Falling Into the Fire

(Mental illness, hysteria, Jesus, pseudoseizures, drugs, and eunuchs )

 

Christine Montross, in her book, Falling Into the Fire, has some applicable quotes -

"Canst thou not minister to a mind diseased?" - from Macbeth

and

"They called me mad, and I called them mad, and damn them, they outvoted me." - Nathaniel Lee

and

"Those wounds heal ill that men do give themselves." - from Troilus and Cressida

Not in her book are - "If she sums in analytic art, don't puzzle as by fluxions" - Eradacus Maximus, 17the century.

and

"If she can see herself in the mirror, don't move the mirror" - The Last and Greatest Maximus, 20th century.

 

There is madness among us and we "vote" in a sense to identify those who are mad. A diseased mind, self-inflicted, has yet to be reduced mathematically and can be seen only as a whole, like in a mirror, all at once. The author doesn't want to be seen there in the mirror beside the displayed self, whoever it might be. That would be falling into the fire. They do burn, she doesn't.

Without mirror or fire, Jesus was killed. Justin J. Meggitt, in a book soon to come out, asserts the Romans thought Jesus to be mad. Meggitt thinks he can then explain why the Romans did not hunt down the followers of Jesus. The "diseased" mind, wounded and not healing, was "outvoted" by the Romans. One can suppose their solution was a rational one from their side of things. From a futuristic standpoint, within a characterization of madness, they ended His suffering. The "cured" Him. It is doubtful they knew of any echoes of a Greek approach for algebra, not as art but as science; nor certainly not the infinitesimal calculus. Nothing like contact with the infinite figured into their calculations for His execution. It was simple arithmetic. It was subtraction for them but it lead to a replacement of them, all things Roman ended and, in addition, Christianity flourished.

Much later, and with Christianity no longer flourishing, the author attended an interdisciplinary conference about madness. The conference was decidedly not weighted toward the clinical approach. The literary types got it going that madness can be a good fuel for productive creativity. They saw "fragmented capitalist selves" or "existential radicals" among those mad. They did not ask if literature is real. Nevertheless, what if all those mad had had a "stiff dose" of phenothiazine, as O'C. Drury speculated might have benefited Joan of Arc? For à la Jesus, the Romans, those ancient psychiatrists par excellence, "treated" the wrongly styled "King" without phenothiazine. Nails and wood sufficed.

The author throughout the book relates patients she has encountered in her rather short few years of practice. A stereotype is an appearance by Jesus. In one case she was upset by his gaze. The parents of Jesus arrived from Chicago. They believed he had had a spiritual awakening although his behavior was a concern. He was joyfully happy. It did his soul good. He stunk and was unshaven. He endorsed such an elated mood but with slow speech supporting grandiose thought. He was expansive and poor in judgment. He failed to see a need for help.

The author adds that Oliver Sacks said to not celebrate good times if it is a departure from a person's typical self. George Eliot called it a "dangerous wellness". One can't be high for long, a crash is coming. In one doubtful example formulated by students of Biblical text, was it a crash right onto the Cross?

Some minds are granted time before madness overtakes them. During such time, they know they are going insane; they cannot stop it. They know there is no escape. They are rational until the greatest of existence is extinguished, burned out by the cruel banality of reality. The last embers of life worth living no longer glow, out in a wink. They can try to keep the mind's eye open, but sooner or later, they wink.

The irony of it all is that now, as 2000 years ago, you can be put to death or reduced to little better than death, for what you may be. Whoever you may be is always a mystery to others. There is more than a leading edge of sadness for everyone's last hurrah. Sliding along, is the best or better always before you or is it far away in time or space? If it isn't front and center, are you going to ransom yourself to be held in hock until time and space reverse? We once knew what we had to accept. Now we medically think faith produces agonizing self-debasement. The doctor, the author, ponders when to medicate. Is there a deity involved? Is God's message now being blocked while it was on a clear channel ages ago? She can talk it out with them, talking about it can be good or it can be an example of talking into it, which makes it worse.

A city can make it worse. There are syndromes named after cities - Florence, Paris, and Jerusalem. For the latter the involved persons have no history of mental illness. Once they leave Jerusalem, they are better. But while there they become agitated, anxious. They have a need to be clean, pure. They put on a toga. They shout verses from the Bible. Then they deliver a sermon "wholly unrealistic" about being moral. It all ends in shame, once they return to reality.

Meantime, the gawkers have a field day. It is not only there in Jerusalem in more modern times but also at other times that the author gives the community of readers-as-gawkers a fair share of material. Accompanying the gawking, the author allows for insider's jargon, wisecracks, and updates on clinical procedures and brain circuitry. Sternal rub, anyone?

Nathaniel Lee, quoted in the above, spent five years in Bethlem Royal Hospital socially known as Bedlam. Tickets were purchased so as to see the "incurables". Perhaps they were in a stupor, having interrupted neural circuits the better to be mute or lack pain. Some of the poor devils were caged. Like horses, some had metal bits in their mouths. Some were underwater for a time or spun wildly.

The author's cabinet of curiosities approach also yields a long list of what one woman of contemporary times intentionally ingests. When stressed, she swallowed. On another shelf of the cabinet can be found those labeled BIID, for body integrity identity disorder. They sense their bodies extend too far. Arms, legs and perhaps a torso should go away - cut away, blasted away, ripped away, or frozen away.

Clocks prominently occupy another shelf to time pseudoseizures. If the not so real seizure trips past five minutes, maybe it is the real thing and status epilepiticus is a bad deal. It doesn't help to call them pychogenic nonepileptic seizures. However named, they are psychological at the source and not neurological in cause. No electrical impulses are firing the brain. The EEG for them shows no seizure.

The author really cranks up with Charcot of the 19th century and his arc-de-cercle or arc-en-ciel, but first she backs up into the 2nd century AD on the subject of hysteria. She faults the treatments because it was said to be a problem confined to females. The majority of cases of psychogenic nonepileptic seizures, for example, occurred in females. For hysteria, massage of the genitals occurred in the 2nd century and much later when the massage was employed until "hysterical paroxysm" for relief of pelvic congestion occurred. But the time spent on doing a massage got to be a bit much so the vibrator was invented. The use of the vibrator was not related to sexual arousal. Even the sight of a speculum supposedly put some females into a lust for an exam. By 1906, the ten-minute vibrator session was substituted for the tiresome hour of effort for treatment of hysteria.

Not only the vibrator but also washes, removal of the stimulated rod or removal of the ovaries were all done. Counter evidence for effectiveness did no good as lobotomies more recently also "trundled on". Charot did get results, he said. Critics, few in number, said he had invented a condition, then and there in Salpêtrière. He fostered a culture of suggestion (à la Freud?) moving subjects from solitary vague unease to continual exposure to real weirdoes. Eventually they succumbed and exhibited symptoms.

Other nonsense had the uterus wandering about the body. But as the author astutely takes note, men don't have uteruses so they did not become hysterical. She says they were tabbed as being "nervous". WWI's shell shock was a warhorse of a different color. But for all their problems they were not castrated though unfairly the women had this and that removed.

Her emphasis is heavy on the gender definition of hysteria. The men got off scot-free. It was men removing the female body parts, damn it. How unjust, eh? Well then, justice was served when Origen castrated himself. Other philosophers, neo-Hellenistic or not, were castrated. After battle, to the victors belong the spoils. Usually the penis was left, but the rest was cut off. Birth control was affected. Eunuchic administrators of harems and bureaucratic activity sold for a pretty penny. Herodotus usually refers to eunuchs in terms of a high value placed on them. Dissent, across the ages, could get you castrated. The Chinese got thousands of boys transformed, voilà! Also, slaves of dark skin pigmentation had both major genital zones whacked for removal. Most died, in terrible agony, but the surviving remainder made for a profitable enterprise. Most of us already know of the castrati obtained so as to hit the high notes in choirs without women. Chemical castration now flourishes as punishment and as medicine. In other words, men did unto men and the women of the above suffered for reasons other than cruelty.

The author wants no part of cruelty. She participates in faith for the effort to cure the mentally ill. The use of "cure" is a strong term as is "treatment" which has a curative connotation that some IRBs will not accept. Anyway, their illnesses generate questions from their states of profound crises. They are people but they are minds too. The doctor, the author, has a mind, as does her partner and her two children. She, early on falsely compares her patients' minds to those of her children. She finds human similarities that are present because both the children and the patients are human. Less training is required for children, honestly, they do have compasses of a sort and a light touch steers them but patients are lost, gone into the fire, burnt to a crisp.

So then, toss pills into the fire. At least her profession sometimes does this. She does robotic, by the checklist, evaluation of those in the fire. She tries empathy, they insult her. It seems she tries to reason with them Try anti-reason, use mindful robots. They need like minds to feel the fire of powerlessness and the lack of response that could make sense to them. Only so much time can be given to them in the author's environment. Guess. Move them out. The system triumphs yet again. Empathy for the burnt evaporates and repugnance tries for the upper hand with many doctors. Go on, deal a deck, give me cigarettes, fatty food, Nazi science, Soviet science, limb removal, enlargement of organs, increased muscle mass, extremely reduced body weight, - in all, subtract from what you were, even if you get an increase, you have taken away what chemical practice, not of itself amoral, but put in the service of what you could have been – helps to light the fire.

In adolescence, once, so long ago, we were taught, yes actually taught, to strive to do good but to accept limitations. It was the striving, don't you get it, that made us not into imposters. Dalma Kalogiera-Sackellares labels a certain condition as being the double imposter. The patient strives to be a real patient, having real trouble and problems and the doctor of psychiatry strives to avoid failure, to be a real doctor. We didn't strive to be real. We didn't need to, we were real, they, the teachers, were also real. There was nothing difficult about it. Eras of enormous falsity have been perpetrated since then.

The author's partner insists on beauty and awe on a daily basis. Bravo! Unknown to us is when we will die, ponders the author. Beauty and awe today, say no more. She gets to the nub in a few pages; the rest of the book becomes of doubtful consequence when she admits to being opaque to the charm of medical science in terms of functional equations, vectors, ion channels, an EKG with a line mathematically representing an assertion of equating itself with a human being. The brain eludes them, mathematically speaking. Where is the mind? Feel the heat.

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