Written as a letter to her recently deceased mother, Gayle Brandeis’ memoir “The Art of Misdiagnosis” opens in 2009 with the news that her mother has hanged herself in a parking garage in Pasadena, two weeks after the author has given birth to her third child. Convinced that she was being pursued by both her ex-husband and sinister “Middle Eastern men,” Arlene Brandeis was clearly suffering from psychosis, but the posthumous diagnosis does little to relieve the author’s guilt or solve the riddle of Arlene’s life.
“Joan Didion says we look for the sermon in the suicide,” Brandeis writes to her mother. “I’m not sure I’m looking for a sermon. I’m just looking for you. 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 can gather on my own.”
The “shards” are memories from the author’s childhood, excerpts from Arlene’s letters and scripts, and descriptions of highly charged interactions between mother and daughter as Arlene slips deeper into her illness while insisting she is perfectly well. These moments from their past are woven into the story of the confusing, uncertain days following Arlene’s death. Throughout, Brandeis’ unsparing, poetic language captures the juxtaposition of love and damage, psychosis and creativity.
Entering their mother’s room after her death, Gayle’s sister, Elizabeth, observes that it was a perfect metaphor for Arlene — “lovely and elegant on the surface, total chaos underneath.” But despite her disease, Arlene also enjoyed long periods of productivity, during which she launched a national support group for divorced women and created art works and film. And her delusions, when they began, seemed relatively innocuous. She was sure her daughters suffered from obscure and difficult-to-diagnose diseases, in particular porphyria and Ehlers-Danlos syndrome. Fashioning herself into a medical crusader, she encouraged her daughters to play their part as “sick girls,” roles they initially embraced, enjoying the positive attention from schoolmates and doctors, and especially, from their mother.
“Of course, I knew illness itself was de facto bad,” Brandeis writes, “but being the sick girl had somehow bathed me in a pallid glow that could so easily pass for goodness.”
As Brandeis and her sister collude with their mother’s obsession — they later appear in Arlene’s unreleased documentary about porphyria and Ehlers-Danlos called “The Art of Misdiagnosis” — the book becomes a meditation on illness, the way it gives the sick person a sense of purpose and identity. When the sisters can no longer sustain the illusion of illness with their doctors, they let it go even as this infuriates their mother. Later, the author will discover that such “factitious disorders” as they are called are surprisingly common among girls — they are a variant of Munchausen’s Syndrome — and in an ironic development, both sisters will later struggle with unpleasant and unexplained physical symptoms as adults.
An author of fiction, nonfiction and poetry, Brandeis is a graceful writer with a novelist’s sense of metaphor and scene, and she makes for a sympathetic narrator. Watching her struggle to be a good daughter even as her mother utterly fails to hold up her end of the equation can be difficult, but “The Art of Misdiagnosis” represents an illuminating portrait of the psychic and physical porousness between mothers and daughters.