There is a tide in the...

There is a tide in the affairs of men,

Which, taken at the flood, leads on to fortune;

Omitted, all the voyage of their life

Is bound in shallows and in miseries.

The sentiments that Brutus expressed to Cassius in Shakespeare’s “Julius Caesar” have been expressed in coarser language by many a publisher over many a publishing surprise. A publisher can spend lavishly on the promotion of a book that founders in the shallows or meagerly on one that takes to the high seas before the publisher has quite hoisted anchor.

Publishers would like to eliminate this unpredictability; but since market research is a luxury they cannot afford, they have no choice but to experiment with the real thing. An experienced editor at a major publishing house once said to me, “I regard the first printing of most of our books as our investment in research and development.”

Promotion for such research-and-development printings is by design and of necessity little more than announcement. But when the tide is there for a book, even a mere announcement will sometimes take that tide at the flood. The announcement brings an unexpectedly strong response from key media: A major talk show, an unexpectedly prominent review. The book has something powerful rolling beneath it. Will it break free? No one yet knows.

The response to the talk show is stronger than the producers expected. There are letters to the editor of the book review. Sales climb. The publisher buys some advertising. The book’s sails begin to fill.

A second surge of reviews follows quickly. The talk show is rerun by popular demand. The author appears on an editorial page. One of his earlier books is brought back into print. Sales for the new book climb still higher. More advertising is scheduled. At length, his ship, his book, is launched, glistening and splendid, outward bound on a long, triumphant voyage.

Can promotion and publicity buy a book this kind of success? People whose favorite words are choreograph and orchestrate will say “Yes.” Publishers’ advertising and publicity experts may even boast “Yes” when up for salary review. In their more candid moments, however, they will admit that their biggest successes are often their biggest surprises. Choreographing the American book market is like choreographing the Pacific Ocean. It can’t be done: The waves breakdance to no rhythm but their own.

The book I have most in mind as I say this is as unexpected a success as the trade has seen in some time. “Surviving Schizophrenia, A Family Manual” by Dr. E. Fuller Torrey is a book on a grim topic for what would seem to be a sharply restricted audience. In its first three months of publication, however, the Harper Colophon paperback edition (306 pp., $8.95) has sold an impressive 43,000 copies. The 1983 hard-cover edition sold an equally impressive 35,000 copies in less than two years’ time. What tide has it taken?

The luck of timing aside for the moment, E. Fuller Torrey is a brilliant writer. There is no one now writing on psychology whom I would rather read. He combines zest for the hard science of his field with an angry clarity about its bureaucracy and a healer’s quiet determination to stay where the pain is worst.

One of his seven published works is “The Roots of Treason, Ezra Pound and the Secret of St. Elizabeth’s” (Harcourt Brace Jovanovich/Harvest), a literary biography set within a gripping forensic-psychiatric investigation. Not to put too fine a point on it, few psychiatrists emerge from their years of medical and professional apprenticeship able to write literary biography. Torrey is one who did.

Harper & Row had reasons for optimism, therefore, when it published “Surviving Schizophrenia,” and yet the success of the book outran the publisher’s optimism.

Response to Torrey’s initial appearance on the Phil Donahue Show was so positive that the segment was rerun. Later, when the publisher decided to issue the paperback edition, it sent Torrey on a small author tour. A fresh, third appearance on the Donahue Show is imminent, and “60 Minutes” has taped a segment on Torrey’s research for next fall. Torrey was invited to write the introduction to Maryellen Walsh’s new, excellent “Schizophrenia, Straight Talk for Families and Friends” (Morrow: $15.95). Clearly a tide is carrying the man and his work. What is it?

The tide of course is schizophrenia itself, a disorder that occupies more hospital beds than cancer, heart disease, diabetes and arthritis combined . Until recently, schizophrenia had almost no public constituency. Now, for at least two reasons, that constituency has begun to gather, and Torrey is the writer it has most welcomed.

The numbers have long been there for this mental disorder. An estimated 6 million Americans have a schizophrenic in the family. As late as the 1960s, however, most schizophrenics were institutionalized and were not their families’ responsibility. Then, during the late 1960s and 1970s, fiscal conservatism and liberal idealism combined to create a system of community mental health centers that--in combination with new drug therapies--was to replace the old mental hospitals.

Unfortunately, the new centers never effectively took charge of the deinstitutionalized schizophrenics. Instead, they turned their attention to the milder, more manageable kinds of psychological affliction, leaving the real “mental patients” to their families or to the streets. (About one third of the homeless are schizophrenics.)

For a time these families tried to conceal their distress--an understandable response but one that prevented them from discovering others like themselves. Then, in 1979, the National Alliance for the Mentally Ill was founded, and schizophrenia began to come out of the closet. NAMI now has 25,000 member families (there are several chapters in greater Los Angeles), and Torrey’s “Surviving Schizophrenia” has turned out to be the book they were waiting for. (For information about NAMI, call (916) 443-6417.)

The second factor transforming the huge but anonymous and disorganized public for books about schizophrenia into an alliance and a market has been medical progress. Medical research money does not go to where the need is greatest but to where the prospect of spectacular progress is greatest. For decades, schizophrenia offered no such prospect. Scientists working on it faced the blankest of blank walls. During the last few years, however, brain research has become perhaps the liveliest area in all science, and schizophrenia research is participating in the excitement.

Drugs providing symptomatic relief for some of the worst effects of schizophrenia--auditory hallucinations, for example--have been in use since the 1950s. Now researchers are beginning to understand why they work the way they do.

Long ago it was noted that schizophrenics tended to be born in winter and early spring. Now scientists are beginning to see how seasonal viruses may be implicated, even when the onset of the disorder is delayed 15 or 20 years. Torrey’s own laboratory research is in this area.

Decades ago, G. K. Chesterton wrote, with a smile:

For the great Gaels of Ireland

Are the men that God made mad,

For all their wars are merry,

And all their songs are sad.

But schizophrenia is a brutal, statistical fact in Ireland, and recent research implicates not God but the potato; specifically, solanine, an alkaloid produced in potatoes exposed to sunlight.

Schizophrenia seems not to have been known before the Industrial Revolution. In the West, it is most common in the lowest socioeconomic classes. Recent studies suggest that New Guinea, at the furthest remove from industrialization, is completely untouched by it. Are industrial chemicals implicated? Or chemicals plus genetic mutation?

Slowly, the circle seems to be closing around this lethal quarry. Maryellen Walsh says that the United States spends $7.35 in research money for each patient who is mentally ill versus $203 in research money for each cancer patient. If there were no signs of scientific progress, her indictment would fall on deaf ears. Happily, there are many signs of scientific progress and a new energy in fund-raising.

In the long run the result may be the one Walsh hopes for: “As I asked my grandmother what diphtheria was, as my children ask me what polio was, I want my grandchildren to ask their parents, ‘And what was schizophrenia anyhow?’ ” In the short run, the result is a market for her own book and for E. Fuller Torrey’s as well--a tide leading them on to fortune and leading their publishers on to the sort of surprise they always hope for and this time may actually receive.