LETTER TO THE WORLD: PAUL GRUCHOW'S LETTERS TO A YOUNG MADMAN
We say that one gets cancer, or a cold, or kidney disease. One would
never think to say that one is cancer. But we say that one is depressed,
or bipolar, or schizophrenic. A disease of the body is a condition. But
a disease of the mind, we think, is a state of being. We no longer
believe, as we did 250 years ago, that the mentally ill are animals,
but we are not yet ready to grant that they are fully human either.
Paul Gruchow
In a voice remarkably clear, eloquent and calm, Paul Gruchow – author of
LETTERS TO A YOUNG MADMAN – explores a double injury inflicted on the mentally ill: The
illness itself, with its often debilitating symptoms, and the more insidious injury made by society,
stigmatization. There is little evidence that the medicalization of what was once called “madness” –
a term Gruchow uses repeatedly in this eliptical memoir – has destigmatized the nearly 300
afflictions now classified as mental disorders in the latest version of the Diagnostic And Statistical
Manual – the bible of the mental health treatment profession.
While Gruchow does not consider this expanding diagnostic umbrella to be an argument
against treatment, his account of his own experience with certain aspects of the treatment system
at the turn of the 21st century – he committed suicide at age 56, in 2004 – is sobering. In several
detailed, Kafquesque depictions of life in a mental hospital, infantilization of patients is the
norm in everything from baby shampoo to toys. The one notable exception to this pattern
of learned helplessness are daily routines so boring, in the age of Piaget and Montessori, we would no
longer subject an infant to them. Television, children's games, crafts, coloring books, and just sitting
alone or with other patients, hour after hour, seems to reinforce the popular stereotype of those
suffering from mental illness as incapable of higher levels of thinking, creativity, self-initiative, or
feeling. The hospital environment proved to be, predictably, non-therapeutic for Gruchow, boredom
increasing depression: His genius level IQ, tested a few years before his death, was 187.
Gruchow cites David L. Reisman's classic study, BEING SANE IN INSANE PLACES, which
followed a group of professional researchers after their admittance to a mental hospital, concluding
that no one on the hospital staff could tell the difference between the presumably sane professionals
and the patients diagnosed with mental illness. This role reversal might be comical – as is the movie
WHAT ABOUT BOB in which a patient suffering from multiple phobias disrupts the life and work
of a narcissistic psycho-therapist – were it not for the unsettling questions it raises about the reliability
of psychiatric diagnosis and about the nature of mental illness itself. If diagnosis and treatment are as
much art as science, the difference between the sane and insane members of any group might best be
understood as a continuum rather than a fixed point. If that is the case, LETTERS TO A YOUNG
MADMAN could be read as one person's journey through a continuum of good and bad days, of
happiness and sadness, of remembering and forgetting, of grieving and being unable to grieve, of
moments in which illness defines the journey and of moments in which telling the story becomes a way
to defy illness, leaving behind a map for others to follow.
LETTERS could not be more timely. The World Health Organization has named depression
the leading health crisis in the world, its impact becoming deeper and more widespread.
Wondering, as I have, who the “young madman” might be to whom these letters are addressed, a friend
familiar with Gruchow's story suggested they were written by the author to his younger self, when he
was experiencing his illness as a shameful secret, afraid of being found out. In breaking a silence he
calls “the cornerstone of evil” Gruchow becomes a modern Job, giving voice to all those who suffer
from not only mental illness, but whatever affliction tries the soul.
by: Louis Martinelli
