BITTER MEDICINE: A Graphic Memoir of Mental Illness

I suppose one might accuse “Bitter Medicine” by Clem Martini of being schizophrenic in the sense of being divided, since it is a graphic novel using drawings on one side of the page and printed narrative on the other. But that’s an old understanding of schizophrenia: “split personality.” This moving book, in its totality, will give you a whole new understanding.

Schizophrenia is a true brain malfunction, where the person is simply not able to process thinking. It’s worth Googling and then returning to Google again now and then as understanding develops (very slowly -- too slowly). It has a big hereditary component (often related to depression, alcoholism), is entirely involuntary (not a character flaw or willful emotion), can’t be “seen” from the outside except through behavior, and is chronic. The behaviors (not moving, disregarding, hearing voices, bumbling and shaking) are stigmatized (mimicking drunkenness) and verge on being criminalized since they lead to homelessness. Economic failure can be fatal.

Clem Martini leads us gently and firmly through his family while his brother Olivier provides the witty and vivid drawings of how it feels from the inside. Originally there were four brothers but the youngest, Ben, developed schizophrenia earlier and had a temperament less amenable to help. He was lost to suicide. Liv plods along stubbornly, doing as he is told, enduring medicines that keep him sane at a cost that is not just monetary but paid in side effects. The family struggles along beside him, blundering, loving, never giving up, making us understand why people need to live in families, whether genetic or not.

It becomes starkly clear that the mentally ill are victims of what Clem calls “The Great Closing of the Eighties.” It hurts a lot more to discover this happened in Canada, which US citizens believe is a far more enlightened country, especially when it comes to health care. The Great Closing happened on both sides of the 49th parallel and was made politically palatable by the idea that new drugs justified turning out all the people warehoused in loony bins so they could be cared for by small community services. Except that in a bait-and-switch, after they had all been sent to the streets, there was no money for those community services.

I would compare this movement to the Highland Clearances in Britain when small crofters and squatters were turned off the common lands in order to pasture more lucrative sheep or to the Prairie Clearances of this continent in which the original people of the land were confined to reservations so that the rest could be opened to homesteaders who would eventually pay taxes and use railroads for shipping crops. Those who favor a vision of the world red in tooth and claw, would say the Great Closing was simply a matter of survival of the fittest, economically driven, and neatly eliminating all the people “wasting” public money. We do it all the time.

Gradually it was revealed that the pharmaceuticals were not fail-save and that research is still falling far short. Liv suffered irreversible damage and each new disorder (esp. diabetes) required either a change in medication or a whole new regime. He was told to get exercise and his brothers walked everywhere with him. His aging mother kept him on his med schedule. Their father, also damaged in some way, died relatively young.

In the course of time, it was discovered that diabetes as a side-effect of one drug was known and ignored by the pharmaceutical company in the by-now familiar practice of suppression of facts in favor of marketing. The Martinis have joined a lawsuit. The task at hand is the raising of consciousness about the disorder and how it is treated. This easy-to-read and sometimes gently funny book is an excellent step in that direction.

Clem Martini is the head of the drama department at the University of Calgary, so he has also adapted this book to a stage presentation, something like “Vincent and Theo.” He has written a trilogy for young adults, called “The Crow Chronicles.” I don’t know it, but I think I’d better find it. Sitting here near the border, even with no passport at the moment, I see wonderful things happening on one side that aren’t known on the other, though the border is an arbitrary legal line. Right now it is hardened because of exactly the kind of world strife and duplicity (one could say schizophrenia) that afflicted Liv and Ben. Imported or exported books have always been problematically handled.

In some ways, Liv was lucky since many mentally ill people are pushed out by their families and for lack of sufficient care get worse until they end up in jail. It is estimated that a huge proportion of prison inmates are simply mentally ill, not even violent. Prisons are simply a reinvention of those original loony bins.

This issue touches me sharply because my brother, cousin, and father were all deeply but subtly changed by closed-skull concussions. Many prisoners also have had head injuries, maybe from high school football. Lost marriage, previously unthinkable violence, immobility, incomprehension, and a need for economic support weighed on us all and still hounds me as I begin to understand better what was wrong. We tried to argue them out of it. Adding to difficulties was their paranoia and their media-skewed belief that admitting mental difficulty meant medieval tortures and confinement. My brother and father lived with my mother who supported the household by teaching. It wasn’t all grim: there were happy times.

Diabetes is another consciousness-changing disorder. When my blood sugar goes too high, I’m sleepy and stupid. When it goes too low, I bump into walls and shake. You can’t see blood sugar, so I have to test monitor and compensate all the time. No one knows the primal cause, though -- as usual -- we tend to blame the victim. It puts me more and more in the hands of pharmaceutical companies and ties me to clinical support. I might appear drunk and be arrested. We are all vulnerable.

In the end we have to rethink what a human being is and what it means to be in society. This very human book is part of that exploration and testimony that one mustn’t give up. We need to make common cause.