The Best Minds

( and The Best Intentions)

The Best Minds

There are some books that never leave me. They live permanently in my mind, becoming part of me. Some are there because they change everything, force me to see the world in new and startling ways.  Some because they change nothing, but so affirm important truths about my world that I carry them as a blueprint to fall back on, to guide me when my own thoughts and memories get muddled or confused. Like a detailed topographical map of home, they reveal and deepen, put context and dimension into a place I know and understand well.

Jonathan Rosen’s The Best Minds is one of these.

Late last night, I finished its 535 pages, long after bedtime, because I could not put it down. On the second-to-last page of the acknowledgments I found the name of a writer friend, who not only knew the characters in the book in college but had researched and written about this story in 2015. I texted her impulsively, and she  quickly answered, sharing her essay, and affirming the deep and powerful effect the story had on her, and on so many people who knew Michael Lauder, the tragic subject of this epic book. 

On one level it is a personal story. Two childhood friends, both gifted, one leaning early into prodigy territory. Both attend Yale, but Michael finishes summa cum laude in three years, then defers acceptance to Yale law school to take a high paying consulting job before completing his education. In those two years, the quirky, oddball behavior that others put off to his brilliance transforms, and his paranoid schizophrenia emerges full-blown. 

In some ways, this tragic story is one I know well. I hated those evaluations, the ones that gave me an eerie feeling from the moment I met the teenager others had started to be “worried about.”  Usually smart, often more than that: talented, artistic, unique in a way others admired but couldn’t quite describe.

 With experience, you feel the disconnect viscerally when you meet them; a sense that something here is off, and is scaring us both. Some of them sense that their minds are splintering and are terrified to answer the questions I dread asking. Others defend the growing unreality of their thinking and the behaviors they can’t really explain. I’ve been eerily prescient about kids too young to officially diagnose, and once, only once, completely blindsided by a boy in my son’s class, whose diagnosis at 21 took me totally by surprise. Either way, it breaks my heart every time. 

This book is also the history of mental health treatment in my lifetime. Beginning in the 1960’s when Freud and psychodynamic thinking still prevailed, postulating theories that blamed families, not biology, for mental illness. Then into the ‘70s, when community psychiatry became the model, changing patients to clients, and redefining illness as social stigma.

Michael Lauder’s parents had professional friends who were in the forefront of de-institutionalization and community treatment models for even the sickest of patients.  By the time he had his breakdown, he was surrounded by people who not only cared about him personally, but wanted to make his imagined life possible, despite the burden of his psychosis. He went from the halfway house that followed eight months of hospitalization to Yale Law School, not to the low stress clerk job his doctors recommended. And the law school community surrounded him with support.  

But getting him through Law School was not the same as letting him become a lawyer. The intellect can fight on academic turf, but it cannot win in the real world, where others need to trust your judgment, your empathy, your clear-thinking guidance. Paranoid delusions wreak havoc on that.  His dad’s daily phone call, coaching him to reach out and touch the flames he saw consuming his dorm room each morning so that he knew they were not real, was not the kind of mentorship senior law partners could provide. 

But America loves a hero. And the redemption story we all want to believe in becomes, in this story, what takes Michael down. A New York Times profile leads to a huge book advance, and almost immediate sale of movie rights, and the cataclysm begins. He cannot write the book taking him back into his personal hell; cannot begin to accept the Hollywood “adjustments” to the movie required to make it sell, and the pressure on his fragile mind builds.

The subtitle of The Best Minds is “A Story of Friendship, Madness, and the Tragedy of Good Intentions”. Those good intentions blossom fully as the culture of mental health intersects with the culture of law. The wish for the mentally ill to have everything the rest of us enjoy brings us the landmark Americans with Disabilities Act, the right to accommodation in school and work, the right to refuse medication, even the right to live in a sick and self-defeating way.

 The right to try becomes the right to fail, and to bring others down with you.

On June 17,1998 Michael Lauder killed his fiancé, Caroline Costello in the midst of a psychotic episode. He remains to this day, locked in a secure facility, a cross between prison and hospital for those unfit to stand trial, and those found guilty of crimes by reason of mental disease or defect.

No one intended to hurt Michael Lauder. Not his parents, who wanted the best life he could have; not the Yale Dean and faculty who supported him; not the New York Times who wanted to use his “overcoming extraordinary odds” story to improve the world for those suffering from mental illness, and show how much was possible.  But the best of intentions can create the worst of situations.

On December 14, 2014, I was at a White House Christmas reception, awaiting the chance to meet Barack and Michelle Obama. Instead, they came in holding hands, confirming the unbelievable rumors that had been circling the cocktail table for an hour:  a shooting of first grade student in Newtown Connecticut, 26 students and teachers dead, a twenty-year-old local boy the shooter.

In the months and years following, I pieced together the story of Adam Lanza, a child identified as having special needs in preschool, whose problems only increased with age in a school system that provided “services” that never really treated his autism, anxiety and OCD in the service of normalizing him.  No residential school treatment, no intensive psychiatric care, and no one with the common sense to insist this child should never be allowed near guns. Insisting he be treated as “normal”, the people caring for him guaranteed he would never be anything close to that.

 Adam Lanza was never psychotic like Michael Lauder. But by age twenty he lived isolated, untreated, in a locked room with blackened windows, existing in an online world that offered his only friendships and became increasingly violent, until the day his mother told him she was selling the house, and he would be on his own. 

The history of mental health culture is a story of extremes.  From isolation and brutal confinement to de-institutionalization without adequate support structures. From patients having no rights, to being granted rights that put them, and many of those around them at risk. From the worse of intentions to the best of intentions, both failing miserably.

The story of Adam Lanza never leaves me.  Mercifully, he died the day he massacred his mother and so many others. He does not have to live with what he did. But I do. And maybe those of us whose job it was to diagnose and treat and educate and make laws to protect people with mental illness should carry Adam’s burden, and Michael Lauder’s as well. 

We have not gotten it right yet. Perhaps we never will.

 But we need to stop blaming them and mental illness alone, as though we played no role in how their stories ended. We need to face how we colluded, and denied, and let wishful thinking sabotage not only the treatment severe mental illness requires, but the public health protections we all deserve.  

With the best of intentions, we failed Adam Lanza and Michael Lauder. With the best of intentions, we failed their victims as well.

If we cannot admit that we will never get it right.