BOOK REVIEW : When Sanity Proves to Be Unbearable

The Comforts of Madness by Paul Sayer (Doubleday: $17.95)

Set your sights high enough, work your imagination until it transcends itself, ground your work in material that you know like the back of your hand, and--you never know--you might come up with a masterpiece.

“The Comforts of Madness” (its title, surely, a distant, echoing homage to the Venerable Boethius’ “Consolations of Philosophy”) takes, as its basic position: The world we live in is unbearable for some of us; we need all the consolation and comfort we can get.

Some of us, the author speculates, take refuge in madness. The question is, then, if a person “chooses” madness, what exactly is the mandate of the “sane” majority? When do good intentions, the urge to cure, to “make sane again,” move over into nightmare realms of thought control and torture?

Paul Sayer, the author, is a staff nurse in a large psychiatric hospital. For that reason, every external detail here rings true. But Sayer’s imagination soars as he creates the inner life of his narrator, Peter, who has been in a catatonic trance for as long as anyone can remember. It is Peter’s greatest wish to be left alone: he has never spoken and never will. But in his earlier life, his body, at least, moved among the living. He was a younger son in a family to which we would now apply the mild term “dysfunctional.”

During the middle part of this harrowing tale, poor, silent, catatonic Peter is hauled out to an experimental treatment center and made to remember his early life.

His older sister grew up planning to be a whore. His father was unemployable and hideously strange. His mother tried to kill herself and finally succeeded in getting herself murdered. This, in literature, might be thought of as Joyce Carol Oates country, but the author reminds us in his bleak, plain style that this is the way many of us live in real life--not in gear, unable to cut it, at the mercy of a system, or a series of interlocking systems that we are totally unable to understand.

By the time a concerned citizen discovers that Peter’s father has died an obscure and terrible death, Peter himself has given up motion as well as speech. He is institutionalized, but that’s just the beginning of his troubles. His silence makes him the perfect confidant, for staff and inmates alike: He learns more than he ever wanted to know about the human condition.

Even more alarming, Peter’s silence threatens physicians who base their own reason-for-being on their ability to “cure” the hardest cases. (All this for a poor man whose tongue has grown to the roof of his mouth from lack of use.) Hideous tortures, both psychic and physical, are applied to Peter, to get him to move, to get him to talk--to bring him back to the living . . .

“The Comforts of Madness” compares to Camus’ “The Stranger.” Peter is a stranger, not like the rest of us, and “the rest of us” won’t quit until, metaphorically, he gets back in line, buys a car and a toaster and cares about the Super Bowl. Otherwise, society’s sentence upon Peter can only be death. It has to be, the author suggests, otherwise cars, toasters and football games everywhere might suffer.

The fine distinctions here thread between what it is to be ill; what it means to cure. In mental illness, in physical illness, there are those who yearn to be well. And in the medical profession, there are men and women whose first concerns are for the patient. These two sets of people are meant for each other.

But in that other, nightmare world, which also exists on this planet, there are people sick unto death kept alive by “heroic measures” that a Romanian prison guard might shudder at. There are physicians (I’m sorry to say this but I’ve met some) who delight in inflicting psychic and physical pain, who treat each illness as if it were a wild animal to be tracked down, tortured and destroyed. It is the patient who is the real victim.

It’s of this nightmare world that Sayer writes. His prose soars, his message is searing in its implications.