The Madman’s Tale

The Madman’s Tale by John KatzenbachFull Title: The Madman’s Tale: A Novel
John Katzenbach
Publisher: Ballantine Books (2004)
Number of Pages: 438
How long it took me to read: 4 days
Where I got this book: local library
ISBN: 978-0345464811

Like a Moth to a Flame

I enjoy Katzenbach’s writing and was drawn to this book because of my background as a psychiatric social worker who has worked on inpatient psychiatric units and who lives in a city that housed a former state mental hospital. I’ve seen and heard about the inner workings of state hospitals, both from the perspectives of professionals and those of former patients. I have a significant understanding of mental health issues and knew I would enjoy Katzenbach’s take on the psychiatric systems of the past (the book is set in a state hospital in 1979 as well as the current outpatient setting).

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Favorite Five

I propose that the top 5 quotes from this book are:

5. “Francis Xavier Petrel arrived in tears at the Western State Hospital in the back of an ambulance. It was raining hard, darkness was falling rapidly, and his arms and legs were cuffed and restrained. He was twenty-one years old and more scared than he’d ever been in his entire short, and to that point, relatively uneventful life…” (p.18)

4. “The hospital was about keeping you out of the sane world’s eyes. We were all bound by medications that dulled the senses, stymied the voices, but never did completely away with anything hallucinatory, so that vibrant delusions still echoed and resounded throughout the corridors. But want was truly evil about our lives was how quickly we all came to accept those delusions.” (p.47)

3. “Fear, he thought abruptly, doesn’t belong to psychiatrists; it belongs to the patients. Fear is irrational, and it settles parasitically on the unknown.” (p.118)

2. “In the momentary confusion of their arrival, Francis saw the retarded man rise up, dust himself off and steadfastly return to the dormitory room, his face wreathed in glowing glory. Francis caught a half glimpse of the man plopping himself down on his bunk, taking his Raggedy Andy doll up in his arms and then turning and surveying his destruction of the door with a look of utter satisfaction.” (p.405)

…and my pick for the No.1 quote is…

1. “ ‘Crazy people sometimes see things with accuracy, Father. An accuracy that eludes us on the street.’ ” (p.262)

Conversation with the Reader

While I read, I write, and as I write, I read. Here’s some of what I wrote while I read this book:

“If you can get beyond the implausibility of the plot, this reading can be an interesting journey into the world of madness and evil—for don’t we all have a propensity of madness within us and aren’t we all struggling with issues of the shadow self? The demarcation between who is mad and who isn’t is a very nebulous line. How and when have I crossed it? How and when have your crossed it? Schizophrenia, bipolar disorder, psychotic depression, mental retardation, personality disorders—a cacophony of inner and outer turmoil. And do we all venture into evil, or is evil a subset of a psychological disorder that we have yet to identify? I am impressed by the author’s ability to relate that those who are supposedly insane are not the ones to be feared; it is those who hide under the mask of ‘normalcy’ that must concern us the most.”

“I think about a comment I made a few years ago while conducting a therapy group on an inpatient psychiatric unit. The subject of the local state hospital came up and I told the patients about an educational tour of the closed hospital that I had attended. I noted how fascinating this was, and a patient replied, ‘You wouldn’t have found it so fascinating if you lived there.’ Ouch—how accurate. I humbly apologized. But how many of us take for granted the lives we live without understanding those who are in both inner and outer crises, who have survived horrific terrors, who have been debased from society? This interchange was a remarkable healing for me and hopefully, the apology was taken in the manner it was given—with sorrow and compassion.”

“I find that the author has an excellent grasp of psychiatric conditions and treatment modalities (although there are a few minor technical errors such as misidentifying the professions of social work and psychology and using these terms interchangeably). He aptly describes the fear and terror of living within a severe mental illness. His descriptions of the horrors that some of the patients experienced are similar to ones I have heard as a therapist. While allowing for a plot that was not quite realistic, his treatment of the psychiatric process, the grounds and the inner landscape of the hospital, is quite accurate.”

“The author’s focus on the inner will of man, the banding together of a group of individuals who would typically be referred to as ‘crazy’ by the outside world, helps me to think about the strengths of all people, including the mentally ill. I must remember that for some of these individuals, there is an incredible insight into the self and the world that is often wrongly perceived by family, friends, and professionals. For example, severe depression may be caused by a chemical imbalance and needs to be treated with medication, but it may also be a form of melancholy necessary for letting a person see that significant life changes must be made. For a person diagnosed with schizophrenia, the hallucinations may be psychotic, or they may be the subconscious mind asserting itself and telling the person and the world that life must be looked at through different lenses than the conscious mind. I always need to be able to explore these differences and listen to what is really being said and done as the soul speaks in so many languages, and unfortunately, I’m not multilingual.”

The Madman’s Tale shows a wonderful compassion and companionship among those who were at the state hospital—both patients and some members of the staff. How they fought for their own humanity within a system that was often inhumane is passionately displayed. The book relates how frightening it must have been to be taken away from family and friends and dumped into an often cold, stark institution. How scary to live within your own inner turmoil—be it of mania, delusions, psychosis, depression, or other psychiatric symptoms—and then to have to cope with so many others going through that same trauma. The everyday fear and terror of violence, of thinking that you are crazy, of being lonely, paranoid, hallucinating, and of watching your peers who also demonstrate very odd behavior is not for the faint of heart. And what about those who are treating you; are they really there to help? I have worked with wonderfully compassionate professionals and ones who actually hate the patients they are supposed to be helping. I think about the hope and lack thereof, that surrounds all of us. I see in my own work how humans must find that hope within themselves and others to recover. And I am constantly reminded of this hope when I see the healing that happens at this fictional State Hospital.”

1 Comment

  1. Cappi says:

    Compelling review. I’m not sure that I want to experience this book but it does express some interesting ideas. Perhaps at a later date this will be something I will want to read.

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