Book Review…Journeying through the world of mental illness

Dec 07, 2014 Features / Columnists, News

Book: Sailing on Broken Pieces: Essential Survival Skills for Recovery from Mental Illness
Author: Gary Rhule
Reviewer: Dr Glenville Ashby

Gary Rhule is a physician by profession. But through this intimate, captivating and enlightening

The book cover of Sailing on Broken Pieces

narrative, he wears more than scrubs and a stethoscope. He is a brother, a caregiver, and advocate for the mentally ill. Rhule chronicles a tragic tale, not easily told. Mental illness is the last frontier of medicine, as he describes it. It is still a forbidden area of discussion, especially when involving a next of kin.
Labels abound in this genre of psychopathology. A patient can be diagnosed with bipolar disorder, dissonance disorder or schizophrenia, to name a few hardly comprehensible conditions. Schizophrenia, to which Rhule’s brother, Sam, succumbs, is notably perplexing, offering little in the way of aetiology.
‘Sailing on Broken Pieces’ offers a rare, authentic and disturbing account of mental illness and its impact on family members. Rhule’s work is emotive, detailed, vividly descriptive, leaving little to the imagination. For sure, mental illness, schizophrenia, in particular, guts all in its path, leaving a sense of hopelessness, guilt and fatigue.
Sam’s story encapsulates the plight of many who are fated to live in a complex, parallel world that is cut off from others. Rhule empathetically recounts Sam’s childhood and early adult life. There was something amiss, different, troubling. His tempestuous outbursts, disciplinary issues at school, inability to keep a steady job spoke volumes, but when coupled with visual or auditory hallucinations, a definitive diagnosis beyond that of Attention Deficit Hyperactivity Disorder (ADHD), was imminent. At times, his life spirals out of control. He is nomadic, walking for hours, miles, aimlessly – brutally taxing his legs until they wear the unmistakable signs of trauma.
And as with other mentally ill patients, Sam is not religiously committed to taking prescriptive drugs. Rhule offers a thought-provoking explanation. “When he took the medications, the voices in his head were quiet. There would be no voices forcing his actions. Maybe he did not like that. He had grown used to the voices and chaos in his head. Some people thrive on chaos and disorder…The chaos was like an old welcoming friend.”
Compounded with a substance abuse problem, Sam inadvertently veers into perilous, life-threatening situations. He is arrested multiple times for raucous behaviour; he is incarcerated; beaten bloody; and abused.
In one haunting episode, Rhule painfully recalls Sam’s abuse at school. The punishment, by a supposed professional, borders on criminality. “Could this be explained by the teacher’s own twisted nature or her genuine inability to understand and deal with a case as mystifying as Sam’s?”
But throughout this experience there is more than one victim. Rhule painstakingly cares for his brother despite his unforgiving responsibility as an emergency room surgeon. His aging mother never swerves, visiting her son in every psychiatric hospital regardless of the distance.
Interestingly, Sam’s travails are interspersed with Rhule’s own challenges in the emergency room. With a battery of the finest doctors working in concert, the most horrific of accidents are addressed. Here, Rhule is pleading his case: “We must have the same protocol in dealing with mental illness.”
On one occasion after his brother is incarcerated, Rhule begs the question, “But in prison what were the costs? He continues, “The prison system was probably not the right place for him. What he needed was to be in a locked psychiatric ward. I wasn’t asking for the earth and sky? Was that too much to want? Was that so unreasonable to ask? To ask for an appropriate place and care for his mental illness that was not in prison?”
And as trying times mount, Rhule offers suggestions to primary care givers, some of which hit the mark with surgical precision: “Fill your bowl with large stone first: family, good friends, education, work; get plenty of good sleep and physical activity. It will help you face challenging days ahead,” and “if you sense that something is wrong, it probably is. However, get the facts to support your intuition.”
Unquestionably, mental illness transcends the individual victim, testing family members to the limit. It demands acceptance, patience, and a single-minded approach to this disease. That it takes the proverbial village to administer care; and that we are our brother’s keeper cannot be over emphasised.
Unquestionably, ‘Sailing on Broken Pieces’ challenges professionals and laypersons to reconfigure their view on mental illness while striving to offer a meaningful and concerted response to an overly complex problem.

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Sailing on Broken Pieces by Gary Rhule 2014
Publisher: Morgan James Publishing
ISBN 978-1-61448-942-9
Available: amazon.com
Ratings: Essential