A Mind at the End of Its Tether

Whether or not madness seems like the right word for such a state of mind, Barbara K. Lipska's The Neuroscientist Who Lost Her Mind: My Tale of Madness and Recovery is likely to make a certain impression on the reader approaching middle age or well into it, writes Scott McLemee.

June 29, 2018

It’s a rite of passage for some adolescents: exploring madness through first-person accounts like Mark Vonnegut’s memoir The Eden Express, Herman Hesse’s novel Steppenwolf or Flora Rheta Schreiber’s best-seller Sybil, which could best be called a work of toxic pseudononfiction. (Checking Amazon to get the author’s name, I’m surprised to find that Sibyl remains in print, appalled the publisher calls it “true in every word” and mildly nauseated by the option to purchase it in “School & Library Binding.”)

None of those books was written with the anguished teen reader in mind, although the appeal is not hard to see. The mad narrator or central figure is in a world that may be experienced as confusing, grotesque or volatile; above all, it is private, closed in on itself, unavailable to outsiders. The plot may turn on finding or creating a connection to someone else, which lends itself to screen dramatization, as with as with I Never Promised You a Rose Garden (adapted from an autobiographical novel) or They Might Be Giants (which started life as a play). The notion of insanity as a kind of extreme loneliness is good for a wallow in adolescent-romantic weltschmerz, if not much else.

By contrast, in Barbara K. Lipska’s The Neuroscientist Who Lost Her Mind: My Tale of Madness and Recovery (Houghton Mifflin Harcourt), the departure from sanity is totally unaccompanied by mood music. It sounds, in fact, more like an exhausting nuisance than anything else, especially for the author’s family. (Lipska, who is director of the Human Brain Collection Core at the National Institute of Mental Health, first wrote of her experience in a New York Times essay two years ago; she expanded it into the book in collaboration with Elaine McArdle, a journalist.)

“Madness” seems a little florid to describe what Lipska went through. She “lost her mind” without breaking from reality; her personality did not disintegrate so much as reduce itself to the dimensions of a chronic and extremely self-centered rudeness that she is horrified to recall. None of this detracts from the story’s interest. In fact, it makes it compelling, for reasons to be clarified later.

First, the general circumstances. Lipska is a Polish neurobiologist who arrived in the United States, and was soon joined by her family, about 30 years ago, not long before the Eastern Bloc disintegrated. Working on rats with colleagues at the National Institute of Mental Health, she developed the neonatal hippocampal lesion model of schizophrenia, also known as the Lipska model. More recently, she took charge of NIMH’s “brain bank,” which collects and preserves brain tissue from deceased persons with a history of mental illnesses (as well as those without one, as controls) and makes it available to researchers. Outside work, Lipska is a fitness enthusiast, which is putting it mildly. Two bouts of cancer in middle age did not deter her from completing a number of Ironman races.

What the author is not, as she emphasizes, is a neurologist or a doctor of any kind. When she notices that objects moving into the lower right quadrant of her field of vision seem to disappear, it’s tempting to put it down to the side effects of a medication or the worsening vision that comes with age. But the effect is disconcerting, and an MRI soon confirms what an ophthalmologist’s tests suggested might be the problem: three tumors, including one “the size of a large raisin” in the visual cortex.

When what she calls “the nasty raisin” is removed by surgery, Lipska’s sight returns to normal. But very little else does: she undergoes immunotherapy, with side effects treated with medications, including steroids, that have their own side effects. Somehow Lipska keeps working (refereeing scientific papers, administering the brain bank and so on) but other areas of life begin to slip out of control.

She becomes prone to bouts of confusion and short-term memory lapse, with a weirdly specific impairments of habits and skills. She can add, for example, but not subtract, multiply or divide. “I know that I can’t drive without wearing a seat belt, and I vaguely know where the seat belt is supposed to be,” she writes of one episode. “But I can’t perform the basic steps to buckle it -- steps that were automatic for me only days ago.” Used to being a disciplined and self-directed person, she assumes that being physically active can only help. It might, except for her brain losing track of where she is, even in familiar places.

“Depleted and exhausted,” Lipska writes, her brain “had entered survival mode. When called upon to do anything that was even slightly complicated … the neural connections within and between my frontal lobe and other brain areas became clogged, like a traffic jam in my head.”

While frustrating, the cognitive lapses are distinct enough to recognize, even by Lipska in her strained condition, as products of the stress her brain is under. The effects on her personality are another matter. She exhibits a low threshold for frustration and loses the capacity to recognize the impact of what she’s doing or saying on others; the affection she normally shows to her family gives way to harshness and tantrums. Once her brain tumors are in remission, she finds it difficult to remember the moods and behavior that put so much strain on those around her. Her narrative is written in the present tense, but my impression is that much of the book was written to assimilate what people told Lipska she’d said and done when, as the title says, she “lost her mind.”

One passage in the book stands out as Lipska’s most cogent reconstruction of what she went through:

My hypervigilance -- my body constantly on high alert, and the sense I have that I’m participating in every event with my whole being -- is possibly being triggered by stress or anxiety. That anxiety, in turn, gives rise to more stress and anxiety. Making it worse, I have the vague feeling that I’m not in control of myself or the world around me anymore. That loss of control makes me angry. My extreme reaction to sensory overload is common in people with brain trauma, autism, and many other brain conditions. Normally, the brain is able to sort through the sensory information that comes at it and prioritize what’s important and what can be ignored. When this filter mechanism doesn’t work, the brain can become overwhelmed by all the information it’s trying to process, like a computer bombarded by data. The brain can no longer distinguish between what it’s safe to ignore, like the sounds of distant traffic or the sensation of wind on your face as you walk along, versus what is important, like the honking of the car that’s about to hit you.

Whether or not “madness” seems like the right word for such a state of mind, Lipska’s account is likely to make a certain impression on readers approaching middle age or well into it. For by then, people a generation or two older will have been close examples of what it looks like to be overwhelmed, to live with diminished powers to process experience and exercise control. “A nasty goblin must have embedded a shard in my brain and made me insensitive to the ones I love,” Lipska says. “He turned me into a callous and unloving caricature of myself.” It is a plausible danger, and something to fear.


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