email page print pageAll Topic Reviews
"Are You There Alone?""Who Could That Be at This Hour?"3 Willows4th of July99 DaysA Beautiful MindA Change in AltitudeA Corner Of The UniverseA Frog ThingA Great and Terrible BeautyA People's History of ChristianityA Question of BloodA Slight Trick of the MindA Step Toward FallingA Thousand Miles from NowhereA Voyage Long and StrangeA Wedding in December Abraham LincolnAcross the River and Into the TreesAfter DarkAgainst Medical AdviceAll the Bright PlacesAll the Way HomeAll Unquiet ThingsAlphavilleAmerica AmericaAmong the DepartedAn EducationAn Object of BeautyAnatomy of a MisfitAre You There, Vodka? It's Me, ChelseaBad BoyBad RatsBarbara the Slut and Other PeopleBeach RoadBeat the ReaperBeauty QueensBed of RosesBefore I DieBefore I FallBefore the FrostBig BrotherBiteBlack Elk SpeaksBlameBleed for MeBlonde FaithBlood, Salt, WaterBody SurfingBog ChildBoneMan's DaughtersBoomsdayBorder CrossingBorn Standing UpBoys Are DogsBoys Will Put You on a Pedestal (So They Can Look Up Your Skirt)Brava, ValentineBreak Through PainBreathingBridge of SighsBrief Interviews with Hideous MenBrutalBy BloodC StreetCalm Beneath the WavesCanadaCellCemetery DanceChange Your Brain, Change Your LifeCheeverCinnamon KissCleopatraClose Your EyesCompulsionCross CountryCyborgasmDakotaDancing at the Shame PromDarkest FearDavid Sedaris Live at Carnegie HallDead EvenDear Zoe,Death Without TenureDeceptionDefending JacobDefine NormalDeliriumDevil in the DetailsDiscovering Pig MagicDisturbing GroundDivergentDivine JusticeDivisaderoDoing ItDown the Rabbit HoleDr. Andrew Weil's Mindbody ToolkitDress Your Family in Corduroy and DenimDriftlessEven Dogs in the WildEvery Exquisite ThingEvery Little Thing in the WorldEye ContactFaith, Hope, and Ivy JuneFaking NormalFalling ManFamily FirstFans of the Impossible LifeFear of the DarkFellsideField of BloodFile Under: 13 Suspicious IncidentsFiregirlForest of the PygmiesFortunate SonFraudFreak the MightyFree RefillsFull Steam Ahead!Furiously HappyGenerosityGenomeGetting a Good Night's SleepGetting the Love You Want Audio CompanionGiftedGirl in TranslationGod Is DeadGod Is Not OneGods and BeastsGoing BovineGranny Torrelli Makes SoupGraysonHappy FamilyHappy Mutant Baby PillsHarmlessHe's Just Not That Into YouHealthy AgingHeartbeatHeftHigh HeatHolidays on IceHot MilkHotel on the Corner of Bitter and SweetHotel WorldHotels of North AmericaHow a Gunman Says GoodbyeHow Full Is Your Bucket?How Successful People ThinkHow to Build a HouseHow to See Yourself As You Really AreHow to Set a Fire and WhyHunger Makes Me a Modern GirlHurt Go HappyHypnography for MenHypnography for WomenI Am Not Joey PigzaI Can See YouI Drink for a ReasonI Feel Bad About My NeckI'd Know You AnywhereIdiot AmericaIf a Tree Falls at Lunch PeriodIf I StayIf You StayImagine Me GoneIn ZanesvilleInfinite JestInheritanceInnocentInside the O'BriensInvincibleInvisibleIt Takes OneJennifer, Hecate, Macbeth, William McKinley, and Me, ElizabethJust LifeKiss of Broken GlassKissing Ted Callahan (And Other Guys)Leaping BeautyLies My Girlfriend Told MeLife After LifeLife InterruptedLife of PiLife StrategiesLisey's StoryLitLittle Black LiesLittle ScarletLive For Your Listening PleasureLiving Your DreamLong Shadow of Small GhostsLooking for BobowiczLost in the ForestLove Is a Mix TapeLove Times ThreeLove, AubreyLowboyMadappleMade For YouMagical ThinkingMagnificenceMaliceMan in the WoodsMeditation in a New York MinuteMeetings with a Remarkable ManMiddlesexMind MappingMindfulness for BeginnersMirrorMaskMischlingMissing PresumedMolly Moon's Incredible Book of HypnotismMommies Who DrinkMunich AirportMy AbandonmentMy Life Among the Serial KillersMy Name Is RedMy One Hundred AdventuresMy Sister's KeeperName All the AnimalsNelson Mandela's Favorite African FolktalesNemesisNever Let Me GoNight FilmNina: AdolescenceNinety DaysNone of the AboveNurtureShockObjects of My AffectionOlive's OceanOn Chesil BeachOne Flew Over The Cuckoo's NestOutliersPaint It BlackPanicParadise LodgeParanoiaPeace Is Every BreathPeople Who Eat DarknessPharmakonPictures of Hollis WoodsPictures of YouPilgrim at Tinker CreekPlaying with FirePlease Stop Laughing at UsPositivityPresumed InnocentPretty Girl-13Prisoner of Night and FogPuddlejumpersPunkzillaReady for AnythingRebuttalRequiemRescueRevolutionary RoadRoomRun for Your LifeSay You're SorryScatSchool of FearSeason to TasteSecrets of a Passionate MarriageSee How SmallSeeds of HopeSex and SpiritSide Effects May VarySilencedSimon vs. the Homo Sapiens AgendaSix Impossible ThingsSkelligSleeping BeautySnowSo Brave, Young and HandsomeSolitaireSomeday This Pain Will Be Useful to YouSourlandSquirrel Seeks ChipmunkStill MissingStory of a GirlStress ReliefSupreme CourtshipSurviving OpheliaSwimming to ElbaSworn to SilenceSymptoms of Being HumanTeaseTeaseTell the Truth, Shame the DevilTen Minutes to RelaxTestimonyThat Old Cape MagicThe Abortionist's DaughterThe AccidentalThe Accidental BillionairesThe AdultsThe Almost MoonThe Anatomy of HopeThe Art of ChoosingThe Art of Exceptional LivingThe Artist of DisappearanceThe Average American MarriageThe Bastard on the Couch CDThe Beat Goes OnThe Best AwfulThe Big LoveThe Boat RockerThe Book of JoeThe Book of LiesThe Book of the DeadThe Boy Who DaredThe Boyfriend ListThe Brass VerdictThe Breakout PrincipleThe Burden of ProofThe Case for GodThe Case of the Case of Mistaken IdentityThe Cemetery BoysThe Chosen OneThe ClosersThe Consciousness PlagueThe Conspiracy ClubThe Cuckoo's CallingThe Day I Ate Whatever I WantedThe Dead Fathers ClubThe Death of Bunny MunroThe Devotion of Suspect XThe Disreputable History of Frankie Landau-BanksThe Diviner's TaleThe Dressmaker of Khair KhanaThe Dynamite RoomThe Earth, My Butt, and Other Big Round ThingsThe EndThe Erotic EdgeThe Essential KamasutraThe First Fifteen Lives of Harry AugustThe Forgotten GirlsThe Geography of You and MeThe Gift of an Ordinary DayThe Gingerbread GirlThe Girl in 6EThe Girl in the GardenThe Girl Who Kicked the Hornet's NestThe Girl Who Played with FireThe Girl with the Dragon TattooThe Grief of OthersThe Grim GrottoThe Guise of AnotherThe Guy Not TakenThe Heart of YogaThe Heretic's DaughterThe Ice QueenThe Ice TwinsThe Immortal Life of Henrietta LacksThe InseparablesThe InterestingsThe Keeper of Lost CausesThe Kings of LondonThe Language God TalksThe Language of SecretsThe Language Of YogaThe Last ChildThe Last MileThe Last Time We Say GoodbyeThe Male BrainThe Man from BeijingThe Man in My BasementThe Man Who Couldn't EatThe Map of True PlacesThe Marriage PlotThe Memory Book The Mermaids SingingThe Ministry of Special CasesThe MuralistThe Museum of InnocenceThe Mystery of the Third LucretiaThe Myth of LazinessThe NarrowsThe Necessary Death of Lewis WinterThe New YorkersThe NewleywedsThe NixThe NursesThe Opposite of InvisibleThe Other Side of the StoryThe Outcasts of 19 Schuyler PlaceThe Particular Sadness of Lemon CakeThe PastThe Penultimate PerilThe PostcardThe Pregnant WidowThe Promise of a LieThe PyramidThe Qi Healing KitThe ReaderThe Republican BrainThe Rule of FourThe Rules of SurvivalThe Savage CityThe ScarecrowThe Second GirlThe Secret Life of BeesThe Secret of Lost ThingsThe Secret ScriptureThe Secret SpeechThe Secret Wisdom of the EarthThe ShallowsThe Shock of the FallThe Silent BoyThe SisterThe Sound of Broken GlassThe SpindlersThe Story HourThe Story of Beautiful GirlThe Sudden Arrival of ViolenceThe Survivors ClubThe Sweet Relief of Missing ChildrenThe Sweetness at the Bottom of the PieThe Tail of Emily WindsnapThe Tenth JusticeThe Thing About JellyfishThe Third AngelThe TouristThe Treasure Map of BoysThe Trouble with Goats and SheepThe Unexpected Inheritance of Inspector ChopraThe Unfortunate Decisions of Dahlia MossThe UnquietThe Unseen WorldThe View from SaturdayThe WaveThe Weed That Strings the Hangman's BagThe Weight of the NationThe Whole TruthThe WilloughbysThe Witch's BoyThe Wolves of AndoverThe Words We Live ByThe Wrong Side of GoodbyeThe Year of the FloodThe Year That FollowsThe Yin Yoga KitThirteen Reasons WhyThis Beautiful LifeThis Body of DeathThis Book Is Not Good For YouThis Full HouseThis Is HowThose GirlsThose Who Wish Me DeadTony & SusanToo Much HappinessTooth and NailTouchTransformation TriburbiaTrue BelieverTrue CompassTruth & BeautyTwinmakerTwistedTwo Can PlayTwo Little Girls in BlueUnaccustomed EarthUnder the HarrowUnder the InfluenceUnder WildwoodUnlessUnthinkingUp in the AirVery ValentineVisits from The Drowned GirlVoid MoonWaiting for SunriseWalkingWarWatching the DarkWhat the Dog SawWhen We Were AnimalsWhen You Are Engulfed in FlamesWhen You Reach MeWhere She WentWherever You Go, There You AreWhite HotWild AwakeWild ChildWildwoodWill They Ever Trust Us Again?Wolf in White VanWomen's Murder Club Box SetYoga SanctuaryYou Look Different in Real LifeYou Should Have KnownYou Will Know Me
This non-fiction book tells the story of Cory Friedman, a boy with Tourette syndrome. It is written by his father Hal and James Patterson, but bizarrely they make Cory the narrator, talking about his personal thoughts and feelings. They authors say that they based the book on medical diaries kept by Cory's mother and Cory's recollections. However, there's a big difference between writing one's own story and confirming the accuracy of someone else's account. The writing is fluent, and reads like a narrator in a James Patterson novel; so it is eminently readable, but it does not make the story believable. Listening to the book, one gets a strong sense of the authors making up the story, with drama and pathos being the main goals. The feeling of fiction is increased by the publisher's promotion of the book. On the front of the box containing the audiobook CDs is written "One family's struggle with an agonizing medical mystery," and James Patterson's website has a headline of "one family's struggle with a tormenting medical mystery," and Hal Friedman's website says the book is "the remarkable story of my son's 15 year battle with a number of medical mysteries," but there is no mystery: Cory has Tourette's and Obsessive Compulsive Disorder, which are diagnosed when he his is a young boy. The publisher website describes the book as "the true story of Cory and his family's decades-long battle for survival in the face of extraordinary difficulties and a maddening medical establishment." However, the book covers 13 years and the book gives the impression that Cory's doctors did what they could to help him, although his parents come to suspect that the medications he was prescribed made his problems worse. Then there's the title of the book, "Against Medical Advice," which implies that the Friedman's took a strong stance against the stance of the medical establishment. However, they didn't: the whole book is a tale of them getting and taking the advice of medical experts. The only time they go against medical advice is in the opening scene of the book, where Cory visits a juvenile psychiatric ward for his drinking problems, gets admitted, and freaks out. His parents work out that the only way to get him out immediately is to discharge him against medical advice, which they do. But there is no strong anti-medical theme in the book. The combination of all these distortions make it especially hard to trust the framing of the story.
The basic facts of Cory's medical history are simple enough. When he was about 5 he started to physical tics and urges to say and do inappropriate things, together with some irrational fears. Although he is first diagnosed with ADHD, he does not react well to Ritalin and soon he gets a diagnosis of Tourette's. He is put on many medications including antidepressants, mood stabilizers, tranquilizers, antipsychotics, and more. None of them work very well, but his doctors pursue the pharmaceutical approach nevertheless. Yet the drugs had many side effects, especially in making Cory put on weight. His life is difficult throughout his school career because he is different and strange. By the time he is a teenager, he has made some friends, but mostly with other outcasts with problematic behavior. They are not necessarily the best influence on Cory, and by the time he is a sophomore, he is addicted to cigarettes and he is drinking on a regular basis. He gets into physical fights with his so-called friends and is extremely unhappy. After falling asleep in his room while drunk and still holding a lighted cigarette, he nearly causes a major fire. It is at this point that his parents take him to the psychiatric ward to deal with his drinking problem, but he refuses to stay, and they don't want to force him. So they end up sending him off to a boot camp for trouble teens, which works amazingly well. After that he goes to a specialized treatment center for people with OCD, where he is taught some relaxation techniques, and they help him control his behavior. Finally he goes to an intensive prep school, but he hates it there and leaves after a month. After some struggle with his high school, he is able to return and he does well. His symptoms start to reduce, and it seems that he is one of the lucky individuals whose childhood disorder reduces or even disappears as he enters adulthood.
The story certainly fits well with the pattern that has become apparent in the treatment of many other serious childhood mental disorders in the USA, with doctors being too quick to use medication, and indeed many different powerful medications at the same time, when there's no strong evidence that those medications are effective for children. Yet the book spends no time discussing the state of knowledge about the effectiveness of the drugs in the treatment of Tourette's and OCD in children, and Hal Friedman gives no justification for his claim at the end of the book that the drugs that Cory was prescribed made his problems worse.
So the reader is left with a story of personal struggle. It is well told, yet the authors do not make Cory a very likable narrator. No doubt it is terrible to have to fight the urges to say inappropriate things, to grab the steering wheel of a car when you are a passenger, and for your body to make you spasm and jerk in bizarre ways much of the time, especially when you have people around you reacting to you as if you were a monster. But Cory repeatedly endangers himself and his family, and does not cope well with his problems, and it can be very difficult to sympathize with someone who has a substance abuse problem and is presenting a danger to others. Furthermore, the opening scene in which he insists he does not belong in a psychiatric ward because he is not crazy makes him extremely unappealing -- he show a profound lack of sympathy and understanding for other people with mental illnesses. The authors, by uncritically highlighting this scene, implicitly endorse his stigmatizing attitudes. Yet the whole justification of this memoir is that it is meant to help people with Tourette's and OCD, presumably by helping people to understand how difficult it is to live with those conditions.
For these reasons and more, Against Medical Advice is a problematic memoir. Yet readers at Amazon.com mostly like it, and the fact that it is co-authored by James Patterson means that it is likely to get more readers than most memoirs of mental illness. It is likely to be read by people who don't know much about Tourette's or OCD, and so it could be educational and may make people more sensitive to the pain that comes with stigmatized conditions.
The unabridged audiobook is performed by Kevin Collins, who does a good job of keeping the energy level up and giving different characters distinctive voices.
© 2009 Christian Perring
Christian Perring, Associate Professor of Philosophy, Dowling College, New York.