Chapter 1 - Notes to My Biographer
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In this chapter, the main character alternately provides the reader with history and symptoms. The story begins with the man in an apparent frenetic driving spree where he tries to visit and contact numerous friends and relatives. He is driving his niece's car and she clearly has no idea that he has taken it for this extended trip. He describes a series of extreme behaviors, up and down. At the time of this story, he is apparently on the up swing. However, he talks briefly of the ECT treatments he had received years earlier. ECT generally used to treat extreme and treatment resistant depression.
The reader can't be sure if any of his employment history of financial success is real or delusions. It could be a mix of both. Even if he has been a successful engineer with financial gains, the behaviors he exhibits clearly point to the diagnosis of bipolar disorder, also commonly called manic-depressive disorder. His symptoms include delusions of grandeur, racing thoughts, mania. This man is in constant motion, rearranging the furniture, making numerous phone calls, spending money, driving at excessive speed. His thoughts are distorted. He thinks that the people in the elevator are a famous couple; he believes the people in the restaurant are stealing his idea. His son, towards the end of the chapter pleads with his to take the medication as he knows that it will help. His son also describes his own behaviors and need to take medication for similar symptoms. Bipolar disorder is a mental illness that causes unusual and extreme shifts in a persons functioning, mood and behavior.
Chapter 2 - The Good Doctor
The patient in this chapter is diagnosed with Post Traumatic Stress Disorder (PTSD) by the doctor who is the main character in this chapter. The patient is a woman who has lost her 16-year-old son in a motor vehicle accident. Her son had a history of drug use and behavioral symptoms, likely at least in part to the methamphetamine use. He was responsible for cutting off his mothers four fingers. The women admitted freely to anxiety, fear and depression but were highly resistant to any treatment aside from sleeping pills. She is detached, numb and almost emotionless in her presentation. She talks about the incidents and is open with there sleep and anxiety problems. She talks about the concern she has for her two young children and her ability to care for them. This woman has much sorrow in her life, aside from the death of her son and the trauma of loosing her fingers. She is sad about her past, sad about her husbands drinking and fearful of her young son, who she is raising the same way she did her older son. The doctor is correct to want to provide therapy in addition to the medication for this disorder. The woman refuses.
Chapter 3 - The Beginnings of Grief
The main character in this chapter has suffered unbelievable guilt and sorrow in an apparently very short period of time. Both of his parents had died. He felt guilty about expressing his own sorrow to his father and then guilty when his father dies in an accident. In addition to this, he seemed to have no other close family or friends nearby and was struggling with issues of sexuality as a high school boy. One senses he has much grief about his homosexual feelings. He becomes involved with an incredibly abusive sexual relationship with another boy at school that is extremely physically abusive and degrading. Yet, the main character seems to continue to pursue his abuser. Even after mush physical injury and a trip to the hospital, he continues to pursue the abuser. The main character was clearly a victim of violence and given his expectation or pursue of violence, one suspects that he may have been raised in a home where violence was the norm. Alcohol abuse was also a symptom and perhaps diagnosis.
Chapter 4 - Devotion
The brother and sister in this chapter have developed a kind of symbiotic relationship. There lives are so intertwined and dependant upon each other. The chapter gives examples of how they seem to be almost the same person. So extreme a case is this that they both actually fell in love with the same person. Neither of them will leave the other and because of this dependency, neither one has had the opportunity to live as an individual. The trauma of their mother's death threw them together and the fact that the brother was uncomfortable with his homosexuality that the sister always protected and cared for him. Even when the sister finds that her brother had sabotaged her chance at happiness with Ben, she ultimately forgives him and they continue to live this quiet life tougher in their parent's home, as they always have. The relationship works for both Owen and Hillary, they both get stability and care and companionship. They miss out of the loving, romantic relationship that they both learn for. Their situation seems to have grown form the trauma and grief of their childhood and the lack of adequate adult caretaking. They have chosen to take care of each other, fell into a pattern and are unable to disengage at this time. While they are resigned to the fact, seems neither happy nor fulfilled. Their relationship is an obligation.
Chapter5 - War's End
The character in this chapter is depressed and suicidal. He speaks freely of the despair and depression and one becomes familiar of his actual plan as he talks about the cliffs early on in the story. This chapter talks a great deal about the effects of the depression on his wife and her desperate attempts to help her husband. She seems willing to do anything. It appears that his depression is doing severe that the psychiatrist has been unable to find a medication or treatment regime that works. The fact that he is unable to work or provide for his young wife in anyway seems to bring him a great deal of guilt. He wants to let her off the hook caring for him. He is uncomfortable with the possibility that she is simply obligated to him and is giving up so much of her own life to care for him. The relationship with the old woman and her grandson gives Mr. Lewis some meaning in his life as he reads to the dying grandson. However, this meaning does not seem sufficient to keep him alive, to prevent him from committing suicide. Mr. Lewis talks of symptoms that include being unable to get out of bed, lack of energy, no interest in sex, and of course the constant suicidal thoughts.
Chapter 6 - Reunion
In this chapter, the main character has AIDS and is preparing for his own death. He is mourning his own death. In preparation, he leaves work, lets his utilities go unpaid and retreats to spending most of his time alone. He is writing letters to his deceased father, explaining his life and letting his father know that he will be with him soon.. The character is sad and likely depressed, though as expected. He is preparing to die. As in some of the other chapters in this book, there is guilt associated with the sadness and grief. He is looking back on his life and feeling that he made mistakes. He didn't do enough to protect himself from the disease, though he was aware of the risks. What is so disturbing about this chapter is that the character has ongoing sexual relationships with strangers in a park. Though condoms are mentioned, one wonders if Finn is acting responsibly or putting other men at risk.
Chapter 7 - Divination
This chapter focused on a young boy's premonition, an experience he felt that he shared with his father. The young boy, Sam had dreams, feelings and what seem to be premonitions about people impending death. His feeling about a teacher at his boarding school was realized when the old man died. Sam was aware that his father had a similar experience about t a cousin that had died years earlier. When he attempts to talk to his parents regarding this feeling they shut him down. They seem afraid of his feelings and want his to ignore the feelings as simply dreams. His mother offers him a therapist and his parents are able to explain the premonitions as more predictions regarding a person who is elderly or ill. When Sam has a feeling that his 16-year-old brother will die, he shares it with his parents and his father punishes him. The story of course ends when his brother is in a serious auto accident and though we never know for sure, the story indicates that the brother, Trevor has in fact died.
Chapter 8 - My Fathers Business
In this chapter, we read about a brief period in a young man life. He is suffering from bipolar disorder that is resistant to treatment. His father had the same condition. The chapter is written in a manic fashion, moving from one scene to the next and includes a great deal of the main characters writing. He is aware of his illness and his father's illness and in one manic phase, an attempt to do what he says is research on human emotions through a series of taped interviews with family and friends. The interviews make little sense as the questions are unstructured and much of his own scattered thoughts become part of the recording. His psychiatrist ahs had the tape recordings transferred to written transcripts for the benefit of a doctor in an inpatients hospital that Dan will be admitted to. By the end of the story we know that Dan leaves the facility after little progress and the doctor does not have a good outlook for Dan's future. The chapter reviews Dan and his fathers racing thoughts, scattered and disorganization which impacts their ability to succeed thought they are both apparently quite intelligent.
Chapter 9 - The Volunteer
This chapter discusses the relationship between an older woman with an apparently long history of mental illness. Her symptoms suggest that she has schizophrenia. She experiences hallucinations and delusions, evident in her trip to the mall with Ted as well as her recollection of giving birth. If her symptoms were recent, coming about with age the reader may conclude that she suffers from Alzheimer's or some other organic brain disorder. However, the history given in the chapter tells of Mrs. Maynard's symptoms and stay at an institution as a young woman, before she was married. The fact that her symptoms and hospitalizations are long term in addition to the hallucination, disorganized thoughts and delusions lead to the diagnosis of schizophrenia. She seems to go in and out of lucidity, at times having meaningful conversations with the teenage volunteer that visits her, Ted. At other times, her thoughts are confused and scattered and she responds to the hallucinations of people in her past, such as Hester. She is able to provide some support and advice to Ted as he considers a relationship with a girl at school and at those times the relationship between Ted and Mrs. Maynard seems like grandson and grandmother.
At eh beginning of the chapter, there is a hint that Ted's mother may have some form of mental illness, or perhaps addiction. He calls to his mother through the bedroom door as he leaves for school and receives no response. His brother tells him not to bother trying. Perhaps Ted's interest in the volunteer position is connected to his own family history and ill mother.
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