Mark gerard mantho

Is There No Place on Earth for Me?
Is There No Place on Earth for Me?, Susan Sheehan’s chronicle of a schizophrenic’s experience with the mental health establishment, is dense, informative, and thoroughly depressing. Those hardy enough to wade through the book are unlikely to find it an enjoyable read, but will come away impressed by the meticulous detail and artful structure apparent in every chapter. One of those chapters, Chapter 13, is a case in point. Sheehan begins by explaining the differences between drugs used to treat mental illness, their relative effectiveness in achieving that aim, and the history of their introduction into the American medical system. Relating how drugs like Librium, Trilafon and Stelazine came to be mistakenly classed as “major tranquilizers” and “minor tranquilizers” after they first appeared in the 1950s, Sheehan’s admirable command of her subject matter is evident: The minor tranquilizers are completely ineffective in treating the symptoms of psychosis, and are all potentially addictive. What the minor tranquilizers have in common with the major tranquilizers is that both have anti-anxiety effects; the minor tranquilizers are now more accurately called anti-anxiety drugs. The major tranquilizers – which are not addictive – were eventually renamed antipsychotic drugs, not only in an attempt to differentiate them from the minor tranquilizers but also to clear up a common misconception that they worked by making people groggy and easily manageable. (Sheehan 203) Sheehan then explains then-current scientific theories as to how such drugs affect the brain in language any reasonably educated reader can understand – no mean feat, and one the author repeats countless times throughout the book. Sheehan’s inclusion of this material not only provides useful background about the characteristics of these drugs, but cleverly advances her narrative as well. After establishing the fact that psychiatrists follow no standard dosage guidelines when doling out Thorazine (the set up), Sheehan ties that information to the plight of protagonist Sylvia Frumpkin, whose dosage of Thorazine is too small to do any good (the pay off). Sheehan uses this technique again and again in Is There No Place on Earth for Me?, always with an eye toward integrating facts and storyline into a seamless whole. For example, the author describes Ms. Frumpkin’s initial stay at Creedmoor state hospital, her disruptive behavior, and the hospital’s subsequent decision to administer electroconvulsive therapy. This leads to a brief treatise on the history and efficacy of ECT, then back to Sylvia, then to a seemingly discursive exposition of the “nature vs. nurture” debate within psychiatric circles, and, finally, the revelation that Frumpkin likely inherited her illness from paternal and maternal relatives. The chapter ends by picking up the narrative storyline again as Sylvia is discharged from Creedmoor for the first time. As she does all through the book, Sheehan cites the literature of mental illness in Chapter 13, from Swiss psychiatrist Eugen Bleuler’s 1911 work Dementia Praexox; or, The Group of Schizophrenias to the latest version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. And, as elsewhere in Is There No Place on Earth for Me?, Chapter 13 also contains a doctor’s report describing Frumpkin’s thought processes, serving the duel purpose of bolstering Sheehan’s journalistic credibility with official documentation and vividly illustrating Sylvia’s deluded state of mind: I want to go to Freedomland with Paul Anka. (Do you know him?) No, but he knows me. I’ve lost the feeling that I’m Diana the Goddess. I have to face reality. Maybe I’m not Diana. I don’t know. (Hear voices?) I talk to Paul. I hear his voice all the time. (People against you?) Yes – No, I don’t know. (Feel like committing suicide?) Yes, plenty of times. (Have you tried?) Yes. All kinds of things, razor blades, cigarettes. (Anything else?) I don’t remember. I don’t want to be normal. Are you going to tear down everything? I want to be Diana – I’m not sick. I want to be Diana. That’s all I want to be. I had a crackup three months ago. I don’t really consider myself sick, though. I want to run in the wind. No, not really. (Sheehan 210) Chapter 13 is by no means the most structurally remarkable or information-laden portion of Sheehan’s book. The level of intricacy in both narrative organization and explication she brings to Is There No Place on Earth for Me? in its entirety is breathtaking. One could easily spend a good month (rather than a week!) examining not only the quality of the author’s reporting but the highly sophisticated way she brings that reporting to bare in telling Sylvia Frumpkin’s story. Sheehan received a National Mental Health Association Award for her work, as well as the 1983 Pulitzer Prize for Nonfiction writing. She plainly deserved both.


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Eur J Clin Pharmacol (2009) 65:465–472DOI 10.1007/s00228-009-0626-7Torasemide significantly reduces thiazide-induced potassiumand magnesium loss despite supra-additive natriuresisH. Knauf & E. Mutschler & H. Velazquez & G. GiebischReceived: 12 November 2008 / Accepted: 23 January 2009 / Published online: 20 February 2009# The Author(s) 2009. This article is published with open ac

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