A phrase from Kafka’s “A Country Doctor” haunted me as I puzzled over this book — its curious performance of brazenness and prevarication. In the story, a doctor visits a patient with a terrible lesion writhing with worms — an affliction the author evokes with improbable beauty: The patient is “dazzled by the life in his wound.” Benjamin is dazzled, too, even as he suffers — there is so much uniquely, harshly human in his illness, he attests. It has cracked him open to a kind of holy compassion. Be advised: You’ll need a mighty tolerance for that Laingian mythopoeic perspective of mental illness to make it through this maze. But succeed and its conclusion feels like a benediction. “We are exactly as lost as each other: Even the most particular is happening to everyone.”
But this is not a simple narrative of striking cases written by a far-seeing practitioner. It’s a turbo-charged race. Language darts and hurtles through a landscape of unyielding and punitive conditions. Transference may ever be in play for the professional mind doctor. In this book, there’s a threat from the start: if Benjamin feels his patients’ conditions intensely, it’s because he also is one... What stood out for me in a book that veers between the expressive and the therapeutic, were the insights into the increasingly impoverished NHS – the waiting rooms, the bare clinical spaces, the cuts, the strain on staff and medics struggling to serve extremely difficult patients. Breakdown is not only a category of the inner world.
Benjamin is a highly unreliable narrator; names have been changed to protect the sick (even AK Benjamin is a pseudonym), and he admits that much of what he has written is either a composite of real events or fiction. This means the book is a disorientating read at times, but the fracturing of the narrative comes to mirror the disintegration of his mind and makes for a disturbing but absorbing account of mental illness. It is, he writes, “a self-portrait in a convex mirror that has been smashed to smithereens”.
It emerges that, in a way that seems peculiarly contemporary, this book is all about him. It’s about the subjectivity, unreliability and instability of psychologists in general, and him in particular. The boy who did bad things to train sets, he later reveals, was him. You see? You can’t even rely on him to tell you what’s going on at any given moment. But there’s a point to this blurring of boundaries between patient and doctor. It’s actually the point...as the chapters pass, the author finds his stride. He stops sprinting and waving his arms. And his facility for language, pin-sharp percipience, and sensitivity to micro-shifts in moods, become clear.
Benjamin is kinetic company, his rangy intelligence matched with a fondness for rarefied locution (he can never resist a “lickerish” mouth) and indelible images. “We are skull-jumpers,” he says of his profession. Often, his descriptions embrace polar opposites.. But it all contributes to a gathering sense that something is not quite right, that the ground has become unstable beneath the reader’s feet...The book’s second half fuses an alarming, increasingly claustrophobic psychodrama with irresistibly sharp cultural commentary that makes even greying bugbears such as listicles and the misuse of the word “literally” seem fresh.
Let Me Not Be Mad is full of the provocative reflections of a discontented, challenging mind. Benjamin is concerned, above all, with exploring the disappearing line between the neurological and the psychological, and the changing relationship between physician and patient. These are compelling ideas that intrigue the author and then terrify him. What if all of the patients bundled together are really a composite of AK Benjamin? He is the kind of physician to whom, halfway through your visit, you might glance up and say: “Doctor, have you looked at yourself recently? What’s wrong?”