A debut author recollects her daughter’s torturous battle with mental illness and delineates the virtues and vices of psychiatric treatment in the United States.
Esperanza’s daughter, Serafina, had a happy childhood in the care of loving parents but still started to show the early signs of mental illness in her teens; feelings of anxiety and alienation fueled anorexia and self-mutilation. Esperanza did what any responsible mother would—enlisted the help of a professional therapist, who began the endless trials of psychotropic drugs, each with its own peculiar successes and sometimes-debilitating drawbacks. Serafina went through a checklist of potentially helpful drugs her doctor prepared and was eventually considered “treatment resistant,” a benignly clinical substitute for hopeless. Serafina tried electroconvulsive (shock) therapy, but whatever gains she grabbed were fleeting and came at the price of memory loss and disorientation. Then one day Esperanza called Serafina only to find her at first groggy and then manic—she confessed to taking an overdose of pills and alcohol, demanding that she not be resuscitated. After a stint in a hospital’s ICU, she was transferred to a psychiatric ward, which resembled a prison more than a refuge. Zombie-ish patients roamed the halls in a fuguelike trance, some of them even dangerous—one attacked Serafina in her room. But since she was admitted involuntarily, she couldn’t be released until her doctors granted permission, a decision at least partially based on exposure to liability. Esperanza finally pursued legal means to win her daughter’s liberty, a costly and complex process, though she may have saved money because Serafina’s insurance had run out. The perceptive book concludes with a series of short essays on the state of mental health care, though the entire work is permeated by these concerns. Esperanza writes affectingly but also with impressive objectivity—the drama unfolds almost like a novel, but she musters remarkable temperance, especially noticeable when she comments on doctors who were largely antagonistic. For example, she is amazingly magnanimous when discussing the physician who blocked Serafina’s release from the psychiatric unit: “I realize how fraught his work was with failures, with negativity, with combat rather than cooperation. And maybe some part of him wanted it to be different.” This memoir is both wise and philosophically rigorous and should be read by anyone curious about the modern treatment of mental illness.
A reflection on psychiatric care that combines emotional poignancy and intellectual astuteness.