Remnants of a Life on Paper

This heartbreaking, compelling memoir details a family’s attempts to cope with the havoc created by mental illness.

Pamela Tusiani was 20 years old and a junior at Loyola College in Baltimore, Md., when she suffered her first serious mental breakdown. Her mother rushed down from New York to help her youngest child through the web of doctors, hospitals, medications and treatments that would become the script of their lives for the next three years. With disarming honesty and clarity, Tusiani (Con Amore, 2004, etc.) chronicles the journey of Pamela and the family as they navigated America’s at times woefully inadequate mental health system. Since her now-deceased daughter left behind copious notes—on pieces of note paper, on legal pads and in journals—Tusiani is able to juxtapose her own recollections with Pamela’s direct observations and feelings. The contrasts are often dramatic, as mother and daughter pull together, apart and back together in a painful dance that hurtles toward a tragic conclusion. Tusiani enumerates the unique difficulties of dealing with a mentally ill family member, from finding Pamela bleeding from a self-inflicted wound—she had a proclivity for cutting her arms and legs so she could “feel something”—to learning that Pamela, either through maliciousness or delusion, falsely accused her father of raping her. The unpredictable is always around the corner. A third component of the memoir is the court battle that ensued when Tusiani and her husband sue for malpractice the final, California-based facility that managed Pamela’s care; each chapter opens with transcripts from the legal depositions of both parents. Pamela’s older sister, Paula Tusiani-Eng, took on the mammoth task of assembling and organizing these disparate elements into this lucid volume that should be required reading for anyone involved with the mental health community. The cocktails of medications, the variety of treatment facilities and the extraordinary monetary outlays are overwhelming. But ultimately, what’s most riveting is the author’s uncensored reporting of her own emotional roller-coaster ride during a relentless search to find what would be best for Pamela.

A haunting narrative sure to linger in readers’ minds.