Works of Lars Eighner at Lars Eighner's Homepage

I remembered when the state highway through Austin passed by the state hospital," writes Joe Holley (a former editor of the Observer and husband of Tara) in his prologue to My Mother's Keeper, "the insane asylum we called it. As children…my brothers and I would peer through the tall iron gate as we drove by. We were hoping to see a crazy person, a lunatic, gripping the barred windows and shrieking to get out."

Urban sprawl has since swallowed the Austin State Hospital. All that remains of the state highway are a few vestigial business-route markers, and the little boys viewing the gate from passing cars are likely to be on their way to Central Park, a trendy shopping center on a part of the hospital grounds ceded to commerce. The iron gate stays propped open.

In the fall, late at night, fraternity pledges race their cars through the narrow lanes on the hospital grounds. They fly over the speed bumps like children dared by a bully to run up on the porch of a haunted house. Not much has changed, because the real gate is not the one of iron, but is of a stronger, more enduring alloy of ignorance and superstition.

A few of us get through that gate: friends and relatives, volunteers, mental health workers—and some of us get through it as patients. Those who have been through the gate learn to overcome the false fears. We are disabused of the myths of wild-eyed psychos, paranoid murderers, and multiple personalities split twelve ways.

Both My Mother's Keeper and Oedipus Road are about people who have been through the gate—at least metaphorically—as children of mentally ill persons. These both are, by any account, serious and important books, but I want to emphasize that My Mother's Keeper could hardly be a better read. If it were a novel, it would be the best Texas novel I had read. Taken as bits of Houston and Austin history, it is just as good. Whether she walks through the West University Village (near Rice) of the '50s with her aunt (one of Houston's magnificent and redoubtable aristocrats) or walks down Austin's Drag in the early '70s, Tara Holley's acute observations are often presented in slight, trenchant anecdotes that characterize without caricature.

Neither book contributes to the stack of serious and important books that are too dull for anyone to get through.

Neither book is about a mentally ill person. Tara Holley's mother Dawn Elgin is diagnosed with schizophrenia, and Tom Dodge's mother Juanita has Alzheimer's disease, but the books are not about the mothers. They are about the children, about the authors. Many differences between the books—the differences between Tara Holley's experiences of her mother and Tom Dodge's experience of his mother—represent real differences in the diseases. Schizophrenia is, overwhelmingly, a disease that becomes apparent in late adolescence or early adulthood. Dawn Elgin became ill near the time Tara Holley was born. Holley has never known a time when her mother was well. Schizophrenia eats identity. Holley can hear stories about what Elgin was like as a child or a teenager. That is not the same thing as knowing what kind of adult Elgin might have become.

Some authorities describe schizophrenia as a process. Often after twenty or thirty years, the process has run its course and departs. The person then is not really well, because the person has no memory of being well as an adult. More than having a hole of so many years in one's life—as for example might happen to someone who woke from a lengthy coma—the person with schizophrenia has also the remnants of a schizophrenic identity. Not only does Holley not know her mother as a well person, but Elgin would not recognize herself as a well person.

In contrast, Alzheimer's usually becomes apparent in late middle or old age, when the task of becoming an adult, for better or worse, is largely complete. Tom Dodge's mother was as well as anyone can claim to be when he was a child, although they were not especially close. Dodge emphasizes her aloofness, and the distance that characterized the relationship—even after Dodge became an adult—might be, in part, the reason Dodge did not apparently recognize the first signs of Juanita's illness.

Typical of people with mild illnesses or in mild stages of more serious diseases, Juanita developed strategies for disguising her illness. Her memory of the distant past was intact, so she took every opportunity to turn conversations to bygone days and evaded direct questions about the present. Also typically, her husband Raymond and her coworkers made allowances for her lapses and took up the slack. This is especially likely in Alzheimer's because senility has long been mistaken for a normal part of the aging process. We are prepared for older people to become increasingly absent-minded, forgetful, stubborn when contradicted, and taught to consider these symptoms normal. People are much less likely to make allowances for schizophrenia, yet schizophrenia is much more common.

Apparently, the incident that gives rise to Dodge's title occurred when Dodge took Juanita to the grocery store after she had insisted on leaving a nursing home:

Dodge got off lightly here. At least Juanita has put this thought in someone else's mouth. To her it was not so outrageous. Juanita's mind was stuck in 1982, when she was sixty-four. When the incident in the grocery store occurred, Dodge was only about seven years younger than his mother believed herself to be. Children, even grandchildren, are often mistaken for spouses or lovers in ways that are considerably more inappropriate. While everyone else in the world grows older, an Alzheimer's patient may grow younger, and the person mistaken for a spouse may come to be mistaken for a parent. In any event, whatever oedipal overtones may exist are all on Juanita's side, for Dodge's obsession is with his father.

Coincidentally, both books raise questions of paternity.

Tara Holley's interest in discovering something about her father has much to do with her mother's illness. Dawn Elgin, from an old Houston family (for whom a Central Texas town and a bit of a major Houston street are named), was a singer with a very promising career when she disappeared from Hollywood at the age of twenty-one. She called her sisters a few times, seeming to be in some kind of trouble, saying she was being watched. When she surfaced, she was in the care of an older man in New York City, she had a daughter—who is Tara—and in very short order she was committed to Bellevue.

Why? While Alzheimer's is too often dismissed as a matter of "just getting old," schizophrenia seems a puzzle that could be solved if only one had the right pieces. In cultures that take an even dimmer view of madness, a blow to the head is often blamed. The disease is hard to accept and hard to understand. In Dawn's case, the thought is that if the identity of Tara's father were known, there might be some explanation of where Dawn went, what happened to her, and why—that elusive, tantalizing why—she became ill. That the patient is ill and that nothing can be done to make the patient really well are things families can accept, in time. But many never get over wanting to know why.

For a child, for Tara Holley, the wanting to know why has a point. Schizophrenia, although not known to be genetic in the usual sense, can tend to run in families. The child of a schizophrenic may wonder "Am I going to go crazy? What about my children if I have any?" Naturally, any simple alternate explanation, such as "a blow to the head," would be welcome. Fortunately Holley avoided the endless cycle of what-ifs.

Dodge's quest for his paternity is more problematic. Most readers will sympathize with a seven-year-old boy who has no one to accompany him to a father-son picnic. And it would be abnormal if that boy did not get some answer, factual or mythical, before he turned twenty. Dodge did not have a father at home, but while she was in her right mind, Juanita gave him a cover story, and the surname of the man she described as his father. And the man, who never had any other children, acknowledged that he was Tom's "father." Some men would have left it at that, and even if they knew it was as much a myth as Santa Claus, would have found more pressing things to occupy their minds, if not by the time they were twenty-five, then by the time they were thirty, and certainly would have put the issue aside by the time they were in their fifties. That was not the course Tom Dodge took.

I invite readers, who wish to, to think otherwise, for there are many other ways in which Oedipus Road is valuable—but I think it disgraceful and unfair for Dodge to avail himself of his mother's illness to dislodge from her failing memory a story she chose not to tell when she had her wits about her. In a way, though, Dodge's obsession is only a symptom of a more widespread and disturbing resurgence of tribalism in what ought to be a democratic and civil society. That kinship could be contained in a vial of semen or that allegiance is owed to a particular set of genes are not ideas worth propagating, and I'd be remiss in recommending this book—which I do—if I did not mention this flaw in its substance.

The good of Dodge's book, besides his fine draughtsmanship in portraying the Cleburne of his youth and it denizens, is that we see more of Juanita and the progress of her illness in it than we see of Dawn in Holley's book. (The author is also a professor of English in North Texas and a writer and commentator for KERA, the National Public Radio affiliate in Dallas.) This difference, too, is largely a function of the differences in the diseases. Alzheimer's patients become more dependent, not only upon their caretakers, but upon familiarity of place and regularity of routine. Schizophrenic people, though they often do little better in caring for themselves, are more likely to strike out on their own and, however marginally, to maintain themselves for longer periods.

Dodge's descriptions of Juanita's behaviors and his insights into them give us some notion of what it may be like in her mind. Is she obstreperous? You would be too if people insisted you had done things you had no recollection of doing, if they urged you prepare for appointments you did not remember making, if you found things moved you did not think you had moved yourself, or if things appeared in your home without your being aware of having bought them. If you had been home all day, it would be perfectly reasonable—a perfectly normal thought process—for you to be suspicious if some ponderous piece of new merchandise suddenly appeared: Who put it there? Are they still in the house? If you could, you would call your son and insist that he come right away to investigate. Strange behavior is often understandable, although understanding does not always lengthen patience.

Sometimes a little insight can be had into the thoughts of a person with schizophrenia, but usually only in bits and pieces. Holley seems to have discovered a few of her mother's bits and pieces. Elgin has a recurring horror involving the MGM lion. Holley discovers lion statues at the apartment building where Elgin was living with the older man just before she was committed. Tara Holley was named for the estate in Gone With the Wind...MGM lion...Gone With the Wind...lions at the entrance of the building where Elgin probably was living when Tara was born...and Dawn Elgin's repeated mentions of the motion picture Black Dawn. There is almost a pattern to it. One schizophrenic thought process is that of investing the most pedestrian coincidences with great meaning and importance.

Is the string of associations: Tara to Tara, lion to lion, Dawn to Dawn, just coincidental? Sometimes the associations are more than coincidental and it is possible to understand a little. Although in persons who are even more ill, nothing at all seems to connect their utterances, which are often described as "word salad."

For too long Perry Mason's expert witnesses have defined schizophrenia as "split personality," a disorder so rare that some authorities doubt it exists. More accurately, schizophrenia is shattered personality: shattered ideas, shattered associations, shattered logic. The synthetic processes of the mind try to put the pieces back together, but as often as not, fit the pieces by the wrong rules. When the synthetic processes are too ambitious, the result is paranoia, which is not the belief in conspiracies, although it is often manifest in that form, but is the over-organization, the systematizing, of the fragments by the wrong rules. A lion on the screen is pasted to a lion on the porch, not much more than that is required to think that the lions are a sort of message, an instruction, a veiled threat, or something very important.

Holley could have given us more of Elgin, but it would have been, for the most part, more of this: more fragments, some of them slapped together as child slaps jigsaw pieces together when they don't really fit. As it is, Holley's own story of herself is fascinating and well told, and offers us as much insight into the diseases as present knowledge will admit.

Holley has the gift of taking Elgin as she is, and this is perhaps the most important skill in caring for a mentally ill person. Too often, the people nearby do not accept the patient as she or he is. They see the person that was, or the person they hope for, or what they fear the person may become. This is the way of false hopes (and false apprehensions). In Travels With Lizbeth I told how I made that mistake in my personal life, despite my years of working with mental patients, and it is a mistake that anyone can make.

The term "mental illness" stands in the way of understanding. And since General Patton tried to slap a shell-shocked solder back to his senses, the nation's understanding has not progressed by much. "Mental illnesses" are illnesses. Schizophrenia is a real illness with every indication of having a physical basis just as real as that of diabetes. Alzheimer's is a real and ultimately fatal disease that can be demonstrated in autopsy just as clearly as cancer or heart disease. The thought that mentally ill people are really suffering from some spiritual disorder or flaw of moral character is what might be called the conservative error.

But there is a liberal error, too. Some mentally ill people really are crazy. There is a physical cause of their craziness, but they are crazy nonetheless. It is not that they have an odd or unusual view of the world, that they have chosen an alternate reality or lifestyle, or that they have found some other plane of consciousness; they are crazy, they are lunatics. And from time to time one of them does grip a barred window and shriek to get out.

A person with a severed spinal cord is not having an alternate lifestyle choice or a spiritual experience, and neither is a mental patient. Alzheimer's, of course, has no ultimately effective treatment. As palliatives go, there are now several for schizophrenia which are very good at least by comparison to what came before. But we fault mental patients who refuse to take their medications in a way that we do not fault people who refuse to take their blood-pressure medication or who mismanage their insulin or who stray from their diets.

We still have a long way to go.