I have more messages sitting in my voicemail box than I can count, ones that extend until an abrupt cut-off by the voicemail timer. I haven’t had the patience to listen through them yet, let alone call her back.
Maybe it’s because Saks has suffered through the psychosis, the seclusion and the feelings of otherness herself, but I envy her gleam of clarified insight in this conclusion to one of her lectures: “The humanity we all share is more important than the mental illness we may not.”
I too often forget that Aunt is a person with desires, hopes, fears, angers and pleasures, just like anyone else. She has a subjective experience, not only of life but of her insanity as well. And just because we do not understand does not mean it does not exist or that it is trivial.
Just because we do not understand does not mean it does not exist or that it is trivial.
There are moments we laugh hard because Aunt tends to speak the dead truth. Although the majority of her sentences are nonsense, she has no conscious filter, so she speaks aloud everything she is thinking. “My mom is freakin’ loony with no memory,” she used to remark long before my grandmother was formally diagnosed with dementia. Aunt, with a consistent vocalized stream of consciousness, makes the comments that no one would ever say out loud. She is sometimes, maybe 10 percent of the time, “right on target,” as my mom marvels. She knows the last names of all my friends. “It was 1968 not ‘67,” she’ll say to my dad when he tells the story of their family trip to France, and my dad admits that his sister is right.
I only wish I could snap on a pair of latex gloves, dig into my aunt’s brain and untangle the messy parts. Plug the toaster into its appropriate outlet, put the phone in its charging cradle, switch the television station from the disconnected white noise to a clear cable program, perhaps a soap opera or a friendly sitcom. Clean up the microwave of all the splattered bits of sauce and start over. Let’s boil the water again and make a new pot of pasta.
But I cannot do that. No one can. The brain is both the most extraordinary and the most untouchable thing in the world.
I don’t understand who is allowed to place value on a person’s life, determine what is good or bad for her, decide what is to be done with her like we might decide where our dogs are allowed to poop, on the pine-straw but not the grass. Aunt can take walks outside, but she is no longer allowed in the Jewish Community Center because of the disturbances she has caused talking to women who want to swing on the elliptical in peace. I question this unspoken Code of Normalcy or Ethics of Standard Behavior our society imposes on its citizens. If freedom is, as Nietzsche said, “the will to be responsible to ourselves,” then who is anyone else to judge what is or is not responsible for Aunt?
The answer is her husband. The answer is her brother, my father. Because schizophrenia is real, and it is a brain disease. And yet, I cannot shake the discomfort of the anonymous yet authoritative system of statutes such as: “Talking about farting or sex at the dinner table is inappropriate,” or “all of your sentences must connect logically, in a relevant order,” and thus people like Aunt are banned from the table. Or if they do come for dinner, they appear odd and inappropriate; they are viewed with a suspicious, almost spiteful eye by the rest of the guests sitting upright, napkins in laps, cutting chicken with knife and fork while discussing the pros and cons of Obamacare.
“What is freedom?” My dad throws the question on the table, over the hard-boiled eggs and snips of parsley and little Wendy’s cups of salt water, as everyone looks down and pretends to read their Haggadah to avoid my father’s eyes. We do it every Spring—retell the story of Exodus, re-question what freedom means to us today. Silence, silence, a crack of matzah coming from the other end of the table.
“Freedom is waking up every morning and being able to smell the roses!” Aunt declares, interrupting the space. I am smiling as my aunt releases a wild, witch-like cackle, and my grandmother yells at her: “Shut up!”
IX. Happy Birthday Live
Thursday, May 9, 2013 1:42 pm
Hi, Candace, honey, it’s your Aunt, I don’t know if this is the same number. I used to get your own voicemail, now it’s recorded message. Anyway, happy birthday tomorrow, what are you doing, it’s your 22nd birthday, it must be really exciting. Alright, Candace, we’re just going to a French restaurant tonight celebrating Mother’s Day and Birthday, I feel like a fool, I got real out of shape. How come I’m not getting your voicemail? Bye. Love Aunt. Tell me what you want for you birthday, Alright? Alright. The girl’s got everything. We could watch it live, too, bye, love you, bye.
Thursday, May 9, 2013 4:24 pm
Did you get my message, honey? Is it warm in Chicago or are you in Israel now? Or were you even watching live? Bye, honey. What do you want for your birthday? We’ll send it to you. We’ll send it to you live. Bye.
Friday, May 10, 2013 3:46 pm
Happy Birthday! I didn’t get your personal phone-call, your personal “Hi this is Candace.” Was it live? We went out last night, I’ve been stuffing, it looks ridiculous too. She has a graduation, when do you graduate, she graduated today, I didn’t go because I’m dizzy as hell on medicine. Bye, Candace, happy birthday again, happy 22nd, bye.
X. Live Live
One new message, bold and unread, flips into my e-mail inbox. “Candace, see it Live!” from Ticketmaster. I delete it immediately. Third one this month.
Voicemail:
Still have the idiot phone. I’d like to see you live. So you must be um had your porcelain put in. My teeth are a mess. You’re very lucky with good teeth and you didn’t even need braces. Did you know that my first one that I had chemistry with is a little guy named Greg Fisher. And he was so nice. Until he punched me in the eye. And it was verbal abuse. But he was so nice. He was so nice. Gets me an engagement ring. He wants to marry me. I flyyyy like Michael Jackson. He was so nice. And you know what the best times was when I didn’t even have the alcohol. Bye Candace, honey. Now tell me what else. Don’t you leave next week? Or you could leave any time. Must be loaded. They take care of them around the world. So, are you still a nanny for some of the kids? Or are they called au pairs or babysitters? Now you didn’t have to get out of my way at Brookwood Grill. But I haven’t been hungry either and I’m still eating this crap. The big vacation is on Saturday. Next Saturday with the boys. Very exciting. It’ll be in the 90s. The better mate in Florida. They go to Florida. They go to Coconut Grove. They go all around the ocean. Last summer I was in Florida to watch at the ocean, I think I died. I’m looking at the guy swimming and I wish I was swimming like Mark Smith. They’re even gonna die. I eat that much cake, too. Who could eat this crapola? Bye. Oh my god, I’m looking at their car now. Somebody must have banged it in with a hammer. I used to listen to Hammertown. But their car. They must have banged it in. Must be time for a new car. Oh and their canopy, I mean their hammock’s not here. Their hammock’s not here either. I know she’s a mulatto. I know she’s part black part white. She took off the weight. I haven’t listened to Hammertown since. Look at this, they got into an accident. I just ran out of time. Tiiiime it’s that your (sung). I don’t remember the music!—
A characteristic symptom of schizophrenia: odd beliefs and superstitions.
Still have the idiot phone. I’d like to see you live.
Aunt has a theory that everyone has this super technology that allows them to see each other’s faces when they talk on the phone, and she’s the only one without this device—she has the phone for idiots.
Is it really so odd that Aunt wants to see it live, too? A bizarre superstition, worthy of labels of otherness and insanity?
I argue, no.
I endorse Aunt’s worries, her fears, her craving to be live with the world. Is that not our most basic thirst as humans? To be hooked in with the moment. To know and to connect—with people, with ourselves, with nature, with existence. To be there when it’s happening. To be present. To see it live.
Candace Mittel is a recent graduate of Northwestern University where she studied Mathematics, Jewish Studies and Creative Writing Nonfiction (and no, they are not connected, but she’s open to suggestions). She currently lives in a Starbucks-free city, otherwise known as Jerusalem, and studies at the Pardes Institute of Jewish Studies where she spends her days (and often nights) making 2,000 year-old arguments relevant to her life today. Candace enjoys interviewing Israelis on the street (see her website Jerusalem Medley), listening/singing to the Les Mis soundtrack and eating a superbly ripe avocado or mango
