Twenty-four years ago, I was hospitalized for two years at McLean hospital in
Belmont, Mass., diagnosed with schizophrenia, often considered a chronic,
incurable disease of the mind. One day I was sitting at the center of the ward
right next to the nurses' station. Sean K, a mental health worker, sat across
from me on a folding chair. He was a big guy with wiry, black hair, a red, acned
face, a paunch that hung over his belt, and large feet in heavy leather sandals.
We were talking about Donna, who was in the quiet room communing with her voices,
and about Gerry, who had been transferred to East House, not because he'd been
violent, but because his refusal to take his medication made staff afraid that he
might be. As we spoke, Sean clutched a clipboard to his knee with one big hand
and stroked his chin with the other. It was midday, a busy time on the Hall, and
every once in a while our vision of each other was obscured by patients and staff
walking by. "Well," he said, "Do you know what makes you different than most of
the other patients here?"
"What?" I asked curiously.
"You don't like it. You don't enjoy it," he said.
"What do you mean?" I asked, not sure of what he was talking about.
"Psychosis," he said. "You don't like it and you don't enjoy it. The others do.
That is what makes you different than most of the other patients here."
According to popular culture, schizophrenia is a brain disease that is often
acquired through heredity. It is characterized by persistent delusions and
hallucinations that are largely suppressed only by the use of powerful
anti-psychotic medications. This past year I watched a program on schizophrenia
produced by Nightline and the prime image I recall from this program is one of a
psychiatrist walking down the streets of a city, eyes straight ahead, intoning
the words "Take the medication" while a homeless man with mental illness clutched
at his sleeve. So, is the schizophrenia I was diagnosed with chronic? Can it only
be controlled by the use of powerful anti-psychotic drugs, or is there another
way, the way of choice, as Sean implied to me years ago as we sat together in
mid-hall?
Apparently, of those diagnosed with schizophrenia, approximately 25% recover
spontaneously and without treatment. One very publicized case of this kind of
recovery is that of John Nash, whose story is told in the movie "A Beautiful
Mind." He didn't take medication. His recovery was the result of choice. "I
became disillusioned with my illusions," he said in one interview. One of the
most touching scenes in the movie takes place when Nash bids them farewell. A
similar scene takes place at the end of the thinly disguised autobiographical
account of schizophenia found in "I Never Promised You a Rose Garden," when the
protagonist Deborah turns her back on her illusions. "I am going to embrace the
real world," she says to her illusions, "fully and completely. Goodbye.
Goodbye."
Somehow, while watching "Minority Report" we knew that by affirming the
capacity to choose, the Pre-Cog Agatha was affirming the fundamental nobility of
the human soul. She knew that, as human beings, we are not mechanical drones
caught helplessly in the twin fists of heredity and biochemistry. So much that we
do in life has to do with attitude, expectations, and, ultimately, choice. Sean's
words that day at McLean echoed in my mind and eventually transformed the
sequence of my choices so that today no one would consider me to be a person with
schizophrenia. Could it be that different words, damning words, caught other
patients on the hall with the same diagnosis that I had, in a trap they could not
escape?
There are no easy answers to the problem of schizophrenia, and I am the last
person to want to add more burdens to the shoulders of people who suffer with it.
I have often used medication temporarily when I thought it was necessary.
However, I would say that 25% of people with schizophrenia, or even more, can
find their way to full recovery by exercising their capacity to choose.
I am aware that within the field of mental health, there are those who would
like to suppress this information and shut down the survivor movements that
insist upon letting us know about it. But just because a fact makes you
uncomfortable, requires you to work harder, or to seek more complex solutions to
problems, doesn't make it untrue. The right to choose defines us as human
beings.
People with schizophenia should be allowed to exercise the right to choose,
because contrary to what some people would have us believe, they are as human as
anyone else.
