I know this much is true

Thomas Birdsey has schizophrenia. It’s gritty and ugly. While sitting in the public library, he pulls out a knife and cuts off his right hand to atone for America’s sins. That’s the opening scene of Wally Lamb’s emotional novel I know this much is true from 1998. It chronicles Thomas’s mental illness and his twin brother’s struggle to cope with it. There are some very sad bits, and the book does well at putting a face to schizophrenia. Even though Thomas is a fictional character, he will haunt me for the rest of my life. I haven’t felt that way about somebody since I finished A Prayer for Owen Meany.

The book left me thinking about what a lonely ride mental illness is. Thomas, like most schizophrenics, runs low on caregivers until his brother is all that’s left. It’s hard to stick with someone with schizophrenia. When I was in the hospital with my second psychosis, the psychiatrist told my boyfriend that our relationship probably wouldn’t survive. We’d been together for nine years. In her opinion, it was unlikely that I would recover to the point where I would be the person I was before psychosis. If I recovered at all. Not a day goes by when I don’t feel extremely grateful to have gone through three psychotic episodes and still have my mental faculties. A lot of the credit for that goes to the antipsychotic Olanzapine and the doctors that got me on it. 

Thomas was not as lucky with his treatment as I was. When the surgeon wanted to reattach his hand, he declined the offer. Instead, he questioned the surgeon’s role in opposing the will of God and quoted from the Gospel of Matthew to explain his actions: 

“And if thy right hand offend thee, cut it off and cast it from thee.” 

It is hard to construct a rational argument against religious convictions. The original reference is to adultery, but Thomas read something else into it. That’s how schizophrenia works. Messages are everywhere. You see things that no one else can see. Unfortunately, it’s often because those things are not there. And sometimes, they tell you to do stuff that you shouldn’t. 

Last year HBO turned the story into a miniseries with Mark Ruffalo which could be worth watching. There’s a lot more to Thomas, but I’m not going to post any spoilers. The book is long, but it’s well worth the time.

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