Patrick Austin Tracey

My book "Stalking Irish Madness: Searching for the Roots of My Family's Schizophrenia" was the improbable winner of the 2009 PEN New England/LL Winship Award for Nonfiction, and no one was more surprised than I. There's a photo of me receiving the award from PEN Chairman Richard Hoffman at the JFK Memorial Library in Boston.

The book was inspired by the discovery of the first gene link for schizophrenia in the land of my ancestors--County Roscommon in Ireland. This discovery, which turned out to be less significant than first thought, inspired me to go to Ireland and eventually return in a second-hand camper van purchased in London.

In my little home on wheels I spend a summer rolling through Ireland for the summer asking tough questions about the people who hear "voices" in my family and a forgotten outbreak of mental illness during the time of my emigre ancestors in 19th century Ireland.

The old rule of thumb is that genetics loads the gun and environment pulls the trigger. We had a highly loaded genetic gun in a hair trigger home environment, which probably explains why two sisters followed a great-great-great grandmother, a grandmother and an uncle into rapid-onset schizophrenia in their early twenties. It's all traceable through a maternal line going back to the time of the Great Irish Famine.

Of course the schizophrenia in our family was rarely talked about. Whenever I did ask my grandfather Jack White about his wife, my grandmother May, who'd been committed to a mental asylum in Rhode Island after having all her teeth extracted in the 1920s, at the command of the voices in her head, he'd only say she was "away with the fairies."

When the schizophrenia began pooling in my immediate family, with two of four siblings disabled rapidly in their early twenties, we got nothing but blank looks from mainstream psychiatry. They didn't have a clue and the only treatment of heavy tranquilizers that did little more than put them in a medicated head fog. Nothing much has changed in 30 years.

During the course of my travelogue through Ireland, a tale is told of a forgotten piece of history, which was an outbreak of mental illness in Ireland that was part and parcel of the maternal malnourishment that increases rates more than other factors such as alcoholism and older fathers, two other conditions prominent in the Ireland of my emigre ancestors. For the roots of the disorder I blame in-vitro starvation, late age of paternity, and alcohol abuse.

As for treatment options, I've concluded that schizophrenia is simply a medical term for those who've been driven psychotic by the very real human experience of hearing voices that no one else can hear. And auditory hallucination--the chief symptom of schizophrenia--has been largely ignored by the medical community. I believe this has been a great disservice.

This medical protocol of changing topics when somebody attempts to talk about their symptoms has changed to one of engagement with the voices in more progressive psychiatric circles today. And there's also a slowly dawning recognition that people who hear voices are not necessarily crazy, that they can learn to manage the voices by talking about them. Ignoring the experience, or changing the topic, is shunning and shaming and not at all helpful. (I am not anti-psychiatry-this fall I've been invited to address the American Psychiatry Association at their annual meeting in San Francisco--but I do believe there's plenty of room for improvement.)

Since the book came out I've been speaking at book shops, mental health groups, high schools and universities, and Grand Rounds of psychiatry at medical schools, and I've had the opportunity on occasion to have my sisters there along with me. On these evenings I'm always reminded that the most helpful thing we can do for someone who's disabled (whether physically or mentally by a non-ordinary state of consciousness)is to let them know that you are not in any way ashamed of their condition and that you are proud to stand next to them in life. Full stop. This has been our experience as a family.

My sisters Austine and Michelle (with Elaine and Seanna) were all there at the PEN Awards ceremony with me, and also Michelle (with Elaine) at the NAMI Awards in NYC for KEN Book Award ceremony too. So the better part of the whole book publishing experience has been stepping out as a family to proudly say HERE WE ARE, WORLD. And in doing so to tell other families that it's okay to talk about the experience of hearing voices, that it's okay to share the pain of loss, because in sharing there is a healing.

I've heard from thousands of families through my website at stalkingirishmadness.com, and that's a small slice of the 3 million diagnosed in America, and the 60 million suffering largely in silence worldwide. To other families like mine, this memoir is a shout out to say that you are not alone. So please keep the faith. Thanks.

Patrick Tracey