When Scott Walker was in the midst of his successful run for Wisconsin’s governorship, Milwaukee County Hospital faced allegations that its mentally ill patients had suffered vicious abuse. As Walker’s team worried about political fall-out – he was Milwaukee County executive at the time – an aid’s email offered reassurance. “No one,” she explained, “cares about crazy people.”
Ron Powers’ new book, which draws its title from that callous phrase, provides infuriating proof that it is entirely accurate, as well as heartbreaking evidence that it is not. On the infuriating side, Powers provides a nuanced, multi-layered history of the callousness, ignorance, greed, and ideological rigidities that have left the nation’s mentally ill in “conditions of atrocity” (xix).
On the heartbreaking side, Powers tells the story of his own beautiful, creative, and schizophrenic sons – one who still struggles with the disease, and another who succumbed to it, hanging himself just shy of his 21st birthday. Powers’ fierce tenderness toward his sons, revealed in family stories and old e-mails, gives the lie to his title. This is an author that cares profoundly about “crazy people,” and has written a sad, but extremely illuminating, book to jar others into doing the same.
Best known as a co-author of Flags of Our Fathers, a bestselling account of the World War II soldiers that raised the American flag over Iwo Jima, Powers has written fiction and won a Pulitzer Prize for television criticism. In No One Cares About Crazy People, however, he returns to what he does best: distill copious research into clear prose and well-told stories about the real world.
Powers is certainly not the first writer to turn personal experience with mental illness into fuel for a book on the subject. Among recent works, the most obvious comparison is to journalist Pete Earley’s Crazy: A Father’s Search Through America’s Mental Health Madness. In both cases, fathers of schizophrenic sons offer searing, closely researched condemnations of a system that is cruel, costly, and illogical.
Powers, however, does more than report on the existing system, which currently houses ten times more mentally ill people in prisons than in hospitals. Instead, he attempts to trace the multiple scientific, social, cultural, and economic vectors that have brought us to the present, shameful debacle.
As he tells this sprawling story, Powers draws on his own family history to give the book a narrative spine and emotional center. In particular, he chronicles his children’s charmed boyhoods in Vermont, as well as their inexorable slide into illness. We watch Dean, Powers’ older and surviving son, as a child with a precocious storytelling ability; as a teenager who makes a life-altering bad decision; and as a passionate young man struggling to live with major mental illness. Likewise, we watch as Kevin, Powers’ younger and deceased son, becomes a world-class guitarist before his schizophrenia emerges. Transcripts of e-mail exchanges give a jolt of immediacy to the tenderness between a good father and his talented sons.
These deeply personal reflections alternate with Powers’ researched chapters, which benefit from his storyteller’s eye for detail and character.
When he traces the history of asylums, for example, Powers begins with a British facility that originated in the 13th century and once charged admission to see “patients” – literal prisoners who slept on straw coated with urine and feces. “Bedlam,” as the institution was nicknamed, was guarded by gargoyles called “Melancholy Madness” and “Raving” (60).
From this lurid starting point, Powers continues through the movement for “moral treatment” and the reformism of Dorothea Dix, ending in the catastrophic 20th century decision to close large asylums. “Deinstitutionalization”, fueled by a disastrous overconfidence in “wonder drugs”, created a situation in which 1.3 million mentally ill people languished in jails and prisons in 2006 (321). Powers also devotes a searing chapter to the criminal justice system itself, with its hair trigger police shootings and casually abusive prisons.
He also takes aim at the pharmaceutical industry. Yet even as he highlights Big Pharma’s unscrupulous marketing and obfuscating approach to side effects, Powers also endorses its biology-based approach to mental illness. Indeed, he narrates scientific history with great flair – explaining, for example, how the search for allergy medication led, by route of antihistamines’ sedative effect, to the earliest psychiatric “wonder drug,” Thorazine.
Powers is at his explanatory best, though, when describing how culture and ideology have affected the treatment of the mentally ill. He devotes an entire chapter to the rise of eugenics, a pseudo-science that used Darwinian “survival of the fittest” to justify scientific racism and the forced sterilization of the “unfit,” including the mentally ill. Eugenics also inspired the Nazis, who made the mentally ill an early target for slaughter. Even today, Powers argues, it undergirds callous attitudes.
More controversially, Powers takes aim at the antipsychiatry movement, whose attacks on the very notion of mental illness dovetailed with both the logic of deinstitutionalization and the non-conformist mood of the 1960s and 1970s. While dealing quickly with thinkers as diverse as R.D. Laing, Ken Kesey, and Michel Foucault, Powers devotes most of his energy to Thomas Szasz, the Hungarian-born psychiatrist who burst onto the scene with 1961’s The Myth of Mental Illness. In essence, Szasz argued that “mental illness” was simply a phrase used to pathologize nonconformist, difficult behavior.
In 1969, Szasz partnered with Scientology founder L. Ron Hubbard to found the Citizens Commission on Human Rights. Among other functions, CCHR continues to resist laws that would make it easier to force people suffering from psychosis to take medication. This insistence – that the civil right to refuse treatment protects people too delusional to know they need help – has long infuriated parents like Powers, who cannot force their adult children to get treatment.
While he makes a few rhetorical gestures toward the schizophrenics who agree with the CCHR position, Powers might have done more to unpack its nuances, especially since it marks perhaps the major fault line in debates over mental health reform. That he neglects to do so is surprising, because Powers gives admirable attention to the links between the oft-demonized “otherness” of the mentally ill and the role of shamans, writers, artists, and other creative sorts who are gifted, and cursed, with the ability to think and live beyond standard conceptual barriers. In short, he appears to have at least some, limited, common ground with antipsychiatry logic.
At the end of the book, after walking readers through the gut-wrenching loss of one son and the ongoing struggles of another, Powers does offer a more hopeful final chapter, “Someone Cares About Crazy People.” It profiles advances, activists, legislative proposals, and treatments that promise to make a difference. Nonetheless, the overall tone of the book moves between heartbroken lament and angry jeremiad. Both fit Powers’ explicit goals for the book, which include telling sufferers that they are not alone and issuing a call to action.
But the purpose that lingers is “consecration” (xx) – as in consecrating a book to the beautiful son Powers lost and the beautiful, struggling son who lives on. For readers who have young children and family histories of major mental illness – and that group includes this reviewer – Powers’ book is a terrifying reminder not only of how suddenly and terribly mental illness can upend lives, but also of how little help our nation, our culture, and our health care system provides. Powers notes that he was “wounded” into writing it. He hopes that the book will, in turn, wound the rest of us “to act, to intervene.” (xxi)
As well we should.
–Ben Brazil is assistant professor and director of the Ministry of Writing Program, Earlham School of Religion.
In “No One Cares About Crazy People,” Ron Powers writes of parental love, bewilderment and rage at the vagaries of biological fate. John Donvan says it is one of the most engrossing accounts of raising a family he’s ever read.
Winning the Pulitzer Prize is one kind of writer’s dream. Nearly a year on the New York Times best-seller list is another. A third: when the best seller becomes a movie with a big-name director. Ron Powers is among the few to hit this particular trifecta. The onetime newspaperman won the Pulitzer for TV criticism in 1973, and “Flags of Our Fathers,” the immensely popular Iwo Jima history he co-wrote, arrived as a film in 2006, directed by Clint Eastwood. Mr. Powers’s newest book is a memoir, covering many of the years during which he scored these wins. A victory lap, however, this book is not. The story he relates—with searing humility and deep respect—concerns his two sons and the mental illness that flowered within them. “No One Cares About Crazy People” is a chronicle of deepening devastation recorded by a father able to do little in response to his boys’ suffering other than to witness and to love.
Mr. Powers’s memoir is the culmination of both those processes, and is motivated by his insistence on making us care—not just about his two boys, Dean and Kevin, but about all individuals and families wrestling with schizophrenia, bipolar disorder, acute depression and other forms of mental illness. His title signals his grim recognition that this will be an uphill battle. He pulled the phrase, verbatim, from an incident unrelated to his main story: In 2010, the future governor of Wisconsin, Scott Walker, was still serving as the Milwaukee County executive when a scandal erupted over the abuse of patients at the county mental-health hospital. Subpoenaed emails revealed Mr. Walker and his aides worrying about damage to his political future. In the midst of these exchanges, one aide, who later went to prison, attempted to reassure another member of the team with the blunt political assessment that “no one cares about crazy people.”
Unfortunately she was right—mostly. Few of us care about the challenges of mental illness until the emergency is inside our own homes. Mr. Powers didn’t—until his sons began showing symptoms as teenagers, which is usually when these conditions clearly manifest. But once he was awakened, the world he had entered frustrated and enraged him.
Mr. Powers gives away the climax of his story in the preface: Both his boys, starting at different times, were beset by schizophrenia, and for the younger one, Kevin, the illness proved fatal. At 20, after three years of struggle, he hanged himself, at home in the basement, while his parents slept upstairs. Mr. Powers’s decision to put this stunning revelation on his first page was a gesture of respect to his son’s memory. There would be no storyteller game-playing with Kevin’s life—no ominous foreshadowing, no false hopes for a happy outcome planted along the way. If anything, the author risks scaring away readers uncomfortable with darkness. But those who stay will learn not only what the stakes are but also why they are on this journey.
The stay is worth it, for what unfolds is one of the most engrossing accounts of raising a family I have ever read, one in which Mr. Powers makes universal his themes of parental love, bewilderment and rage at the vagaries of biological fate. At the start, he was just a dad, and his wife, the scientist Honoree Fleming, was just a mom. Neither had any experience in raising children with mental-health challenges. They weren’t experts in schizophrenia. Nor did they need to be, for the first 15 years or so. Mr. Powers’s early chapters conjure his family’s time of pure ordinariness—a quality he cherishes all the more because it was lost. He seems tormented by these recollections—his family’s “before” years—but also blessed by them. And by sharing them he lifts his book into something more elevated than a eulogy for Kevin.
Instead, Kevin lives again in Mr. Powers’s poignant portrait, which he pieces together from excerpts from middle-school essays; quotations from father-son bedtime conversations that sound as fresh as last night; and, most powerfully, Mr. Powers’s descriptions of Kevin’s musical talent. The young man was a true prodigy on the guitar, playing since age 4, and was on his way to making a career as a singer. You can find at least one of his teenage performances on YouTube, and his dad’s right—Kevin Powers was going to be great.
All of which makes his deterioration, with its declared inevitability, more moving and painful to observe. Mr. Powers, in the middle of it all, had no idea where his son’s life was heading or how to keep him from slipping deeper into trouble. Medications were tried. And hospitalizations. But Kevin eventually wanted no part of treatment. The laws limiting involuntary treatment made it difficult to counter Kevin’s preferences—a reality Mr. Powers laments. In a way, Kevin had moved past his parents’ help, which is one of the things that still eats at the father even now.
Another thing is the sorry history of American society’s response to mental illness over the past two centuries. Mr. Powers thumbnails this history in chapters alternating with his sons’ stories and aims his anger at the seemingly natural impulse most of us possess to shun the mentally ill, much as we do the severely developmentally disabled. There is a loneliness to being in either of these categories, a loneliness that also afflicts the families of affected individuals and that is exaggerated by the “solutions” developed, over time, for “dealing with the problem.” Thus Mr. Powers relates the many remedies put forth over the years by usually well-meaning people who, in profound ways, missed the mark. He covers the eugenics movement; the many decades when the severely mentally ill and developmentally disabled were warehoused in so-called asylums; and the scandal that followed the deinstitutionalization movement, when a benevolent assertion of civil rights led to the shuttering of mental-health centers, but without adequate provision for former residents’ continuing need for treatment or even basics like food and shelter. The result: a swelling number of homeless and the transformation of the prison system into a custodial program for people who should be getting help, not doing time.
The real scandal of Mr. Powers’s exposé—and he knows this—is that he is not revealing anything new. These failures have been described many times, by muckrakers and reformers, since the mid-19th-century. But each time the outrage proved short-lived, swallowed up by renewed indifference or perhaps mass amnesia. As the author keeps finding, society’s impulse to “other-ize” the mentally ill is constant: These individuals are politically voiceless and therefore easy to marginalize.
The most uplifting chapter in “No One Cares About Crazy People” is its brief epilogue, focused on the present. Mr. Powers talks about getting visits in his dreams from a guitar-playing Kevin, and he reports that his older son, Dean, who was given the same diagnosis as his brother, is now “doing fine.” Dean has acknowledged that he needs help. He is, says Mr. Powers, “in possession of himself, aware of his limitations, and ready to live on his own in the wider world.”
Still, you can hear the caution in those words. Mr. Powers seems to sense that the progress is provisional; that Dean, now 35, will always be at risk; and that his own fathering remains on trial. Assuming the best, though, Dean will outlive his parents, who are his current chief protectors. That is when he will need the rest of us to be on his side—his and all of those among us who face similar kinds of struggle. That’s why this book was written: to get us to understand, to empathize, to identify. In short, to make its title a lie.
—Mr. Donvan is the co-author of “In A Different Key: The Story of Autism.”
From the New York Times
NO ONE CARES ABOUT CRAZY PEOPLE
The Chaos and Heartbreak of Mental Health in America
By Ron Powers
360 pp. Hachette Books. $28.
In the opening chapter of his extraordinary and courageous book, the author and critic Ron Powers writes about a recurring dream in which he imagines his sanity as resting atop “a thin and fragile membrane that can easily be ripped open, plunging me into the abyss of madness, where I join the tumbling souls whose membranes have likewise been pierced over the ages.” The “horror and helplessness of the fall,” he goes on, “are intensified by an uncaring world.”
In “No One Cares About Crazy People,” he joins those tumbling souls, two of whom are his beloved schizophrenic sons. He writes with fierce hope and fierce purpose to persuade the world to pay attention.
No doubt if everyone were to read this book, the world would change. But its clumsy title (taken from a stunningly cruel offhand remark by one of Scott Walker’s staffers) is painfully correct. The mentally ill are still viewed with fear or suspicion, as broken, as damaged goods or objects of pity. Still, Powers will surely help to correct that perspective; it’s impossible to read his book without being overcome by empathy for his family, respect for his two beleaguered boys and, by the end, faith in the resilience of the human heart.
Powers, whose books include an acclaimed biography of Mark Twain and, with James Bradley, “Flags of Our Fathers,” is a deft craftsman of sweeping tours of history but also intensely personal human narratives. He brings all his talents to bear in this account of his literature-loving, endearingly goofy, high-achieving family’s descent into hell. Powers, his college-professor wife, Honoree, and their children had a beautiful life in Middlebury, Vt., until their younger son, Kevin, a gifted musician, began to exhibit symptoms of schizophrenia at age 17. Three years later, in 2005, he took his own life. Dean, the Powerses’ elder son, also developed the disease but eventually found some stability and a productive life through vigilant, compassionate care. In the boys’ letters and emails to their parents, elegantly threaded through the book, you can hear the voice of a family holding tight to one another and frantically expressing love as a shield against an onslaught of pain. I’m not sure I’ve ever read anything that handles the decline of one’s children with such openness and searing, stumbling honesty. This sort of truth-telling is particularly difficult inside a family, where fictions are often deeply baked and compounded by what they have invented (or ignored) to survive tragedy. And this candor is always serving a larger purpose: “to arm other families with a sense of urgency that perhaps came to us too late,” Powers writes. “When symptoms occur in a loved one, assume the worst until a professional convinces you otherwise. Act quickly, and keep acting. If necessary, act to the limit of your means. Tough advice. Tough world.”
Powers’s stated objective, and one that he brilliantly fulfills, is “to persuade my fellow citizens in the Schizophrenic Nation that their ordeals, while awful, are neither unique to them nor the occasion for shame and withdrawal,” and “to demonstrate to those who fear and loathe ‘crazy people’ that these victims are not typically dangerous, weak or immoral, or in any other way undeserving of full personhood.” But he is less successful in his second goal: to call for America to “turn its immense resources and energy and conciliatory good will to a final assault on mental illness.” In doing so, he creates what feels like two books, alternating his family’s story with a densely reported, sometimes dizzying survey of mental illness through history, from 1403, when London’s notorious Bethlehem “Bedlam” Hospital first began accepting “lunaticks.” He shows how major leaps in science and innovation have found twisted applications in the care and treatment of the mentally ill — Darwin’s theories of evolution become the basis of Nazi eugenics; pharmaceutical companies promoted “wonder drugs,” freely exaggerating claims, playing down dangerous side effects and unjustifiably inflating prices. These are mainly horror stories, broken by the occasional crusader-heroes like Dorothea Dix, who fought for the establishment of America’s first mental hospitals in the 19th century.
More often, even the best intentions have had disastrous consequences. In the 1960s the deinstitutionalization movement shifted patients from large, crowded psychiatric hospitals to what was viewed as more effective and humane community settings. Today there are some 10 million Americans with mental illness and only 45,000 inpatient psychiatric beds, leaving the suffering to shuffle between “crisis hospitalization, homelessness and incarceration.” Jails and prisons are now the nation’s largest mental health care facilities. The worst data point: There are 38,000 suicides a year in this country, and 90 percent of the victims are mentally ill.
Midway through, the book fuses into a powerful coherence. Sweeping exposition and finely grained narrative weave together, as confusion, pain and uncertainty emerge in the Powers home. An email from Dean, in college in Colorado, about a football game — “I think that game was fixed, and probably by the government” — strikes Powers as odd. Dean’s behavior becomes erratic. His father blames drugs or alcohol.
Meanwhile, Kevin, studying at the Berklee College of Music, is increasingly anxious. Powers chalks it up to adolescence until Kevin calls at 4 a.m., giddy with the news that he has been selected to go on a concert tour of Russia. His parents try to make sense of it. “Such is the power of persuasion, or the need to believe, or something, that we tried to fit his announcement into some plausible context,” Powers writes. “He was pretty damn good, after all. Had he made it through an all-night winnowing process of deserving students?” When Kevin reports a few hours later that he’s boarded a Greyhound for Los Angeles, where he expects to be a rock star, they race from Vermont to intercept his bus. But they find that he had already been removed by a police officer and delivered to a hospital emergency room in Syracuse, where he was sedated. The doctor suspected bipolar disorder, which, he said, “was a better diagnosis ‘than the alternative,’ ” Powers writes. “Yet, uninitiated as we were, we thought that perhaps we knew.”
They learn, as does the uninitiated reader, how the mentally ill retain their humanity, with all its hues, through the perils of the damned, in and out of emergency rooms, chased by police officers, from one good day back into the abyss. Powers and Honoree do what all parents do. They fight right until the end, when they find their son’s body. Then they fight, with added ardor, to save their other son.
Dean also attempts suicide — but is rescued in time. He finds the right doctor, the right medicine, the right dose. He walks again in sunlight. Is he different, from peak to valley? Not in his essence, or in his bond with his brother, which animates the book. “I am grateful for the almost 21 years I was given with Kevin,” Dean writes in a letter to a local newspaper after his brother’s death. “And after God takes back a gift like Kevin, it is a small request to ask Him for enough hope and strength to endure the grief.”
Like many families that have struggled with mental illness, the Powerses have seen way beyond their reasonable share of darkness, but they do eventually find a kind of hope and strength. This brave book — which reads like the act of consecration it is — imparts both, and demands society do the same for all who struggle.
From Kirkus Reviews
Pulitzer Prize-winning journalist Powers (Mark Twain: A Life, 2005, etc.) presents two searing sagas: an indictment of mental health care in the United States and the story of his two schizophrenic sons. Having previously published notable books in the realms of biography, media criticism, small-town ethnography, investigative journalism, and memoir, the author once again demonstrates his versatility. The unforgettable title of his latest book derives from a callous comment made by a politician in 2010. As Powers demonstrates through in-depth reporting and his own personal experience, even when those in positions of authority sincerely believe in the importance of helping those who are mentally ill, meaningful care tends to receive short shrift at budget time. The author never wanted to write a book about mental health because of the nightmares that would arise discussing highly personal matters. However, he decided that the urgency for improved mental health policy and funding in this country compelled him to forge ahead with a manuscript. By the time of his decision, nearly a decade had passed since his younger son, Kevin, had hanged himself in the basement of the family home a week prior to his 21st birthday. Then, as Powers and his wife continued in the grief and healing process, their only remaining child, Dean, began to show signs of schizophrenia. A psychotic break on a Christmas morning melted away the author’s resolve to refrain from writing this book—and readers are the beneficiaries. Powers intends for the book to comfort families dealing with severe mental illness, to shock general readers with examples of atrocities befalling the mentally ill, to show that “crazy people” are rarely dangerous to anybody but themselves, and to push for significant reform. “I hope you do not ‘enjoy’ this book,” he writes in the preface. “I hope you are wounded by it; wounded as I have been writing it. Wounded to act, to intervene.” This hybrid narrative, enhanced by the author’s considerable skills as a literary stylist, succeeds on every level.
From Library Journal
“A Pulitzer Prize–winning journalist and New York Times best-selling author, Powers offers a detailed social history of mental illness and particularly schizophrenia in this country, moving from the hellish abuse of early times through the eugenics era and the misguided antipsychiatry movement to the uncertainty and lack of support patients and their families still experience today. His story is also a heartrendingly personal one, as both of his sons have suffered from schizophrenia, with son Kevin taking his own life in 2005 after a courageous battle. Approximately 3.5 million people in this country have been diagnosed with schizophrenia, with half of them having never received treatment, which makes this book an important wake-up call. With a 50,000-copy first printing.”
From Publisher’s Weekly
“This resounding rebuke to scornful attitudes toward the mentally ill takes its title from a notably insensitive 2010 email exchange between high-level staffers of Scott Walker during his run for Wisconsin governor. Using that moment as a touchstone of indifference, Powers (Mark Twain: A Life) weaves a dual tale of the personal and the political. In one thread, he traces the history of public efforts to ameliorate (or, more often, hide) the plight of those living with mental illness, from London’s infamous Bedlam in the 18th and 19th centuries, where wealthy visitors were charged admission to gawk at the inmates, to America’s present-day prison-industrial complex. In the other, he tells his own family’s heartrending story of grappling with disease: both of his sons have struggled with schizophrenia, and his younger son, Kevin, lost his life to it in 2005. Along with grief, this section of the book is full of joy, serving as a loving tribute to Powers’s sons and putting a human face on serious mental illness for anyone lucky enough never to have been forced to confront it. Readers will surely be moved by this double portrait of one family’s days of happiness and sorrow, and the world’s halting and flawed attempts to care for troubled people.”
From Booklist Online
Pulitzer Prize–winning writer Powers shares his family’s struggles as two sons suffer from schizophrenia. Youngest son Kevin ends up committing suicide by hanging himself in the basement just before turning 21. Older son Dean remains under treatment for the disease. So much pain and loss, helplessness and frustration. Powers recalls the boys’ darkening moods, increasing opaqueness, and psychotic episodes. He points out a major obstacle to survival is anosognosia—a lack of insight into one’s condition, a faulty belief that nothing’s wrong with your mind. His very emotional memoir also covers some of the history, legislation, pharmacology, and science of schizophrenia. He reminds us how apathetic and cruel society can be when it comes to mental illness. Consider the colloquial nomenclature: loonies, lunatics, nutcases, psychos, wackos. He reviews the tsunami of miscalculations and mistakes in the 1960s that launched mental-health care on a terrible trajectory: the denouncing of psychiatry, dosing patients with new drugs to make them more docile, and releasing hundreds of thousands of mentally ill individuals from psychiatric hospitals and community-health centers. Presently, prisons are America’s biggest mental-health facilities. Powers grieves, “Too many of the mentally ill in our country live under conditions of atrocity.” Shame on us.
— Tony Miksanek
From Shelf Awareness
In the opening line of No One Cares about Crazy People: The Chaos and Heartbreak of Mental Health in America, Ron Powers, Pulitzer Prize-winning journalist, author and co-author of nonfiction such as Mark Twain: A Life and Flags of Our Fathers, writes: “This is the book I promised myself I would never write.” It is a hybrid, a nontraditional history of mental health care fused to an incredibly personal story about his two sons’ struggles with schizophrenia. For his son Kevin, that struggle ended in suicide, and the heartbreak of that experience (among others) permeates every impersonal date and statistic in the book with sorrow and rage.
Powers doesn’t attempt an encyclopedic history of mental illness and care in the United States, instead focusing on specific factors–trends, innovations, individuals, etc.–that played a role in creating a status quo wherein “too many of the mentally ill in our country live under conditions of atrocity.” Powers finds one of his chief culprits in deinstitutionalization, a program whose name “carried the lilting harmony of silverware spilling from a cleanup tray.” The well-intentioned experiment was designed to move prisoners from “the malingering scourge of decrepit mental asylums” to “community centers for treatment of the mentally ill.” Instead, budget cuts left hundreds of thousands of patients stranded and desperate, fueling the rise of homelessness as well as mass incarceration.
Clueless politicians are hardly the only ones to blame for the current crisis, however. Powers’s story is one of repeated moral failings, from the doctors performing transorbital lobotomies to the greed-fueled depredations of Big Pharma–“to open the dossier on the behavior of American and European pharmaceutical giants over the past quarter-century is to confront a fortified casino of riches and debauchery.” The title of the book is a quote from leaked government e-mails, repurposed into a damning allegation.
For the families of the mentally ill, of course, caring about “crazy people” is a necessity. In roughly alternating chapters, Powers allows us to watch his sons grow up, dealing with the challenges of incipient schizophrenia as well as tragic events that shape their young minds. All the while, Powers movingly relates the joys of raising creatively gifted children. Kevin proves to be something of a musical savant, while his older brother, Dean, shows talents for music and writing. A typically sweet anecdote recalls Kevin’s introduction to music as a young child serendipitously brought up on stage at a concert: “His poker face held, but inside him, volcanoes were erupting and winds were blowing one life out and a new one in.”
Unfortunately, the reader is also witness to schizophrenia sweeping through the loving family as Kevin and Dean experience hallucinations, paranoia and psychotic breaks. The boys’ interactions with the mental health care system give Powers a first-hand look into its failings, and in turn he shows the reader the devastating human consequences of society’s indifference toward the mentally ill.
—Hank Stephenson, bookseller, Flyleaf Books
‘No One Cares About Crazy People’ cries for more attention for the mentally ill – Pulitzer Prize-winning writer Ron Powers draws on heart-wrenching personal experience in writing about the way society treats the mentally ill.
From Kirkus Review
When Kelly Rindfleisch wrote the words, “No one cares about crazy people,” she never dreamed Pulitzer Prize-winning, New York Times-bestselling author Ron Powers would read them.
“I cannot describe to you the emotion, the shockwave, that hit me when I read that quote,” says Powers, author of No One Cares About Crazy People: The Chaos and Heartbreak of Mental Health in America, who Kirkus reached at home in Castleton, Vermont.
Rindfleisch, who was Wisconsin Governor Scott Walker’s Deputy Chief of Staff, wrote the hateful words in a 2010 email uncovered by the Milwaukee Journal Sentinel. To her campaign colleagues, she mocked and dismissed the depredations of the Milwaukee County Mental Health Complex, where a woman being treated for bipolar disorder died of starvation. Where workers sexually assaulted and impregnated patients.
“The fact was ungodly abuses happened at the Milwaukee County Hospital that were medieval in nature,” Powers says. “The rape of patients, starvation, naked patients walking around, physical abuse—there it is, in our time. It’s not something you have to look in an encyclopedia to find.”
Powers is an award-winning writer with criticism, narrative nonfiction, and biography to his credit. He is the author of Mark Twain: A Life and coauthor of the No. 1 New York Times bestseller Flags of Our Fathers, which was adapted into a film directed by Clint Eastwood. He and his wife, Honoree Fleming, a pioneering biochemist, are the parents of two sons, Dean and Kevin, who were diagnosed with schizophrenia in young adulthood.
“This is the book I promised myself I would never write,” Powers writes in No One Cares About Crazy People. “And promised my wife as well. I have kept that promise for a decade—since our younger son, Kevin, hanged himself in our basement, a week before his twenty-first birthday in July 2005, after struggling for three years with schizophrenia.”
No One Cares About Crazy People is a treatise on the state of mental health care in America today—how we arrived at the disgust, hostility, and ignorance embodied by Rindfleisch and her ilk. It’s also the emotional story of the Powers family’s struggle with the fearsome scourge of schizophrenia.
“I did not want to commodify my sons,” Powers says of his hesitation to include his family’s struggles in the book—a decision that came at the behest of his literary agent, encouraged by his editors at Hachette. “I didn’t want to turn them into a profit center, even unconsciously. I didn’t want this to be a ‘poor daddy’ book. There are so many…unworthy motives you could [have] for writing a book like this.”
Powers spent a decade researching nosology, political history, and structures of care and governance of schizophrenia (i.e., how the police and the courts treat the afflicted). In the book, he traces mental health care’s shocking history: from “Bedlam” asylum in London, the scene of centuries’ worth of shocking abuses, through American deinstitutionalization; the deleterious denial enacted by popular figures like Dr. Thomas Szasz, author of The Myth of Mental Illness and L. Ron Hubbard colleague; the noble mental health care initiatives of Presidents Truman and Kennedy and mass defunding by President Reagan; and the consequences for those living with the disease today, bumping up against untrained police, ignorant lawmakers, and fearful neighbors.
“Schizophrenia is different from depression, it’s different from hysteria, it’s different from any kind of bad mood or grudges or the kinds of things we all encounter,” Powers says. “It has a genetic component and it flows through families—probably, almost certainly, has flowed through mine, although no one in my family was ever diagnosed…. It must be understood as different, and it requires different solutions than I think we traditionally apply.”
Forced to bear witness to the inadequacies of our current system, Powers has issued a clarion call to arms: to do better by those with mental illness, their loved ones, and communities; to move toward ameliorative policies that consider their health, well-being, and civil liberties. In short, that we start to care about “crazy people.”
“I hope you do not ‘enjoy’ this book,” Powers writes. “I hope you are wounded by it; wounded as I have been in writing it. Wounded to act, to intervene. Only if this happens, and keeps happening until it needs happen no more, can we dare to hope that Dean and Kevin and all their brothers and sisters in psychotic suffering are redeemed; that they have not suffered entirely in vain.”
Megan Labrise writes “Field Notes” and features for Kirkus Reviews.
From Mike Miner, Chicago Reader
As you read No One Cares About Crazy People you might think it’s two books or you might think it’s one. There’s the book author Ron Powers tells us that he set out to write—a critical history of societal responses to mental illness—and there’s the personal story that compelled him to write this book—the raising of two sons who became schizophrenic, one of whom killed himself. An agent told Powers that to write one he must write the other. And so he has.
For a time beginning in college and continuing to the Sun-Times—where he won a Pulitzer Prize for TV criticism in the early 70s—Powers and I were close and had the forward-looking conversations young men have. Never—I repeatedly thought as I turned the pages of Crazy People—did anything cross our imaginations close to what lay in wait.
Crazy People is his response to that rendezvous. It draws on the wit and anger I remember, on research compelled by circumstance, and on paternal devotion then untapped in either of us. Powers has collaborated before—with Ted Kennedy on Kennedy’s memoir, and with James Bradley on Flags of Our Fathers. In Crazy People, Powers, the reporter and stylish writer, collaborates with himself, the father with a story.
“The world of mental illness,” Powers writes, is everywhere; it hides in plain sight. “Its camouflage . . . little more than the human instinct to reject engagement with the pitiable, the fearsome, the unspeakable.”
Rather than illness we’d see witchcraft; rather than humans in need we’d see menace, and we’d feel a duty not to assuage agony but to hide it from sight. The places where the mad were hidden gripped the public imagination for their gothic mystery. Powers tells the centuries-long history of the London madhouse known as Bedlam; in Saint Louis, as he surely remembers from his years there, an institution for the mentally ill was known to one and all simply as “Arsenal Street.”
You kept your distance from Arsenal Street.
Mental illness can hide in plain sight because we don’t like to think about it. But take your own inventory as I take mine. Two members of my book group have grown schizophrenic children. One daughter’s closest childhood friend is schizophrenic; another daughter’s grade school Spanish teacher lost her husband when he was stabbed to death during a psychotic breakdown by their schizophrenic son.
Powers and his wife, Honoree Fleming, raised sons Dean and Kevin in Vermont, where Powers wrote and Honoree, a professor, taught biochemistry and did research. Both sons were bright and creative, and Kevin was a guitar prodigy. The instructors his parents found for him soon threw up their hands—they had no more to teach him. But he was not yet 21 when he hanged himself in the basement of his family’s home.
Do madness and creativity go hand in hand? Powers devotes a chapter to this ageless question, to which there are correlations to be cited but no clear answer. Asked by a teacher in grade school to identify human needs, Kevin wrote, “I need music.” He inhabited, his father tells us, an “inaccessible” inner world of music, though the yield of that world can still be sampled today, as in a concert at Interlochen and an album the two brothers recorded together.
Powers places emphasis on the power of stress to trigger psychosis, and much less emphasis on the role of genetics, though years earlier his own younger brother had killed himself. Creativity and stress were palpable presences in the young lives of Dean and Kevin, and it’s those lives that preoccupy their father.
One Friday night toward the end of Dean’s junior year of high school, he took a curve too fast and his car slammed into a tree. The understanding around town was that Dean had been drunk, though he wasn’t. The girl next to him suffered injuries she was years recovering from, and her parents crusaded to see Dean thrown in prison. The high school principal banned Dean’s picture from the yearbook. Awaiting sentencing, prison a clear possibility, Dean wrote, in an essay, “my life is like a river and I am being swept away helplessly.”
And in Crazy People his father writes, “These were the days and months and events, I am convinced, that launched my eldest son into his rendezvous with schizophrenia.”
But today, Powers reports, Dean’s last psychotic episode a few years behind him, “he seems in possession of himself, aware of his limitations, and ready to live on his own in the wider world.”
Powers also introduces readers to a word I’d never heard or read before: anosognosia, or, “the false conviction within a person that nothing is wrong with his mind.” Powers calls it a “cruel joke.”
I’ve always supposed the joke is that when the meds work they make the patient feel so clear-headed he decides he doesn’t need them any longer. So he hides his meds, as Kevin did, or flushes them down the drain. Then he reverts. Confronted, he lies. But Powers says changing a patient’s ways isn’t as simple as screaming sense at him or waiting for him to learn from experience. He says anosognosia is actually a physiological condition disrupting the brain’s ability to recognize the condition it’s in; it shows up in 50 percent of schizophrenia cases and 40 percent of bipolar cases.
As his book concludes, Powers puts anosognosia to use as a symbol of obliviousness and denial—our own. He has seen what the mentally ill ask of the world—which is simply a place in it.
“The mentally ill people in our lives, as they strive to build healthy, well-supported, and rewarding lives for themselves, can show us all how to reconnect with the most primal of human urges, the urge to be of use,” Powers writes. “To put it another way: the mentally ill in our society are awaiting their chance to heal us, if we can only manage to escape our own anosognosia and admit that we need their help.”
Does putting the shoe on the other foot this way seem a sentimental stretch? I would say yes—if Powers were writing only about a set of issues he wanted to wrap up in a fancy ribbon. But the project’s too personal for that. He’s told us stories about the mentally ill burned at stakes, chained in dungeons, flogged and lobotomized, and treated to à la mode theories that they’d do just fine if turned out onto the streets, that they aren’t really ill at all because crazy people are the only sane ones. This is the history of society’s predisposition not to give a damn about Dean and Kevin!
And Powers won’t have it. They speak and we must listen. They are his sons.