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Just Like Someone Without Mental Illness Only More So: A Memoir [Hardcover]

Mark Vonnegut M.D.
4.0 out of 5 stars  See all reviews (2 customer reviews)

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Book Description

Oct. 5 2010
More than thirty years after the publication of his acclaimed memoir The Eden Express, Mark Vonnegut continues his remarkable story in this searingly funny, iconoclastic account of coping with mental illness, finding his calling as a pediatrician, and learning that willpower isn’t nearly enough.
Here is Mark’s childhood spent as the son of a struggling writer in a house that eventually held seven children after his aunt and uncle died and left four orphans. And here is the world after Mark was released from a mental hospital to find his family forever altered. At the late age of twenty-eight—and after nineteen rejections—Mark was accepted to Harvard Medical School, where he gained purpose, a life, and some control over his condition.

The brilliantly evoked events of Mark Vonnegut’s life are at once perfectly unique and achingly relatable. There are the manic episodes, during which he felt burdened with saving the world, juxtaposed against the real-world responsibilities of running a pediatric practice. At times he felt that his parents’ lives would improve if only they had a few hundred more bucks in their bank account, while at other points his father’s fame merely heightened expectations that he be better, funnier (and crazier) than the average person.
Ultimately a tribute to the small, daily, and positive parts of a life interrupted by bipolar disorder, Just Like Someone Without Mental Illness Only More So is a wise, unsentimental, and inspiring book that will resonate with generations of readers.

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"Mr. Vonnegut's book surpasses all expectations--his heartfelt effort to enlighten us about mental illness is a gift. I read in awe and recognition, to say nothing of how many times I laughed out loud. People with mental illness, their families, friends and caretakers in the world of psychiatry will learn so much and continue to be fascinated by this remarkable man." 
 --Patty Duke

"Mark and I both started communes in 1971, and reading his new book I feel like a hippie brother. Sharing so vulnerably his woundedness and his family’s and society's woundedness, he shows you can step out of it all, into a celebration of imperfection and a life of meaning."
--Patch Adams, M.D.

"The man who wanted to bite R.D. Laing has grown into the doctor who helps us understand how compassionate healthcare has given way to mindless bureaucracy. As a psychiatric patient and a pediatrician, he lucidly conveys his experience of psychosis, as well as the maddening effects of today's health insurance and big pharma collusions. He is uniquely qualified and positioned to show us both sides of the insanity." 
-- Julie Holland, M.D., author of Weekends at Bellevue: Nine Years on the Nightshift at the Psych E.R.

About the Author

Mark Vonnegut is the only son of the late Kurt Vonnegut and Jane Cox Vonnegut and the author of The Eden Express: A Memoir of Insanity, an ALA Notable Book. A full-time practicing pediatrician, he lives in Massachusetts with his wife and son.

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1 of 1 people found the following review helpful
4.0 out of 5 stars A Follow-up to The Eden Express Sept. 16 2012
By IvanW
I had read The Eden Express many years ago and realized that Mark Vonnegut was misdiagnosed with schizophrenia when he really had bipolar disorder. So it was interesting to see that in this book he relates his life after his bipolar disorder diagnosis. It was also interesting that even though he is now a physician he didn't take his prescribed medications and his bipolar psychosis came back.
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4.0 out of 5 stars Excellent account of a personal struggle Oct. 27 2013
By jwo
Format:Kindle Edition|Verified Purchase
Mark Vonnegut writes with great prose about a topic that others see as taboo. He makes you feel what he is feeling and I found myself pulling for him throughout the novel.
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Amazon.com: 4.4 out of 5 stars  55 reviews
95 of 96 people found the following review helpful
4.0 out of 5 stars "None of us are entirely well, and none of us are irrevocably sick."... Oct. 9 2010
By Kcorn - Published on Amazon.com
Mark Vonnegut, son of Kurt Vonnegut, Jr., first wrote about his struggle with mental illness in The Eden Express. His newest book has an updated focus, written from a seasoned perspective, with doses of humor which make the book very engaging. To get a fuller perspective about how the newer volume fits into Mark's life, I'd strongly suggest reading The Eden Express first. No, it isn't necessary, but does add perspective and a historical comparison between views about mental health in the 70s and now. It also makes it easier to grasp Vonnegut's changed views of mental health diagnosis and treatment.

By Mark Vonnegut's own admission, "craziness" ran in his family and manic depression affected at least four generations of the Vonneguts - and maybe even more. Alcoholism also seemed to be a common theme, with his great-grandfather drinking when he needed to escape from the voices he heard in his head. His maternal grandmother went through periods of psychiatric hospitalization.

When he wrote The Eden Express, Mark believed he had schizophrenia and was even formally diagnosed as schizophrenic. But he later decided that he actually had a form of bipolar illness, characterized by periods of mania as well as depression. Perhaps that is the prime reason his new book has more of an emphasis on bipolar illness. Vonnegut now questions the vitamin therapy which he credited in The Eden Express for much of his recovery. He has revisited that treatment option, noting it didn't work for many others.

Having read The Eden Express, I was eager to find out what had happened to Mark Vonnegut in the years since its publication. As it turns out, he'd not only gone to Harvard Medical School but became a practicing physician, all described in detail in his latest work. He also had to deal with the loss of his famous father and other blows. He eventually had a relapse (his fourth), complete with hallucinations, hearing voices and delusions that led to potentially lethal acts.

For those who are familiar with some of the biographical information about the Vonnegut family, it is relevant to keep in mind how the family history of depression may have made Mark particularly vulnerable. Mark's father (Kurt Vonnegut,Jr) had spells of depression so severe that he couldn't write for long periods of time. Mark's grandmother (Kurt's mother) committed suicide. So there is a case to be made that a tendency towards depression, bipolar illness, and alcoholism was inherited and may have played no small part in Mark Vonnegut's psychotic breaks.

Adding to the complexities, Vonnegut came of age in the 70s, a time when there was some support for the belief that there was no such thing as "mental illness" and that it was society which was "crazy" or out of whack. This was the time period and social construct when The Eden Express was written - but not the same time frame for his newest book. Finally, like so many in the late 60s and early to mid 70s, Mark took drugs and this complicated things even further. He joined a commune and was seen as a mystical figure, helping to obscure his increasingly disjointed thinking and delusions.

When Just Like Someone Without Mental Illness..etc...was written, drugs were still a factor but consisted primarily of Xanax and alcohol (never a good combination, potentially fatal). After Mark recovered from his first breakdown, the one chronicled in The Eden Express, and became a physician he also became a fairly heavy drinker, although he was careful not to drink at work. He'd sometimes add a bit of Xanax to the mix. Then he stopped drinking, quit the Xanax and everything went haywire again. He started to hear voices, something which hadn't happened to him in 14 years. Then he spiraled downward, began listening to the voices and ended up leaping through a glass window as an act of faith. In short order, he was back in a mental hospital and put on a daily dose of Xanax which seemed to be the bright spot in his day. At one point, he was also put on Haldol. All of this is chronicled very well by Vonnegut.

Maybe all this seems too grim for the average reader. But this isn't just a memoir about very bad periods in Vonnegut's life but also serves as an inspiring and truthful look at getting on with life, in spite of the possibility of regression. It took some bumpy years for Vonnegut to find some sort of equilibrium. After taking a close look at his past, Vonnegut began going to AA meetings and worked hard on his marriage. Although he was out of the psychiatric unit of a hospital, he still had to face a wealth of continuing problems - that turbulent marriage, a dying mother, uncertain funds, and more. And yet he persevered and became a practicing physician again. His success came in bits and pieces and this book chronicles his journey, from the lowest moments to the decisions he made to find some normalcy again.

Whether potential readers of Vonnegut's book have experienced mental illness or known someone who has, this memoir is worth reading. I hope it dispels some of the stigma about bipolar illness and other forms of mental illness. It is a courageous and open account. Vonnegut's memoir also lends credence to the fact that mental illness is a condition which can affect anyone, including those who are highly creative and famous as well as the poor and homeless. Vonnegut is proof that even a respected physician, someone named a leading physician by Boston Magazine, could be seriously impacted by bipolar illness. Vonnegut also doesn't take the stance that there is such a thing as complete mental wellness.

But he does find a way to schedule his life in hopes of staying well enough to be happy, function in the world and (hopefully) avoid any recurrence of severe episodes. He attends AA meetings and adds creative activities, including remodeling homes, to his life. All of this seems to help. I found the tone of the book to be best described as one of cautious optimism, of learning to be "comfortable with being uncomfortable" (as Vonnegut puts it). In his own way, he seems to have come to terms with his family's history of psychiatric problems and found his unique methods for maintaining some balance.

Perhaps Vonnegut expresses it best when he writes: "None of us are entirely well, and none of us are irrevocably sick. At my best I have islands of being sick entirely. At my worst I had islands of being well. Except for a reluctance to give up on myself there isn't anything I can claim credit for that helped me recover from my breaks. Even that doesn't count. You either have or don't have a reluctance to give up on yourself. It helps a lot if others don't give up on you."
39 of 40 people found the following review helpful
5.0 out of 5 stars A Small, Good Thing Oct. 5 2010
By emmejay - Published on Amazon.com
JUST LIKE SOMEONE WITHOUT MENTAL ILLNESS ONLY MORE SO is Mark Vonnegut's follow-up to The Eden Express, his 1975 memoir of a series of psychotic breakdowns in his early 20s.

This is memoir also, of perseverance, told through a collection of thoughts, vignettes, and longer pieces. Vonnegut writes about attending Harvard Medical School (of twenty programs he applied to, his only acceptance); a passage describing his first patient death, alongside a staff nurse, reminded me how often nurses guide doctors-to-be through that experience. He writes about his practice as a pediatrician, including criticism of contemporary healthcare and the health-insurance industry. He includes passages about his own childhood -- his weirdly prescient (and mentally ill) mother; his plainly weird (and genius) father (before he was successful and famous); the orphaned cousins his parents took in and raised as his siblings. He describes a medical mission to Honduras. He examines marriage, fatherhood, being alcoholic ... and a fourth psychotic episode, wherein he takes us inside his mind as it breaks down.

Each chapter opens with a personal photo or sample of his own artwork, and he includes bits of advice about sanity and sobriety throughout, for example: "It's possible within any given moment of any given day to choose between self and sickness. Rarely are there big heroic choices that will settle matters once and for all. The smallest positive step is probably the right one."

Vonnegut is curious, optimistic, fun, philosophical ... and this gentle memoir is highly recommended.
32 of 33 people found the following review helpful
5.0 out of 5 stars The Vonnegut tradition of humor carried on - hi-ho, so it goes Nov. 9 2010
By Timothy J. Bazzett - Published on Amazon.com
This book will make you smile, smirk, chuckle and laugh out loud. It will also make you wince, perhaps in recognition, but certainly in sympathy. Because Mark Vonnegut's road to finding some measure of peace in his sixty-three years of life has been filled with bumps, collisions and countless stretches of "under construction." One would think that being the son of a famous author like Kurt Vonnegut would have made for an easy and charmed life. Nope. As it turns out mental illness ran in Vonnegut's family on both sides probably back three or four generations. With a family history like that, it's not surprising that Mark Vonnegut cracked up in his early twenties, the first of at least four major episodes in his life which each time left him hospitalized and scrambling to find purchase on a sudden downward slide. The last time it happened, Vonnegut had reconstructed his life well enough to have gotten into Harvard Med School and had successfully completed an internship and residency and was already well established as one of the top pediatricians in the Boston area. Alcohol and prescription drugs (Xanax) played a part, and denial played perhaps an even bigger role.

Mark Vonnegut has written only one other book, a memoir 35 years ago. The Eden Express, an insider's tale of mental illness, was a smashing success, enough to finance the author's med school and buy him a house. I must have read the book, probably soon after it came out, because my brother said I lent it to him years ago. But I can't remember it at all, so I'll have to find a copy and read it again. Since I'm a few years older than Mark Vonnegut, I guess I'll just chalk my forgetfulness up to age. Because I love this new book. While mental illness is not exactly a happy subject, Vonnegut's wit, wisdom and wry and dry slightly off-center sense of humor make the journey an extremely entertaining one. I found myself nodding in agreement to many of the things he had to say, smiling and chuckling at much of it. A confirmed introvert myself, I had to laugh at what he had to say about people like me and also about extroverts -

"Introverts almost never cause me trouble and are usually much better at what they do than extroverts. Extroverts are too busy slapping one another on the back, team building, and making fun of introverts to get much done ... I can pass for normal most of the time, but I understand perfectly why some of my autistic patients scream and flap their arms - it's to frighten off extroverts."

There's more, but you get the idea. This perhaps gene-propagated Vonnegut sense of humor is very much in evidence throughout the book. Here's another sample from pediatrician/would-be handyman Vonnegut - "Since I took up carpentry I measure children much more carefully, sometimes to 1/32 of an inch." Hmm ... I wonder if, like most good carpenters, he measures twice, so he'll only have to cut once.

Vonnegut has many points he wants to make and is pretty successful in making all of them I think. He is quite disenchanted, for example, with insurance and pharmaceutical companies and the general state of the health care business today, and pretty much everything he has to say on these things rings true and makes sense. He has numerous comments to make about his famous father, usually making allowances for his crankiness and ungraciousness, calling him "more like an unpredictable younger brother than a father ... [who] fiercely defended and exercised his right to be a pain in the ass on a regular basis." But he obviously loved Kurt, as evidenced in the chapter entitled, "There Is Nothing Quite as Final as a Dead Father," when he comments sadly, "I was no longer on deck."

The final chapter in this slim volume is called "Mushrooms," and is quite hilarious as he describes his late-in-life discovery and fascination with finding various fungi and cooking and eating them, which leads to what he calls the UNFORTUNATE INCIDENT. In a book describing a life filled with UNFORTUNATE INCIDENTs, Vonnegut somehow manages to end his story on a upbeat note, with "a wish to move forward. I love finding out what happens next."

I sincerely hope this guy is not finished telling his story, because he is an extremely talented and engaging writer. This apple didn't fall far. I want to know what happens next too. Take notes, Dr. Vonnegut, and please write it all down. Your daddy would be proud, but then again ... Well, he SHOULD be proud. - Tim Bazzett, author of the memoir, BOOKLOVER
8 of 9 people found the following review helpful
5.0 out of 5 stars Compelling Description of Life With a Mental Illness Nov. 14 2010
By Dinah Miller Md - Published on Amazon.com
I'll cut to the chase: I loved this book.
Five stars. Two thumbs up.

When I read books, especially psychiatry books that I write about on Shrink Rap, I often read more carefully and sometimes more critically. I was so immersed in reading Just Like Someone Without Mental Illness Only More So that I didn't stop to think, I just went on the journey.

Mark Vonnegut is a pediatrician and he is also the son of my favorite author from when I was in junior high school. His memoir is a poignant and candid account of his struggles with...well... life in general, and life with a psychotic illness in particular. Schizophrenia, bipolar disorder---who knows (I'll vote for bipolar disorder)? Some illness where he had three episodes in his twenties, then another episode 14 years later. Thorazine and lithium and megavitamins and psych wards. Xanax and alcohol and how humiliating it is to be psychotic on a stretcher in the ER hallway of the hospital where he works. Divorce and remarriage. First and second families. Childhood as the son of a financially struggling, not-yet-famous, eccentric writer, and adulthood as the son of an icon. Vonnegut is a hippy, a mainstream doctor, a middle-aged softball player, then finally a guy who accidentally poisons himself with wild mushrooms.

Dr. Vonnegut's struggles are those of vulnerability, fragility, hope, and resilience. He comes back from these life-altering episodes of psychosis and applies to 20 medical schools. He gets in to Harvard, and only Harvard. If you're going to apply to med school with a 1.8 science GPA from college, then I imagine it's helpful to have a very famous dad who teaches at Harvard. Vonnegut does well enough that he stays for residency and teaches there after. His illness and the possibility of its return hang on him--once you've heard voices, he says, you're never like someone who hasn't. As serious as the topic is, the author is able to make light of himself and the writing is funny and tragic all at once. It's a quick and engrossing read.

In case I didn't like this memoir enough, Vonnegut makes intermittent jabs about the tedious things that weigh down life as a doctor-- paperwork (my favorite rant), the influence of big pharma, and insurance companies.

So would I like Mark Vonnegut in real life? I liked him in his book. And so it goes.

This review was posted on Shrink Rap, a psychiatry blog, on November 13, 2010
11 of 14 people found the following review helpful
5.0 out of 5 stars Unusual life Oct. 20 2010
By Karen Ziminski - Published on Amazon.com
Format:Kindle Edition|Verified Purchase
Mark Vonnegut's family tree has a lot of creative, high achievers, and a lot of people with mental illness. Mark is both, which is unusual. Most of the people I know with bipolar disorder, severe, with psychotic symptoms are on disability. I liked this book for its portrayal of bipolar disorder, Harvard Medical School, the advantages and disadvantages of being Kurt Vonnegut's son, and what's wrong with medical care in the U.S. His expose of the medical mission to Honduras was a real eye opener. A minor complaint is that he mentions McLean without explaining that it is an expensive psychiatric hospital in the Boston area. Most people outside of Massachusetts have no idea what McLean is.
There is an error at the beginning of chapter 12. He writes about how Harvard Medical School has about 6000 applicants each year and how they interview only 800 of them. He writes, "Once the first forty-two hundred or so have been eliminated..." Wait a minute......6000-800 = 5200, not 4200. Mark wrote earlier that his math grades weren't too good; he proves his point. I guess the editor's math grades weren't too good either.
The Eden Express: A Memoir of Insanity, which Mark Vonnegut wrote about his young hippie days, is also worth reading before this one, to get the background. Mark didn't do anything half-heartedly. He was a very good hippie, is now reputed to be a very good pediatrician, and appears to have been a very good mental patient, the kind that would warm the heart of any therapist who lives to see a seriously ill patient get well.
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