Review – The Best Minds by Jonathan Rosen

If you aren’t familiar with The Best Minds, let me copy part of the Amazon description:

Acclaimed author Jonathan Rosen’s haunting investigation of the forces that led his closest childhood friend, Michael Laudor, from the heights of brilliant promise to the forensic psychiatric hospital where he has lived since killing the woman he loved. A story about friendship, love, and the price of self-delusion, The Best Minds explores the ways in which we understand—and fail to understand—mental illness.

I’ve seen other reviews that complain about the book’s length, specifically that the thread of Michael’s story sometimes gets lost in the cultural and historical tangents the author takes along the way. I can understand that. This can get a little dense if you’re looking for a memoir of the author’s relationship with Michael. On the other hand, if you are interested in treating mental health and how we’ve gotten to where we are today, the tangents are pretty valuable.

Because the treatment options afforded to Michael were a product of the time and place and a product of privilege. Understanding how those options led to the death of his fiancé is part of the story.

It’s the history of moving away from asylums to community care and how that allowed Michael to fall through the cracks, even as he was given opportunities due to his charm and brilliance, that plenty of other people struggling with delusions and severe mental illness are not provided. Those tangents put his story in context while also showing us that mental illness is complicated and individual.

It will leave you asking more questions than it provides answers, but these are questions we should be asking.

• Why have we failed to create community-based resources to replace the old mental hospitals and asylums?
• Even when community support is available, is it the correct support for that person?
• When is it appropriate to force someone to medicate? Is it ever?
• How often do we convince ourselves that everything is good when it’s not?
• How does something like paranoid schizophrenia develop, and who develops it?
• How does generational trauma impact what happened? (Michael grew up hearing about how his family members escaped the Holocaust and had delusions of Nazis trying to kidnap and kill him, which may not seem like delusions to someone so close to that history.)

The book also leaves you scratching your head at how many times people in authority were taken in by his charm and brilliance and let their guard down, not seeing the signs of his deterioration and the danger he could be. This includes the policewomen who found him with blood all over his clothes yet didn’t keep him restrained.

It’ll also leave you wondering if anyone could have done anything to prevent all this and what that would look like. (Commitment to an inpatient facility, forced medication, abandonment?)

I walked away, wondering what we needed to do to answer some of these questions. What research can we do to figure out when a supportive community is the right way to help someone with severe mental illness and when something else is required?

So, if you want a story to picture overlaid on the history of mental health treatment, the law, and the culture of the US from the 70s forward, this is a great book. If you’re not looking to invest that much time and want to focus on the story of one patient, this book might not be the best choice for you.

Have you read it? What questions did you walk away with?