ALSO BY CHRISTINE MONTROSS Body of Work: Meditations on Mortality from the Human Anatomy Lab THE PENGUIN PRESS Published by the Penguin Group Penguin Group (USA) Inc., 375 Hudson Street, New York, New York 10014, USA USA • Canada • UK • Ireland • Australia • New Zealand • India • South Africa • China Penguin Books Ltd, Registered Offices: 80 Strand, London WC2R 0RL, England For more information about the Penguin Group visit penguin.com Copyright © Christine Montross, 2013 All rights reserved. No part of this book may be reproduced, scanned, or distributed in any printed or electronic form without permission. Please do not participate in or encourage piracy of copyrighted materials in violation of the author’s rights. Purchase only authorized editions. Grateful acknowledgment is made for permission to reprint excerpts from the following copyrighted works: “Crazy” words and music by Thomas “Cee Lo” Callaway, Brian Burton, Gianfranco Reverberi, and Gian Piero Reverberi. © 2006 Warner/Chappell Music Publishing Ltd., Chrysalis Music Ltd., Universal Music Publishing Group, and BMG Ricordi Music Publishing SpA. All rights for Warner/Chappell Music Publishing Ltd. in the U.S. and Canada administered by Warner-Tamerlane Publishing Corp. Chrysalis Music (ASCAP) administered by Chrysalis Music Group Inc., a BMG Chrysalis Company. (“Crazy” contains elements of “Last Man Standing” by Gianfranco Reverberi and Gian Piero Reverberi, © BMG Ricordi Music Publishing SpA.) All rights reserved. “Stopping by Woods on a Snowy Evening” from The Poetry of Robert Frost, edited by Edward Connery Lathem. Copyright © 1923, 1969 by Henry Holt and Company. Copyright © 1951 by Robert Frost. Reprinted by permission of Henry Holt and Company, LLC. “In a Dark Time” copyright © 1960 by Beatrice Roethke, Administratrix of the Estate of Theodore Roethke. From Collected Poems of Theodore Roethke. Used by permission of Doubleday, a division of Random House, Inc. Any third-party use of this material, outside of this publication, is prohibited. Interested parties must apply to directly to Random House, Inc. for permission. “Human Personality” from Selected Essays by Simone Weil, translated by Richard Rees. Copyright © Richard Rees, 1969. Reprinted by permission of Peters Fraser & Dunlop on behalf of the Estate of Richard Rees. Published in French as “La personne et le sacré” from Ecrits de Londres et dernières lettres by Simone Weil. © Editions Gallimard, Paris, 1957. By permission of Editions Gallimard. Library of Congress Cataloging-in-Publication Data Montross, Christine. Falling into the fire : a psychiatrist’s encounters with the mind in crisis / Christine Montross. p. ; cm. Includes bibliographical references and index. ISBN 978-1-10161778-6 I. Title. [DNLM: 1. Mental Disorders—psychology—Personal Narratives. 2. Mental Disorders—therapy—Personal Narratives. 3. Attitude of Health Personnel—Personal Narratives. 4. Behavior—Personal Narratives. 5. Mentally Ill Persons—psychology—Personal Narratives. 6. Physician-Patient Relations—Personal Narratives. WM 140] RC438.6.M665 616.890092—dc23 [B] 2013007699 ( ) AUTHOR’S NOTE The names of all patients and certain details of their stories have been changed in order to preserve confidentiality. For the same reason, the names of some of my colleagues have also been changed. For Deborah and my children, who multiply my life’s joy And for my patients, who help me to never take that joy for granted ( ) CONTENTS ALSO BY CHRISTINE MONTROSS TITLE PAGE COPYRIGHT AUTHOR’S NOTE DEDICATION EPIGRAPH PROLOGUE Bedlam CHAPTER ONE The Woman Who Needed a Zipper CHAPTER TWO Fifty-Thousand-Dollar Skin CHAPTER THREE Your Drugs Take Away the Love CHAPTER FOUR I’ve Hidden All the Knives CHAPTER FIVE Dancing Plagues and Double Impostors EPILOGUE Into the Fire, Into the Water ACKNOWLEDGMENTS BIBLIOGRAPHY INDEX ABOUT THE AUTHOR To acknowledge the reality of affliction means saying to oneself: “. . . There is nothing that I might not lose. It could happen at any moment that what I am might be abolished and be replaced by anything whatsoever of the filthiest and most contemptible sort.” To be aware of this in the depths of one’s soul is to experience non-being. It is the state of extreme and total humiliation which is also the condition for passing over into truth. —Simone Weil They called me mad, and I called them mad, and damn them, they outvoted me. —The Restoration playwright Nathaniel Lee, regarding his committal to Bethlem Royal Hospital