The Death of a Mental Patient

On the evening of October 28, 2015, three days after my brother Robert’s death, I held a memorial service for him in my Manhattan apartment. Despite a torrential rainstorm, more than fifty friends and relatives came, arriving from various parts of the city as well as from New Jersey, Connecticut, and upstate New York. I was surprised that so many people had come, especially given the short notice, the weather, and the fact that, except for my son Eli, not one of them had seen Robert, or had any interactions with him, for at least two decades. Robert had spent most of his adult life—more than fifty years—in and out of mental hospitals, psych wards, and halfway houses, and during those years—our parents having bailed out on him and moved to Florida—I’d been his sole caretaker and advocate. Our father died three years after their move and never saw Robert again; our mother lived for another thirty years, during which she saw Robert twice.

Until Robert’s first breakdown, in 1962 at age nineteen, he had been an exceptionally gifted boy and young man. Famous in our neighborhood as an actor, singer, and dancer, he performed on street corners, in candy stores and barber shops, and invariably won leading roles in school and summer-camp stage productions. In his teenage years, he was a published poet, winner of a citywide essay contest, a good tennis player, and an excellent chess player. At Brooklyn’s Erasmus Hall High School, he and Bobby Fischer were in a chess club together; Fischer was already National Junior Chess Champion, but refused to play with my brother. When Robert would ask why, Fischer would reply, “Because you play crazy.”

For the first day or so after Robert’s death, I fantasized about having a memorial service where I would ask those who came to honor him in death why they had never visited him while he was alive. What would it have cost them to stop by for a cup of coffee at one of the two residences in Manhattan where he’d lived, or to have taken him out for lunch or dinner, especially when several of them lived no more than a short walk or ride away? But I knew that this was how friends and family dealt with people afflicted with those conditions we call mental illness. I usually visited Robert at least once a week, yet in the half-dozen years he lived in a halfway house on West Forty-Seventh Street—a handsome brownstone that was home to fifteen residents, all diagnosed with serious and persistent mental illness—I never saw a single family member visit one of the other residents. The sad reality for individuals with chronic mental illness is that the longer they shuttle back and forth between psych wards, halfway houses, and the streets, the more people fade from their lives.

Aware that our friends and family had behaved no differently from the way most people behaved, I put aside the idea of haranguing them. Although I felt the situation personally, I told myself not to take it personally, and while this did not allow me to forgive them (and I didn’t), it did allow the anger I felt to dissipate. When it did, I was able to realize how much I was missing Robert. His absence was an enormous presence, reminding me that he had been important not only in my life, but to my life; that who he was had made me who I was.

Most people, I knew, would be coming to the service not to memorialize Robert, but to comfort me, and—as I knew from messages I’d been receiving—to praise me for what I’d done for Robert. More than ever, my instinct was to deflect praise. Over the years I’d written about my brother and our relationship, and in question-and-answer sessions following talks and readings I gave, individuals would ask how and why I’d been able to stay the course for so long. My answer had always been the same: because he was my brother. What other answer was there? The more important question was not why I’d done what I’d done, but why others—family members as well as mental-health professionals—had not stayed the course. In any case, what I desired to explain to the guests at the service was not what I’d done for Robert, but what Robert had done for me.

I talked of how, blessedly, he’d had a peaceful ending to a most unenviable life, and of how in that life he’d outperformed and outlived all prognostications. I talked of his incomparable resiliency. One measure of that resiliency, and of his remarkable courage, was that despite more than fifty years in and out of mental hospitals and psych wards, he had somehow lived, with brain, memory, spirit, and sense of humor largely intact, to the same age, almost to the day—seventy-two years and six months—that our father had lived. And he had done so despite the abundance of medications that had been poured into him, despite a multitude of medical problems—many brought on by medications and abuse—and despite having been abandoned by parents, relatives, friends, and mental-health professionals.

To conjure up Robert’s presence and his distinctive sense of humor, I told stories. I talked about the time I took him for a stress test at St. Luke’s-Roosevelt Hospital, of how terrified he was, and of how, once he was on a treadmill, he kept shouting, “I’m not a mouse! I’m not a mouse!” I talked about the time we were visiting on New Year’s Day, and I said that I thought we had a lot of things to be thankful for. Robert defied me to name three, and when I began with, “Well, first of all, we’re still here,” he smiled his most mischievous smile.

“—and mother’s not!” he exclaimed.

I spoke of how Robert raged against the forces that beat him down, and how he never fully submitted, either to the demons within, or to those individuals and institutions that exacerbated the wretchedness he endured. I said that I was not on this evening going to rehearse the heartlessness and dysfunctionality of those institutions and systems that shaped Robert’s life—or minimize how difficult, and nasty, he could sometimes be—but would simply state that Robert was always more human than those who had done their utmost to dehumanize him.

There were, of course, individuals who, through the years, had worked to give him a better life. I talked about Doctor Alvin Pam, Director of Psychology at Bronx Psychiatric Center who, two decades before, and against the consensus of his staff, had believed that Robert did not have to live on locked wards for the rest of his life; because of his good offices—and a treatment plan that included once-a-week, old-fashioned talk therapy—Robert had come to live outside hospitals and psych wards for a dozen consecutive years, with a room of his own, able to get around by himself in the city he knew and loved. They were his best and happiest adult years.

Stating the obvious, I noted that our relationships with our siblings were generally the longest of our lives. Contrary to what some might think, my relationship with Robert had never been a one-way street, and I listed gifts I’d received from him: first, and most essentially, that he knew me better than anyone, and that it was a source of ongoing strength and love to be truly known. Starting in childhood, Robert and I had been best friends and allies. Although like all brothers we sometimes fought, we both knew (and bragged to one another) that we were far closer with each other than any of our friends or cousins were with their siblings. And in knowing me, Robert was able to put aside whatever disappointments he’d felt about his life, or resentments about mine.

Thus, three months earlier, when we were eating dinner in his room at the nursing home, and he was going on and on in a manic soliloquy about Adlai Stevenson, Ed Koch, Dylan Thomas, E. E. Cummings, summer camp, and childhood friends, and stopped for a moment, I commented on how good the dinner was, and said that perhaps, since I was getting on in years, I might someday move into his nursing home. Robert’s mania disappeared instantly. “Oh Jay—” he said softly “—you don’t ever want to live here, believe me.”

Nor were we blindly supportive of one another; just as I would often tell Robert he was talking nonsense, so too, when I talked nonsense, he would correct me with a simple, “Oh, come on, Jay—who do you think you’re kidding?”

For a multitude of reasons having to do with what information I sensed Robert could or could not tolerate on any given day, I’d learned that it was often best to withhold certain thoughts and feelings; merely because I felt and thought something did not mean I had to express it. When our mother was in her eighties, and Robert in his fifties, she was still asking him when he was going to get married, have children (she seemed unaware he was gay), and get his college degree. I could sense both the frustration her unfulfilled hopes caused her, and the pain that her voicing them caused Robert. So I tried to appreciate Robert for who he was, and for the rich life that he in fact did have (even if, at times, it was rich mainly in madness and misery), and not to talk or even think, more than was necessary, about the life he did not have. In time, such learned responses, not doing or saying what I might otherwise have felt compelled to say or do—and not asking questions that would be perceived as accusations—served me well in my own life, especially as parent to my children and, above all, in the years when I was a single parent to them.

By the pride Robert took in the book I wrote about us (Imagining Robert: My Brother, Madness, and Survival), and in other writings that revealed his history of breakdowns, hospitalizations, and furies—mad acts of which others might have felt ashamed or humiliated—he helped set me free from things in my life about which I might otherwise have felt ashamed and humiliated. Once, at a book signing, when a woman asked Robert if it embarrassed him to have me write about his life as a mental patient—“as a madman is what she means,” Robert whispered to me—he shrugged, and said, simply: “This book gave meaning to my life, and I hope it can give meaning to yours.” By his generous acceptance of my life and achievements, Robert taught me how to accept my own frustrations, and to curb the envy of others I sometimes felt. By the fact of his survival—his recovery again and again from circumstances and experiences that would have done in most people—he taught me about the vast reserves of courage, humor, and resiliency that lie within us. And he taught me about the damage anger can do to oneself and others, as well as the ways anger can, in the service of survival, become one’s friend.

Robert and I, to use a familiar figure of speech, were mirrors of one another. In childhood we were both bright Jewish boys with blond curly hair, both about the same weight and height, both talented at athletics and the arts. We performed well academically, even though teachers summoned our parents for conferences because, bored, we either daydreamed away our school hours, or distracted classmates with jokes and mischief. But mirrors reverse images as well as duplicate them, and Robert and I had frequently defined one another, and were defined by others, by our differences. Thus, at a funeral for one of our uncles, when Robert was out on a pass from a mental hospital, an older cousin had approached us and, shaking his head, said, “Why can’t you just grow up already, Robert, and be like your brother?” And the more permanent Robert’s condition as a mental patient became—the more frequent the episodes of madness that undermined his chances to lead an independent life—the more determined I became to lead as outwardly conventional a life as possible, so as never to go mad…or at least never seem to be going mad.

During Robert’s early breakdowns and hospitalizations, I often wished I could change places with him, thereby setting him free while at the same time punishing myself for whatever it was, in my character and actions, that had enabled me to survive. (It took many years for this feeling to fade, and to be replaced, though never completely, by the knowledge that even if, metaphorically, I did clip my wings, doing so would not enable him to fly.) And, too, if society defined me as crazy—and here my envy for the attention he received as “the sick child” revealed itself —I would be given license to say, write, and do anything I wanted, and thus become the free, flamboyant spirit Robert had often been and I had often longed to be. 

I also became aware that writing about Robert had set me free both as a man (father, brother, son) and as a writer, for if I could write about things that were close to the heart and bone of my actual life, then I could write about anything. The constancy of Robert’s presence in my life, and my attempt, as brother and writer, to explore his life—to imagine what it might be like to be Robert—had enabled me to reimagine my own life. Our collaborations and our friendship, that is, had set me free to remember, conjure up, and reflect on painful memories, as well as on shameful and angry feelings I’d previously suppressed or left unexamined, and to be able, by bringing them to consciousness, to deprive them of their power over me—to trust them, and to draw on them in my life and in my writing.

The ongoing tragedy of Robert’s life had fired my imagination and—a gift no one else could have given me—provided me with some of my abiding subjects and themes: those characters, in story after story and book after book, who, like Robert, did not get to live out their early dreams and promise, and who, for one reason or another—suppurating emotional wounds, worldly circumstance, inner demons, lousy luck—had the lives they might have lived stolen from them. All this I received from my brother; all this I owed him and owe him still.

From the time of our father’s death in 1976, I’d been carrying on imaginary conversations with him, conversations in which he’d become more like the warm, confident, wise father I’d longed for. In those forty years I’d also taken to talking regularly with other relatives and friends who had passed away. And so, on the day Robert died, and on those that followed, Robert and I talked; and when a thousand-word lead obituary appeared in the Sunday editions of both the New York Times and the Boston Globe, I read it aloud to him.

Only when I was done reading did Robert tell me that where he was now—“splendid panoramic views, by the way,” he said—he had, of course, already seen the obit. Freely admitting that, like our mother, he’d always loved being the center of attention, he confessed delight at the fact that of all the individuals who had had the bad judgment to pass away during the previous week, these newspapers had deemed him the most important.

“You’re not the only famous son in this family, you know,” he said.

“I know,” I said. “And do you know what else?”

“Tell me,” he said.

“That obituary confirmed something I’ve often thought but rarely expressed aloud. Something I can now clearly see—”

“Now that I’m gone, you mean,” Robert said.

“Okay,” I said. “Now that you’re gone. Yes. But I am very proud of you, Robert, and now that you’re gone, I can clearly see something else: that although your life was, as I said at the memorial service, an ongoing tragedy, it was also—”

“—a triumph!” Robert exclaimed.

“Yes,” I said. “Your life was a triumph, Robert.”

Robert was silent for a second or two. “But really, Jay—who knew?” he said. And then: “It didn’t always feel like a triumph, though. I can tell you that.”