For all the extraordinary advances in medical science seen in the past century, mental illness remains an area of conspicuous uncertainty. It’s perhaps a reflection of this doubt that three separate specialisms – neurology, psychiatry and psychology – contest overlapping areas of the field, and amid the confusion other disciplines such as philosophy and cultural theory have enjoyed an influence often unsupported by empirical evidence.
It is in this disputed territory that Jonathan Rosen tells the heart-rending story of his friendship with Michael Laudor, a gifted young man whose rapid rise to the American intellectual summit is first cruelly restricted by the onset of schizophrenia and then, after a miraculous turnaround that draws the money and attention of Hollywood, finally ended when in the grip of psychosis he commits an horrendous crime.
Rosen and Laudor were two Jewish boys born in the early 1960s who grew up in New Rochelle, a community north of New York that boasted many writers and intellectuals. Rosen, the anxious son of a Holocaust surviver, befriended Laudor, the cocksure son of an aggressively opinionated economics lecturer. They were both precocious, but Laudor was fearless, willing to take on anyone in debate, however mature or established, usually winning.
The path of their friendship through competing academic ambitions, awkward teenage flirtations and bruising moments of disloyalty is memorably captured in nuanced prose. Almost every page is filled with poignant observations, subtle ironies and a commentary pregnant with the unbearable weight of future knowledge.
There are tragic echoes of The Great Gatsby, with Rosen performing the reflective Nick Carraway-like narrator role to Laudor’s semi-mythical Jay Gatsby, and it’s a testament to Rosen’s powers as a writer that the book could stand on its own as an incisive and moving memoir of a childhood bond. But that story is merely the central narrative thread around which the author, who is also a novelist, interweaves a complex history of mental health in America as well as the tormented unspooling of Laudor’s life and its dreadful impact on those close to him.
Broadly speaking, for the first half of the 20th century mental illness was viewed as a malady that required isolation from society. Large numbers of people in America and Europe were consigned to mental hospitals or “asylums”, places with little oversight, where electric shock treatments and even partial lobotomies were conducted with limited understanding of their effects.
In the second half of the century, a combination of leftwing idealism and rightwing economics produced a shift away from housing the mentally ill and towards community-based solutions. A vivid illustration of this cultural mood change is the 1975 film of the 1962 novel One Flew Over the Cuckoo’s Nest, whose problematic conclusions Rosen exposes with surgical skill.
In that book and film the American mental health system was depicted as an individuality-crushing gulag, in which the well were made sick and the sick made mad. At the same time mental health was subject to a kind of liberation ideology that viewed all kinds of psychiatric complaints as reactions to, and manifestations of, the sickness of capitalist society.
Among the most influential of thinkers was Michel Foucault, who, Rosen writes, “engendered a low-level paranoia that took the place of thought while making you feel smart”. Everything was a social construct, a hidden system of power relations.
Such ideas turned organic reality into cultural metaphor, and in that discourse schizophrenia became less a medical concern than a symptom of socioeconomic pathology. Like Foucault, Laudor was interested in the excluded, the marginalised, the “other”. He recognised his privilege, although that did not stop him from trying to maximise it.
His friendship with Rosen was based as much on rivalry as it was on their shared backgrounds. Both excelled at school, although Laudor appeared – at least to his friend – effortless in his accumulation of knowledge and strident in his expression of thought. After an incident in which Rosen is beaten up and Laudor runs away, an unspoken tension enters their friendship.
Both are accepted to the summer programme at the elite Telluride Association and both gain entry to Yale. But once again Laudor seems to take the intimidating environment in his stride, becoming one of those charismatic figures around whom undergraduate legends continually sprout. He is eccentric and enigmatic by turns, sleeping at odd hours, staying up all night, one moment utterly distracted, the next totally engaged.
They could be the characteristics of any hard-living student, but when Laudor takes a job with a demanding management consulting firm his latent schizophrenia begins to take hold. Paranoid, obsessive and depressed, he is forced to quit. From there, he becomes yet more debilitated until he somehow manages to persuade the hugely prestigious Yale law school to take him on.
Everyone is charmed by Laudor’s story, and he appears in a glowing profile in the New York Times. He gets an agent and writes a proposal for a book about his life. It’s bought for $600,000 and the film rights sell for $2m. Ron Howard is slated to direct, and Brad Pitt is to star as Laudor.
Rosen views all this from afar, a struggling writer who roots for his old friend, yet his public recognition inspires insecurity and envy. Rosen is also sceptical about the poster-boy image and the unquestioning acceptance that schizophrenia can be surmounted with a mixture of intellectual effort and celebrity endorsement.
On the surface Laudor’s life looked like an advert for overcoming disability: he was feted, wealthy, he had a girlfriend who loved him, and she was pregnant with his child. But in reality he couldn’t write the book and was spiralling out of control. In 1998, at the age of 35, he exploded in a fit of delusional and lethal violence (murdering his girlfriend), bringing to a brutal end not just another life but also the hopes that so many had hung on his success. “Michael had become famous for denying the stereotype,” Rosen writes, “and infamous for conforming to it.”
This is a rich and deeply thoughtful book about the nature of madness and the way that western society deals with it. If the mentally ill have been freed from antiquated asylums, many of them in the US and the UK have ended up confined in real prisons. The stark truth is that, unless they are an obvious danger to others or themselves, the psychotic are all too often left to fend for themselves. Drugs can help but not always, and frequently, as in Laudor’s case, people stop taking them.
There are no easy solutions to be found in these pages. One of the bitter ironies The Best Minds offers us is that Laudor is spared prison and sent to a psychiatric hospital (where he remains), thanks to a legal finding that he acted under delusional thinking. As Rosen sardonically notes, that was enough to “exonerate Michael after the terrible fact, [but it] hadn’t been sufficient to medicate him before it”.
• The Best Minds: A Story of Friendship, Madness and the Tragedy of Good Intentions by Jonathan Rosen is published by Allen Lane (£30). To support the Guardian and Observer order your copy at guardianbookshop.com. Delivery charges may apply
