Mark Vonnegut has a heavy last name for a writer. It’s a lot to live up to. But that didn’t stop him from penning The Eden Express: A Memoir of Insanity in 1975. The book chronicles his three psychotic breakdowns and recovery. His famous father wrote the foreword.
More than 30 years later, Vonnegut finished a sequel called Just Like Someone Without Mental Illness Only More So that looks at the time after his recovery. He became a doctor. He had kids. And then he had another breakdown. “I’ll never fully shake the feeling that I’m being tracked by the voices and a parallel psychotic life,” he writes in the introduction.
Vonnegut’s coming to Albuquerque to talk about mental illness and being constructively skeptical of psychiatric diagnoses. “I was called schizophrenic. Then I got to be called manic depressive. Then I got to be bipolar,” he tells the Alibi. “It’s just a bunch of nonsense, and it isn’t really helpful.” He’s also going to discuss how painting and writing have helped him cope with mental illness. “It's really hard to think of something like the arts, where you literally make something out of nothing,” he says. “And then you can say, I am good for something.”
Mark Vonnegut told us about his work, his opinions on American health care and his father.
I never wanted to be on the wrong end of the stethoscope again.
You write about the long history of mental illness in your family. What changes have you observed in the way we treat it?
It's more acknowledged now than it was for my grandmother or my mother. We certainly have better medications. There is a more positive, hopeful attitude in that it's assumed that people can and do get better. That's true of alcoholism and drug addiction, which are also mental illnesses. People now have the sense: Yeah, people can be pretty sick, and they can get better. That's enormously positive, and we're more likely to think of it as a biochemical medical condition rather than some sort of weakness or moral failing.
Did your experience with mental illness prompt you to go into medicine?
Absolutely. I used to deny that and say, Well I was just a kid that was good at math and science. But I think there was something about being a patient and being powerless. I never wanted to be on the wrong end of the stethoscope again.
It just doesn't seem like anything's worth it. You have to fight that.
Your fourth breakdown came after you achieved some success and had a career rolling. Was it harder to recover since you’d gathered so much respect?
It was much harder in many ways because I was afraid. It felt like I had a limited time—like maybe six months—to get my act together or I would get kicked to the curb and lose my job and my license to practice medicine and all that. So, certainly there was a lot more riding on my recovery having a career and children. Before, it was just me.
Also, you have a lot more energy in your twenties than when you're in your late thirties to forties. You just start to get a little tired. I had this feeling like, Do I really have to do this again? It was different, but on the other hand, I had the sense of, Well, you did this before. So to that extent, it seemed really positive.
I didn't have any positive models of recovery from the first time. I was told I had a horrible disease and a lousy prognosis. Nobody was really saying anything positive, which sort of made me think, Well, I'll show them. But there is an extreme tiredness if you have a psychotic break. It just doesn't seem like anything's worth it. You have to fight that.
As a doctor, what do you think of the American health care system?
The American medical system is as close to a complete disaster as it could be.
It's terrible. It's getting worse rapidly. The care you got—whether it was for appendicitis or mental illness or whatever—was better 20 or 30 years ago. The health insurance industry and the pharmaceutical industry have really turned it into a business enterprise where you have people over a barrel, as opposed to neighbors trying to help each other deal with hard things in life. The American medical system is as close to a complete disaster as it could be.
What do you think as a patient?
I've been lucky enough to have a primary care doctor I've known for many years, but most people don't. I have a psychiatrist I've known for a long time. I think there's a lack of personal connection with the care most people get, and most people would rather pull the covers over their head and hope they get better than go to a hospital or a doctor.
Why did you write this book so many years after your first?
It was being a little dissatisfied with my overconfidence as a young man, like I had everything all whipped. The first book sounds like: Man encounters mental illness, overcomes, goes to medical school and lives happily ever after. And that's not remotely what happened. So, I think I reached the point where that bothered me some, and also I reached the point where I was really comfortable. It's taken a long time to be comfortable with some of this stuff.
It was reaching the point where I didn't really feel responsible for my own recovery. I felt very lucky, but I didn't feel like there was a lot that I had done. That sort of freed me up to write.
Also, losing my father. Continuing to write was a way to stay in touch with him.
Was it hard to write while he was alive?
It wasn't hard, exactly, except it was just this extra concern. I felt like maybe writing was sort of a tag-team kind of thing, and he wasn't around to do it anymore.
What did he think of your first book?
He was a good but very harsh critic before it was published. When it was published, his initial personal response was negative. Then he came around to love it and really brag about it. So it was really a process. Certainly, his initial response was something I was very nervous about, and I had reason to be nervous.
Because he was so frank?
Well, yeah. He was very, very concerned about how he appeared in the book, and it was something I thought he wouldn't care that much about. I didn't think that he was a big part of the book at all. But there were little things, like as one part of my hallucinations, I had him at a heavy boxing match. He said [after reading about it], “You know I'm serious about my pacifism.” He thought people would take that to mean he wasn't sincere about his pacifism, and to me, that seemed like such a long stretch. I never even thought about it. For one thing, I was crazy as a loon. For another, he had nothing to do with that. It was just a vision his son had. So it was an interesting interchange we had about lots of things in the book. But I really, honestly, was surprised that he took what I had written about him so seriously.
But then he kind of got over it?
He did. And we had a lot of fun. He would get letters that were meant for me, and I'd get letters meant for him. I told him one time, which he thought hysterically funny, "The difference between my fans and your fans is my fans know they're crazy. And yours are very crazy, but they don't know it. They think they're enlightened."