email page print pageAll Topic Reviews
"Are You There Alone?""How Come Boys Get to Keep Their Noses?""My Madness Saved Me"10% Happier365 Days49 Up56 UpA Beautiful MindA Beautiful MindA Beautiful MindA Book of ReasonsA Can of MadnessA Child's Life and Other StoriesA Dangerous LiaisonA Fight to BeA First-Rate MadnessA Good Enough DaughterA Heartbreaking Work of Staggering GeniusA Lethal InheritanceA Lethal InheritanceA Life ShakenA Life Worth LivingA Little PregnantA Message from JakieA Million Little PiecesA Numerate LifeA Pocket History of Sex in the Twentieth CenturyA Slant of SunA Special EducationA Tribe ApartAbout FaceAddicted Like MeADHD & MeAEIOUAgainst Medical AdviceAgents in My BrainAileen - Life and Death of a Serial KillerAlgernon, Charlie and IAll Out!All Seasons PassAlphavilleAlways Too Much And Never EnoughAlzheimer'sAn Anthropologist on MarsAn EducationAn Unquiet MindAngela's AshesAngelheadAnna Freud: A BiographyAnnie's GhostsAnother Bullshit Night in Suck CityAnthology of a Crazy LadyApples and OrangesApproaching NeverlandAre You There, Vodka? It's Me, ChelseaAs I Live and BreatheAs Nature Made HimAt Home in the Heart of AppalachiaAt the End of WordsAvalancheBad BoyBad GirlBeautiful BodiesBeautiful BoyBeautiful WreckBecause We Are BadBecoming AnnaBecoming MyselfBen Behind His VoicesBequest and BetrayalBereftBertrand RussellBlackoutBlanketsBloodlettingBodies in Motion and at RestBoneBorn on a Blue DayBoyBoy AloneBoyleBrain on FireBreaking ApartBreaking the SilenceBrokenBulimics on BulimiaBuzzCamus and SartreCharles DarwinChasing the HighCheeverCherryCity of OneCluesClumsyComfortComplications Compulsive ActsConfessions of a Cereal EaterConfessions of a Former ChildConfessions of a Grieving ChristianConfessions of the Other MotherConfidingConquering the Beast WithinContesting ChildhoodCrackedCrazyCry Depression, Celebrate RecoveryDamned to EternityDancing at the Shame PromDante's CureDaughter of the Queen of ShebaDavid Sedaris Live at Carnegie HallDays With My FatherDefeating the VoicesDementia Caregivers Share Their StoriesDepression and NarrativeDescartesDetourDevil in the DetailsDiagnosis: SchizophreniaDirty DetailsDirty SecretDivided MindsDivine MadnessDon't Get Too ComfortableDown Came the RainDress Your Family in Corduroy and DenimDrinkingDriving My FatherDrunkardDryEarly Embraces IIIEarly ExposuresEinsteinEinstein and OppenheimerElectroboyElegy for IrisElijah's CupElliott Smith and the Big NothingElsewhereEnough About YouEpilepticEvery Girl Tells a StoryEverything In Its PlaceExamined LivesExiting NirvanaFaces of Huntington'sFamily BoundFast GirlFearless ConfessionsFind MeFinding Iris ChangFirst Person Accounts of Mental Illness and RecoveryFirst Person PluralFixing My GazeFlanneryFolie a DeuxFor the Love of ItFortress of My YouthFrank Ramsey (1903-1930)Franz KafkaFraudFree RefillsFreudFreudFreudFriedrich NietzscheFrom Joy Division to New OrderFumblingFun HomeFuriously HappyGalileo Get Me Out of HereGetting OffGirl in Need of a TourniquetGirl Walking BackwardsGirl, InterruptedGirl, InterruptedGirls on the VergeGoing BlindGoing Through Hell Without Help From AboveGraysonGrowing Up JungGuttedHalf a Brain Is EnoughHardcore from the HeartHead CasesHeal & ForgiveHeal & Forgive IIHeavier than HeavenHeinz KohutHeinz KohutHello from Heaven!Hello to All ThatHer HusbandHer Last DeathHigh PriceHole in My LifeHolidays On IceHolidays on IceHope's BoyHouse of Happy EndingsHouse of Happy EndingsHow I Stayed Alive When My Brain Was Trying to Kill MeHow to Lose Friends & Alienate PeopleHow to Make Love Like a Porn Starhow to stop timeHumeHunger Makes Me a Modern GirlHurry Down SunshineI Am Dynamite!I Am I Am I AmI Feel Bad About My NeckI Never Promised You a Rose GardenI Remain in DarknessI'd Rather Eat ChocolateI'd Rather LaughIf I Die Before I WakeImagining RobertIn Search of FatimaIn the Realms of the UnrealIn the Wake of SuicideInside TherapyInternInvisible No MoreIt Happened to NancyIt Takes a Worried ManJack Cole and Plastic ManJean-Paul SartreJohn Stuart MillJourneys with the Black DogJust CheckingKafkaKantLa SierraLab GirlLast Flight OutLearning to FallLet Me Make It GoodLife As We Know ItLife InterruptedLife ReimaginedLimboLincoln's MelancholyListening in the Silence, Seeing in the DarkLittle PeopleLive For Your Listening PleasureLive Through ThisLiving in the Shadow of the Freud FamilyLiving With SchizophreniaLiving with SchizophreniaLockeLonelyLong ShotLook Me in the EyeLooking for The StrangerLoose GirlLosing Mum and PupLosing My MindLove Is a Mix TapeLove SickLove Times ThreeLove Works Like ThisLove You, Mean ItLuckyLudwig WittgensteinLyingMad HouseMad PrideMadame ProustMadnessMagical ThinkingMalignant SadnessManicMarcel ProustMarcus AureliusMary BarnesMaverick MindMe Talk Pretty One DayMeaningMelanie KleinMemoirMemoirs of an Addicted BrainMemoirs of My Nervous IllnessMen-ipulationMisconceptionsMiss American PieMockingbird YearsMomma and the Meaning of LifeMommies Who DrinkMonkey MindMore, Now, AgainMortificationMy Age of AnxietyMy Body PoliticMy Brain Tumour AdventuresMy DepressionMy Father's HeartMy First Cousin Once RemovedMy Flesh and BloodMy Horizontal LifeMy Life Among the Serial KillersMy Sister LifeMy Stroke of InsightName All the AnimalsNeural MisfireNietzscheNietzsche: The Man and His PhilosophyNinety DaysNo Apparent DistressNo Hurry to Get HomeNo Impact ManNo More ShavesNo One Cares About Crazy PeopleNolaNotebooks 1951-1959NothingOdd Girl Speaks OutOedipus WreckedOf Spirits & MadnessOn Being RapedOn the Edge of DarknessOn the MoveOne Hour in ParisOne Hundred DaysOphelia SpeaksPagan TimePassing for NormalPeople Who Eat DarknessPerfect ChaosPerfect ExamplePermanent Present TensePersepolisPlanet of the BlindPlaying with FirePlease Don't Kill the FreshmanPoisoned LovePollockPOPismPortraits of Huntington'sPoster ChildProzac DiaryPsychiatrist on the RoadPsychosis in the FamilyPuppy Chow Is Better Than ProzacQuitting the Nairobi TrioRaising BlazeReasons to Stay AliveRebuiltRecovered, Not CuredRelative StrangerRescuing JeffreyRestricted AccessRevengeRewind, Replay, RepeatRichard RortyRiding the Bus With My SisterRobert Lowell, Setting the River on FireRoom For JRosemaryRough MagicRunning After AntelopeRunning with ScissorsRXScattershotSchizophreniaSchopenhauerSecond OpinionsSectionedSeeing EzraSeeing the CrabSet the Boy FreeSex & Single GirlsSex ObjectShakespeareShe Bets Her LifeShe Got Up Off the CouchShut the DoorSickenedSilencing the VoicesSimone de BeauvoirSinging in the FireSkin GameSlackjawSlut!SmashedSome Assembly RequiredSome Kind of GeniusSometimes Amazing Things HappenSometimes Madness Is WisdomSongs from the Black ChairSongs of the Gorilla NationSoren KierkegaardSpeak to MeSpeaking Our Minds: Revised EditionSpecial SiblingsSpentStandbyStick FigureStill LivesStretchSunset StorySurviving OpheliaSwing LowTales from Both Sides of the BrainTales of PsychotherapyTalk to HerTell Me Everything You Don't RememberTellingTelling Tales About DementiaThe Accidental BillionairesThe AddictThe Anatomy of HopeThe Anti-Romantic ChildThe Art of MisdiagnosisThe Bastard on the Couch CDThe BeastThe Bell JarThe Best Seat in the HouseThe Big FixThe Body SilentThe Boy on the Green BicycleThe Boy Who Loved Too MuchThe Boy Who Loved WindowsThe Bright HourThe Buddha & The BorderlineThe Burn JournalsThe Camera My Mother Gave MeThe Cancer Monologue ProjectThe Center Cannot HoldThe Chelsea WhistleThe Churkendoose AnthologyThe Day the Voices StoppedThe Devil WithinThe DisappearanceThe Discomfort ZoneThe Doctor Is InThe Eden ExpressThe Family GeneThe Family SilverThe Farm Colonies: Caring for New York City's Mentally Ill In Long Island's State HospitalsThe Fasting GirlThe First Man-Made ManThe First TimeThe Geography of BlissThe Glass CastleThe Good DoctorsThe Hillside Diary and Other WritingsThe Incantations of Daniel JohnstonThe Infidel and the ProfessorThe Last AsylumThe Last Good FreudianThe Last Time I Wore a DressThe Liars' ClubThe Lives and Loves of Daisy and Violet HiltonThe Lives They Left BehindThe LobotomistThe Long GoodbyeThe Looked After Kid: Memoirs from a Children's HomeThe Loony-Bin TripThe Madness of Our LivesThe Making of a PhilosopherThe Making of Friedrich NietzscheThe Man Who Couldn't EatThe Man Who Shocked the WorldThe Man Who Tasted ShapesThe Marvelous Hairy GirlsThe Maximum Security Book ClubThe Me in the MirrorThe Memory PalaceThe Mercy PapersThe Mistress's DaughterThe Mother of Black HollywoodThe Naked Bird WatcherThe Naked Lady Who Stood on Her HeadThe Neuroscientist Who Lost Her MindThe Night of the GunThe Noonday DemonThe Notebook GirlsThe NursesThe Only Girl in the CarThe Only Girl in the WorldThe Orchid ThiefThe Other HollywoodThe OutsiderThe Philosopher's Autobiography The Philosophical Breakfast ClubThe Philosophical IThe Pits and the PendulumThe Pornographer's GriefThe Private Memoirs and Confessions of a Justified Sinner The Professor and the MadmanThe Psychopath TestThe Quiet RoomThe RecoveringThe Red DevilThe Rescue of Belle and SundanceThe Ride TogetherThe Rules of the TunnelThe Secret of LifeThe Shaking Woman or A History of My NervesThe Shared HeartThe Shiniest JewelThe Siren's DanceThe Statistical Life of MeThe Story of My FatherThe Strange Case of Hellish NellThe Summer of a DormouseThe SurrenderThe Talking CureThe Thought that CountsThe Three of UsThe Undoing ProjectThe Vagina MonologuesThe Velveteen FatherThe Winter of Our DisconnectThe Woman Who Walked into the SeaThe Years of Silence are PastThe Yellow HouseThe Yipping TigerThick As ThievesThinThis Close to HappyThomas S. SzaszTiger, TigerTits, Ass, and Real EstateTo Redeem One Person Is to Redeem the WorldTo Walk on EggshellsTransforming MadnessTrue CompassTruth & BeautyTruth Comes in BlowsTuesdays with MorrieTweakTwitch and ShoutUltimate JudgementUndercurrentsUnholy GhostUnlikelyVoices of AlcoholismVoices Of Alzheimer'sVoices of CaregivingVoices of RecoveryVoluntary MadnessWaiting for DaisyWar FareWashing My Life AwayWastedWaveWe're Going to Need More WineWe're Not MonstersWeather Reports from the Autism FrontWeekends at BellevueWhat Did I Do Last Night?What Goes UpWhat I Learned in Medical SchoolWhat's Normal?When a Crocodile Eats the SunWhen Breath Becomes AirWhen Do I Get My Shoelaces Back?.....When It Gets DarkWhen the Piano StopsWhen You Are Engulfed in FlamesWhere Did It All Go Right?Where is the Mango Princess?Where the Roots Reach for WaterWhile the City SleptWhile They SleptWho Was Jacques Derrida?Why I Left, Why I StayedWhy I'm Like ThisWildWill's ChoiceWinnicottWinnieWish I Could Be ThereWith Their EyesWomen Living with Self-InjuryWomen, Body, IllnessWrestling with the AngelYou Must Be DreamingYour Voice in My HeadZeldaZor
The amount of books one can buy which tell the tale of authors who suffered and recovered from some seemingly insurmountable illness is climbing steadily, and some even make it into the movies: recently, Brain on Fire described the most deadly of these which the initially wrote off to mental illness rather than the neurochemistry of glutamate. Some books describe the experience of neurologists who slip and fall on icy pavement, some of a neurologist who discovers, after a ride at the fair, how a leg refuses to climb into bed with him. In all of these descriptions, experts who should know better find themselves befuddled by what we call a lack of awareness of deficit, more scientifically known as anosognosia.
The experience of this lack of awareness owes its appearance to widespread brain dysfunction, resulting in firstly, a disruption of cognitive self-awareness and appraisal of changes in behaviour, which includes a concreteness that may even lead to paranoia, and secondly, a psychological defence against catastrophic awareness that all hell is breaking loose cortically speaking. In all of the above, a direct brain insult was emerging, which confounded their senses. In this case, Lipska experiences something a little different.
Lipska is a Pole who is headhunted to come to America to work on harvested brains, after losing her first husband to melanoma, and marrying a second, only to face the same illness in the form of breast cancer and melanoma, which she beats.
But like many, it comes back in the form of a metastasis, in her brain, in the form of three neoplasms, and from the way one is bleeding, the size and placement, it is melanoma. Fortunately, Lipska has two things one requires in the USA in the face of such disaster, and the first is good insurance, the second is access to experimental drugs which they will pay for when therapy as usual fails.
As many who have gone through such treatments, the brain possesses a remarkable dislike for being messed with, either by growths or the attempts to persuade them to reverse their growth. It is precisely the response of her brain that Lipska sets out to describe in detail.
Along the way she tells the story of her survival, but the journey is paved by a descent into a loss of both cognitive capacity and connection to self-reflect on the changes occurring. She is unable to comprehend what is happening initially, and then later on, before, during and after diagnosis. This includes some snippets of her insight into the brain, lending her knowledge to commentary on the value of primary association areas as well as the prefrontal cortex, where one of her tumours makes its home, hence the neurobehavioral changes her family witnesses and tolerate, albeit with much concern and painful distress.
Shielded by her lack of awareness, she is less terror-stricken then they are, even when she is told she is to die unless treatment kicks in. She is however becoming unrecognizable as she progresses through illness and intervention owing to the chemical lobotomy the main and side-effects of the medication are producing, hence the secondary title of the book.
What helps to save her is her extreme fitness, even though she is in her 60’s when the illness hits. She tries to preserve this and the ultimate challenge is to do this when the steroid medication is destroying her body.
The book is largely a reconstruction of prompted and then recalled memory, as she clouds over during the horrifying experience of losing her mind, and her self-awareness during the process of surviving. She accurately describes the concreteness of her cognitions, and the distancing she feels from her emotions even when her life is in peril and those around her are resigning themselves to her demise. Vast areas of her skills are dissolved, and then reappear, and her life before and after are compared as she emerges. Adjusting to her new normal will take time.
The 11 chapters of the book are an easy read. Tom Insel approached her after the first essay on which this book is based appeared in the newspaper, and as the ex-head of the NIMH remarked on what a contribution this would make to the world, an insider’s view of a specialist scientist losing her marbles.
The question is, does this book do it? The style in which it is written is really interesting in the opening pages, but an editor might have restructured the sequences of information that follow these first few pages, that are given to provide a more cohesive view of what is happening in the moment. The book loses this style as it progresses, become a simple narrative, and in that I don’t think McArdle has done justice to the power of the struggle Lipska has had to produce to survive. So, until the top of page xiii we are caught up in a true reflection of what being in her head is like, but further on the book, it gets factual, not as personal, weakening the narrative.
An important contribution to the book would have been descriptions of what the family saw, not just in Lipska’s reconstruction, but truly reflecting what a family has to go through when someone comes so severely off the rails. No explanation is given as to why she is allowed to drive, when she is so dangerously devoid of visuospatial capacity, or so impulsive and out of control, losing it in the parking lot and on the freeway. These are important if the aim of the book is to educate from within. The book is left thinner than other accounts of such illnesses, and the blame I think might fall in McArdle’s lap as the presumed journalist here.
Nevertheless the book is compelling reading, moving quickly across the years of her struggle, and retains your interest in the looming catastrophe, and how the void is avoided. She tells the story without sparing details about her family or her reported failure to stay the distance with her first husband, who would go on to lose his life to cancer.
The most important aspect of the book, or at least it seems to me, is her description of the vagueness of her response to the news that there was little chance for her survival, after the cyberknife failed to eliminate her tumours: masked by her brain dysfunction, the threat of death seems somewhat surreal to her. She loses any empathic response to her family’s distress, consumed by the egocentricity of anosognosia. She sees no threat to others in her erratic driving, and her family seems to back off an allow her to continue to drive, although knowing better, as they too are caught up in the unfolding tragedy. An introduction or writing in levels with input from her son, daughter and husband as to what they witnessed and what they survived, would make this book outstanding.
It would be no spoiler alert to say she survives, or clearly the book would not have been written. She makes no mention of the risk she still faces for the future, and one hopes her fights have been finally fought and she will be well.
And finally there is the encouragement to make sure you are as fit as she is, nurturing brain and body with her fanatical running, continuing as far as she can through the fatigue and brain fog, to keep herself physically active as therapy for both body and brain. A great inspiration, and well done to Dr Lipska.
© 2018 Roy Sugarman
Roy Sugarman PhD, Director Applied Neuroscience, Performance Innovation Team, Team EXOS USA