Reaching Down the Rabbit Hole by Allan H. Ropper Page A

the best days? Look here!’”
    That’s when it hit me: graphomania (the obsessive writing), alliteration (the Sanjay Sanjanista business), and the biggest red flag of all: the tinplate locomotive. Only a wealthy collector buys a $2,000 locomotive, and then only to put on display, not to run it on his setup.
    “Did we get a family history for Wally?” I asked Hannah.
    “More or less. We talked to the son.”
    “Which one?”
    “He has more than one?”
    “Yes.”
    Wally did indeed have two sons. The first one who visited had provided the family history that the residents had relied on: no history of psychoses, no similar events in the past. His confusion had come out of the blue. Except that it hadn’t. We had talked to the wrong son. The other son, Wally’s bipolar son, who showed up a week later, painted a very different picture, one in which a history of psychosis ran deep in the family, deep in his own past, and deep in his father’s past. Wally had snapped under the pressure. He’d had a nervous breakdown, something, as we would discover, that had happened before. That’s when we knew he would probably be okay.
    Psychosis is a special type of confusion with its own reality, an internal reality that is consistent only with itself. It does feature a connected, ever-flowing “stream of thought,” to use William James’s term (not a stream of consciousness , a phrase that James came to dislike). In his Principles of Psychology , James claimed that all of us carry on a virtually continuous internal conversation. While a psychotic’s internal stream may seem bizarre and disconnected, it has its own internal logic. Anyone could follow it, according to James, if they were standing in the waters of the stream. Wally Maskart’s thinking might have been crazy (in fact it was crazy), but it wasn’t stupid. My job was to step over the boulders and out into the middle of the current, and try to lead him back to shore.
    That wasn’t possible with Gordon Steever. Gordon was severely confused, but not psychotic. During his stay in the hospital, and increasinglyduring the weeks leading up to it, he lived in a fog, in a miasma in which there was no connection between one moment and the next, no continuous stream of thought, no path of return. Wally, on the other hand, was caught up in a very different struggle. He was delusional but he could connect. Even though he insisted that I was both Dr. Ropper and Dr. Sanjanista, he was not detached from all reality. A confusion of this type is in most cases a reversible state because it is a reflection of the dynamic functioning of nerve cells. If the causes are addressed, the patient will get better. It just takes time. If the causes are not addressed, the confusion takes over.

    When I was a boy I had a Jimmy Piersall baseball glove. Piersall was my favorite ballplayer, and he was famously nutty. He made his major league debut with the Boston Red Sox in September 1950. Before he stepped up to the plate, he turned his bat upside down, and with the knob end made an X in the back right-hand corner of the batter’s box, something he would continue to do throughout his career. Wally Maskart saw Piersall play right field at Fenway Park many times during the ’50s, and watched with passing interest as Piersall’s life fell apart due to a bipolar disorder.
    Piersall was a local boy from Waterbury, Connecticut, and he became one of the best fielders in the game, but he was plagued by a past that included a deeply troubled mother who had been institutionalized, and a demanding father. Frequently involved in brawls, bizarre on-field stunts, and tantrums, Piersall racked up a score of ejections over the years. In his autobiography, Fear Strikes Out , he tells of being admitted to a psychiatric hospital in 1952 after a nervous breakdown. “I ran away,” he recalled. “I had just gotten so wound up that I lost all control of my memory.” Treated with lithium, he would last seventeen