/ 19 May 2016

‘Difficult Night’ is a compassionate take on mental illness

Mishka Hoosen
Mishka Hoosen

Mishka Hoosen’s Call It A Difficult Night is a thought-provoking title for a book dealing with institutionalisation and mental illnesses. 

It suggests that by reading the book one might arrive at a point of compassion for someone who has faced that situation. The compassion coursing through the book comes from its authenticity and the choices the author makes in conveying the story. 

By choosing to use various forms such as poetry, anecdotes and research findings, Hoosen asks us to step into the shoes of the character for a few moments so that we may see things anew. 

The book delves into the mind of a psychiatric patient as she negotiates her stint in a mental institution, with increased dosages of her medication producing debilitating side effects: impediments to forming connections versus the human impulse to do so, and the equally, if not more compelling madness of the outside world. And the irrational, self-serving need by pharmaceutical companies to medicate for everything.

In between bouts of medication, or perhaps in flashbacks, we relive the howling in her mind and the cold shivers of her body. Everything appears scrambled, with temporal lucidity. We relive her interactions with doctors and patients, with friends from the outside world. Most of all, there is the loneliness brought on by the medication, which dulls until there are “no more words”.

For those who may have lived in proximity with someone experiencing bouts of mental unease, the book could be profoundly emotional. 

Despite the fact that it deals with a complex subject, and is not structured in a linear narrative, one gets an immediate sense of where the author is leading the reader. The method to the madness is clear from the get-go. How else does one begin to understand except to walk a mile in those trembling shoes?

Call It A Difficult Night is immersive, both in its feverish pacing and in its insistence that the reader inhabit the mind of one whose mind is broken.

The execution of this, partly a function of Hoosen’s lyricism as well as his thoughtful presentation, gives the story its pace.

That Hoosen’s description of her protagonist’s fits of rage, some restricted to the corners of her mind, never seem repetitive speaks to someone whose vocabulary for her subject could only have come from deep insight or serious research.

Some readers have commented on how difficult it is to wade through the first few pages of the work but, having been forewarned, I found this to be a function of the baggage we bring to novels. Our expectations are often that they immediately explain themselves to us.

As one journeys through Difficult Night, one gets a particular sense of how Hoosen wants us to think about mental illness. Her anecdotes, varying in length from a few sentences to long paragraphs, shape this understanding. 

In a chapter titled Findings, Hoosen digs up some research on schizophrenia. “Seroquel [a drug administered to people with schizophrenia] is an atypical antipsychotic. It is known as SuzieQ on the streets, where it is commonly used as a date rape drug.”

In another vignette, she speaks of Frieda Fromm-Reichmann, whom she says went on to pioneer the use of psychotherapy as a way of treating “the most serious illnesses, like schizophrenia”. Fromm-Reichmann viewed schizophrenia as a condition of abject loneliness, that even in its most severe forms “could … be healed through relationship”.  

These research findings become more dense as the book reaches its conclusion, giving it the air of an academic treatise. We learn of Thorazine, which the pharmaceutical companies punted as the reason the numbers of psychiatric patients went from 550 000 in the mid-1950s to 70 000 by 1994. So what did this magic ingredient do exactly? It merely suppressed violent outbursts. 

If Hoosen’s own comments about her book at a recent literary festival are anything to go by, Call it A Difficult Night is an attempt to humanise people outside of the easy categories used to dismiss or “understand” them. It is about her belief in how people outsmart systems, no matter how bad, every day.