David's Inferno (43 page)

• Epigraph: From Siddhartha Mukherjee's (2010)
Emperor of All Maladies: A Biography of Cancer
, a fascinating look at the disease and our relationship to it over the last few thousand years.

• Bipolar I & II. As mentioned, doctors draw the line in various places. The clearest explanation for me was when my doctor said, “If you were in a full-blown mania, you'd be bouncing off the walls, not sitting in this chair.” There were, of course, times that I
felt
like bouncing off the walls, but I never did.

• There are a variety of Patient Health Questionnaires. I assume the one I filled out was a version my doctor had customized. There were, indeed, 132 questions.

• By the way, I'm serious about DSM codes. That
is
how insurance companies determine reimbursement. Insurance companies also have different policies about whether they require pre-authorizations for brand vs. generic drugs.

• Epigraph: From Notebook IV in Albert Camus'
Notebooks: 1942-1951
.

• Epigraph: From an article by Peter Schjedahl called “Rule Like An Egyptian: Hatshepsut the King and Queen,” published in
The New Yorker
, April 3, 2006.

• My physics professor friend (who, by the way, also takes Lamictal) wrote:
The way the molecular weight business works is: (100mg) × (1 mole/256.0926
g) × (6.02 × 10^
{
23
}
molecules/mole) = 2.45 × 10^
{
20
}
molecules. That's not exactly explaining how it works in English, but if you track through the units you would say I have 100 mg = .1 grams of Lamictal, and 1 mole of Lamictal has a mass of (256.0926 g), so that gives me the number of moles of Lamictal that are in 100 mg. One mole contains Avogadro's number of molecules, so I multiply the number of moles I have by Avogadro's number and voilà, I have the number of molecules. 10^
{6}
is a million, 10^
{9}
is a billion, 10^
{
12
}
is a tera (big hard drives currently have 1 - 1.5 terabytes), so the 100 mg of Lamictal has 24.5 hundred billion tera molecules. I guess that goes to show molecules are very small! Even molecules of Lamictal. Who would have thought that such a small molecule could have such a big effect. This gives you the number you wanted, but it doesn't explain what a mole is, or why it's related to Avogadro's number, or how weight is related to mass, or whether gram is a unit of weight or mass, and so on. If you are interested in that stuff then there's another email
.

• I do really encourage you to find one of the many representative illustrations of synapses if you want to try to follow this. I highly recommend the children's site listed above:
http://www.enchantedlearning.com/subjects/anatomy/brain/Neuron.shtml
. If you want to get a little deeper, check out the one from “How Stuff Works”
http://www.howstuffworks.com/enlarge-image.htm?terms=nerve+communication&page=0

• The article in the June 1998 issue of
Scientific American
was written by Charles B. Nemeroff.

• Epigraph: With the caveat above, the site
www.crazymeds.com
deserves a bookmark on the browser of anyone involved in mental illness. A guy named Jerod Poore writes it, and it's the most comprehensive, comprehensible, and irreverent presentation of psychopharmacology and prescription drugs on the web … and perhaps anywhere. This quote is right from his home page.

• The correct answer is the Red Sox.

• Kay Jamison devotes a whole chapter to the alleged suicide of Meriwether
Lewis in her book
Night Falls Fast
. This quote is on
this page
.

• The reference is to Neil Young's song, “Hey Hey, My My (Into the Black)” (1994) from the album
Sleeps with Angels
.

• Epigraph: From the works of Galen, the 2
ND
century Roman physician who elaborated upon Hippocrates' theory of “humors”. He was also the court physician to Emperor Marcus Aurelius, which gave him the freedom and resources to write extensively on medicine.

• Dr. Andrew Weil is one of the most famous MDs to encourage people to combine western and alternative medicines for maximum health. His first book was
The Natural Mind
(1972).

• Hippocrates, who lived from 460–370
BC
is known as the Father of Modern Medicine. He's most famous for his “oath” that doctors should first do no harm.

• Paracelsus was a brilliant alchemist of the sixteenth century. The idea of combining ordinary elements to make gold, however, was not the focus of true alchemists like him. Rather he combined breakthrough scientific discoveries with careful observation and traditional folk wisdom to create a new scientific and medical paradigm that, while incorporating some traditional folk wisdom, went far beyond mere “superstition.”

• Dr. Patricia Slagle now offers her book
The Way Up From Down
(1994) as a free eBook:
http://www.thewayup.com/ebook/ebook.htm
. It really is a great way to learn about why/how vitamins, minerals, amino acids and herbs can affect your mental health. She also offers newsletters on her site and phone consultations.

• The quote from the Dalai Lama is at
http://www.webmd.com/depression/features/the-dalai-lama-and-depression-treatment
. As an aside: I'm kind of surprised he said it and I hope I'm not quoting it out of context. Of course he's right: compassion is a great friend during times of great stress. But, as I say in another place, to ask someone in the throes of mania to feel compassion can be like asking someone who's color-blind to see red.

• Epigraph: Cookie Monster's favorite cookie is chocolate chip, although oatmeal comes in a close second. An obvious binge eater, Cookie Monster also shows clear signs of “Pica” (DSM-IV 307.52), which involves eating things that are not food, as well as memory lapses that might indicate Disassociative Fugue (300.13). Thanks to Louise Finley's website for helping me clarify some of the fine points of this diagnosis.
http://www.louisefinley.com/?cat=18
.

• This paraphrase of Dylan is from “Just Like Tom Thumbs Blues” on
Highway 61 Revisited
.

• Epigraph: One of Socrates' most famous. From Plato's
Apology
. No one seems to know for sure whether Socrates actually existed. That's another thing that at least I know I do not know.

• The costs I used to analyze the difference between treating someone with antidepressants versus hospitalization are based on several sources, primarily
http://www.cms.hhs.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads//InpatientPsychFac.pdf
which gives the federal
per diem
base rate for 2012 and
http:consumerreports.org/health/best-buy-drugs/antidepressants.htm
for the typical retail prices.

• Robert Whitaker, the author of
Anatomy of an Epidemic
(2010) also wrote
Mad in America
(2002). The wide variation between various statistical analyses as well as their cognitive dissonance with personal experiences can be pretty confounding. As I discuss later in the book, I suspect that a great deal is due to the subjectivity of when a condition of mental
imbalance
becomes one of mental illness, as well as what it means to be cured.

• The William Blake quote comes from his
The Marriage of Heaven and Hell
(1790-1793).

• Epigraph: I seem to be “afflicted” with a Quixotic drive to find the true source of any quote I use; especially because the Internet has become filled with quotes that were spliced together to serve someone's purpose, taken totally out of context, or were never said by the person in the first place! I've made an exception in this case. I've looked unsuccessfully for a film, interview, or letter in which Marilyn Monroe actually said this. Regardless, it's such a great expression of how depressives feel, I hope she doesn't mind my attributing it to her …

• The story about brain scans that my friend told me was based on the work of Dr. Daniel Amen,
http://www.amenclinics.com
.

• The comments about talking to children about a parent's depression come from an email correspondence with Caroline Carr,
http://www.carolinecarr.com
.

• Epigraph: From Jane Austen's
Pride and Prejudice
.

• Epigraph: From
The Self in Transformation
(1965) by Herbert Fingarette. This book, which explores the relationship between personal growth and
spirituality was a staple of psychology and religion curricula when I was in college.

• You can find more about my writing about historical characters on
www.davidblistein.com
.

• Epigraph: Polonius says this about Hamlet in Act 2, Scene 2, after one of the Prince's most eloquent pieces of triple-entendre imagery.

• Here in Vermont, stealing rocks from walls is charged the same as theft. But across the river from us in New Hampshire, there's a law that specifically says you can be fined three times the costs of rebuilding the wall, plus attorney's fees. It's an update of a 200-year-old law. See
http://www.abajournal.com/news/article/n.h._ups_ante_for_stone_wall_thieves_new_law_provides_for_attorney_fees
.

• I'm pleased and proud to say that my little arched bridge survived Hurricane Irene in 2011, one of southern Vermont's worst storms in decades.

• I've mentioned our late neighbor Dwight Miller a couple of times. See
http://www.boston.com/news/local/breaking_news/2008/08/obituary_dwight.html
for a brief bio. Among other things, he's known for being one of the founders of Brattleboro, Vermont's annual Strolling of the Heifers (
www.strollingoftheheifers.com
), which has become a major celebration of locally-grown food.

• I'm paraphrasing Elvis Costello's “(The Angels Wanna Wear My) Red Shoes” from his album
My Aim is True
.

• Epigraph: Paul Reps (1895-1990) was one of the key figures in bringing Zen Buddhism to the West. His
Zen Flesh Zen Bones
(1957) was one of the very first books about Zen Buddhism published in America. The quote itself comes from
Reps: Letters to a Friend
, a compilation of letters and drawings that Reps sent to his equally enlightened friend William Segal over the course of their 30-year friendship. I knew both men and, in the late 1970s Segal gave his collection of Reps' correspondence to some friends and myself. We self-published the book in 1980.

• The very unofficial “world record” for running an 11-circuit labyrinth is held by the much-loved Keith Wilson (1985–2009).

• For details on ways to find true north just like a real Boy Scout, see the nearest Boy Scout handbook or go to
http://boyslife.org/outdoors/outdoorarticles/1739/true-north
.

• Epigraph: The Jane Kenyon (1947-1995) lines are from her poems “The Suitor” and “Credo.” Both are included in
Otherwise: New &
Selected Poems. (1996)
. By the way, one of the conditions of reprinting these lines is that they are flush left as she wrote them.

• R. D. Laing's line about insanity being the only sane response to an insane world is from his seminal
The Politics of Experience
(1967).

• Kurt Vonnegut's quote is from his book of short stories
Welcome to the Monkey House
(1968).

• Akira Kurasawa's quote is spoken by the character Kyoami in his film
Ran
(1985).

• Epigraph: Edgar Allen Poe's quote is from the short story “Eleonora” (1842). Harriet Rubin's quote comes from her book
Dante in Love
(2004).

•
Of Mice and Men
(1937) is by John Steinbeck.

• The story about Ram Dass giving Maharaji some LSD is in
Be Here Now
. Originally, it was a boxed set with a booklet, poster, and twine-tied book on rough paper put together in 1970 by the Lama Foundation in New Mexico, one of the first spiritual communes in America. Over the last forty years, I've left a lot of books and records behind in various places. But this is the only one I really regret losing track of. Not because its rare-book value—but because so much of my late adolescent yearning for enlightenment was psychically imprinted in my copy. When it came out, shortly thereafter, as a one-volume paperback, distributed by Crown Publishers, it cost $3.33. It is still in print, now published by the Hanuman Foundation.

• The story of Huxley doing LSD on his deathbed is told by his wife Laura in her book
This Timeless Moment
(2000). His last words are probably counter-cultural urban legend.

• Peter Kramer writes about depression and creativity in his book
Against Depression
(2005).

•
Storming Heaven: LSD and the American Dream
, by Jay Stevens, was published by Grove Press in 1998.

• Before he died, William Blake (1757-1827) actually started doing illustrations of
The Divine Comedy
, see
http://www.blakearchive.org/exist/blake/archive/work.xq?workid=but812&java=no
, a project of the Library of Congress in conjunction with the University of Rochester, University of North Carolina at Chapel Hill, and National Endowment of the Humanities.

• Bob Dylan's homage to Dante is in the song “Tangled up in Blue” from the album
Blood on the Tracks
(1975).

• I'm very poorly read (if at all) in the philosophy of deconstructionism. But I've always liked the concept. I found the Jacques Derrida quote in Rubin's book.