Stephen Fry, who had his own much publicised breakdown, writes on the back fly-leaf:
‘A perfectly extraordinary, not to mention an extraordinarily perfect – tense Hitchcockian psychodrama. I have rarely read a more haunting and enthralling account of descent into madness.’
A.K. Benjamin is a therapist working in London. His patients are given nom-de-plums and anonymised, ‘JB,’ ‘Lucy’, ‘Michael,’ ‘Jane,’ ‘Dr Samuels,’ ‘Brad76,’ ‘Murray,’ ‘You again,’ ‘Me’. Their narrative is Benjamin’s story. In Robert Pirsig’s classic zeitgeist book of the 1970s, Zen and the Art of Motorcycle Maintenance, just as the narrator’s kids, shout out from the backseat of their dad’s car and tell him whether he should turn the steering wheel left or right to take a turn, or go straight ahead, Benjamin relies on his patients—his mad patients—to keep him on the straight and narrow, because, whisper it, he too might be mad. Only an unhinged person wouldn’t think they were mad and is sure they know which way they or we are going. #MeToo I say.
When the distance between therapist and patient as Valeria Ugazio suggests at ‘the maximum level of empathy’, ‘the two points of view would become fused’.
Benjamin is patient with his patients because he, too, is a patient. ‘You,’ for example,
‘Look at you, you are no accident. For once my dinosaur colleague is right: you really are ‘charming’. We have spent the whole morning together. That’s more time , with more tender, dedicated attention, than either of us would share with our children or partners in any given week.’
There is an erotic tone. Therapists don’t usually write love letters to their patients. We all know about transference. The jingo of therapy speak. But this is a love letter to what is lost.
‘I see your future unspool. Forgetfulness first, losing your children’s friend’s names, what you’d come into the living room for, [shit, I do that] what time you put the roast on, asking the cleaner if you’d fed the cat, asking again five minutes later. The beginning of ‘dyspraxia’: a moment when you forget how the remote for the television works, which way the key turns in the lock, how the buttons on your blouse fasten. (‘Dizzy’) The onset of ‘anomia’ following the rule of frequency: losing the name for Caerphilly, then Cheddar, then cheese, then children, your children. A steady upsurge of confusion: why the weekend started on a Tuesday. Where the living room is (Don’t we live in all our rooms?)
My mum had dementia. This was her future. Perhaps mine too. This was my past. She’s dead and I said I was glad. Our personality, our person and their reality is tied in with memory. Different people inhabited the same body. We all do that. But she forgot the way back and we couldn’t help her, abandoned her in Boquanran Old Folk’s Home.
‘Could you hold your left hand up?’
‘My left hand?’
She had Alzheimer’s or vascular dementia or corticobasal degeneration or nothing. She had the same name as my mother, was close to her in age, wore the same that mum might wear.
She was not doing well and she knew it. The lines on her tired, aging face gathered like a storm map…She had earlier mistaken her neighbour’s house for her own…She had flooded the kitchen answering a cold call while washing up, or the washing machine wasn’t working properly. It took her 15 minutes to find her way back from the Ladies.
Names would stick on her tongue like peanut butter.’
Writers are told to show not tell. This is fantastic writing. We can see ‘Lucy’, just as a few weeks ago I spotted my neighbour Hugh. I was going out on my bike and he was standing in the lane. I shouted ‘Hallo,’ but stopped. He was in his seventies, but still had a full head of hair and a moustache. He liked to nip down to the bookies, along the canal and back to put a wee bet on. He turned his head, squinted at me: ‘Can you tell me where I live?’ he asked. He was standing at his back gate and gable end of his house.
There are thirty-three variants of dementia, perhaps more. Hugh couldn’t count them. He’s in ‘freefall’. And there’s nobody to catch him. That’s the sad part. I hear his wife shouting and swearing at him. I’m not sure if she’s got dementia too.
Benjamin tells of his own madness, or mental-health difficulty. ‘A summer evening in 1999.’ Tottenham Court Road.
‘I escort myself up the escalator and out of the station, and frogmarch myself all the way home, so taken was I with the idea that I would jump’.
… the doctor was friendly enough: he seemed to believe me.
… a follow-up appointment with my GP, I was told I met the criteria for a major psychiatric disorder…The psychiatrist prescribed a cocktail of drugs I was to take indefinitely. I never took the prescription to the chemist.’
‘L’ confused me. I thought I had a handle on who A.K.Benjamin was, a male therapist around my age (late fifties). But here he is out on a second ‘date’ with ‘L’ at a Greek in Marble Road, he’s used to and is known in. (‘In truth the Greek was a Cypriot raised in Penge. In truth there had been far too many awkward, depressing nights in the years since I’d moved out of Helen’s house’).
‘L’ was a social worker, specialising in neurology (Benjamin’s field of medicine).
‘He was a few years older than me, a six-former to my third-year…I might as well have been a teenage girl drawing his picture in biro on my maths folder.’
…he brought unusual interest and therefore depth to each case, he was able to think about the meaning of injury, imagine for himself the lived experience of the person, their family, how it would translate into their forever changed lives.’
L is therefore the type of man you’d want to care for you or yours. He is loveable. But it flipped me because I believed from what I’d read so far that A.K.Benjamin was a man, a heterosexual man. But here I was re-imagining him as a her, as gay, as bisexual. Which made ‘L’ also one or more of these fluid gender categories. But later he or she described ‘L’ as ‘fatherly’. What had thrown me was the word ‘date’. Date to me means sex. It is not erotic love (or perhaps it is) but agape, the unconditional love of another
Benjamin wanted ‘L’ to be his hero.
‘I wanted Lewis to look his disease dead in the eye, stare it down. I wanted him to tell the truth, however frightening…I realized I couldn’t bear his denial – couldn’t bear it because it disrupted my own; couldn’t bear it because it brought to mind my father in different ways…’
Benjamin wanted ‘L’ to be superhuman, but, like the rest of us, was all too frail and human. A geriatric patient at fifty.
Let Me Not Be Mad tells painful truths. You can read it like you’d read a collection of short stories with a common overarching theme. As character studies it’s hard to beat and should be on the syllabus of any creative writing class. This is not a hymn to Lear’s madness but uncommon human decency, which is perhaps the same thing.