Kaysen, like many of her fellow patients, is straddling the line between sanity and insanity, between the world outside the hospital and the world inside. She identifies with both the other patients and the nurses, who each represent the world they inhabit. Even though she feels a connection with other “insane” patients, she also longs for the sense of normalcy that the nurses bring in from the outside.
The book, with larger than normal print, is not even 170 pages in the Vintage edition I read and there’s plenty of white space, as well as transcripts of Kaysen’s mental diagnoses within. In a sense, this sets up the piece to be quite poetic. In fact, this is where the poesy of the prose comes from, not the ability to craft gorgeous prose.
Most of the few dozen ‘chapters’ are brief— 3-4 pages is usual, and they are often dreamy or hazy recollections that sometimes briefly and violently come into focus in describing a fellow patient’s illness or death. In other chapters, Susanne goes off rambling about mental illnesses, philosophy, her sexual precocity, and other things. While many of these individual reminiscences and areas fall flat, the way they are woven together and contrast with each other make the whole greater than the sum of its parts.
Although she is declared “recovered” upon her discharge in 1969, Kaysen freely admits that once you’re insane, that other world never really disappears. It hovers around the edges, and even affects people who have never been inside a hospital, as if she carries a “crazy cloud” around with her. Kaysen explores the difference between insanity of the brain and insanity of the mind, arguing that each need to be treated differently.
She also includes actual documents from her medical records from her time at the hospital, which provide an interesting backdrop for the narrative of the so-called “insane” person. This isn’t “The Bell Jar.” There is no real mental breakdown, no literary examination of one’s own insanity. And no, the happy-ending movie is not like the book, though crazy Angelina Jolie definitely deserved the Oscar. Although Kaysen does explore her own illness to a degree, this is mostly an exploration of the dual worlds that mentally ill people must inhabit: the world of the sane and the world of the insane.