Mad girl reviews: Bitter Medicine

Bitter Medicine: A Graphic Memoir of Mental Illness
Written by Clem Martini and illustrated by Olivier Martini
2010
Freehand Books, paperback, 261 pages, black & white

[Content note: suicide, particularly in the book itself]

I didn’t really know what to expect from this book – I didn’t read any reviews, and hadn’t seen it mentioned very much (it’s not normally listed in the ‘top comics about mental illness’ posts that I continuously read)…all I knew was that it was about mental illness and a comic and therefore I needed it. So it was a bit of a gamble. And god, did it pay off. This book is pretty brilliant – at times deeply, deeply sad, and yet somehow hopeful. And a scathing indictment of the mental health system in North America. So, all in all, right up my street.

Written (Clem) and drawn (Liv) by two brothers, the book documents one family’s experience of having two (of four) brothers diagnosed with schizophrenia and all that comes with that. It deals with the aftermath of suicide in a brutally honest, shattering way; the frustrations of trying to navigate a mental health system not fit for purpose; and the endless merry-go-round of medication changes. More than that though, it captures both the tension and the love between siblings when one has a severe and enduring mental illness.

In terms of layout, it sort of reminded me of Couch Fiction, with chunks of text juxtaposed with the images, often on the opposing page. However, whereas Couch Fiction lacked integration overall for me, Bitter Medicine works. This is mainly because you’re aware from the quite early on that you’re simultaneously reading two different (but linked) stories. Sometimes Liv’s scratchy, almost childlike images and captions clash with Clem’s text, like we’re at different parts of the two stories, which can be jarring, but in a good way, reminding you that this is two individual people’s narratives. The text flows pretty consistently throughout the book, and seems more of a whole. In contrast, the images and captions can be quite fragmentary, like small windows into Liv’s experiences over the decades, some of which are short sequential bursts and some of which are more standalone images. The way these two elements contrasted with each other really worked for me. I wouldn’t normally say this, but the lack of integration in parts of the book made it all the more arresting and highlighted the complexity of the relationship between the two stories being told.

At times, Liv’s images and captions and Clem’s text become more integrated, most notably during the ‘Interlude: The Circles of Hell’ section. It is introduced by Clem’s text as:

“…you have to understand that for those with mental illnesses, beneath the surface of society there exists another dimension, and it is always, always waiting.

It’s a special dimension of Mental Health Hell, and it can best be evoked as a series of spiralling circles. The circles curl one into the other. Each represents an increasing torment.”

This part of the book is raw. It describes the fear – and, of course, reality for many – of progressing through diagnosis to unemployment, abandonment, homelessness, and finally imprisonment. Clem’s text is terrifying, written as a second-person narrative, describing “your” descent into Mental Health Hell. It forces you to consider your position in relation to this spiral, and for me made me both recognise the similarities and differences between my fears and experiences and those being described. Overlapping this are Liv’s drawings of the circles and people being tormented (for example, the foreman of the printing shop Liv worked in is shown as a devil poking a fork at an employee (who I assume is Liv, also shown with horns) while he says “I won’t be calling you again”, which relates to Liv getting fired.) For me, this was horrifyingly accurate in terms of worries about my life with a severe and enduring mental illness that sometimes makes it impossible for me to work, i.e. worrying what would happen if I permanently lost my job, could no longer afford rent, was betrayed by the benefits system and abandoned by my loved ones. Conversely, it reminded me of the privileges I have, and the way they provide a cushion to the experience of having a mental illness. I think this section could have done with more of an analysis of race, sexuality, gender, and class privilege in terms of their intersection with disability and the corresponding likelihood of homelessness and imprisonment. Despite its shortcomings in this respect, it felt significant that the book was even going where it went. Of all the comics I’ve read about mental illness, this is perhaps the only one that’s even mentioned these issues, or at least in this much depth.

The two stories this book tells of the experience of having schizophrenia and loving someone with schizophrenia are in many ways ordinary, but simultaneously extraordinary in their clarity and cutting analysis. I don’t have schizophrenia, but I do know a bit about mental illness from the person-diagnosed perspective, having been diagnosed with bipolar in 2009. Liv’s half of the story, though very different from my own, felt somehow familiar in certain ways. The frustrations of trying to get adequate healthcare, the side effects and desperation of attempting to find medication that keeps you sane but doesn’t also kill you, the alienation from family, but the simultaneous love of them. For those people who haven’t had these experiences, I would hope that this would be eye-opening and teach them something about what it’s like to live with a mental illness yourself.

The other story of the book, Clem’s account of having and loving a sibling with schizophrenia, was by turns painful and reassuring to read as someone with a mental illness. It left me wondering to what extent my own family would identify with his story (maybe I’ll get one of them to read it one day…): do they also feel the same agony and anger and frustration of poor treatment, stonewalling and exhausted (and at times incompetent) staff? Fear of what the future would hold? On the other hand, the celebration of progress? And love despite wildly different experiences? I suspect these things are common to a lot of loving families where a member of the family has a mental illness. Quite a lot of the time I am not keen on stories told about people with mental illness and usually advocate that we be asked to tell our own stories. Bitter Medicine manages to navigate this well – although Clem is telling parts of Liv’s story, I think more significantly he’s also telling his own, while also avoiding the “it’s so terrible to have a mentally ill loved one, let’s make this all about me” trap. It manages to walk a very fine line respectfully.

Elsewhere, I’ve seen this book described as a book of two halves – the first half about a family’s experience and the second a political analysis of mental health care in North America. While I can understand why people would think this, in my opinion, this is wrong. From my perspective the book flowed naturally from direct personal experience to a sharp, devastating, and fact based analysis. The experiences of the brothers directly informs the political examination and gives it both motivation and clarity. It would be impossible to read about their experiences attempting to navigate a state health and benefits system without asking about why this is all so difficult and the book is quick to provide answers to these questions. I read one reviewer call it “preachy” and frankly that’s just offensive. What is laid out is an experience-informed indictment of a broken system, from sharp criticism of the failures of the deinstitutionalisation project, to the woeful underfunding of the services that were meant to replace the large hospitals, to the devastating impact of criminalisation and the prison system’s treatment of those with mental health problems. It is searing and furious and brilliant.

Of all the comics I’ve read about living with mental health problems – and I’ve read a few – this is easily the most political. What others have lacked in analysis of the systems you have to navigate as a person with mental health problems, this directly delivers in a comprehensible way, pulling no punches while it does so. It’s devastating and yet somehow hopeful that it is possible to survive, with a bit of luck, both the illness itself and the ludicrous, impoverished systems you are forced to interact with. Overall, I would strongly recommend that this be read by healthcare professionals and those who design mental health systems (chance would be a fine thing…), as well as those who have experienced having or loving someone with a mental health problem –  there’s a lot to identify with here, even if the stories differ in the details.