THE MADNESS PILL: One Doctor's Quest to Understand Schizophrenia, can be a tough read but has a hopeful ending

THE MADNESS PILL: One Doctor's Quest to Understand Schizophrenia
JUSTIN GARSON
St. Martin's Press (non-affiliate Bookshop.org link)
$15.99 ebook, available now

Rating: 4.5* of five

The Publisher Says: A rollicking history of the life and work of an unheralded genius: Dr. Solomon Snyder, whose experiments with mind-altering drugs helped change the way we think about the causes and treatments of schizophrenia.

In the 1950s, the field of psychiatry had nothing to show for itself. While polio was being cured, antibiotics were being discovered, and cancer research was developing, the mental health world had no wins. Asylums were full and nobody had figured out how to fix insanity—specifically schizophrenia, the severest mental illness. Scientists became convinced that if they could engineer a pill to create madness, then they could cure it.

Centered around Solomon Snyder, the psychiatrist who ultimately did identify the madness pill, and the community of doctors and researchers he worked with, THE MADNESS PILL recounts the drug-fueled quest to cure schizophrenia. A wunderkind who started medical school at 19, Snyder worked steadily for decades to replicate the illness, ultimately finding in 1970 that amphetamines could trigger a schizophrenia-like state by flooding the brain with dopamine. Five years later, he went on to discover the dopamine receptor and proved that antipsychotic drugs work by disabling dopamine neurons. Snyder’s dopamine hypothesis inspired a generation of researchers to part ways with psychoanalysis and look for the biological basis of schizophrenia and other mental disorders.

Using first-hand research and interviews, THE MADNESS PILL is at once a raucous history and insightful portrait of a remarkable scientist who turned psychiatry into a respected science by transforming how mental illness is treated.

I RECEIVED A DRC FROM THE PUBLISHER VIA NETGALLEY. THANK YOU.

My Review: I did not think I'd review this book all that politely. The publicists who wrote the synopsis above used two words in particular that felt...off, odd, even a smidge dishonest, in my mental ear: "rollicking" and "raucous." A scientist's life's work decribed in storytelling superlatives, not scientific ones like "groundbreaking" or "paradigm-shifting"? ::side-eye::

One victory for y'all, publicists. This story as told by Author Garson does indeed rollick raucously through Solomon Snyder's life's work in neurochemistry. I'm a big proponent of talk therapy for those able to benefit from it. Those who can benefit include me (happily) when, after a major crisis that was stabilized by antidepressants, aka neurochemicals, I entered another phase of talk therapy that has presented me with ongoing benefits that I remain deeply grateful for.

Schizoaffective disorder and the multitude of brain-chemistry malfunctions related to it is not adequately addressed by talk therapy. Until Solomon Snyder got to pokin' around because there was zero progress towards curing this life-ruining disorder, there was no good outcome for its sufferers on offer anywhere. It's still a horrendously difficult condition to manage even with neurochemical models explaining some root causes of its symptoms, and chemical therapies helping manage some of devastatingly painful results of its symptoms.

Author Garson is chatty in his presentation of the facts uncovered by Sol, as Dr. Snyder seems to be universally referred to after a time, and his collaborators and even enemies. (No one who changes paradigms is going to be without enemies, detractors, and ill-wishers.) The chattiness and the organizing principle of Sol's personality and perspicacity leads to the strange sense that we're getting to know *about* Sol, getting to know how he affected people and worked with them...or didn't...but not to *know* him. The research, the systems of conducting it, aren't glossed over or lingered on. It's very uncomfortable stuff to our twenty-first century eyes. Sol was in the thick of it. He did wonders for people who previously had little to hope for; getting there, he caused harm and suffering. Those who suffer with experimental animals are strongly cautioned not to read this story; those who feel raw about issues of consent are not going to find this subject matter at all easy to contend with.

There truly is no light without shadow.

Light there is, all in despite of the dark tunnel traversed to get to it. I have known eople suffering with schizophrenia who, when medicated, felt worlds better than without these hard-won treatments. Some have not felt the positive effects outweigh the frustrations of the side-effects that come from altering one's brain chemistry long term. My sample size might not be huge but is exactly in line with the results reported, and analyzed, in Author Garson's story. The names of the chemicals, the names of the drugs, the explication of the functions of them...all of that's a lot, and be ready to use Google often. But the reason to keep your attention on the page is that this detailed information is the foundation of the genuine miracle that is the help offered to previously unhelpable sufferers.

I was so buoyed up by this end result that I was able to consider the abusive and unethical (by today's standards) actions committed and/or not opposed at any point in the process as distasteful, but not disqualifying of the results as very much positive. I do not feel that way about, say, watching a Weinstein-produced film now that I know the crimes he committed, or the awfulness of that transphobic conversion-therapy supporter whose wizard books I once enjoyed.

I offer my ethical calibration for your reference only. Your decision about learning the good with the unpleasant in search of help for the mentally ill is not for me to do more than inform. I felt all the way through the read that I'd've been even happier had Author Garson discussed ethics in specific and open terms as we went along but the way he chose to address the issues passed my muster. Barely...more would've been better.

Again I strongly caution those sensitive to animal suffering to avoid this entire topic. It will not reward you commensurate with your own distress.

ASK AGAIN, YES is a deeply felt, carefully observed, and difficult to read tale of family crises

ASK AGAIN, YES
MARY BETH KEANE
Scribner
$17.00 trade paper, available now

Rating: 4* of five

The Publisher Says: A profoundly moving novel about two neighboring families in a suburban town, the friendship between their children, a tragedy that reverberates over four decades, the daily intimacies of marriage, and the power of forgiveness. How much can a family forgive?

Francis Gleeson and Brian Stanhope, rookie cops in the NYPD, live next door to each other outside the city. What happens behind closed doors in both houses—the loneliness of Francis's wife, Lena, and the instability of Brian's wife, Anne, sets the stage for the explosive events to come.

Ask Again, Yes is a deeply affecting exploration of the lifelong friendship and love that blossoms between Kate Gleeson and Peter Stanhope, born six months apart. One shocking night their loyalties are divided, and their bond will be tested again and again over the next 40 years. Luminous, heartbreaking, and redemptive, Ask Again, Yes reveals the way childhood memories change when viewed from the distance of adulthood—villains lose their menace and those who appeared innocent seem less so. Kate and Peter’s love story, while haunted by echoes from the past, is marked by tenderness, generosity, and grace.

I DON'T REMEMBER WHO GAVE ME THIS LOVELY BOOK, BUT THANK YOU!

My Review: I'm not a spoilerphobe, as I've mentioned before, but there are certain events in this book that it would just rot on ice for you not to see for yourself for the first time. So there will be some tap-dancing around some events.

What matters to me in a read, the thing I seek and must find or I'm put out and feel I've been hard done by, is the sense that I'm seeing characters make efforts, take chances, do things, and as a result of whatever combination of those things the author chooses, they need to change. Not necessarily dramatically, or for the better or for the worse. But there needs to be some perceptible alteration in that character's life, sense of purpose, or station.

That is very much not a problem in this story.

Immigrant Francis is Irish to his core. He moves to New York because 1970s Ireland was not the Celtic Tiger it became decades on. His adjustment to American manners and mores wasn't easy on him, but he fell in love with the right woman and built a life with her. So that base is solid, right?

It is a truth universally recognized that people are their own worst enemies. Actions that seem, in the moment, inevitable or destined to occur are deeply stupid and cause problems it's hard to imagine. Yet here we are, with only the moment to live and as often as not without a clear understanding of the past to build on. As Author Keane says, "We repeat what we don't repair." That just rang me like a bell the first time I read it. Such a lovely, distilled way to say the truth as I've learned it the hard way.

The quiet of the house when she kept to her room was not the peaceful silence of a library, or anywhere near as tranquil. It was...more like the held-breath interlude between when a button gets pushed and the bomb either detonates or is defused. He could feel his own heartbeat at those times. He could track his blood as it looped through his veins.

Families are the prime breeding ground for things that need repair. Most often we don't see that...in ourselves, of course, since it's incredibly easy to see in others and there's even this thing called "fiction" to feed our schadenfreude watching others screw up chances to repair the damage done to us. But some damage is done in some families that is, in the truest sense of these words, irreparable and unforgivable. That's when the stories get really good.

Telling her, bringing that story to England, spoiled England for her. When she left for America two years later, she knew she would be smarter. She'd bring none of Ireland with her.

But no matter where you go, there you are, right? Our selves and our bodies are coterminous if not identical, where one goes there the other is as well. It's not always that great a feeling. But unless we repair the breaks, well...you're adults, you know already. And how sad, how burdensome is that knowledge.

The burden travels down generational rivers, too. In this story, Peter the son of truly miserable man and truly evil woman, falls for Kate the daughter of stoic parents whose inability to communicate doesn't keep them from mangling each other. There's a bad patch (!!) and the young people are separated against their wills; there's a reunion, and what flowers is a very beautiful blossom of hope and love.

He dreamed of sharing an apartment with Kate someday, coming home to her each evening and telling her about his day, hearing about hers, going to bed naked with the covers pulled up to their chins, feeling her warm skin next to his when he woke up every morning.
–and–
If they could do all those things and pay their bills and not dread going to work each morning, coming home each night, then that was a life. That was a great life, in Kate’s view. What else could there be? If they reminded themselves that these small things were enough, she believed, then they’d always be okay.

They're having different relationships. That's so often the way with couples, and sadly most often between couples freshly in love. The true emotional core of the party of the second part isn't always easy to reach, but the fact is most people don't really even ever try. It's hard. It's vulnerable. It's often met with anger or rejection or outrage. Who tries, they are abusive! Intrusive! I need my space! Who resists, they are elusive! They are secretive! Why won't you trust me and let me in?

Surviving those shoals, accommodating each other and bending to and fro, allowance-making and temperature-taking, survival...until new shoals hove into view as soon as the seas looked smooth.

And then she saw it so clearly, the whole trajectory of their lives, a twin flare of lights against the gunmetal winter sky: we're born, we get sick, we die. Beginning, middle, end. She saw her life as if held aloft by her own hand, and in an instant it spun away from her. Where did she want it to land? She was in the middle. The exact middle. Peter too. How could she have failed to notice that the beginning had come to an end?
–and–
It wasn’t that she didn’t love him, he knew. It was that she loved him so much that it frightened her, loved him so much that she worried she might have to protect herself from it. He tried to let her know that he’d figured that out, finally, that there was no need to explain, but then he realized that she might not know it herself.

It is a damn difficult thing to keep being in a present-tense relationship with someone over a long period of time.

They'd both learned that a memory is a fact that has been dyed and trimmed and rinsed so many times that it comes out looking almost unrecognizable to anyone else who was in that room or anyone who was standing on the grass beneath that telephone pole.

Allow this novel's steady pace to lead you where the story goes. Possess your soul in patience, don't get agitated and skip and flip; stand on the grass with Author Keane. Make a memory. Make it well.