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A Review of The Art of Misdiagnosis: Surviving My Mother’s Suicide

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The Art of Misdiagnosis: Surviving My Mother's Suicide
by Gayle Brandeis
Beacon Press, 2017; 264 pp; $26.95 (hardcover)

In 2009, a week after Gayle Brandeis gave birth to her third child, a son, her mother Arlene hanged herself. The Art of Misdiagnosis: Surviving My Mother's Suicide is a compelling and suspenseful read, a medical mystery, a family drama. Brandeis recounts her mother's final week, reexamines their complicated relationship throughout her life, and questions: What drove her mother to take her own life? And will Brandeis, her new marriage, and her family remain intact in the aftermath of her mother's suicide?

Throughout the memoir, Brandeis moves back and forth in time from her childhood to the time after her mother's death. She recounts the days leading up to her mother's suicide as well as when her mother's illness first surfaced—oddly enough, after the birth of Brandeis's second child, a daughter, over 15 years earlier. During these "episodes," her mother is paranoid, delusional, believing her husband (the author's father) is hiding assets, poisoning her, and hiring men to kidnap and kill her.

As the 2009 Thanksgiving holiday approaches, Brandeis's mother shows up unexpectedly, wanting to stay with Brandeis's family, as she doesn't feel safe. She fears Middle Eastern men in white vans are after her. After failed attempts to help her, Michael, Brandeis's new husband, asks Arlene to leave their home because she is causing too much stress for the expectant mother. This is the last time Brandeis sees her mother.

After her mother's funeral, her sister Elizabeth, who came to help with the newborn and stayed to assist with their mother, returns to her home in Canada, and Brandeis begins searching for answers: "I become Nancy Drew." She brings her new baby to her mother's home to sort through her belongings. It is an emotionally overwhelming task, but one that she feels compelled to complete. One she could not endure alone: "The baby on my chest is a life vest; without him, I would be sinking." Among her mother's things are notes she took during a workshop on grief, as if Arlene left her daughters a guidebook on surviving her death. Brandeis has no idea when and why her mother took the class.

In other chapters, Brandeis writes letters to her dead mother at the urging of her therapist. It is through these that her desire to communicate honestly with her mother comes through. This is Brandeis at her most truthful and vulnerable as she says things she could never say to her mother or things her mother could never hear.

I am aching to understand you now, to figure out your story, the path that led to your unraveling. All I can really do is patch together a narrative from the spottiest of clues—the fragments you handed me, the shards I gather on my own. All I can really do is write my own scenario, my own (mis)diagnosis of your life.

While Brandeis begins this correspondence asking questions, as she continues to write she begins to explain her own behavior, particularly as a sick teenager, to her mother. She admits what was real and what was manufactured, writing about her time at the Billings Hospital, where she was diagnosed with Crohn's disease.

The place where barium would be shot up my ass, and scopes shoved down my throat; the place where I would be changed, superhero-like, into a mythical creature known as the Sick Girl, you as my trusty sidekick. It was your calling—Mother of the Sick Girl. You had never been more ready for an assignment. In truth, if anyone was the sidekick, it was probably me.

She admits she enjoyed being "a celebrity of sorts" at her new high school as the "Sick Girl," a title she was unwilling to give up.

Brandeis also includes transcripts of the documentary her mother was producing at the time of her death, The Art of Misdiagnosis: An Art Tour into the Genetic History of the Artist. The film explores the family's two rare (or rarely properly diagnosed) medical conditions and showcases her mother's abstract paintings inspired by these illnesses. The first, Ehlers-Danlos syndrome (EDS), is a family of connective tissue disorders that affects skin, joints, and sometimes, the heart. Second, porphyria is "responsible for all sorts of strange phenomena: purple pee, vampirism, werewolfism, the madness of King George." After suffering episodes of violent vomiting, Brandeis is diagnosed with acute intermittent porphyria, possibly brought on by the changing hormones of puberty. Both illnesses are hereditary. Her mother believes that if not for her persistence in caring for her daughters and insistence that something was wrong, these conditions would never have been diagnosed.

Neither Gayle nor Elizabeth, who is eventually diagnosed with porphyria, wished to be a part of the documentary:

Elizabeth and I had asked our mom not to talk about our own journeys with illness in the film, but when she showed us the rough cut, there she was, talking at length about how her poor daughters had been misdiagnosed. She doesn't say anything about how both of us had fabricated our own illnesses, at least in part—we've tried to tell her this over the years, but she hasn't been able to hear it.

In the film, her mother tells of when Brandeis was diagnosed with EDS and, as it's a hereditary disease, Arlene was diagnosed too. Tears well up in her eyes as she describes finally understanding her own bruising and the sudden, unexpected deaths of her brothers thought to be heart attacks. Their deaths, she believes, could have been prevented if they had been properly diagnosed with EDS.

Despite being a "heroic crusader" for her children, Brandeis's mother couldn't take control over finding her own diagnosis, and so, her mother's mental illness remains a mystery. In the "Postmortem Diagnosis" chapters, Brandeis researches her mother's symptoms, looking to diagnose her, as her mother had done for her siblings. Could her mental illness be explained by acute intermittent porphyria brought on by menopause?

The trauma of her mother's illness and suicide intensifies her relationships with her family, who rally to support each other. Both her father and sister Elizabeth (a midwife) arrive to help with the baby. Her father, despite her mother's horrible accusations, remains devoted to Arlene to the end. For Brandeis, there are moments filled with love and gratitude:

I lie between my dad and my baby—ninety years old, ninety hours old—and it occurs to me this is the purest experience I'll ever have of middle age. Here I am, firmly—sweetly—in the middle of our spacious generations, dead center between the edges of human experience, listening for signs of life.

Brandeis is the author of Fruitflesh: Seeds of Inspiration for Women Who Write and several novels, including The Book of Dead Birds, which won the Bellwether Prize for Socially Engaged Fiction. She also teaches in two low-residency MFA programs: Antioch University Los Angeles and Sierra Nevada College. While this is Brandeis's first memoir, there seem to be more personal stories to tell. However, unlike her mother, Brandeis won't reveal the stories of other family members. Her mother needed to be dead before she could write about her, before she had to write about her in order to process her grief.

In dealing with her mother in life, as a child or as an adult, Brandeis has difficulty communicating. "When I get near her, words harden in my throat, get stuck there, like the grits I'll have to clean out of the mug later, stubborn as crystals in a geode." Something about her mother renders her mute, unable to speak the truth. In The Art of Misdiagnosis, Brandeis has found a way to communicate both her frustration and compassion to her mother and to herself.


Susan Barr-Toman is the author of the novel When Love Was Clean Underwear (New Rivers Press 2009).  Her work has appeared in Watershed Review, The Los Angeles Review of Books and the Philadelphia City Paper among others.

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