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ORB speaks with Susan Doherty

The Ottawa Review of Books' Caroline Vu interviews award-winning Montreal writer, Susan Doherty, in this month's issue.

CV: Congratulations, Susan on winning the Quebec Writers' Federation Non-Fiction Prize for The Ghost Garden! The book has been translated into French and has received great reviews in both the English and French press. You have been giving talks around the country and been solicited by the media. You truly deserve this acknowledgement for your remarkable book. A few years ago, you joked that you could line the floor of your study with rejection letters. How does it feel to be in the limelight now?

SD: I don’t really view it as the limelight, but winning the Mavis Gallant award was certainly a validation of my volunteer work in the realm of achieving better mental wellness for the most marginalized. It was equally validating to see the book in another language. The French edition is a very faithful translation, although I laughed more while reading Louise Sasseville’s interpretation of some of the scenes. And yes, I did get 34 rejection letters from agents and publishers for A Secret Music, but J.K. Rowling had 43 for Harry Potter, of which 12 were from publishers, so I felt I had a ways to go before feeling the flutter of defeat. As a woman entering the writing field in later life, I had anticipated rejection. Enough key people told me to keep going, which kept me in the game even as the letters piled up. Signing a contract with Cormorant Books for my debut novel was a singular thrill. It was easier to secure a contract the second time around.

CV: A Secret Music, your first book, is a work of fiction. How hard or easy is it to transition from one genre to another?

SD: Both of my books required exhaustive research, so there is that similarity. Also, when you love your characters at the soul level, fictional or real, you want to spend endless time with them, regardless of the genre. In my case it was years. The biggest difference for non-fiction was that I agonized about getting the message right, and being true to each family who had shared aspects of their difficult lives. At all times I needed to retain their dignity despite the heart-breaking nature of the events. The narrative aspect of The Ghost Garden lent a fictional feel to the writing, and hopefully to the reading. At the end of the day, I write stories about people.

CD: In The Ghost Garden, you detail your decades-long friendship with Caroline, a schizophrenic patient. Despite her numerous failings and frequent relapses, you stood by her. You were always there to give a helping hand. You also volunteer at the Douglas Hospital where you allow mental patients to call you at home in the middle of the night. I admire your courage, generosity and patience. As a medical student, I’d wanted to become a psychiatrist. But I soon changed my mind after my first rotation in psychiatry. How do you trudge on when even family members give up? What is the source of your unending good will? Is it your education? Your family support? Your religious faith? Tell us about yourself.

SD: There is mental illness in my own family. I have long wondered how childhood trauma affects us as adults. As a teen, my father lost a sister, a brother and a father. Do our enduring memories of past events trigger the symptoms of mental illness? As far as my own goodwill, I get as much in return from my engagement with the patients as they do. Don’t forget, I get to walk away, like a grandmother or a fairy godmother. It’s why I stress the role of the volunteer— so many more shoulders are carrying the burden. Families burn out, as do social workers and nurses and psychiatrists. I completely understand that it’s a form of self-protection to harden oneself to the incomprehensible behaviours. I don’t judge when a family member turns away. We should walk in their shoes before we criticize.

I survived a grave illness, but it didn’t awaken my faith. That was there all along. What it fortified was my need to live with purpose, and to do more of what comes easily for me, and that is to work with highly symptomatic people suffering from schizophrenia. It’s some kind of blessing, but I have zero fear. I recently had a two-hour one-on-one meeting with Vincent Li, the man who cannibalized and be-headed Tim McLean on a Greyhound in Manitoba. He was given a complete discharge, and I needed to see for myself what his recovery looked like. He was a free man, but how was he coping with ongoing mass rejection? Did he have a pipeline of kindness that helped him get up every morning and face the day?

CV: You mention the various side effects of anti-psychotic medications and you are right, there are side effects to all medications. In their place, you argue for a more human approach in the treatment of mental illness. You are right again, human contact helps, but I wonder how feasible this is in our over burdened health care system. Not all volunteers are as devoted and conscientious as you are. One of your children is a medical doctor. What is her opinion on this matter? Do you have robust family discussions on the subject of medications vs human connection?

SD: Such a hard question to answer. If we believe whole-heartedly in the pathological model of mental illness, then drugs will always be the primary component of treatment. No such proof of pathology exists, which does not mean it’s not there, it simply makes all drugs speculative, and dosing is trial and error. Why are we using solutions we don’t know enough about instead of what we know very well, which is human connection, physical touch and belonging? Right now billions of dollars are spent on medications, and it would require a seismic shift in resources to move from one foot to the other. My most basic message is that behind all the hard to fathom symptoms is a human being—an overlooked concept in a medicalized disease model.

My immediate family are onboard with my ideas, however my daughter works as a resident at a large hospital and acknowledges that medical management of schizophrenia is often to subdue the patients, as psychosis feels unmanageable for medical providers and family members. She believes the human connection model is wonderful for people with mild to moderate symptoms but says we don’t currently have effective treatment options for people with extreme psychosis where connection can feel unattainable. The connection model is time-consuming and life long, therefore further efforts need to be made to provide the resources for this essential therapy.

CV: Are you still volunteering at the Douglas Hospital? What have been the patients’ reactions to your book?

SD: I continue to work at the Douglas every Tuesday. We are a group of volunteers that paint large canvases with the patients. However, I still do my best work in the group homes after a person has been discharged from the psychotic disorders unit. Nowadays the Douglas is a thriving hub of activity with many recovery-focused programs, whereas the group homes are under-funded, and under-resourced. I see far more loneliness in those out-sourced housing situations than in the hospital. We need more people on the ground willing to do that kind of work.

Caroline Evans, the main protagonist, had great trepidation about the release of the book, despite giving me an infinite amount of time to plumb the depths of her memory and experience. She greatly worried that she would be judged all over again for her behaviours while psychotic that often had disastrous effects. I reminded her that she was a heroic trailblazer for all mothers who coped with the symptoms of schizophrenia. She’s reflective and insightful, and I learn something every time we speak. Her friendship has been an enduring gift. Caroline’s sisters are also heroes for bravely sharing their story in a climate of shame and stigma. I applaud every person who was able to shed light on a condition that still mystifies researchers and scientists. I try not to let myself feel outraged by the profits made by the pharmaceutical giants. My hope is that the patients themselves will rise up and demand something better, something that allows them to be seen as fully formed human beings instead of ghosts, who are feared and forgotten.

CV: Your first book deals with depression and your second with schizophrenia. What’s up for the next book? Will it be fiction or non-fiction?

SD: Fiction. I will try to untangle temptation. The temptation to do good and to do evil is the same dopamine pathway. I have my title: Arthur W. Barnes, which is a variety of apple in England.

CV: Thank you, Susan, for this interview.

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