Psychiatrist Small (co-author: iBrain: Surviving the Technological Alteration of the Modern Mind, 2009, etc.), director of the Memory and Aging Research Center at UCLA, tells the stories of his most intriguing cases.
The book, co-authored with his wife, Vorgan, begins in 1979, when as an insecure trainee in a Boston psychiatric clinic, Small attempted to help one of his first clients, an apparently neurotic housewife suffering from anxiety attacks. Not only was his diagnosis “off the mark”—she turned out to be a potentially dangerous, borderline psychotic—but he was misdirected by his “clueless” supervisor. This was his first lesson in learning to trust his own instincts and look beyond the obvious. Just months later, the naked lady of the title, who appeared to be psychotic, turned out to be a diabetic young actress suffering from an “amnesia-driven delirious state” induced by low brain sugar. The author’s instant cure, a cup of orange juice, was followed by therapy to help her with lifestyle changes. A year later, an apparent incident of mass hysteria at a Boston school—students started fainting, “dropping like flies”—piqued his curiosity, and he volunteered to join a health-department investigative team. This led him to combine his clinical practice with ongoing research projects. Over the years, Small has studied mass hysteria, psychosomatic diseases, brain scanning and geriatric dementia, and he has pioneered in the development of brain-imaging technology to identify Alzheimer’s disease. As a practicing psychiatrist with a specialty in geriatrics, the author’s cases cover a wide terrain—e.g., a young man who developed hysterical blindness when he attempted to confront his father, a patient who shifted from a food disorder to becoming a shopaholic to an addiction to multiple psychotherapists—and Small writes with empathy and humor about the complexity of human relationships, reflecting on his lifelong struggle to help his clients gain insight and surmount their problems.
A highly personal but generally fascinating memoir spanning more than 30 years.