The Best Minds is a coruscating indictment of psychiatric services for psychotic patients in the US. It is also a moving and shocking account of the trajectory of Jonathan Rosen’s childhood best friend, Michael Laudor, struck in his youth by schizophrenia, and whose starry ascent through Yale law school to spokesman for stigmatised patients with psychosis plummeted dramatically when he relapsed, with catastrophic results.
Schizophrenia is terrifying for the sufferer, characterised as it is by a distortion of reality brought about through paranoid delusions and auditory hallucinations. Those who wrinkle their noses and sneer ‘crazy’ need only gently press their closed eyelids to experience transient visual hallucinations of flashing lights. Now imagine instead if that flash were a constant stream of voices telling you that people were trying to kill you, and a conviction that you were being monitored and about to be harmed.
Rosen, who has suffered from anxiety himself, evidently has huge empathy for those with mental illness. With flair and eloquent despair, he takes us through the ways in which these vulnerable individuals have been failed by society, even by those with the best of intentions.
First, there were manacles and inhumane conditions in long-term asylums. Then came ‘treatments’ such as lobotomy, which reduced patients to stunted shadows of their former selves. There were experiments with LSD on institutionalised patients, and a misguided ‘freeing’ of residents of long-term institutions by releasing them into the community, a move that failed not only because of inadequate community facilities and support, but also because the most extreme schizophrenics, who do not take their medication (part of the condition is not believing that they are ill), need humane hospitals for in-patient care.
Then there was a vogue for seeing the severely mentally ill simply as societal rebels refusing to conform to bourgeois norms.
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