Summary: Velocity
vs. Viscosity
Kaysen believes that mental illness can be divided into
two types: fast and slow. The slow type brings everything in a patient’s
mind to a crawl. Time seems to creep by, powers of observation and
insight are blunted, and even the body’s heart rate and immune system become
weak. The fast sorts of illnesses greatly increase a patient’s velocity.
Thinking speeds up immensely, torturing patients with a never-ending
series of internal arguments, questions, and investigations. Kaysen
delineates the thought process of a person suffering from a “fast”
illness. Images and memories accompany the smallest observation,
and the patient is overwhelmed by a tidal wave of perception. Yet
Kaysen believes that fast and slow illnesses can appear the same
to the casual onlooker, because both freeze up a patient’s ability
to act, one by inaction, the other by presenting too many options
upon which to make a decision. Also, patients are aware that even
one small negative feeling can signal the beginning of a thought
process that will culminate in overwhelming depression and self-loathing.
Eventually, however, the repetition of these episodes dulls their
impact. Kaysen suffers from both kinds of illness. She is never
sure which is about to emerge.
Summary: Security
Screen
Lisa makes a scene, demanding fresh air. She harasses
the nurses, banging on their door and threatening to call her lawyer.
Valerie, the head nurse, agrees to open Lisa’s window, but Lisa
is dissatisfied. She taunts Valerie, imagining out loud what the
head nurse’s experience as a patient would be like. Just as quickly
as she began her tantrum, Lisa relents. Valerie is calm and able
to deflate Lisa’s angry moods. The nurse goes about the difficult
task of unlocking and forcing open Lisa’s heavy, barred window.
She realizes that Lisa doesn’t intend to sit by the window but was
merely creating a scene to entertain herself. “Hey man,” says Lisa,
“it passes the time.” Valerie agrees that it does, indeed, pass
the time.
Summary: Keepers
Kaysen describes Valerie, the head nurse. Valerie is young,
with attractive, waist-length hair that intrigues the girls. She
is firm but earns the girls’ trust because she stands up to both
them and the doctors. The patients meet with a doctor, a medical
resident, and a therapist each day. Kaysen and the others are distrustful
of the doctors and their psychiatric language, which Valerie doesn’t
use. The doctors are all men except for Dr. Wick. Dr. Wick is an
old-fashioned character with a colonial British background and is
quite unfamiliar with the culture that produced Kaysen and her fellow
patients. Dr. Wick is particularly uncomfortable with foul language
and sexual allusions. Kaysen describes her relationship with her
high school English teacher to Dr. Wick, including in her story
a crude, invented account of how she became sexually involved with
her teacher. This embarrasses Dr. Wick. The student-doctors, or
residents, change often and have little familiarity with their patients’
daily lives. Therapists, the girls’ third daily medical appointment,
are primarily responsible for prescribing medication. The girls
dread the evening hours between the point at which Valerie and the
day staff have left and the time at which the night staff comes
on. During this time, Mrs. McWeeney supervises the ward. Mrs. McWeeney
is a nurse of the old school, with a traditional nurse’s uniform
and the personality of “an undisguised prison matron.” Although
the girls detest Mrs. McWeeney, they feel protective of her in a
way, because she seems as crazy as they are. Student nurses also
appear regularly on the ward. The nurses remind the girls of the
lives they might be living beyond the walls of the hospital. The
girls pretend not to be ill and dispense advice to the student nurses,
who learn very little about psychiatric care as a result.
Summary: Nineteen
Sixty-Eight
The world is in turmoil. Kaysen and the other patients
witness on television the unrest outside McLean Hospital. The war
in Vietnam rages on, as do civil rights movements and anti-war struggles.
The assassinations of Dr. Martin Luther King and Robert F. Kennedy shock
the girls as much as they do the rest of the nation, which is mired
in university protests and civil disorder. The girls identify with the
protestors on the outside because they see their own anger acted out
by others. The nurses relax as their patients’ behavior seems to be
calmed by the actions they see on television. The girls slowly realize
that the world might not actually be changing for them, or indeed
for many of those fighting the battles in the streets. They watch
as Bobby Seale, leader of the Black Panthers, is wheeled into a
courtroom bound and gagged. His plight is not the same as theirs, the
girls think, because his cause is great and righteous and theirs
is small and shameful.
Analysis
Kaysen attempts to explain the nature of mental illness
as she understands it with two simple analogies: viscosity and velocity.
A viscous substance, like syrup, moves slowly and with great deliberateness. Velocity
is defined in physics as the ratio of speed to time, and is a measure
of movement. Kaysen distinguishes between “slow” and “fast” types
of illness, but the effect of each is the same: immobility. “Viscosity
causes the stillness of disinclination,” she says, and “velocity
causes the stillness of fascination.” This “stillness” is a result
of either a profound inability to make decisions or an overabundance
of options that makes decision impossible.
When Lisa throws a tantrum, demanding that Valerie open
her window, she offers a glimpse of what the monotony of confinement can
inspire people to do. Lisa’s outburst arrives without warning, but
the scene is a familiar one. The girls are obliged to create whatever
excitement they can. Lisa’s favorite form of expression is to cause
a scene that invites the attention of the nursing staff. A telling moment
arrives at the end of the chapter, when Valerie realizes that Lisa’s
antics have been pointless: she never cared whether the window was
open or shut. Lisa offers a succinct explanation for her behavior
that everyone on the ward can understand: “Hey man,” she says. “It
passes the time.” Time is the girls’ greatest resource and most
oppressive captor. The best the girls can hope for is a diversion that
passes the time.
The girls respond most positively to Valerie, the head
nurse, because she neither condescends to them nor treats them harshly. Valerie’s
presence is reassuring. Most of the girls shun the authority figures
around them, from parents to doctors to other nursing staff, because
they feel misunderstood. Valerie treats the girls with an evenhandedness
that contrasts sharply with the excessive intrusiveness and panic
they perceive in others. Dr. Wick is an example of the cultural
divide that exists between the patients and the authority figures
they typically confront. Dr. Wick doesn’t understand the culture
that informs the girls’ opinions and behavior. Dr. Wick is older, from
another country, and bothered by frank discussions of sexuality.
Without any cultural reference point from which to understand her
patients, Dr. Wick’s efforts are largely useless. Mrs. McWeeney’s dated
nursing uniform is an outward manifestation of her value system,
one that doesn’t correspond with her patients’. The biggest reminder
of their confinement to the girls is the presence of the nurses-in-training.
Because the trainees are the same age as the patients, they remind
the girls of the lives they could be leading. The “parallel universe”
Kaysen discusses in the first chapter finds expression here, as
the girls watch their mirror images live their young lives in freedom.
The cultural upheaval of 1968 initially
encourages the girls. They see riot and revolution on television
and live vicariously through the actions of others. However, as
the reality of their confinement sets in, the girls come to realize
that living through others is sad and ultimately unfulfilling. Their
participation in the greatest cultural shift in decades is limited
to a TV screen on a mental ward. Kaysen gains some perspective on
her plight when she begins to comprehend the scope of the struggles
going on outside the walls of the hospital.
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