October 2008

Christina Gombar


An Interview with Patrick Tracey

Patrick Tracey doesn't come from the M.F.A. mixing bowl typical of most personal memoirists. His story is one that’s almost defied telling: within the space of two years, two of his beautiful and highly promising sisters rapidly developed schizophrenia. Then his mother died from the stress and sorrow of realizing she'd passed on a family illness thought left behind with her Irish immigrant ancestors’ poverty and oppression. 

The tragedies that felled his once-prosperous, tightly-knit family filled Tracey with a despair and anger that often sent him living on the margins, among life's outcasts. At times his life has been as much about crack as about craic -- an Irish term for good cheer. But even after he traded Guinness for lemonade, he was still an habitué of the pubs of London, where he’d moved for a writing job in 2000. In an East End Pub, he struck up a conversation with a British doctor, who mentioned a genetic clue to the cause of schizophrenia in Ireland. The link was discovered in blood samples taken in County Roscommon -- home of Tracey's famine-starved ancestors. Though the information didn’t offer an immediate cure for his sisters, it fired his imagination. Tracey launched his investigation, a quest to dig up the roots of his family's multigenerational struggle with schizophrenia.

The resulting Stalking Irish Madness: Searching for the Roots of My Family's Schizophrenia is less a survivor's trauma memoir than a sometimes rollicking, always absorbing road story: Jack Kerouac meets Frank McCourt. Instead of looking inward and wallowing in the family misery pool, Tracey looks out to the "cracked looking glass" of Ireland -- where he ultimately finds the roots of his family’s illness in the country’s history of British oppression.  In County Roscommon, from where the "twisted strand of DNA" originates, he finds a cauldron of factors that created a perfect storm for the madness to strike, as well as a rich trove of Irish myth surrounding the long-recognized disease. Carl Jung said that myth was the forebear of psychoanalysis -- a way of explaining the unexplainable to ourselves. In Irish folklore, the myth surrounding schizophrenia is that fairies "steal souls" and replace them with changelings. 

Tracey searches haunted caves and faerie mounds, historical records and healing springs, questioning the reticent Irish, secretive and ashamed of the scourge which disproportionately afflicts their population. After meeting with the country's foremost genetic researchers, Tracey can find no cure for the family curse, but comes home with a fuller sense of what led to an outbreak of insanity in Ireland that haunts his family five generations later. Fear of passing on the hereditary disorder stopped Tracey from having his own family, but he crosses the Atlantic to come home to the one family he has, the afflicted sisters who need him close by.

I’d say that your writing style is hyperbolic -- you speak of a storm rolling over from Ireland and engulfing members of your family. Except that these metaphors understate the transformation that takes place: The person is gone, but not dead. 

I'm not sure how hyperbolic it is, since by any metric my family is as mad as they get. In terms of the sheer number of schizophrenics that cluster in my mother’s family line, and the way we see schizophrenia waxing in my immediate family with not one but two sisters affected, stormy is a fairly understated adjective.

The rapid onset that characterizes schizophrenia, the way it comes out of nowhere in late teens and early twenties, was a gut-wrenching thing to witness over and over -- more like seeing my sisters sucked out in a tsunami than wrecked in a hurricane, especially with the younger of the two, Austine. The way schizophrenia swept her out to sea was devastating. More interesting than devastating was the way it ran from generation to generation.

I'll be the first to acknowledge that my book is a bit of a Hobbit's tale, with me in the role of Frodo Baggins and schizophrenia the ring, this thing that cannot be harnessed by mortal means. I wouldn't say a fellowship of the ring develops between me and the Irish, but through talking to them, I find there is a healing or a means to forgiveness. I believe that you must forgive something before you can ever truly understand it, so in the memoir I am forgiving the schizophrenia, but also understanding this blood feud we've had going for 160 years. That's a daily process that will continue for all my live long days. I'm prepared for that. It's part of the territory of being me.

If by hyperbolic you mean a bit fanciful, your point is well taken. All is myth in Ireland. And myth, by its nature, is hyperbolic. I think that the myths of madness -- that the Irish were away with the fairies -- do get ground down and out by me in the narrative as I tool all over the Emerald Isle in the old camper van I bought in London. I am endeavoring to demythologize madness as I chat with people to learn what I can. My basic approach was to take the science, on the one hand, and the folklore, on the other, and then to link them as best I could through conversations with people on the ground. Everywhere I went in Ireland there was someone who had the lore of this fairy mound or that healing well or this stone circle or that famine graveyard where those who cross it are mysteriously stricken with hunger.  

Ireland was the narrative set piece for the story, which was fortunate as it happens to have this deliciously rich history of insanity, more colorful than any other nation -- the contest isn’t even close. Ireland is dripping in myth, it’s nothing but myth. Even the Catholicism, thick as it is, is influenced by pagan myths. 

The myth of madness goes back to the notion of the changeling. The schizophrenic was an impostor put in place of the sane person, whose being has been spirited away to the fairy "otherworld." This notion of the otherworld is the perfect metaphor for schizophrenia. Its victims seem to be spirited away to another place altogether, a separate reality inhabited by disembodied voices. These voices are very much like the fairies of the mythic realm. So it's nearly literal to say that the schizophrenics are "away with the fairies."

Myth can't be missed in Ireland and should be sought out because the keepers of the folklore flame will soon die off, and with them whatever bits they didn't get to hand down to us because we never bothered to ask. So I’m off on a bit of a mad errand, but one that begins to make sense as the fanciful becomes less so. Take my conclusion that the fairies were framed -- that may seem mad to most, but if you’re Irish, it isn’t mad at all.

Saying the mad Irish were "away with the fairies," as I was told as a child, was only a way of letting the Brits off the hook. The fairies were framed. The true culprits -- famine in the form of maternal malnutrition, and unusually older fathers, itself a byproduct of the famine, with heavy strain of alcoholism thrown in for good measure -- were the conditions of the schizophrenia stew in old Ireland. And the Brits, who ruled from Dublin Castle, were cooking the broth.  

This is far from fanciful, we have the hard science to prove it. This insanity was biological, rather than expressive of any underlying psychological condition or personal qualities of the Irish. The links between famine and schizophrenia and older fathers and schizophrenia are clear. They nearly triple the risk of offspring developing the disorder. The downstream effects through the generations are plain to see, this hereditary mental illness that runs like mad in my own family.  

On its face it may sound hyperbolic to link my sisters' insanity with the famine that was more or less a permanent economic condition when England ruled Ireland. After all, it was 160 years ago that we came to America. But the biological brain disturbances that afflict schizophrenics were, in my family's case, sewn in the Irish famines, watered in the Irish famines, and reaped in the Irish famines.  
You learned that there were two kinds of mythic fairies -- whose makeup roughly corresponded to the two different kinds of schizophrenia afflicting your sisters.

In Irish folklore there are two basis species of fairies, if you will: the trooping fairies and the solitary fairies. Weirdly, the trooping fairies, who are bit wild and manic, resemble my sister Michelle's form of schizophrenia, while the solitary fairies, who are in quiet world of their own, are much like my sister Austine. This is curious, and but one instance where the folklore appears more factual than fanciful. Remember that myth was man's earliest form of psychology, because it explains complex matters. It's been said the science makes complicated things simple, and myth makes simple things complicated, but in the case of madness it may very well be the other around. 

It's also interesting that schizophrenia is the name of a mental disorder that manifests itself in widely different symptoms in some than others. Austine has a form of schizophrenia known as catatonic schizophrenia, which gives her very little cognition and a much greater disassociation emotionally.  It's baffling how two people so clearly unalike -- Austine and Chelle -- could have the same disorder.

Michelle, who was a stage actress, has a very theatrical set of schizophrenia symptoms. She is what's called schizoaffective, which is both schizophrenic and bipolar manic depressive. My feeling is that many of these labels are meaningless beyond categories for prescribing hit-and-miss psychotropic medications. What all schizophrenics have in common is the chief symptom -- the hearing of voices.

These voices are known to be disembodied, third person voices, unlike the first-person voices of the superego that we all hear. Often a schizophrenic can be suffering torment from a whole vault of voices, many of them, male and female, screaming loudly. The feeling that overwhelms the schizophrenic is one of being overwhelmed by the voices, ruled by them entirely, unable to listen to much else.
Is there a schizophrenic effect in Irish literature?

James Joyce was profoundly affected by his daughter Lucia’s schizophrenia. I do not think it goes too far to say that the birth of post-modern literature -- born with the publication of Finnegan's Wake -- was mothered by it. Lucia, who had been a promising dancer before her onset, danced around her father, sending her own telegrams to the dead as the great Irish author wrote. His first-hand observations of schizophrenia in a loved one affected him deeply. There's just no way a thing like that can't, so rapid is the onset, so severe the change in the person's personality, so bizarre and demented their behavior. There's nothing quite like schizophrenia. It's completely off the time-space compass. Joyce knew this, and it was schizophrenia in his lovely daughter more than anything else that influenced his famous pseudo-scientific notions of the occult.

You’re 50 now and this is your first memoir. You seem more of an “old school” writer in the sense of being a sometime investigative journalist and traveler, rather than someone who looked to an advanced degree to find his voice or story. Yet, you grew up in posh Milton, Mass., your sisters were debutantes and models, your father ran a prosperous business and your mother was a lawyer in the era of the Donna Reed. When two of your sisters developed schizophrenia within two years, it seemed to pull some of you half-way down with them.  

Real tragedy may be the best training ground for a memoirist, and so it was interesting for me to observe from the bar stool the rise of the family memoir and to think about whether my wildly schizophrenic family had a place on the shelf.  From there I needed to decide what sort of memoir it would be. I knew it would never be a funny book in a camp sort of way, because there's nothing particularly humorous about schizophrenia. It's serious business -- the most severe form of mental illness.

The other consideration, as a memoirist, is that madness is a universal concern. It may be the deepest fear for all of us, because more than anything else we are our minds. We are a family that has experienced in a first hand way what few feel free to speak of. But I have no shame and believe, fundamentally, that we are only as sick as our secrets.

I also felt an obligation to conduct a sort of due diligence on schizophrenia in its Irish manifestation for future generations in my own family. I could easily have tucked it away in a desk drawer, to be handed down to my nephew to hand down to his children, but it might've got lost in the shuffle. So it was important to have the story published. That, however, never changed the fact that I was writing it with my own family in mind as the reader. You don't need training from the Iowa School of Writers to talk to your own family in a conversational manner. What could be more natural than that?

Apart from the schizophrenia that distinguishes us, I don't think there's anything too unusual about who we were, nothing to hang a memoir on. We were "lace curtain" Boston Irish Catholics, and in the end, due to Dad's gambling, something of a riches to rags story. But remember -- schizophrenia is an equal opportunity illness that strikes at all levels of society. Quite apart from the madness, we were a colorful bunch -- the four gorgeous girls, child models, my mother, born in 1920, was an attorney way ahead of her Donna Reed time, and my flashy alkie father. Who knows where this colorful side comes from? To me, it’s in the genes. But all this pales next to the story of our schizophrenia. Introduced in the first sections, the back-story of family madness hovers over the second section as I take off through Ireland, tracking down answers. The circle is closed when I return to my sisters here.

You describe your mother as being overcome by the sorrow of seeing two of her four beautiful, bright, daughters succumb to the family illness -- despite giving them the best "incubation" possible. 

It wasn't just guilt that killed my mother -- it was loss. An overwhelming feeling of loss, and regret that she had bet big and lost. She’d married a gambler, oddly enough, and at his insistence had this big Irish brood. And when not one but two went mad, she had a brain aneurysm and died. She was devastated by Chelle's onset, horrified to see that she was, in fact, a carrier for the disorder that had struck her brother and mother too. Her very worst fear was to pass it down -- and she did. And then when her baby girl Austine followed Chelle, it was the final blow. A blood vessel blew in her brain and she died right there at Austine's feet.
Your mother, who grew up with her own mother in an insane asylum and later a brother on the funny farm, had the hard evidence that schizophrenia was heritable. So from girlhood she planned an alternate course from the expected motherhood, setting her sights instead on the challenging legal profession. Then your father convinced her to marry, and after consulting some upbeat doctors, who urged them to put aside empirical evidence, took the risk and had children. It seemed back then the doctors felt that bad environment -- starvation and persecution on Ireland, prejudice, poverty, hard-drinking and ill-living conditions in America -- played a part in hosting the illness. Your parents were fourth generation, prosperous, happy and healthy. Still, the illness struck.  

I think there was a lot of pressure in the post-war era to settle down, get married, have kids in the suburbs. But my mother knew from the outset that there might be trouble. I think the feeling was that it would be diluted through the generations. But when it waxed in our immediate family, taking not one but two daughters -- all bets were off for me.
You go from your mother's funeral, summing up 25 years as a "lost weekend" before you jump to "getting sober" striking up a conversation with a doctor over sparkling water in a British pub, and beginning your quest to nail down the roots of your family's disease, finding its context.  You structure your story as an odyssey.  You searched for scientific answers, what did you find?   

Yes, the jump from my mother's funeral when I was in college to me waking up sober in London 25 years later is quite a leap. I easily could have thrown in a few hundred pages of what I call the missing years -- my blackout drinking and drug-taking years -- but to me it's not interesting. I've heard and read more than my share of drunkalogues, with their predictable rise and fall and redemption. I didn't think the reader would mind if I spent only a few pages on it, because nothing really noteworthy in terms of schizophrenia happened in those 25 years. My sisters were stabilized on too much medication, but their conditions had not changed, and science itself was shooting in the dark. That changed for me with the discovery of this gene link -- dysbindin -- in tiny County Roscommon of all places, home of my Irish ancestors and the source of our insanity.

In the book I sprinkle the folklore in liberally with the science, because a little bit of either goes a long way. But we now have solid data on the associations between schizophrenia, on the one hand, and famine and older fathers and drink, which is what I call my three-legged stool theory of Irish schizophrenia. Famine doubles and can nearly triple the risk of schizophrenia developing in children. Older fathers also can double to triple the risks. It wasn't the fairies that drove the Irish mad. It was hunger and old sperm.

A much smaller but significant association is substance abuse, a no-brainer in the case of the Irish, pardon the pun. But famine and older fathers were the biggest drivers. Famine was more or less a permanent economic condition in Ireland. My insane ancestors came out the Great Famine. The links between maternal malnutrition and schizophrenia developing in those children whose mothers carried them through famine are clear. Late age of paternity is a bit of a puzzler, but easily explained, too. As the English squeezed the Irish off their land, there was very little to go around. As a result, only the oldest Irish brother became "eligible" when he inherited the right to lease the pathetically small potato patch, and he had to wait until his father was dead. And then, windfall of all windfalls, the old geezer farmer had his pick of young parish girls.  

Here we come to the key finding about schizophrenia and older fathers. It's known as the "copy error" hypothesis: Starting at puberty male sperm cells divide every 16 days. By the time we are 50, when peasant Irish men were fathering their first children, our sperm has "copy errors." Our sperm is highly mutated, and this is thought to double the risk of schizophrenia in offspring.

A lot of this is very new information. Previous theories of schizophrenia stressed psychological causes, but most doctors now believe it’s due to biological disturbances in the brain -- in the Irish, linked to famine conditions. Ireland sowed our madness, Ireland watered our madness, and Ireland reaped our madness.

At the same time, I recognize from my own inner journey that all things must be forgiven before they are truly understood. This may be the biggest lesson of all for me -- that forgiveness must come first, before true understanding can ever follow. It's counterintuitive to the ego, but this is something of a metaphysical point: I had to go back to Ireland to forgive it and, through that forgiveness, come to understand this thing that swept my sisters away and prevented me from having my own children. 

In that sense, I was on my own inner odyssey, which may resonate with readers because we are all on an odyssey -- everyone who's ever born is on a journey. In one sense or another, we are all trying to get back to Ithaca after the Trojan War. My war was with the madness of insanity and alcoholism. The war is over for me. I'm done fighting. I surrender. And oh great paradox of life, I win by surrendering. I think people who have been through the fire have an understanding of that. 

So I am trying to forgive Ireland as I slouch toward and ultimately through it, threading my way back home to Boston. That's my journey, to go home with as much knowledge and experience as possible about a madness that still persists in my family five generations after my famine-starved ancestors fled the forsaken place. When I sobered up it was time to take a fearless moral inventory of my past, as part of my recovery. Only in my case that fearless moral inventory stretched back 160 years, which was as long as the schizophrenia stretched back, from Boston back to Roscommon. My family was part of that history.