This past week, I had a bizarre reading experience. At the author’s request, I read A Patient’s Narrative by Chris Smith. I promised to give the author a fair and balanced review. I will be reviewing from the vantage point of the Prosumer. I am someone with lived experience in mental health and who has been committed to a psychiatric hospital at the state and local levels numerous times. 

There is no way to describe the strange, otherworldly excursion into the dark annals of forensic psychiatry than to say reading A Patient’s Narrative was anomalous. Let me explain why the text differed from other memoirs and autobiographical accounts. Generally, recovery autobiographies fall into a few categories. The first was the dark, hellish precipitating events that led to hospitalization. The book begins when the narrator is already committed to the hospital. Other accounts are the ‘ah-ha!’ moments that lead to recovery and stabilization. Others are more laden with semi-psychotic language in which the reader worries that the author still isn’t quite recovered. A Patient’s Narrative is not that story either. The writing is lucid, clear, and focused. 

The text offers the reader a first-hand account of living, or more accurately, confinement and punishment in a forensic hospital in Connecticut. The author holds nothing back as he describes every noticeable facet of institutional life from the shocking to the mundane experiences he believes the reader needs to be aware. After all, anyone hospitalized knows, life on the unit can be tranquil, almost deadly, until a switch flips, and all hell breaks loose. The writing painted some of this hell in the narrator’s views of women and, generally, their behavior.

In this vein, the author makes many critical remarks and generalizations about female behavior in this institutional setting. I am hard-pressed to believe all women are ‘out to hurt’ unassuming and unsuspecting men. The author points to other issues when he talks about the inappropriate sexual behaviors of women in the unit. The infections, unsafe sexual practices, and interpersonal transgressions to women (and men alike) can fall victim or prey. So, I have to give the author a few points regarding gender bias. 

I want to be frank about the quality of the writing. Chris Smith knows how to make words work. He is a skilled writer, and the level of authorship, in terms of language, and his narrating desire to paint every detail for the reader is a huge success. I wasn’t glaring at typos or wading through flowery prose.

Smith’s prose is to the point and painfully detailed when capturing the more ‘problematic patients’ and their behaviors. The author excels in writing short, brief character descriptions and problem statements, and captures the systemic issues well in short, concise blurbs for almost every staff member he knew-or, at least, it would seem by the volume of vignettes offered in work. I am unsure if the assortment, and the sheer number of vignettes, were needed to make his point and demonstrate how lousy and ineffective most of the staff was in terms of the desired goal of healing.

These vignettes demonstrate the author’s keen awareness and depth of understanding regarding social norms and how far life in the hospital can veer from ‘everyday life, leaving the reader wondering what transgression the narrator committed to finding himself in this setting. 

Ultimately, the author successfully demonstrates how lousy and ineffective most of the clinical work is and how hands-off the executives were when fielding complaints and questions regarding patient care. Reading this reminded me of the nonstop notes I wrote to the executive director at the state hospital I lived in for over six months. Not once did I get a reply. 

In terms of the desired goal of the text, the author makes his point that the system broke and no longer works. In the end, there are a few unresolved questions about the text. The biggest issue is now that we know the system is broken-what now? The author doesn’t offer recommendations for change. No ideas were generated in the text at all about reforming the Connecticut system, given the authors’ experiences. 

I was also hoping for a more significant reflective moment which is missing. I wonder about the status of the narrator’s life. I also wonder about his health and where he has landed in life. Here I am today might have encapsulated the narrative and perhaps provided some hope or ideas to the reader on how to push reform.

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