Published in 2010 by Delacorte Press.

“I’m getting better again, taking medication, doing my very best to be a good patient, but then out of the blue, the chain-link fence that surrounds the hospital pulls me toward it, wraps around me, and is going to crush me. […] At some point in there I try to tell my father that I’m feeling better, and he says that he wouldn’t nominate me as Mr. Mental Health quite yet. I want to ask him if he is in the running or just one of the judges.”

I’m fully prepared to be wrong here, but I suspect that high on the lists of why people gravitate towards reading memoir is because they anticipate a certain unflinchingness in articulation. They expect, oft-erroneously, that if a person’s got the testicular/cervical fortitude to put themselves out in the limelight, then, by gad, they’re going to write with moxy, with aplomb, with some brass! I’m pleased to report that Mark Vonnegut’s got all three. Even though I’ve not yet read anything by his famous father, I was hesitant, approaching this title. You know full well how the children of illustrious creatives often balk from the wide circles of fame their parents cast. If they do venture into productive waters of their own, they typically embody one of the following traits:

1. They offer work that is painfully, ludicrously derivative—but this is forgiveable, and less egregious than—
2. the fact that they just as easily feign ignorance of their parents’ existence, shunning the specific styles of their mothers and fathers.

Shunning is all well and good, but shunning for reasons that are petulantly emotive rather than deliberately stylistic—well, that smacks of danger, to me… the danger of potentially good art being obscured by the long, long arm of familial resentment. It’s important to note that Vonnegut doesn’t write with cloying sycophancy or feigned apathy about Kurt, when he writes of him. In this way, I suppose people who turn to Just Like Someone Without Mental Illness Only More So to glean more of Vonnegut Senior’s inner workings would be most put out. I respectfully posit that they’re looking in entirely the wrong place. This is Mark’s story, after all. Readers like myself, who’ve not had the benefit of reading his previous book, The Eden Express, will likely be relieved to know that this second offering stands heartily on its own—though, doubtless, if you enjoyed this one, as I did, you’ll want to seek out the first.

A wideness and generosity of range drives the scope of the memoir; it feels like we’re touching base with Vonnegut at various points on his life, that he’s chosen this approach in attempt to round and flesh out the narrative: to show the polyvalency of the paths he’s trod. In addition to sharing the trajectory (if not the specifics, but more on that anon) of his four psychotic breakdowns, the writer presents his childhood days, his memories of Kurt the non-writer (his pre-fame father was, to quote Mark, “the world’s worst car salesman who couldn’t get a job teaching English at Cape Cod Community College.”) We’re also treated to reflections on Mark’s seemingly circuitous path to entering medical school at the age of twenty-eight, glimpses into his family’s mental health (or lack thereof) history, his decision to specialize in paediatrics, humorous anecdotes gleaned from his stint of relief work in Honduras. The overall impression created is less linear than good-humouredly scattered, with the chapters anchored by the author’s own paintings.

What’s particularly illuminating about Vonnegut’s situation is that, as both mental patient and physician, he’s able to speak candidly and forthrightly about either side of the institutional coin. His perspectives on the profession, patient-doctor relationships and medical insurance are wise, modulated by experience rather than any desire of his to sell you something. The insights he proffers on what one might term “behind the scenes” goings-on in the world of health care might not be novel, but it’s refreshing to have them uttered by someone in his specific white coat. Here, he speaks about the nature and classification history of his ailment:

“I was diagnosed as suffering from schizophrenia. […] What I had and have is more consistent with what is now called bipolar disorder, which used to be called manic depression. The name change was an effort to get away from the stigma around the diagnosis of manic depression. Good luck. Until we come up with an unequivocal blood test or the equivalent, we’re all blowing smoke and don’t know if what we call schizophrenia and bipolar disorder are one disorder or a dozen.”

It’s especially gratifying to read Vonnegut’s less than flattering opinion of the corporate concerns that undercut the quality and consistency of aid given. In remarking on the shifting behaviours that govern patient-doctor discussion, he reminisces with gratitude on the open, wide-ranged talks he was able to have with his own psychiatrist when his Thorazine dosage was being reduced. In speculating on what that procedure would entail in a present-day setting, his tone is resolutely bald.

“Today, if I was lucky, I’d see a case supervisor monthly and maybe a psychopharmacology nurse every three months. Clinical guidelines would mandate that I be on antipsychotics for at least five years. The medication I was on would be determined by who paid for lunch and what deal was cut between my health insurer and the pharmaceutical industry.”

I didn’t get the impression that the author was trying to earn a battery of enemies in the medical insurance field. He’s not calling out the insurers, the pharmaceutical manufacturers, the impersonal practitioners, because he’s trying to curry favour with readers for his audacity. One senses that Mark Vonnegut’s just speaking his mind, that having lived through his psychotic episodes (which he refers to as “breaks”) made him less susceptible to tolerating perceived injustices: in short, that those very breaks helped build him into a more genuine, candour-driven self.

An anticlimactic area centres on the issue that there is little visceral untangling of the four psychotic breaks themselves. The writer doesn’t shy away from bringing them up, but we’re never allowed a full and inexorable assessment of those specifics. The autobiography opens with the general delineation of Mark’s symptoms: his inability to eat or sleep; the voices that plagued him; his tendency toward self-harm; his heavy sedation. I kept waiting, with bated breath, to be led further down the rabbit hole of an insider’s vivid description of bipolar disorder… but it felt like Mark kept me solidly, perhaps even safely, at the fringes. Maybe this is as much enlightenment as can be reasonably expected, and maybe this is just the way Mark experienced those breaks, too. Still, it’s difficult not to feel stranded on the shore of apprehension, hoping an illuminating wave of prose will sweep us into the churning emotional seas of a world populated by voices in your head. It never happens. Perhaps I ought to be grateful for that, rather than critical.

What will win readers to this artful autobiographical meandering is, ultimately, its ease of voice. The narrative is laden with quotable illuminations on the role of art in assuaging despair, on the combined weight-inspiration of laying claim to a famous father, on the ways in which interludes of madness can wreak havoc on your life and simultaneously transform it to your best advantage. All of these are shared in the writer’s personable, gently self-deprecating style. Just Like Someone Without Mental Illness Only More is a interior journey you can take with the signposts of a life that’s been, by turns, extraordinary and reassuringly simple. If you think of your autobiographical narrator as a companion and cohort in the reading experience, you’d be hard-pressed to find one more earnest and admirably principled than Mark Vonnegut.

A free electronic copy of this novel was provided by the Random House Publishing Group (Delacorte Press imprint) for review, through NetGalley. The opinions expressed in this review are entirely my own, and are not influenced by their generous gift of gratuitous literature.