February 21, 2011
Symphony of Pain in Two Accounts of Schizophrenia
By ABIGAIL ZUGER, M.D.

Every book is born alone, but sometimes a pair will surface in accidental synchrony, a single theme creating an impromptu pas de deux.

Such is the case with two new memoirs of schizophrenia. There is hardly a shortage of such books, but Mira Bartok and Patrick Cockburn have created mirror-image story arcs, one by the daughter of a schizophrenic mother, the other by the father of a schizophrenic son. Each is a model of narrative restraint, but in combination they combust, conveying the intensely painful experience of this disease in the literary equivalent of quadraphonic sound.

A foreign correspondent for the British press, Patrick Cockburn was on assignment in Afghanistan in the winter of 2002 when his son Henry, 20, was fished fully clothed out of an icy river back home. Henry’s mother had noted “sinister changes” in his behavior for months, but this was the big break, with hallucinatory voices and visions so threatening that the river seemed the best place to hide. He was taken to a mental hospital and since then has never lived unsupervised or entirely free of disease.

The Cockburns are a prominent Irish family of letters — Mr. Cockburn’s brother Alexander is the noted political journalist — and Henry, until his “final decline,” in Mr. Cockburn’s words, fell into the expected mold of verbal, artistically talented British schoolboy.

The elder Mr. Cockburn dispassionately reconstructs his own mental journey in the intervening years, from his first naïve assumptions that Henry would recover and resume his previous life, to his final stark, resigned descriptions of Henry at age 27, living in a halfway house in London, a person who “spent a lot of his waking life thinking about where he could get his next cigarette and where he could smoke it.”

Mr. Cockburn moves through the usual soul-searching — was his own peripatetic nonpresence to blame for Henry’s illness? Were family genes at fault? He muses at some length on the case of his father-in-law, a scion of the eminent Anglo-Jewish Montefiore family, who converted to Christianity after a teenage vision of Jesus: could that be construed as a family history of psychosis?

Meanwhile, Henry contributes his own version of the story in flat staccato prose, highlighting his obsessive need to be outdoors (he has escaped from even top-security facilities dozens of times) and his profound reluctance to medicate all his vivid hallucinations away. “The forest would come alive and speak to me,” he writes. “The tree roots would move at the touch of my finger.” Indeed, the book’s ending suggests that although Henry has made an uneasy peace with his meds, the trees are still not entirely silent.

Mira Bartok’s narrative begins almost exactly where the Cockburns’ ends, with an unstable young adult and her unnerved family. Her mother, Norma Herr, had been a piano virtuoso as a child, but at 18 the voices inside her head “arrived unannounced in all their terrible glory.”

Products of a brief marriage, Mira and her sister had a childhood punctuated by their mother’s agitated pacing, her fierce conversations with herself, her suicide attempts. Occasional family trips to the symphony were invariably cut short because “something inexplicable” happened that made their mother whisper obscenities in the aisle.

The girls grew up and moved far away, but their mother tracked them down by mail, by phone or sometimes in increasingly disheveled person. “Have I been a bad mother to you? Do you still love me? I need you here. We have things to discuss.”

She wielded knives, a broken bottle. Finally, in desperation, both daughters changed their names (“She took Isaac Bashevis Singer’s last name, I took Bela Bartok’s”) and severed all contact with their now homeless mother.

Or such was the plan; Ms. Bartok never quite managed to pull it off. She continued to send her mother letters and small presents for years, even as she concealed her own address and phone number. But only as her 80-year-old mother lay dying of cancer did they meet again, and did Ms. Bartok, by then an artist and prolific author of children’s books, experience once again the disease’s tangled words and thoughts.

That was not so much through her mother’s physical presence as through the wealth of diaries she found in a storage bin, with decades of entries stumbling back and forth along a thin edge of reason: “I see that little bits of my life in distorted form have gotten into movie stories. I still have received no compensation for that. Ultimately, what I do know is this: I am a homemaker, my records have never been straightened out, and my need for privacy and house is greater than ever. I write this in a motel room looking out onto garbage bins.”

As with the Cockburns’ book, the intertwined voices of grief-stricken, articulate sanity and not-so-sane but often quite poetic illness make a duet both wonderful and terrible. Sadly, it is not nearly so terrible as the worst detail of both books: the failure of the medical system to help much with the pain of either set of writers.

In the 60-odd years separating Ms. Herr’s psychotic break from Henry Cockburn’s, mental hospitals have closed in droves, community-based services have proliferated, generations of antipsychotic drugs have been patented. The disease, at least in the severe form represented here, remains undaunted. It is hard to think of one that requires more courage from patients or their families.

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