A Beautiful Mind
In Is There No Place on Earth for Me?, Susan Sheehan told the complete story of one woman’s struggles with schizophrenia
Columbia Journalism Review | January/February 2013
THERE WERE TIMES WHEN THE LOBBY of The Village Voice seemed to be a magnet for crazy people. When I worked there as a reporter in the late 1990s and early 2000s, it was a weekly, if not daily, occurrence: A mentally ill person walks in with a fistful of tattered, mimeographed papers, claiming to have the inside scoop on a major news story. The standard response for reporters: walk by quickly and try to ignore their paranoid rantings.
One day I opened the door to the lobby and spied a middle-aged woman with wild hair and manic energy. She was rambling on and on to the security guard—and instantly I knew which reporter she was looking for. Despite appearances, she was not one of our usual visitors. This woman was my aunt.
Aunt Holly, my father’s sister, lived with her husband and son some 20 miles away in New Jersey, but whenever she stopped taking her lithium—and the manic side of her manic depression reared up—she’d take off. Other family members had seen her appear unannounced on their doorstep. That day, I guess, it was my turn. Encountering her in the lobby of my workplace, I felt two contradictory emotions: embarrassed by her appearance, but also fiercely protective, raging silently in my head at any co-worker who might dismiss her as yet another of our usual insane visitors.
That’s the thing about mental illness. When your family member is the one affected—when you know that person’s life story, the childhood dreams that never came true, the countless job interviews that went nowhere—you want everyone else to see what you see: not a “lunatic” or a “mental case” or a “nut,” but a real person whose story is as important as anyone else’s, whose hopes and aspirations matter no less just because they are often so desperately out of reach.
Maybe this is why I’ve long admired Susan Sheehan’s Is There No Place on Earth for Me? The book, which originally ran as a four-part series in The New Yorker in 1981, chronicles the life of a young woman diagnosed with schizophrenia. Sheehan calls her Sylvia Frumkin—her real name was Maxine Mason—and she followed her for two-and-a-half years, much of which was spent inside a mental hospital, Creedmoor Psychiatric Facility, in Queens. The book won the 1983 Pulitzer Prize for nonfiction, and it stands as a landmark work of reportage on both what it’s like to be mentally ill and how the mental-health system treats, or fails to treat, those it was designed to serve.
The book is also a first-rate example of how to tackle a complex, often-misunderstood subject in a way that both captivates and educates the everyday reader. To report and write this book, Sheehan had to gain unfettered access to a state mental hospital, demystify a highly technical topic, secure the trust and cooperation of family members, and spend more than two years in close contact with a main character who was often erratic, manic, and beset by delusions. Any single one of these hurdles might have caused a lesser reporter to abandon the story and find something easier to write. Not only did Sheehan overcome each hurdle, she ultimately worked them into a fascinating and poignant narrative.
EVERY NARRATIVE JOURNALIST faces the task of trying to imagine the world from someone else’s point of view, and then writing in a way that allows the reader to do the same. This task varies in difficulty depending on whom you pick for your subject. It’s one thing to write about what it’s like to be a cop on patrol, a surgeon in the ER, or a lawyer on the eve of a high-stakes trial. But how do you get inside the mind of someone who is teetering on the edge of insanity, whose every other sentence makes no sense?
This was, perhaps, Sheehan’s greatest challenge, and it’s one she masters memorably in the book’s opening pages:
“Shortly after midnight on Friday, June 16, 1978, Sylvia Frumkin decided to take a bath. Miss Frumkin, a heavy, ungainly young woman who lived in a two-story yellow brick building in Queens Village, New York, walked from her bedroom on the second floor to the bathroom next door and filled the tub with warm water. A few days earlier, she had had her hair cut and shaped in a bowl style, which she found especially becoming, and her spirits were high. She washed her brown hair with shampoo and also with red mouthwash. Some years earlier, she had tinted her hair red and had liked the way it looked. . . . She imagined that the red mouthwash would somehow be absorbed into her scalp and make her hair red permanently. Miss Frumkin felt so cheerful about her new haircut that she suddenly thought she was Lois Lemaris, the mermaid whom Clark Kent had met in college and had fallen in love with in the old 'Superman' comics. . . .”
On the way out of the bathtub, Sylvia slips, smashes the back of her head, and ends up in a hospital emergency room. Because she is psychotic, she then gets sent to Creedmoor—and the book’s journey begins.
Is There No Place on Earth for Me? is divided into four parts that, taken together, tell three stories: what happens to Sylvia once she gets to Creedmoor; her personal and family history in the years before her hospitalization; and a larger tale about how mental-health care has evolved over the decades to the point where Sylvia finds herself enduring her eighth trip to Creedmoor and is confined there for months on end.
In the mid-1950s, the rise of new psychotropic drugs sparked a nationwide effort to move patients out of state mental hospitals and back into their communities. As patient populations shrank and state budgets did, too, these hospitals came to feel like rickety, forgotten places to those patients who’d been left behind. For someone like Sylvia, who was too sick to survive on her own, even in a supervised setting, Creedmoor remained her de facto home, albeit one that, Sheehan writes, “smelled of coffee, stale cigarettes, and unwashed and incontinent patients.”
In many ways, Is There No Place on Earth for Me? is a textbook on how to report inside a closed institution. Step one, of course, is getting inside. Sheehan doesn’t detail exactly how she pulled this off, but the book’s acknowledgements section offers a couple clues. The first person she thanks is the hospital’s director, who, she writes, “welcomed me to Creedmoor” and “encouraged me to spend 24 hours a day at his institution.” As she puts it, he told her: “Talk to everyone, go to all our meetings, and let the public know how bad things are here, and perhaps they will get better.” For a journalist, it’s hard to imagine sweeter words than those.
The benefit of walking in through the front door—rather than, say, feigning insanity and getting committed, as Nellie Bly famously did to report on the “Women’s Lunatic Asylum” in New York City in 1887—is that you can do in-depth interviews with everyone you encounter, reporter’s pad in hand, a task that’s much harder to pull off when you’re busy pretending to be crazy. By weaving together everybody’s point of view—Sylvia, her parents, sister, psychiatrists, therapy aides, hospital administrators—Sheehan presents a devastating picture not only of the ferocious power of schizophrenia to destroy one woman’s prospects of a decent life, but of the ways in which those charged with caring for her, despite their good intentions, often made a bad situation worse.
SYLVIA FRUMKIN WAS AMONG the most troubled patients on her ward—and also, at times, the most entertaining. On her 36th day at Creedmoor, she wears a pair of blue jeans tied around her neck, gold sandals with high heels, socks, and a bandanna on her head with a spoon stuck in it. She paints her entire face with bright-red lipstick. She talks for an hour without stopping, delivering rambling soliloquies about various celebrities: Geraldo Rivera, Paul McCartney, Mayor Koch, Neil Diamond. Her monologues—which Sheehan captured in shorthand, then transcribes at length—are the best parts of the book, offering a glimpse straight into Sylvia Frumkin’s beautiful mind. To a fellow patient, she announces:
“I’m going to marry Geraldo Rivera. I think we’re going to get married in Madison Square Garden, just like Sly Stone did. Mick Jagger wants to marry me. If I have Mick Jagger, I don’t have to covet Geraldo Rivera. Mick Jagger is St. Nicholas and the Maharishi is Santa Claus. I want to form a gospel rock group called Thorn Oil, but Geraldo wants me to be the music critic on Eyewitness News, so what can I do? Got to listen to my boyfriend. Teddy Kennedy cured me of my ugliness. I’m pregnant with the son of God. I’m going to marry David Berkowitz and get it over with . . . ”
Sheehan describes Sylvia as a “perpetual-motion machine, marching, pacing, jogging, and trotting all over the ward.” A fellow patient calls her “the greatest show on earth.” But the show can’t go on forever, and for every grandiose and entertaining soliloquy, there was a time when Sylvia stripped off all her clothes and dashed down the hall, insulted the African-American women who were her caretakers, or spent an entire night screaming while locked inside the “seclusion room.”
During earlier stays at Creedmoor, Sylvia had been injected with Thorazine, bound for weeks in a straitjacket, subjected to electroconvulsive therapy, even given “insulin coma therapy,” in which, as Sheehan writes, “she was put to bed and injected with insulin until she went into a hypoglycemic coma.” When she arrived this time, the psychiatrist who evaluated her was foreign-born, like many of the doctors at Creedmoor. When she tells him she knows Mary Poppins and is making a movie with Don Knotts, he has no idea who she’s talking about. As a result, he gives her an incorrect diagnosis—manic depression instead of schizophrenia. Months of medication mistakes follow, causing her to get worse rather than better.
Eventually the reader comes to realize that no matter how crazy Sylvia may be, the world of Creedmoor might be even crazier. The “seclusion rooms” have no pads on the walls, even though some patients have a habit of head-banging; female patients sleep hugging their pocketbooks for lack of a safe place to store them; more than a few employees steal from the job (one year, half the turkeys for the patients’ Thanksgiving dinners disappeared); medical charts teem with errors, including notations that “numerous patients had taken their medication on February 29 and February 30, 1979.”
There is no doubt that Sylvia’s psychiatrist is a terrible doctor—he gets indicted a year later for “selling more than five thousand prescriptions of Valium and Tuinal,” Sheehan writes—but among Sheehan’s most troubling insights into the mental-health system is how haphazard so much of the care is. No psychiatrist bothers to read Sylvia’s chart long enough to become an expert on her case. There’s little logic to her treatment. She’s given medicines that hadn’t worked for her in the past—or medicines that only worked at a much greater dosage than she’s prescribed. She bounces from doctor to doctor, from one facility to another, her fate and her sanity determined by whomever winds up with her chart in their hands.
I WAS IN THE FIFTH GRADE when is There No Place on Earth for Me? was published, and it wasn’t until maybe 15 years later, after I’d started working as a journalist, that I first picked it up. Only when I reread the book recently did I realize that Sylvia Frumkin was born in the same year as my aunt Holly: 1948. There were other similarities, too. Both were dramatic characters, garrulous and vivacious. And when I was growing up, I remember Aunt Holly calling our house to announce that she, too, was planning to marry Mick Jagger. Once, she even went to Saks Fifth Avenue and bought a dress for the wedding.
My father has two sisters—there’s Aunt Holly and also Aunt Sue—and for reasons nobody could ever quite explain, both became seriously mentally ill. They shared the same diagnosis, manic depression (now known as bipolar disorder), though each manifested the illness differently. Over the years, they were both diagnosed with schizoaffective disorder, too.
Aunt Holly had been a dancer when she was younger, and sometimes she’d hear voices telling her things she wanted to hear: “You’re going on tour with Bob Dylan!” For a moment, she’d feel elated at the news, but then the voices would turn on her, adding: “You’re going to dance on the grave of your murdered friend.”
Murdered friend? What murdered friend? What were they talking about? It made no sense, but the voices spoke to her so often and so emphatically that at times she believed them. It was an invisible sort of torture: Nobody could see what she was going through, and, if she tried to talk to anyone about it, well, they would think she was crazy. And, like Sylvia Frumkin, she seemed to be “treatment-resistant”: No matter what antipsychotic medication she took, the voices would not stop.
Aunt Sue didn’t hear voices like Aunt Holly did, and she had no delusions about marrying a Rolling Stone. She did, however, once cover the metal handle of her toilet flusher with two band-aids. As she explained: “I had to cover up every reflective surface in the house because that’s where the cameras are.”
Today Aunt Sue lives some 300 miles away. I don’t see her too often, but we did get the chance to talk recently at a family party. The topic of magazines came up, and my husband asked whether she read The New Yorker. “I read this piece about a mentally ill woman . . . ” she said, and anyone listening in on the conversation would have assumed she was talking about an article published recently. As it turned out, she was describing the four-part series about Sylvia Frumkin that Sheehan wrote for The New Yorker 31 years ago. “I’d never read anything like that, anything that was that descriptive and that was really compassionate,” she said. “It was the best journalism I had ever read on the subject.”
Her own introduction to the mental-health system had taken place two years earlier, when she’d spent three weeks in a mental hospital, where, she recalls, she was pinned down by aides and shot up with Thorazine. When I asked her what she liked about Sheehan’s work, she said: “I felt it was a really accurate view. The way she described the well-intentioned search for help and how everything gets screwed up: Error after error, bad judgments, each one compounding the next. That’s how it happens! The misunderstandings never get straightened out. It’s just this abyss that she’s going down. I really identified with it.”
The remarkable thing about Is There No Place on Earth for Me? is how easy Sheehan makes it for the reader to empathize with Sylvia. In real life, if confronted by a psychotic woman slathered in makeup and spouting delusional ideas, the average person would make a beeline toward the other side of the street. But by sticking with this story for so long, Sheehan lets the reader see Sylvia not only during her most insane moments, but at those times when she’s lucid, too. At one point, when her medication kicks in and her fantasy world begins to evaporate, Sylvia bemoans the absence of her own delusions. “You know, it was fun believing some of those things I believed, and in a way I hate to give up those beliefs,” she says one day at Creedmoor. “I’ll miss having those fantasies.”
Without an upcoming wedding to Mick Jagger to look forward to, she’s forced to confront the sorry state of her own life: "I once thought, when I was about to finish medical-secretarial school, before I had a breakdown on the last day of school, that I’d graduate and get a job. I was looking forward to earning my own money, to having a credit card, to being a grown woman in my own right. If you can work and earn money, you can . . . buy new clothes instead of wearing state clothes. And you can have fun. But . . ." she says. “When you know all those things exist for other people but not for you, sometimes it’s very hard to endure the not having.”
Moments like these illustrate the true toll that schizophrenia has taken on Sylvia. Her lucid moments allow the reader to see her as something other than a crazy person, which, in turn, make the later scenes—when her illness rears up again, when she is delivering nonsensical diatribes to her fellow patients or screaming about Jesus to her terrified family—all the more devastating.
BACK IN THE LATE 1970s, before mental illness became a frequent topic of public debate, families with a schizophrenic child had to contend with enormous ignorance and stigma. This, in turn, ensured that the family would often become its own sort of closed institution, not unlike Creedmoor itself. I cannot remember my grandfather ever talking frankly about his daughters’ mental illness. The notion of having a journalist at the dinner table, taking notes with a plan to write about our family’s most taboo topic? It’s impossible to imagine.
And yet as deeply as Sheehan dives into life inside Creedmoor, she goes just as deep in her reporting on the Frumkin family. Sylvia’s parents and older sister are strong presences throughout the book, offering a window into the ways in which severe mental illness can warp every aspect of family relations. Sylvia was hospitalized at Creedmoor for the first time at age 16. By the time Sheehan enters the picture, Sylvia is 30, and the endless ups-and-downs of her illness—the psychotic episodes, the slapping and punching of her parents, the ambulance trips to the hospital, the search for a competent psychiatrist—have thoroughly exhausted everyone.
The Frumkins’ hospitality doesn’t buy them favorable treatment. Rather, Sheehan slices through the denial, shame, and frustration to deliver a brutally honest account of everyone’s shortcomings, whether it’s the mother’s refusal to visit Sylvia in Creedmoor because their relationship had become so toxic, or the father’s insistence that she swallow megadoses of vitamins to try to cure her schizophrenia, though there’s no evidence this works.
One night, when Sylvia is home from the hospital, Sheehan goes over to the Frumkins’s house in Queens for dinner. The conversation turns to a young woman, Sonya Finkel, who had been a patient at Creedmoor on the same ward as Sylvia, and who had recently committed suicide by throwing herself onto the subway tracks. The Finkel parents had always wanted to move to Arizona but didn’t because they didn’t want to leave their daughter when she was so sick. After her death, they relocated to Phoenix.
Sheehan recounts the dinner-table conversation:
Mrs. Frumkin: “Since Sonya killed herself, Isadore Finkel hasn’t had another heart attack. The Finkels come to New York to visit every few months. I saw them a while ago, and they looked so gorgeous. It’s no wonder. The cause of all their trouble was removed.”
Sylvia’s response: “Ma, are you trying to tell me something?”
At this moment, Sheehan commented years later, “I wished I could crawl under the table.”
The entire final section of the book is horribly uncomfortable, as the reader can see the whole Frumkin family cracking under the strain of Sylvia’s illness. And as she oscillates between lucidity and madness, you can predict her decline: her violent outbursts, her medication mismanagement, her ultimate return to the hospital. Once she’s back at Creedmoor, she picks up right where she left off. She dabs blue eyeshadow on her lips, ties a white T-shirt around her neck, and sashays through the ward.
“I first met Geraldo Rivera when I was in Elmhurst,” she says. “I think the Cowardly Lion was secretly married to Judy Garland. I’m going to marry Lyle Waggoner, who plays Steve Trevor. I’m going to take Lynda Carter’s place on Wonder Woman when I marry Steve. I want to have my own show, a show called Sylvia’s. I’m my favorite person. I only wish I could get along with everyone as well as I get along with me.”
IN SOME WAYS, Sheehan’s greatest achievement boils down to the fact that she was able to get this book published at all. My own experience writing about mentally ill people—or prisoners, juvenile delinquents, addicts, and others on the fringes of society—has taught me how hard this can be. Tougher than the challenges of reporting and writing can be the ineffable task of trying to excite an editor enough to get your story into print.
Can you imagine any magazine today publishing the four-part series on Sylvia Frumkin that became this book? Even in 1981, its mere existence was improbable. In her book’s acknowledgements, Sheehan admits as much when she thanks William Shawn, editor of The New Yorker, describing him as “the only editor in the world who would have let a writer try to write about such a sad and difficult subject and who would then have published a hundred thousand words on the subject.”
In 1995, The New Yorker published “The Last Days of Sylvia Frumkin,” an article by Sheehan that doubles as a postscript to her book. Sylvia had died the year before of cardiac arrest inside another state mental hospital, Rockland Psychiatric Center, at age 46. In her article, Sheehan offers a behind-the-scenes look at her relationship with Sylvia: the inevitable tensions between writer and subject, which were compounded by Sylvia’s schizophrenia, and her efforts to maintain a friendship with her subject long after the book was done.
Three years ago, my aunt Holly passed away, too, though she made it to 61. She died at home, alone, in a tiny, dingy apartment in New Hampshire, her marriage long since ended. Like Sylvia, Aunt Holly’s last years were her worst. She became progressively sicker, the illness tightening its grip on her psyche, the voices in her head growing louder and more menacing. Some days they told her that 9/11 was her fault—that somehow she’d caused the Twin Towers to topple—and she’d feel overwhelmed by guilt, no matter how many times you tried to tell her that she had nothing to do with 9/11.
Her death had been unexpected; we don’t know the exact cause, but it, too, may have been cardiac arrest. I wrote her obituary for the local paper and included everything I thought she’d have wanted it to say: that she was an “extraordinary woman” with a “feisty spirit, warm manner, and an artistic soul”; that as a child she’d studied with the legendary Mary Day at the Washington School of Ballet; that she’d been a dance major at Skidmore and gone on to teach dance in Germany.
Her mental illness had first appeared when she was 22, and by the end it had left her impoverished, isolated, and at the mercy of voices she could not escape. None of it seemed fair, especially when you knew the whole backstory: when you saw the photos of her as a child and a teenager, so full of promise and optimism, before mental illness seized hold of her and quashed so many of her dreams.
At its heart, Is There No Place on Earth for Me? accomplishes what anyone who has loved someone with a mental illness would want: a portrait of a woman battling schizophrenia that tells the whole story, how the illness ravaged her life and how she fought back, how the system did and didn’t help her, and how, through it all, she persevered. Sylvia herself provided the book’s title. She was a student at New York’s High School of Music and Art when she had her first psychotic break. At 16, in an ambulance on the way to the hospital, she asked her mother, “Is there no place on earth for me?” It’s a question she asked again and again over the next years—and by the book’s end, this question haunts the reader, too.