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Kaysen begins her account of mental illness and hospitalization with
a question often posed to her: how did she end up there? Kaysen
believes that people are curious about the circumstances of her hospital
stay primarily to discover whether they might find themselves in
the same situation. “It’s easy,” she says, to find oneself in a “parallel
universe” of mental illness. Georgina, Kaysen’s roommate at the
hospital, was stricken with severe depression during her junior
year at Vassar. While watching a movie, Georgina realized that she
was undergoing some kind of mental breakdown. Most people suffering
from mental illness do not enter the parallel universe immediately,
Kaysen says. Instead, they catch brief glimpses of this other world
where everything is different, including time, the laws of physics,
and even the way everyday things appear to the eye. Eventually,
the temptation to cross over is irresistible, and the alternate
reality replaces the familiar. Once in the parallel universe, one
is perfectly aware of the world left behind.
Kaysen travels to the suburbs of Boston to see a psychiatrist.
He notices that she has a pimple, and that she has been picking
at it. Kaysen describes the sense of achievement she felt that morning, popping
the pimple. The doctor believes that the pimple is a symptom of
a self-destructive disposition. He suggests to Kaysen that she take
a rest. Kaysen agrees under his repeated questioning. She is tired
and distracted by thoughts of the effort it will take to travel from
the doctor’s office to her job. While the doctor calls to reserve her
a bed at a mental hospital, Kaysen considers escaping, but she is too
exhausted. Kaysen notices that the doctor seems pleased, even proud,
of his decision. She weakly attempts to postpone admission to the
hospital, but the doctor is firm: she will leave immediately. He puts
Kaysen in a taxi and instructs the driver to be sure that she makes
it there. Kaysen, having submitted to the plan with little argument,
thinks about how much more pleasant it is to be driven in a taxi
than to wait for a train.
Etiology is a branch of medicine that deals with the causes
of diseases. This chapter is a one-page, multiple-choice questionnaire, asking
us to identify which of the answers best describe an imaginary patient.
Several of the questions are absurd, asking whether the person is
possessed by the supernatural. Others present historical treatments
of the mentally ill, from removal of the uterus (hysterectomy) to
leeches and electric shock. The final questions are the most relevant
to Kaysen’s story: is she in fact in full possession of her mental
faculties while the world has gone mad? Is she embarking on a dangerous
voyage that will take her life?
Polly is a fellow patient of Kaysen’s on the hospital
ward. Prior to entering the hospital, Polly poured gasoline over
herself and lit a match, badly scarring her face and upper body.
Kaysen notices that scar tissue does not age or change as skin does,
but remains the same throughout a burn victim’s life. She imagines
that the ruined tissue is a protective shell disguising the person
underneath. Despite her horrific injuries, Polly is always kind
to the others and never complains. Kaysen thinks that the fire must
have burned any negativity out of Polly forever. Kaysen concludes
that anyone who would choose to end her life so painfully must have
tremendous courage. Kaysen tried to kill herself once by swallowing
fifty aspirin, but she thinks that her half-hearted effort means
little in the face of Polly’s dramatic choice. One day, the girls
on the ward hear crying and screaming. They discover Polly overcome
with emotion, as though she has seen her damaged face for the first
time. Kaysen realizes that though she might one day emerge from
her difficulties, Polly is trapped forever in her damaged body.
The metaphoric “parallel universe” of mental illness that
Kaysen describes gives us insight into the all-consuming nature
of diseases of the mind. Afflictions of this sort are, in the author’s
view, as encompassing as a physical disability, a life of crime,
or even death. Georgina’s life enters the parallel universe without
any warning when a “tidal wave of blackness” sweeps over her. This
frightening description of the sudden and inescapable onset of profound
depression sets the stage for the memoir’s exploration of Kaysen’s
own struggles. She notes that even from within the parallel universe
of illness, one is aware of the reality left behind. Kaysen and
the other patients are trapped in more than one kind of parallel
universe. Behind the barred windows of the hospital ward, the girls
are conscious of the events taking place in the world around them
but are unable to participate.
Kaysen’s interaction with the doctor sheds light on both
the reality of Kaysen’s illness and the chilling consequences of
a medical establishment too quick to pronounce someone ill. Kaysen
puts up little resistance to the doctor’s hurried diagnosis, even
when he draws conclusions from an offhand observation about a pimple.
She considers escaping, but pleads exhaustion. In truth, Kaysen
doesn’t need to “escape”: she is eighteen and can leave any time
she chooses. Too exhausted by depression, however, Kaysen relents.
Her fear in this scene is justifiable and foreshadows the bleak
months of hospital confinement ahead. At this crossroads, both the
doctor and Kaysen make choices that will have grave consequences
for Kaysen in the two years to come.
The mock questionnaire of the “Etiology” chapter provides
a darkly humorous look into the history of treatment for mental
illness and foreshadows the direction of the story to come. For
hundreds of years, the mentally ill were often assumed to be the
victims of supernatural possession. By presenting options, each
more absurd than the last, Kaysen asks us to consider the nature
of psychiatric medicine. Should we accept today’s mental illness
diagnoses without question, just as the people of other eras accepted
the notion of demonic possession? Kaysen is purposefully vague on
this subject, insisting that we draw our own conclusions. The questionnaire
goes on to pose a choice of treatments: medieval-era leeching, in
which a patient’s blood or other fluids is drained in the belief
that too much of one or the other has built up in the body, or electric shock
therapy and Thorazine. Shock therapy became common in the 1930s,
and Thorazine, a powerful sedative, in the 1950s.
Both treatments were popular during Kaysen’s time at McLean; doctors continue
to prescribe them today. Kaysen challenges the dogma of the psychiatric
medical establishment in order to demonstrate that there is no simple
explanation for mental illness.
Polly’s horrific story of self-immolation puts Kaysen’s
illness in perspective and reveals the grave nature of certain mental
disturbances. Kaysen initially envies Polly’s scar tissue because
she feels that her own suicide attempt was timid in comparison.
She imagines a sliding scale of suicides, from the violent to the
relatively peaceful, that ranges from the ingestion of pills to
more violent options. The method of suicide indicates the courage
a person brings to the task. With Polly’s shrieking realization
of the extent of her injuries, however, Kaysen realizes that she
herself is fortunate. Kaysen might one day escape her own affliction,
but Polly’s ruined face will forever be a reminder of her troubled
past and will trap her, at least outwardly, in the parallel universe
of mental illness.
Ace your assignments with our guide to Girl, Interrupted!