Search Results for: health

Can ‘Mad Maps’ Offer Patients a Way to Take Charge of Their Psychiatric Care?

Like advanced directives for the dying, DuBrul explained, mad maps allow psychiatric patients to outline what they’d like their care to look like in future mental health crises. The logic is: If a person can define health, while healthy, and differentiate health from crisis, that person can shape his or her own care. The maps are not intended to be rejections of psychiatry, though they could be that. The maps are designed to force patients and family members to plan ahead—to treat a relapse as possible or even likely—in order to avoid, or at least minimize, future mistakes.

When Jonas was 16 months old, Giulia and I put a bottle of anti-psychotics in our medicine cabinet, just in case. This might seem reasonable, but it was silly. We hadn’t yet heard of mad maps, so we’d never discussed what a situation would have to look like for Giulia to take the pills, and that made the medication useless. Was she going to take them if she wasn’t sleeping enough? Or was she going to wait until she was already psychotic? If she waited until she was psychotic, she would also likely be paranoid, meaning that she wouldn’t take the pills willingly. Me convincing her to do so at that point would be almost impossible.

…This is where mad maps offer a shard of hope. Giulia and I, finally, are trying to make one, and now that we’re doing so I have to concede that in some ways, Laing was right: The treatment of psychosis is about power. Who gets to decide what behavior is tolerated? Who chooses how and when to enforce the rules? We started trying to create Giulia’s map by discussing the pills in the medicine cabinet. Under what circumstances would Giulia take them, and how much would she take? I took a hardline approach: No sleep for one night, pills at maximum dosage. Giulia wanted more time before jumping to medication, and favored starting the dose out light. We argued bitterly as we outlined our positions and punched holes in each other’s logic. Ultimately we had to sit down with Giulia’s psychiatrist to figure it out. Now we have a plan—for one bottle of pills. It’s a small victory, but a genuine step in the right direction in a world where such steps are rare.

—From “My Lovely Wife in the Psych Ward,” a recent essay by Mark Lukach for Pacific Standard. In the piece Lukach discusses his relationship with his wife Giulia, and how it shifted from husband to caregiver and back again after she suffered a psychotic break.

A Meditation on Pain

Illustration by: Kjell Reigstad

Ira Sukrungruang | River Teeth | Fall 2014 | 15 minutes (3,767 words)

River TeethFor this week’s Longreads Member Pick, we are thrilled to share an essay from Ashland, Ohio’s narrative nonfiction journal River Teeth. Longreads readers can receive a 20 percent discount off of a River Teeth subscription by going here.
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“And once it comes, now that I am wise in its ways, I no longer fight it. I lie down and let it happen. At first every small apprehension is magnified, every anxiety a pounding terror. Then the pain comes, and I concentrate only on that.” –Joan Didion, “In Bed”

It’s happening, says the woman I love to someone in the other room. The someone is most likely her sister, and I hear the shuffle of clogs on the ruined carpet, the swish and swirl of her turquoise dress. I feel the shadow of her body in the doorway. I hear her breathing, tiny bursts of air through the nose and mouth. I feel and hear everything, but I am not a body. And because I am no longer a body, I do not register sound or voice. I do not register anything. Even my presence on the scratchy carpet. I do not know that I have been lying in the lap of the woman I love as she soothes my sweat-drenched hair, as she whispers that this will pass. I do not hear her because I do not have ears. I do not have eyes. I do not see the hazy outline of her humid-frizzed hair or the worry etched in her face or how she looks down at me and then out the window, out past the dilapidated houses of this rundown block in Lafayette, Colorado, past the Rockies rising in jagged edges to snowy peaks, past logical explanation. Because right now, I do not register logic. Because this pain is not logical. This pain makes me whimper, makes me produce a noise that is octaves higher and sharper than I can otherwise make. I become a supplicant to its needs. I have a mouth. Of this I am sure. I have a mouth but it acts without my guidance. Saliva seeps from corners. Lips chapped as cracked earth. The woman I love feeds me water. I sip from a straw, but all of it dribbles out from the corners of my mouth. All of it wetting my cheeks and chin, like a child sloppy with food. I am a child. I am helpless. I am without strength. I am without will. I believe I might die. That this might be the end of me, this moment. I believe that death would be a relief from it all.

Hang on, she says. It’s almost over, she says. The end is in sight, she says. Read more…

Autistic and Searching for a Home

Illustration by Kjell Reigstad

Genna Buck | Maisonneuve Magazine | Winter 2014 | 28 minutes (7,101 words)

MaisonneuveThis week we’re proud to feature a Longreads Exclusive from the new issue of Montreal’s Maisonneuve Magazine, about a young autistic woman who needs a home.
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Longreads Best of 2014: Business Writing

We asked a few writers and editors to choose some of their favorite stories of the year in specific categories. Here, the best in business writing.

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Max Chafkin
Writer focusing on business and technology.

Schooled (Dale Russakoff, New Yorker)

This piece explores the failed attempt by Mark Zuckerberg and Corey Booker, among others, to fix Newark’s schools—and in doing so makes clear just how hard education reform is. Most shockingly, it exposes the huge sums of money spent by the city and its supporters on education consultants who managed to extract huge fees without, apparently, doing a whole lot. It’s pretty hard to make a dense story about education reform read well, but Russakoff amazingly manages it, while managing to be fair and incisive. Read more…

Longreads Best of 2014: Essay Writing

We asked a few writers and editors to choose some of their favorite stories of the year in specific categories. Here, the best in essay writing.

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Meaghan O’Connell
Freelance writer, “Birth Story” author, motherhood columnist at The Cut, who believes her best work is at The Billfold.

The Empathy Exams (Leslie Jamison, The Believer)

I did not know who Leslie Jamison was before I read her essay “Empathy Exams” late one night at the pie shop that I use as an office when the library is closed. I was hungry, and it was dark out, and I was very pregnant and needed to get home. But I stayed in that uncomfortable chair and read it the whole way through, bursting with excitement. I G-chatted friends in all caps asking them if they’d read it. I Googled her, saw she had a book coming out, and floated home feeling like, “Yes, let’s do this. Let’s write some fucking personal essays, people!” I think Jamison, especially here, convinced or re-convinced a lot of people of the possibilities and the value of writing in the first person. Of course I think it’s horse shit that it takes a white lady with a veneer of intellectualism to make it okay, but I’ll take it where I can get it. Jamison, for her part, rises to the occasion. She certainly reminded me to hang onto the art of the thing, all the while going deeper, letting the problem of whatever you’re trying to do take up its own space. Read more…

Longreads Best of 2014: Science Stories

We asked a few writers and editors to choose some of their favorite stories of the year in specific categories. Here, the best in science writing.

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Virginia Hughes
Science reporter and soon-to-be science editor at BuzzFeed.

The Itch Nobody Can Scratch (Will Storr, Matter)

I’ve thought about this story (an excerpt from Storr’s book, The Unpersuadables) many, many times since reading it. It’s superficially about Morgellons, a disease in which people think that they’re infected with bugs or fibers. But it’s really about the nature of disease and diagnosis, evidence and belief. It’s creepy, fascinating, and profound. The best part about it is the way Storr describes these patients and their delusions. It would be easy to make them seem stupid or crazy or worse. But Storr’s writing creates empathy and understanding. The not-insignificant downside of this piece: it makes you feel itchy. Read more…

18 Hours in Tel Aviv’s Central Bus Station

Longreads Pick

The writer spends a long day observing life in the notorious Tel Aviv Central Bus Station. The station—reviled in Israel because of its reputation for prostitution and crime—also houses a Yiddish library, two synagogues, a church, “a dime-store megamall,” a health clinic for asylum seekers and artists’ studios.

Published: Dec 13, 2014
Length: 20 minutes (5,000 words)

The Gothic Life and Times of Horace Walpole

Carrie Frye | Longreads | December 2014 | 16 minutes (4,064 words)

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As a child, Horace Walpole frequently heard it said of himself that surely he would die soon. Born in England in 1717, the last of his mother’s six children, he was fragile and prone to illness from birth. Two siblings before him had died in infancy, and so in the family order it went: three older children, loud, healthy and opinionated; two grave markers; and then young Horace toddling up behind—half child, half potential grave marker.

Naturally, his mother, Catherine, spoiled him. His father, Sir Robert Walpole, was the King’s prime minister. This often kept him away from home, as did a long-time mistress who acted, more than his wife did, as his hostess and companion. For her part Catherine had her own dalliances. It was that sort of marriage. The Walpoles of old had been middling country gentry—ancient name, quiet prosperity—before Robert had come along and, through a blend of shrewdness and charisma, wolf-halled his family into riches and the nobility. When Robert was young, the hope for him was that he might one day make a fine sheep-farmer; he died the first Earl of Orford, after a 20-year run as prime minister, a colossus of English history.

His son Horace worked himself into history another way. In his early 30s, he bought a box-shaped house—just an ordinary sort of house, sitting on a bit of hill in a fashionable country suburb—and decided to transform it into a Gothic castle. Room by room he went. Stained-glass window of a saint here, ancient suit of armor stowed in a wall recess there.

Then one summer, sitting in his castle’s library, he wrote a novel called The Castle of Otranto. Its setting was a medieval castle, not unlike his own mock-castle in many of its details, but grown, in the way of novels and dreams, into something grand and imposing. There the villainous Manfred schemes to block the return of the castle’s rightful heir, a young man named Theodore. Commonly pegged as the first Gothic novel, The Castle of Otranto turns 250 this year. It’s a strange, great, terrible, campy novel, slim but with some paragraphs so long and dense that you have to slash your way through. If Gothic literature had a family tree, its twisted gnarled branches chock-full of imperiled, swooning heroines and mysterious monks, with ghosts who sit light on the branches, and Frankenstein’s monster who sits heavy, with troops of dwarves, and winking nuns, and stunted, mostly nonflammable babies, at its base would sit Horace Walpole’s Castle. (Presumably with some lightning flickering dangerously nearby.) Read more…

Longreads Best of 2014: Here Are All of Our No. 1 Story Picks from This Year

All through December, we’ll be featuring Longreads’ Best of 2014. To get you ready, here’s a list of every story that was chosen as No. 1 in our weekly Top 5 email.

If you like these, you can sign up to receive our free weekly email every Friday. Read more…

Five Stories About the Way We Sleep

Photo: epSos. de

I am one of those people who needs as much sleep as possible; I can easily sleep for 12 hours; I nap frequently; I rely on lattes and Coke Zero to keep up morale. This week, I thought about sleep a lot. Here are five pieces on different facets of sleep: a short story about sleepwalking, a dispatch from Gaza, a person who can’t help but sleep when he’s stressed, and more.

1. “Broken Sleep.” (Karen Emslie, Aeon, November 2014)

Sometimes I wake up at 5 a.m., awake and ready to get up, but I inevitably scroll through Twitter until I fall asleep again. I always attributed this to a beneficial lull in REM sleep, but this article gave me pause—perhaps it’s symptomatic of “segmented sleep.” Historically, people slept in two chunks of four to five hours, separated by one to three hours of wakefulness. There are many health benefits to segmented sleep, as the author explains, but in our 9-to-5 industrialized society, this kind of sleep schedule doesn’t jibe. Read more…