From The Washington Post's Book World/washingtonpost.com Reviewed by Reeve Lindbergh "It has been said that grief is a kind of madness. I disagree. There is a sanity to grief, in its just proportion of emotion to cause, that madness does not have." So writes Kay Redfield Jamison, the clinical psychologist whose widely acclaimed 1995 memoir, "An Unquiet Mind," revealed her lifelong struggle with manic-depressive illness. "Nothing Was the Same" is the story of her marriage to the late Richard Wyatt, a man who overcame severe childhood dyslexia to become a leader in schizophrenia research. With the blend of straightforward frankness and poetic eloquence for which her earlier book drew praise, Jamison describes the almost 20 years of their life together as a love affair that encompassed not only their shared work, colleagues, family and friends, but also her mental illness and the cancer that ultimately claimed his life in 2002. One thing that makes this book especially compelling is its quiet matter-of-factness in the face of personal catastrophe. This is not lack of feeling. On the contrary, Jamison periodically offers a brief, chilling glimpse of her sufferings with bipolar disorder, once writing to her husband: "There are moments when you provide a minute of sweetness and belief, and then the blackness comes again. I shall be done for one of these times. No matter what I do, this illness will always bring me to my knees." And her account of Wyatt's battle with cancer will be very familiar to anyone who has traveled the same painful path, the harrowing roller-coaster ride from diagnosis to treatment to remission to reevaluation to further, damning diagnosis, and on to the final days of a beloved life. Every step carries emotion -- shock, dread, hope, joy, despair -- and Jamison portrays each of these with piercing clarity. Still, the overall tone of her recounting is even, spare and thoughtfully analytical, avoiding grimness and offering some leavening lighter touches, like Wyatt's affectionate characterization of Jamison's manic-depressive mind: "a delicate ecosystem, a pond of subtle alkalinities, which was kept alive through a finely honed mix of lithium and love and sleep, or, as he imagined it, 'water grasses and dragonflies, and a snail or two to tidy up.' " Here were two people eminently qualified to evaluate and treat illness, she as a professor of psychiatry at the Johns Hopkins University School of Medicine, he as chief of neuropsychiatry at the National Institute of Mental Health. All of their combined expertise could not protect them from their own pathology or from mortality, but the life they shared gave both of them the strength they needed to meet the unavoidable. At the same time they gave one another what was, in the circumstances, a rare and bountiful measure of joy. It is startling to learn of Jamison's discovery that her husband secretly kept a syringe and a vial of antipsychotic medication in his office at their home, in case her mania got out of control. He told her, "Medicine is imperfect," and then, "Love is imperfect." It is delightful, on the other hand, to read that he filled her bathtub with lilacs and roses when they stayed together in a hotel in Rome. Wyatt often told her that she provided quietness and constancy in his life, despite her illness. He wrote to her, "Your stillness is a sanctuary." She, who had written a book about the chaotic anguish of her "madness," was amazed. The great gift Jamison offers here, beyond her honesty and the beauty of her writing, is perspective: a clear-eyed view of illness and death, sanity and insanity, love and grief. As she writes, she often invokes the words of scientists, philosophers, novelists and poets, from Sigmund Freud to Graham Greene to Edna St. Vincent Millay. The excerpts are well chosen, but the voice that rings truest is her own, with its disciplined mix of openness and restraint. Once again, Jamison seems to be telling the truth, no matter how difficult it may be, in a way that avoids self-pity and inspires courage. To write the truth with such passion and grace is remarkable enough. To do this in loving memory of a partner is tribute indeed.
Copyright 2009, The Washington Post. All Rights Reserved.

The love you gave me wasn't fresh and young,
It didn't melt the sun or set the town aflame.
But it was warm and wise as any street,
Where hope and sorrow meet in bars without a name.
I only know that one day was a drink
And then the next was you and nothing was the same.
—STUART MACGREGOR

Prologue

When I was young, I thought that fearlessness and an easy way with love would see me to the other side of anything. Madness taught me otherwise. In the wake of my first insanity I assumed less and doubted more. My mind was suspect; there was no arguing with the new reality. I had to learn to live with a brain that demanded more coddling than I would have liked and, because of this, I avoided perturbance as best I could. Needwise, I avoided love.

I kept my mind on a short lead and my heart yet closer in; had I cared enough to look I doubt I would have recognized either of them. Before mania whipped through my brain I had been curious always to go to the far field, beyond what lay nearest by. After, I drew back from life and watered down my dreams. I retaught myself to think and to negotiate the world, and as the world measures things, I did well enough.

I was content in my life and found purpose in academic and clinical work. I wrote and taught, saw patients, and kept my struggles with manic-depressive illness to myself. I worked hard, driven to understand the illness from which I suffered. I settled in, I settled down, I settled. In a slow and fitful way, predictability insinuated itself into my life, and with it came a certain peace I was not aware had been missing. Grateful for this, and because I had no reason to know otherwise, I assumed that peace was provisional upon an absence of passion or anything that could forcibly disturb my senses. I avoided love.

This lasted for a while, although not perhaps as long as it seemed. Then I met a man who upended my cautious stance toward life. He did not believe, as I had for so long, that to control my mind I must first control my heart. He loved the woman he imagined I must have been before bowing to fear. He prodded my resistance with grace and undermined my wariness with laughter. He could say the unthinkable because he instinctively knew that his dry wit and gentle ways would win me over. They did. He was deft with my shifting moods and did not abuse our passion. He liked my fearlessness, and he brought it back as a gift to me. Far from finding
the intensity of my nature disturbing, he gravitated toward it. He induced me to risk much by assuming a portion of the risk himself, and he persuaded me to write from my heart. He loved in me what I had forgotten was there.

We had nearly twenty years together. He was my husband, colleague, and friend; when he became ill and we knew he would die, he became my mentor in how to die with the grace by which he lived. What he could not teach me—no one could—was how to contend with the grief of losing him.

It has been said that grief is a kind of madness. I disagree. There is a sanity to grief, in its just proportion of emotion to cause, that madness does not have. Grief, given to all, is a generative and human thing. It provides a path, albeit a broken one, by which those who grieve can find their way. Still, it is grief's fugitive nature that one does not know at the start that such a path exists. I knew madness well, but I understood little of grief, and I was not always certain which was grief and which was madness. Grief, as it transpires, has its own territory.