The Biden administration has released a proposal to raise standards in nursing homes. Why one expert calls it the most significant development for the industry in decades -- and why it might still not be enough.
Kurt Vonnegut’s son gives an intimate glimpse of what it was like to grow up with a used car salesman turned iconic author. Mark Vonnegut also gives his account of coping with mental illness and finding his calling as a pediatrician.
- Mark Vonnegut Pediatrician, the only son of the late Kurt Vonnegut, and author of "The Eden Express: A Memoir of Insanity" and "Just Like Someone Without Mental Illness Only More So."
MS. DIANE REHMThanks for joining us, I'm Diane Rehm. "I've gotten used to it, but very little about my life has been likely." That's the opening sentence of the new memoir by Mark Vonnegut. He tells the story of his unconventional upbringing of the son of author Kurt Vonnegut in a family with a history of mental illness. Despite suffering several mental breakdowns and an alcoholism, Mark Vonnegut went on to become a Harvard trained pediatrician, a father and a writer. His new memoir is titled, "Just Like Someone Without Mental Illness Only More So." Mark Vonnegut joins me in the studio and we are going to welcome your calls, questions, comments, 800-433-8850, you can join us by email to firstname.lastname@example.org or you can join us on Facebook or Twitter.
MS. DIANE REHMGood morning to you. It's so good to have you here.
MR. MARK VONNEGUTThank you very much.
REHMI mentioned your writing, but I also wanted to mention your drawing. Beautiful.
VONNEGUTThank you very much. When the book got published, I said, it's cool they're publishing what I wrote, but the extra cool thing is they're gonna make pictures of my drawings and paintings.
REHMDid you not know they were going to do that to begin with?
VONNEGUTWhen you do a book, you don't know what you're going to get away. My first thing was, they're not gonna let me keep my title. And then when they let me keep my title and I started trying to sneak in the paintings.
REHMTell me about that title. Explain it.
VONNEGUTWell, I gave a talk at NAMI, National Alliance of the Mentally Ill, it's a wonderful organization and somebody asked me the question, they said, well, here you are, you're talking to us. You have a job you go to every day. What's the difference between you and someone without mental illness? And I just said, I'm just like someone without mental illness only more so.
REHMOnly more so. And what did that mean to you?
VONNEGUTWhat I really think it means is that we all have mental illness.
REHMTo one degree or another.
VONNEGUTTo one degree and I sometimes wish I was more stable and less emotionally liable than I am, but on the other hand, I'm just very human. And I think the mentally ill, in all their various disease diagnosis or whatever, usually suffer from extremes of being human.
REHMTell me how human you feel right now.
VONNEGUTI feel very human. I feel lucky. I feel like I sort of made my way through a minefield that could have ended up very differently. I could have easily not survived mental illness. I could've very easily could've not gotten into medical school. I could've very easily not had children. I could have -- all of that could've easily gone the other way, so I feel lucky.
REHMAnd I can certainly understand why you do. Describe your childhood for us.
VONNEGUTIt was kind of a magical childhood. I was alone a lot. I spent a lot of time in the woods and fishing and making forts. And children accept whatever is as normal. I now look back at the way my father spent his hours sort of trying to write and typing and throwing things away. I look at the big ramshackle house, I look at the fact that we adopted four first cousins when their parents died. I looked at -- it -- there were a lot of odd things that I just accepted as normal and I look back now as precious.
REHMRead for us that paragraph you and I talked about.
VONNEGUT"When I was 10, I told my mother I wanted to kill myself. I was failing at school and sports and fighting every day and had been studying poisons. My mother told me that bright, young, idealistic people like myself were going to save the world. It was a successful play for time. Before I killed myself, I should at least join forces with all the other suicidal 10-year-olds and give saving the world a try. When the '60s came around and there didn't seem to be any adult plans worth much, I thought my mother's solution was coming to pass. Making the world a place worth saving was up to the outcasts. Who would've guessed in the '50s that there would be such a thing as hippies?
VONNEGUTWhen I had had three psychotic breaks in three months and I didn't think getting better was possible, my childhood looked particularly dark and dismal. Now, not so bad."
REHMWhat was it about your childhood? One the one hand, you just said it was magical. On the other hand, dark and dismal.
VONNEGUTIt -- I came to look at it -- I was desperately afraid that I wasn't going to recover from being mentally ill. And at that time, they had this -- these criteria for pre-morbid adjustments. And the fact that I had grown up largely without friends, the fact that I had grown up not playing any sports, the fact that I had -- I looked like a loner of a child and there were things I loved about it and I love now, but then, it looked like a threatening thing to me.
REHMWhy were there no friends in your recollection?
VONNEGUTIt was because we had moved to the Cape when other families had been there for many, many generations. Everybody else was Republican, everybody else had nice houses. We had this run down house, so it didn't -- it wasn't possible for me to fit in and it took like years and years of fighting and it was sometime after the adoption of my cousins who were athletes, who were tall and handsome and fit in much better that I did, that I became accepted, but that was many, many years.
REHMHow well did you get along with those cousins? And talk about the accident that brought them to you all.
VONNEGUTWell, it was this very bizarre thing. A commuter train coming from New Jersey went into Newark Bay in 1958. I believe 60 some odd people were killed, among them my uncle and his wife died within 48 hours of cancer. A cancer she had essentially, because it was the '50s, not been told that she had. So there were all of a sudden four boys who needed a home and it was my father's decision with -- my mother agreed 100 percent was we should take these boys in.
REHMNow, you write that there was mental illness in the family. Were you aware of it?
VONNEGUTAbsolutely not aware. I was aware -- it was around a couple of years after the Adams' had been adopted that my father had told me somewhat about my mother's hearing voices and being -- but it had seemed to be something that she had integrated quite well. And then after I had been seriously ill and hospitalized for four months, I learned about my grandmother's illness. Again, that had been just sort of, not hushed up, but it was, yeah, your grandmother's spent several years in Indiana State Hospital.
REHMSo your family took in these four boys, tall, good looking, athletic. How did you blend with them?
VONNEGUTI was thrilled, really, to have a bunch of brothers. I was sort of socially isolated and I was thrilled to go out for sports. I was thrilled to become part of -- much more a part of the world than I had been. I actually ran for vice-president of the eighth grade class, so I became much more one of the guys, but I always still felt like a bit of an outsider.
REHMAnd did your father help you with that at all?
VONNEGUTIn his own way.
REHMWhat does that mean?
VONNEGUTI remember Jim asked me to get something and I went and got if for him and my father sort of said, don't you ever act like somebody's servant again. And so it was something I wished he hadn't said that, but in a way, that was helpful.
REHMYour father was pretty proud of being a loner. He didn't have any friends and he seemed proud of it.
VONNEGUTRight and so on the Cape, that -- it worked out that way. I was shocked later in life to find pictures of him in high school with his arms around girls at parties and he was part of a band or this or that. He was enormously social and I think -- the truth is, I think WWII, like it changed a lot of people, changed him. But at the time, I grew up thinking that I was loner, my father was a loner, a loner was a good thing to be.
REHMHe's served in WWII?
REHMIn what capacity?
VONNEGUTHe was a scout in the infantry and he was at the Battle of the Bulge and he was captured by the Germans and put on freight trains and put in -- kept under guard in prisons in Dresden. And then after the bombing of Dresden, he was recaptured and forced to go in and get the dead bodies out of the German air raid shelters.
REHMHe came back a changed man.
VONNEGUTHe did and his writing is very changed. You look at his -- again, I look at the silly kid in the high school pictures and I also look at his writing for the high school newspaper and his writing for the Cornell Sun and it's all light and fluffy. And after WWII, he is not light and fluffy anymore. And he took it on with seriousness, I think, to tell the truth about what had happened to him and what WWII did to people.
REHMHow did you view his relationship with your mother and how did that affect you?
VONNEGUTI thought it was -- you know, I think all children at some point think of their mothers and fathers as this wonderful royal couple. And I know that there were rough times. There were lots of arguments about money, but I sort of remember them as dancing through the aisles of department stores like kings and stuff and highness. I just -- I imagine them as really magical.
REHMAnd of course, their lives changed a great deal after his success. Mark Vonnegut is here with me. His new book, a memoir, is titled, "Just Like Someone Without Mental Illness Only More So."
REHMAnd if you've just joined us, Mark Vonnegut is with me. Of course you recognize the famous last name, but Mark Vonnegut is a writer and artist in his own right. His new book, a memoir, is titled "Just Like Someone Without Mental Illness Only More So." There are not only extraordinary writings here, but wonderful drawings and a couple of which I found fascinating, one actually a photograph of you, it doesn't say how old you were, with the wonderful hat and flowers and bright smile on your face and a self portrait, 1972, looking anything but happy. Can you tell me how far apart?
VONNEGUTThose are, like, two or three years apart.
REHMI thought so.
REHMI thought so. So one was how you saw yourself...
REHM...and the other how others saw you.
VONNEGUTRight. It was -- that self portrait was the first time they would let me have paper and pen in the hospital and I just tried to make a picture of myself.
REHMTell me how old you were when that first breakdown came.
VONNEGUTI was 22.
REHMCan you describe for us what that felt like?
VONNEGUTIt started as sort of this ecstasy. I felt I had been a seeker who was looking for the truth or religious -- just, you know, what's the meaning of life or whatever and then all of a sudden, I just felt this wonderful breath and I was going to find out the truth of everything. Of course, I lost the ability to sleep and eat, but it felt wonderful in the beginning. Like when you first hear the voices, it's like, oh, good, I can talk to somebody who really knows what's going on.
VONNEGUTAnd I had a lot of questions, but very, very shortly, when you can't eat or sleep, I lost about 20 pounds, my friends tried to keep me out of the hospital and I was desperate to try to get back to some sort of place where I could understand what was going on and I could communicate with my friends or anybody. It was like on this terrifying ride and I didn't know when, if ever, it was gonna run -- end.
REHMHad you been using or abusing alcohol at the time?
VONNEGUTIf I had had a bottle, I would've been okay, because my drinking was mostly drinking to be normal and be okay and I had times in college where I would be very unhappy or I'd be a little manic or whatever and there's something about drinking yourself into a blackout, which seemed therapeutic. And we had no alcohol, we had no drugs out at the farm. You know, people, I think, mischaracterized the hippy movement or the communal movement as being mostly about -- we had no drugs, no alcohol whatsoever. And so if I had had a later break, I tried to try to save myself by smoking a lot of marijuana. Just one of the many stupid mistakes I made, but at that particular time when I -- at the first break, it just -- it was a manic episode and it just got completely out of hand.
REHMI want to back up just a little. You were 21 years old when Slaughterhouse-Five came out. How did that affect the life of the family and you?
VONNEGUTIt was really -- the first thing was, great, thank God. You know, 'cause I always thought whatever problems we had as a family could've been solved by a few hundred extra dollars. And here was a few hundred extra dollars and then some, but I also felt like all of a sudden, my family were -- they could go to Europe or my mother took my sister to Israel or to the -- there was -- all of a sudden, there was a ton of money around and I felt really, really good about it, but then uneasy.
VONNEGUTBecause my childhood as a working class hero was gone. My -- was really, really fun to root for your father as being just as good a writer as Fitzgerald and Hemmingway and Faulkner and never have to have that be taken up on. It was like my father as an underdog was gone.
REHMSo then did your father become a little happier?
VONNEGUTHe did. And it was like I felt somewhat betrayed. Like when my father was an underdog, he was all mine or he was mostly mine. And when he was a success, all of a sudden wearing nicer clothing and going to parties and stuff like that, I felt like he was betraying not only his own self, but he was betraying me a little bit.
REHMAnd what about your mother?
VONNEGUTAnd that, too. I mean, she was so ready and would've been so wonderful, you know, in New York as successful and having enough money and it became clear that he was leaving her.
REHMHe was leaving her.
VONNEGUTAt -- that became true over time.
REHMAnd how long was it before he left her?
VONNEGUTIt was -- when he -- you know, they started having, you know, more distance between them in Iowa and I just sort of ignored it. Or there was more distance again when he had his multi-book contract and there was more -- I just tried to ignore it and it was one of the things that became impossible to ignore right before my first breakdown. There was a pile of things that seemed, you know, calculated to drive somebody crazy.
VONNEGUTMy father's leaving my mother, a girlfriend leaving me and so forth, you know, so it was bad timing. But also -- there's always going to be stress in life and most people go through stress without getting into a manic or a psychotic break.
REHMAnd the psychotic break ended you up in the hospital. And the first time you had pencil and paper, you made that drawing...
VONNEGUTI made that drawing.
REHM...of yourself. Do you think that that was the beginning of moving out of it?
VONNEGUTI do think so. And I do think there were other coincidences like when I got out of the hospital, there was a note that a magazine called Earth Magazine was gonna publish an article of mine. And I had forgotten that I wrote it. I was in terrible shape, but it was also being able to draw and that somebody was going to publish an article of mine. And during the illness, I had thought to myself, if I can remember the truth of what's going -- happening to me, I might survive.
REHMWhat was the article about?
VONNEGUTIt was about failing the draft physical. I was taken to South Boston army base and the kid who looks a lot like that photograph and they gave you a valuable bag and I couldn't tell what was valuable or not. I tried to fit my hat into the valuables bag. I drew attention to myself by my oddness and it was scary at the end of it to realize it hadn't really been an act. And I got right in the face of a drill sergeant who -- you know, he was questioning me about some of my answers. And I said, I don't give -- whatever your little stamp says, I'm not going near your f-ing army. And he said, relax son, you're out.
REHMWhoa. How'd you feel after that?
VONNEGUT...but also, I wondered why was it so easy for me to allegedly be acting mentally ill when all these other people who didn't want to go to Vietnam either were unable to do so.
REHMHow long was it before your second breakdown after the first?
VONNEGUTThe second breakdown was, like, just a few weeks, maybe a month. I was discharged and I did not understand I was supposed to still be taking medication.
REHMYou didn't understand.
VONNEGUTI honestly didn't understand and I think I had some Thorazine pills I was told to take if I needed them and I threw them into the water.
REHMAnd ended up right back in the hospital.
VONNEGUTWithin a few weeks, I was back -- right back in the hospital.
REHMFor how long?
VONNEGUTThe next time was in -- the first time I was in for a few weeks and the next time was for a few months.
REHMAnd then discharged...
REHMWhich you maintained.
VONNEGUTI did. I was desperately interested in getting well.
REHMThird breakdown, how much later?
VONNEGUTThat was -- again, it was just sorta -- the thing that was horrible about that is it just sort of came on me when I was taking medicine and I was really next to a fence in trying to talk to somebody and all of a sudden, I was hallucinating that the fence was pressing at me and there were all these awful noises and I had no explanation for why I was in the hospital again.
REHMAnd that time for how long?
VONNEGUTAbout a month.
REHMAnd that's all.
VONNEGUTYes. And then I went back up to the farm for a little bit and I went back east and I started writing. I started writing "The Eden Express."
REHMAnd "The Eden Express" did what for you?
VONNEGUTIt gave me hope. I did not know that it was possible to recover from mental illness. And it also -- there were not a lot of people coming around offering me other jobs. I didn't have a lot of alternatives. I started teaching doing substitute teaching at (word?) high school. I started writing. I actually got a short piece published in Harper's and then the Village Voice published a couple pieces. So I started thinking, this is pretty good. I'm getting publishing.
REHMBut then, Mark, what possessed you to apply to medical school?
VONNEGUTPartly arrogance and a huge chip on my shoulder and wanting to know what I could do and what I couldn't do. And I was -- you know, and again, it's pure luck that I got into medical school.
REHMAnd to Harvard, nonetheless.
VONNEGUTI don't think anybody else considered taking me. Harvard had their own quota. They wanted unusual applicants because they didn't want doctors who were narrow and just based in the sciences and stuff. And I honestly think if I hadn't had some published articles, they wouldn't have looked at me either. I think it was as a writer they were interested in me.
REHMAnd you don't think it was your name.
VONNEGUTI don't really. I think the name is a -- you know, no matter how much you love my name, you're not gonna publish me unless I can write (laugh).
REHMThere was also some, shall I say, ridicule that you underwent from professors who were lecturing about mental illness and the fact that you had undergone massive vitamin intake as a purported or real treatment for mental illness.
VONNEGUTThat's right. And I very, very much wanted to be part of the established medical thing and I was horrified that people would be citing me as -- there was also the hypoglycemia thing, there was the vitamin thing and I just wanted to wash my hands and just be a Harvard doctor, thank you very much.
REHMDid you take huge doses of vitamins?
VONNEGUTThat was part of what I was treated with at the hospital I was hauled off to. And the mentally ill don't have much choice in their treatment. We are dependent on where you take us (laugh). And so yes. And I found myself -- I found the argument between the so called establishment psychiatrist and the megavitamin doctors instructive in terms of how little either of them seemed to care about the mentally ill. I mean, people were just sort of, you know, whiplashed between these two adversaries who got a lot of fun out of criticizing each other.
REHMMark Vonnegut, his new book, a memoir, is titled "Just Like Someone Without Mental Illness Only More So." Do join us, 800-433-8850. I wonder if you could describe for us, as you do in the book, what mental illness was like for you when you were at your worst.
VONNEGUTIt feels hopeless. It feels like you're on a pendulum and you're only briefly at the bottom of that pendulum able to understand what other people are saying or what is going on. You feel completely unable to take care of yourself and you are willing to do anything to get out of it. And if that anything includes, you know, jumping through a window or if it includes hurting somebody or it includes taking your clothes off and running in the streets or for me, it included taking out a major picture window with a boulder. So you are just desperately trying to stop the horrible things that are going on. Now, there are very many different kinds of mental illness and some are acute and some are chronic, but they all involve not really being able to take care of yourself.
REHMDid you experience that mental illness as you were going through medical school?
VONNEGUTNo. I was never delusional. I was -- sometimes I would get a little too happy or a little too sad and some of which I did at that time I learned to manage with just a little bit of alcohol. And as I say, I think there are a lot of people with mental illness who, in the beginning stages, can drink to keep them -- to be normal. I didn't drink to get drunk ever.
REHMYou did try an experiment with alcohol. You were drinking what, half a bottle of wine a day and told yourself you were not dependent on it. So you'd stop for a week or so. But at one point, you crashed.
VONNEGUTThat's right. And I think the point of sort of six years into daily drinking and using Xanax, an old friend of mine, I stopped it all and again had a complete manic episode where I couldn't eat, couldn't sleep, the voices came back and that was the last break up -- the last crack up.
REHMAnd you managed to be put back into a hospital again.
VONNEGUTYes. I ended up in restraints in the hospital I was used to taking care of people at. Which if there's a more humbling experience, I don't know what it is.
REHMSo you had already graduated from medical school.
VONNEGUTYes. I was a practicing physician on the staff. I was an attending physician in the emergency room and I ended up on a stretcher in four-point restraints in my own hospital.
REHMOh, Mark, how difficult that must've been.
VONNEGUTIt was. It was also a I don't want to ever be here again kind of moment.
REHMHow did you manage to pull yourself back?
VONNEGUTAgain, I was given a lot of favorable circumstances in terms of the medical care I got, in terms of the family support I got. In terms of I felt very much like if I didn't get well quickly, I would be kicked to the curb, but I felt like my job was still waiting for me. The people who love me were still waiting for me.
REHMMark Vonnegut, his new book is "Just Like Someone Without Mental Illness Only More So."
REHMAnd welcome back. We'll open the phones now and start taking calls for Mark Vonnegut. His new memoir titled "Just Like Someone Without Mental Illness Only More So." Mark Vonnegut is someone who has experienced mental illness. He's been hospitalized four times for exactly that. He is a practicing pediatrician having gone through Harvard Medical School. In fact, he's seeing patients this afternoon.
VONNEGUTTomorrow afternoon (laugh).
REHMTomorrow. Forgive me, forgive me. All right. Let's open the phones to Oklahoma City. Good morning, Matt, you're on the air.
MATTGood morning, Diane. I had a question for the guest, obviously.
MATTI was diagnosed with bipolar disorder shortly before this year. I was hospitalized for about five days due to a medication withdrawal. Of course, I knew what was going on, so I guess really my question was whenever you realize that you had a mental illness and whenever you understood that you went through phases where you felt like you knew the truth, you know, whenever you get into that, oh, man, everything just makes sense.
MATTAfter seeing where that can lead you, did your -- did you find a struggle in when you went to do something productive or creative, did you wonder whether or not it was the illness, if you -- if by doing that, you would feed the illness and put yourself back in a state or did you have the insight to discern, okay, I can do this without -- you know, it's -- it is me, it's not the illness that's giving me these ideas and driving me to do these things?
VONNEGUTYeah, yeah, the -- for myself, certainly the -- it's easy to discern when you start hearing voices and stuff that this is not good. And I have certainly developed a healthy skepticism and reticence to talk back to them. And my attitude now is sort of like, take a number, I'm a busy guy. I don't think you can go too far wrong if you have interesting ideas. And I think there is a wonderful side of mania, but you do have to have an inner critic which says, maybe not all my good ideas are good and I think you get that with time.
REHMDo you know what kind of mental illness you've been diagnosed with?
VONNEGUTI now fit the definition of bipolar as well. When I was diagnosed back in the '70s, it was called schizophrenia, but there are several changes now of the diagnostic statistical manual such that what I now have and what I call it in the book, it is bipolar disease, formerly called manic depression. I wish we had better diagnostic tools than we do.
REHMAnd let's go now to Kristen in Greensboro, N.C. Good morning to you.
KRISTENHi, good morning, Diane and Mark.
KRISTENHi. Mark, I wanted to say thank you first of all because it's inspiring to hear what you've been doing and I'm looking forward to read your -- reading your memoir. My brother, Ronnie, who is two years old than I am was diagnosed with bipolar 1- years ago and he's been through some harrowing experiences, been in and out of the hospital more times than I can count. And I was just going to ask you if there is something that helped you to keep going when you were having -- maybe the times that you were in the hospital or otherwise in one of your manic states that somebody could say that would kind of bring you back to remember, you know, what you are and who you are and just encourage them to keep plugging along and not get discouraged.
VONNEGUTThe two things that I was told which has always been helpful is, you're not alone and you're not in charge. And everybody with mania thinks that a lot is depending on them, so those are the two things. You're not alone, you're not in charge.
REHMYou've been married twice.
REHMYou have grown children.
REHMMarriage is hard enough...
REHM...without the introduction of something like mental illness. Did that play a role in the breakup of that first marriage?
VONNEGUTIt absolutely did. My first marriage did not survive my illness. I -- and I think that's true for a lot of people.
REHMWere you ill at the time of that marriage?
VONNEGUTYes. And it was my final episode, which I think put an enormous strain -- and getting better from that episode and all that getting better entailed. And it's sort of the kind of peace that we had worked out between each other, between ourselves, could not survive a manic episode. And then my not being able to drink anymore, I mean, the alcohol -- it's not like she was -- you know, that she -- it just -- it changes you in such a way that it makes it hard. You're not exactly the same person.
REHMHow did you behave in that last manic episode?
VONNEGUTYou know, I did -- I tried to go through a window to save the world and I threw rocks at people. I had to be physically restrained by the police. Again, it's just you reach a bursting point. I certainly reached a bursting point. I'm sorry about the behavior, but at the same time, it's -- you know, I had about as much control of that behavior as I would if I was having a seizure. It's just not in your control.
REHMDo you think medicine in general, the medical profession, understands mental illness?
VONNEGUTSome do and some don't. I think at this point, in terms of the profession, is much too in love with trying to find the right diagnosis, whether or not you're schizophrenic, schizoaffective, manic depressive, bipolar one or two and that's really the easy part. The hard part is creating circumstances which allow people to recover and I think those circumstances are much more similar for schizophrenics than bipolar and severe depressives and post traumatic stress. I think the sort of supportive circumstances which help people get their lives back are much more similar than different.
REHMHere's an e-mail from Kelli. No, actually, it was posted on our website. She says, "My husband has been between diagnoses for two years. Those diagnoses ranged from generalized anxiety disorder, depression, bipolar disorder, schizoaffective disorder, agoraphobia and now social anxiety, insomnia and panic disorder. He is happy and normal around me, but others, including family, don't even know him now. How do you overcome the constantly changing mental health industry and learn to function and communicate about your illness?"
VONNEGUTI think that that is the key question and I think we're much more likely to find help from organizations like NOMI or the Clubhouse Movement or people who are in general supportive because again, whether or not somebody is bipolar or schizophrenic, they're still gonna be playing around with the same medicine and if the sum total of the medical model is to pin a diagnosis on somebody and then find the magic bullet as a medicine, I think most care will be -- will not be successful.
REHMAre you still in contact with your children by your first marriage?
REHMAnd you have been married now for 10 years to your second wife. You have an eight-year-old child. Tell me the kinds of questions people ask you.
VONNEGUT(laugh) People ask me -- because I am the son of a public figure, I mean, people have asked me outrageous things about Kurt and they've also asked me, in the presence of my children, how -- knowing that mental illness is genetic, how can I have had children, as if I've created some unforgivable gaff. But I think -- you know, I think mental illness has as many positive things and somebody recovering from mental illness can be pulling people up and elevating their game as somebody who is unable to get well pulls a lot of people down.
REHMDo you see children who have signs of mental illness?
VONNEGUTAbsolutely. I have heartbreaking cases of very young children who have to be hospitalized.
REHMBecause they are...
VONNEGUTBecause they become usually assaultive towards their mother and -- or just it becomes a situation that the parents can't handle and they're horrible situations. And what's horrible now is that to get to see a child psychiatrist to get, you know, to be treated well, you have such a blizzard of prior authorizations and co-pays and unavailable beds and stuff. And one of the things we know for sure leads to mental illness and drug and alcohol problems is patients and parents who have untreated mental illness and we're just creating a lot of it.
REHMWas your mother ever treated for mental illness?
VONNEGUTShe was treated with great kindness, as she deserved. She was such a pleasant, wonderful person, but she was given some medication and stuff. And then she had certainly these manic delusional episodes and she would snap out of it and she was the rock of our family, the rock of a lot of people, you know, in Barnstable Village. She was -- and in spite of the fact that she -- yeah, she had her relationship with the voices and such, she did great.
REHMAnd once your father left her, how much contact was there with your father after that point?
VONNEGUTBetween them? Quite a bit.
REHMBetween you and...
VONNEGUTQuite a bit. Yeah, I would go and stay with him in New York.
REHMAnd his new wife?
VONNEGUTHe wasn't married for a long time but eventually, yeah, with a new wife and sometimes, you know, if it was uncomfortable, whatever, I would, you know, I'd stay in a hotel next door and try to have lunch with him or something.
REHMWhat do you mean if it was uncomfortable?
VONNEGUTI did not -- you know, it -- sometimes he was just so busy and he would say, oh, Lily has a cold, whatever. It was not always, you know, ideal, but I made a point of staying in contact with my father.
REHMAnd what about your cousins who were brought into the home. Did you maintain contact with them?
VONNEGUTVery definitely. He -- they have -- I call them regularly and they call me regularly and I was all worried that they weren't gonna like my book or they were gonna object to my characterization of their parents and stuff, but they're fine with it, so I didn't -- I worried needlessly.
REHMWhy did you think they might object to your characterization?
VONNEGUTIt's their story. You know, it's their story. I was telling my version of the death of their parents, so, you know, I think be an easy thing to be touchy about.
REHMI'm glad you've been able to maintain that connection. Let's go to Bill in Gainesville, Fla. Good morning to you.
BILLGood morning. As I've listened to the show, I've been struck at some of the similarities. The first comment I wanted to make, I suffered an extraordinary episode of depression after my father, who was very famous nationally in his field as an engineer, suicide. There were a lot of calls of conspiracy theories, et cetera. And became catatonic and shoved a refrigerator through the wall, et cetera, but this was at a time when the new generation of antidepressant drugs were coming out and I'm convinced that that's what saved me.
BILLAnd I wanted to comment that when people talk to me about depression, I always tell them, it's about chemistry, not character. And I went to one of my psychology professors. I was in school at the time trying to get into medical school and I said, when I am gonna get over this? And he said, never, but you'll come to a place where you include it.
VONNEGUTThat's very well said. I think you do -- you don't ever get over it, but I also think the -- my only quibble is with the chemistry. It is about chemistry, but also the circumstances we create for an ill person, if it's secure housing and they're not deprived. And a lot of homelessness just makes mental illness worse, so I do think it is about chemistry, but chemistry also responds to generalized support and supportive circumstances.
REHMAnd you feel that in your present circumstances, you have that support to remain stable?
VONNEGUTI do. And I feel -- as I say, I feel very, very lucky. I think I've been through a minefield and I have friends who are just like me who are homeless and chronically ill.
REHMOne caller asks, "With your experience, why didn't you go into psychiatry?"
VONNEGUTMy true answer is I would've been in too many fights too often. I care too much. I honestly think that it's better to have my specialty be pediatrics 'cause I think I would've drawn a lot of fire and I would've returned a lot of fire.
VONNEGUTBecause just what I'm saying about diagnosis. It upsets people to intimate that schizophrenia and bipolar are not mutually exclusive diagnoses. It upsets people to -- yeah, there are lots and lots of things. Most of them boring, but I would not get along with most of my psychiatric profession.
REHMAnd how has writing this book helped you, changed you, affected you?
VONNEGUTIt's really been wonderful. Writing is sort of the worst, most awful, terrible, dreadful thing you can do, but then every once in awhile, you get something right, and you say, yeah, that's really -- you know, and so to work at something that hard and have it turn out -- to have a vision for something and have it be not that far off and get stuff right just feels great to me.
REHMHow do you think it's affected your views or your sense of your father?
VONNEGUTQuite a bit. It was -- I don't think you honestly know what you think about something until you've tried to write it. I think I certainly believe that I knew all about my father or I knew all about my mother, whatever, but actually trying to get the words down on paper and saying, that's not right, that's not right, that not right, that's not right and then, that's right.
REHMMark Vonnegut, his new memoir is titled "Just Like Someone Without Mental Illness Only More So." Mark Vonnegut is a pediatrician in Massachusetts. He is the son of the late American writer, Kurt Vonnegut, and author of "The Eden Express." Thank you so much.
REHMAnd thanks for listening. I'm Diane Rehm.
ANNOUNCER"The Diane Rehm Show" is produced by Sandra Pinkard, Nancy Robertson, Susan Nabors, Denise Couture and Monique Nazareth. The engineer is Tobey Schreiner. Dorie Anisman answers the phones. Visit drshow.org for audio archives, transcripts, podcasts and CD sales. Call 202-885-1200 for more information.
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