Welcome, Silence

by Carol S. North

This is the amazing true story of one woman's journey deep into mental illness and her return to sanity -- and to a successful life and career. Carol North was diagnosed with schizophrenia in college. The story of her life is traced from her early life in a middle class small-town family in the Midwest. For many years, Carol struggled against overwhelming odds to achieve in school in spite of her illness and was finally admitted to medical school to pursue her hopes and dreams of becoming a doctor. In medical school, however, she slid further into psychosis and finally succumbed the inexorable incapacitation so often characteristic of the illness. Carol was fortunate enough, however, to find a skilled psychiatrist who understood her dedication to becoming a physician and who worked with her to stay well enough to remain in school. When all hope seemed lost, her doctor enrolled her in an experimental dialysis program, similar to the treatment given to patients with kidney failure. With this treatment, her illness went away and she no longer required medication for it. This engrossing and ultimately triumphant story of courageous struggle against mental illness will inspire anyone who has ever had to battle for achievement against overwhelming odds. After recovering from her illness, Carol returned to school and received her medical degree from Washington University School of Medicine in St. Louis, Missouri in 1983. She then completed her internship and residency at Barnes Hospital/Washington University, and subsequently obtained a masters degree in psychiatric epidemiology (the study of psychiatric disorders in populations) while simultaneously pursuing a NIMH fellowship in psychiatric epidemiology at Washington University. Dr. Carol North is currently a board-certified psychiatrist and full Professor of Psychiatry at Washington University School of Medicine. She treats patients with schizophrenia and a range of psychiatric illness, trains young physicians and psychiatrists, and pursues federally funded research in psychiatric epidemiology. She is the recipient of numerous national awards and has appeared on many national television and radio programs.

Genres: Memoir, Psychology, Nonfiction, Biography, Mental Health, Mental Illness, Health

324 pages, Paperback

First published June 1, 1987

Reviews

[Judi · Rating 5 out of 5]

This book was written by my sister, who is now a professor of psychiatry. She has been free of schizophrenia for over 25 years now. A firsthand look at what a person with schizophrenia can go through and how difficult it is for the family.

[Stephanie · Rating 3 out of 5]

This book by Carol North, published in 1987, is subtitled “My triumph over schizophrenia.” The writer is a psychiatrist whose struggles with schizophrenia began when she was six years old and intensified during college and medical school. Hers is one of the few cases in which her illness was cured by dialysis, and she now practices and teaches medicine.

In my cursory research of schizophrenia, I have never seen dialysis mentioned as a treatment. The book’s happy ending is therefore not going to be attainable by most schizophrenics. Although there are quite a few medicines to treat the symptoms of schizophrenia, their side effects are often bad enough that many patients prefer to continue living with their confusion and paranoias.

The book was enormously helpful in understanding the inner life of someone with schizophrenia. In a very matter-of-fact way the author describes the extraordinary activity that was going on in her head and shows how she tried to make sense of the chaos. It is helpful to be aware that while people with schizophrenia often reach confused and erroneous conclusions, they can be founded on very real perceptions.

It struck me how important it was for the author to have people around her. By other people’s reactions to the environment she was able to gauge the reality of her perceptions, and she did this fairly successfully during the healthier periods of her life. Again, I hope this insight can help people in their interactions with people who have this illness. It is important to be patient and kind, realizing that your input is crucial and that any frustration that you have with the person issuing strange statements cannot compare with their own stress and confusion.

I will include an interesting excerpt from the book that shows you how simply and factually the author’s experiences are presented. Here the author has been telling her psychiatrist about the voices that she hears:

“You appear to be having some trouble concentrating on what you’re saying today,” said Dr. Hemingway. “Is there a particular problem?”
“Well, yes. They have sound-effect machines. Like now they are using an Echo Machine that makes both of our voices reverberate, and that bothers me so I can’t think very well. There are other machines like the Barking Dogs Machine and the Helicopter Machine that they can use to produce sounds out of nowhere. Sometimes I can’t tell whether noises are my neighbors or the sound-effect machines.”
I felt creepy talking about the voices. It was like talking about them behind their backs, except even worse because I knew they knew what I was saying about them…
“Do you ever hear your thoughts as if they had been spoken aloud?” Dr. Hemingway asked.
Wow, how does he know about that? Has he been reading my mind? I glared at him.
Finally I responded to his question: “Yes, I hear my thoughts out loud. In lecture. It bothers me.” …
“When was that the last time that happened?”
I felt my skin turning gray and starting to slide off my forearms right there in the psychiatrist’s office. The sensation was so alarming that I couldn’t possibly think to answer his question. It took all my concentration just to hold on to my skin. I was too embarrassed to tell him about my skin problem because I was sure it was a result of mental weakness.
“Is there some reason why you aren’t saying anything?” he asked…
I thought it would probably be better for me to tell him about my skin problem than for him to hear it from the voices or pick it up from my own thought waves. I explained to him that I had been quiet for a minute becasue I had been using all my concentration to keep my forearm skin from sliding off.
He offered up another “Mm-hmm.”

[Cranky Commentary (Melinda) · Rating 5 out of 5]

This is a must for anyone interested in, or presently working with the mentally ill. To have someone who has actually lived through psychosis describe with such clarity not only what her thought process was, but the emotions she experienced as well, truly enables the reader to "walk in her shoes". Not only educational, and interesting, but great sensitivity training! I loved it.

[Tammy · Rating 5 out of 5]

My aunt's gripping story of her battle with schizophrenia. Gives incredible insight into what it must be like to have this crippling illness. It also gave me a different view into my own family, and so I found it fascinating.

[Sjoen · Rating 5 out of 5]

I loved this book. Everyone interested in the human mind would benefit from reading it. The author had schizophrenia from childhood until young adulthood. She endured it with amazing fortitude and courage and was eventually cured. She can tell us with an authentic voice what it was like to have the structure of reality break down and to persevere through the experience and survive.

[Kaye Mclaren · Rating 5 out of 5]

This book is a fascinating insight into what it's like to be surrounded by people and objects that aren't really there, to hear voices that are not from actual people, and the struggle to distinguish between what is real and what is illusory. The best illustration of this is when Carol goes to an apartment she recently moved out of and sees mushrooms all over the floor. I thought 'oh a hallucination' but in fact there had been a leak and the mushrooms were real! It gave me a very small sense of what it must be like to constantly doubt what you see and hear. Another vivid image is when she is convinced she is a machine and decides to cut into her foot with a piece of glass. The book is vivid, honest, gruelling to read at times. The happy ending is a bonus - one that most stories of schizophrenia don't come with. Next to talking to someone who actually has schizophrenia, this is the best way of finding out what it's like to live with it.

[Kcastro · Rating 5 out of 5]

This is a wonderful introduction to the world of the schizophrenic.

[Donna · Rating 4 out of 5]

I appreciated the depth of detail that the author provided on her experience of being schizophrenic. It showed how frightening and disruptive it was in her life as she struggled in her goal to become a doctor. I couldn't imagine sitting in medical school and having to contend with Voices and severe paranoia while absorbing all that content. It is amazing that she was able to overcome these handicaps to achieve her goal and I was pleased to see Dr. North able to contribute to research and treatment of others after her unusual recovery. I was also interested in the relationships she described with family, boyfriend, professionals in the process.

Here you can see her experiences of paranoia, the feeling others are controlling her thoughts, thought and word disorganization and being overwhelmed by sensory stimuli. This small example shows how she tried to overcome the obstacles in a clever way, with her own code, but her mind was not able to manage it.

More and more, my thoughts escaped my control, diffusing out from my brain for others to hear. I increased my efforts to police the contents of my thoughts at all times. It wasn’t easy trying to not think thoughts, but it was something I knew I absolutely had to do. Most of all, I wanted to keep my mother from hearing my thoughts. Whenever it seemed she was tuning in on my thought waves, I purposely substituted nonsense words for my true thoughts, or intentionally scrambled the words as they came to me. But in the process, my thoughts sometimes got so hopelessly jumbled that I needed to write them down to straighten them out for my own comprehension. To keep anyone from being able to read the thoughts I was writing, I invented a private code of original characters symbolizing letters, words, phrases and tenses all mixed up in such a way that no one could possibly break it. On paper it looked like endless columns of nonsensical symbols.

Eventually my thoughts thinned out so far that I could find nothing at all to say. Meanwhile, my perceptions magnified. My mind, a vacuum, slipped into a state of Pure Perception; environmental stimuli constantly bombarded my senses with unrelenting, nearly unbearable intensity.

[Kerri Thomas · Rating 5 out of 5]

Wow, just wow. There is no way a person who has never experienced hallucinations, been delusional, or had voices talking to them all the time can understand what it must be like, but Dr North gets you as close as possible by her descriptive prose. You will lift your head from the pages of her book feeling dazed and disorientated. I understood the hallucinations part because I used to indulge in LSD as a teenager, and her descriptions of having the air filled with multi-coloured patterns, and having the concrete world around you shift and change its shape brought all those trips back, lol. However, mine lasted only a few hours; Dr North lived with them for YEARS and they were so bad at times that she couldn't even read because the page disappeared under them, and people who were talking to her had faces that disconcertingly did weird things, or she would have to stop conversations because she was fighting to prevent the skin from sliding off her forearms. My God, how terrifying it all must have been.
You will shake your head in wonder at how this extremely determined and driven young woman kept going through this horror to end up being cured, thanks to a psychiatrist who also wouldn't give up, and who then turned her suffering around to become an eminent psychiatrist herself who has given countless people hope in their's. It's stories like these that really make you wonder if these events are not as random as they appear......

[Jessica · Rating 5 out of 5]

I found this at a secondhand bookshop and had no prior knowledge of the book or author. It was a great find! The book is absolutely gripping. As a reader you feel like your observing someone slowly go through the worst depths of hell and it's so awful seeing the protagonist slowly go to the brink of insanity then we'll beyond it....really, you just can't stop reading. This is such a harrowing story that I'm so glad there is redemption at the end with her recovery. I have since passed this book on to two friends who loved this book as much as me. I have a good friend with schizophrenia and I wished they had the chance to do dialysis but there are no treatment options. Be good if there are more studies on this. Thanks for sharing your amazing story Carol.

[corvuss · Rating 5 out of 5]

Incredible book. I liked it even more than The Center Cannot Hold. The author's experiences with psychosis are so poignant and so relatable, as someone who has experienced psychosis myself. Some bits are like she was peering into my own experiences. It's amazing to me that she got through so many years of college and medical school while being so sick. And I have no doubt it makes her an amazing psychiatrist. Highly recommended, especially to anyone who struggles with psychosis, is interested in the healthcare field, or both.

[Sahar Afnan · Rating 5 out of 5]

wow. schizophrenia is so so interesting to me and to read a memoir about it really transformed my understanding of it. to see her recover through such a tumultuous journey made me so so so emotional especially having witnessed how pervasive of a disorder this is. would recommend everyone to read this

[Rachel]

Read in 1996. My review from then: The author heard voices and saw patterns all her life and was floridly psychotic in college and med school. Tried kidney dialysis as an experimental treatment, was totally cured. Well written, and a good story of what goes on in schizophrenia from the inside.

[Elizabeth Humphreys · Rating 4 out of 5]

Couldn’t put it down at the end!

[Jamie Bronstein · Rating 5 out of 5]

Read this book in less than a day.

[Jesse Pina]

Life Saver

[Erin Hagemeister · Rating 5 out of 5]

Fascinating!

[Carol · Rating 4 out of 5]

Dr. Carol North is a recovered schizophrenic. This true story is a riveting and detailed account of her 8 years of psychosis. During her illness, she attended medical school, which is an incredible feat as she also battled voices and hallucinations which put her in a psychiatric hospital for intermittent periods of time. She had the support of an amazing psychiatrist who helped her escape the grips of this debilitating condition.
As it is written from her point of view in present tense it puts you right into the mind of someone suffering with mental illness.

The ending is totally unexpected and poses some intriguing questions with it.

[Kevin Black · Rating 2 out of 5]

The author is an academic psychiatrist who describes her past experience as a patient with a severe psychiatric illness.
Her illness course is extraordinarily unusual for schizophrenia, and Dr. North does not recommend to her patients the treatment she was receiving when she recovered. However, her description of what has been called a "delusional mood" during the prodrome to her first hospitalization is extraordinarily clear.
I read this book circa 1994.

[Kevin Black · Rating 3 out of 5]

The author is an academic psychiatrist who describes her past experience as a patient with a severe psychiatric illness.

Not a book to read for learning about schizophrenia treatment, but a great book to see how severe mental illness can affect someone. Also, the best source I've ever seen for describing what has been referred to as a "delusional mood."

[Nurgül Tekeli · Rating 2 out of 5]

fantastic story badly written.

[Elaine · Rating 3 out of 5]

An incredible cure. Worked in the mental health field for 20 years. Never heard anything like it.

[Tina Krogdahl]

Superb book.