Dancing In the Dark - Bruce Springsteen

I thought posting this song would be appropriate, as it is the song that Liv is singing at the end of the memoir. This song reminds me of a song that plays while the credits roll at the end of a film; and it is appropriate to the end of Liv and Clem's journey.

Clem Martini: Career and Awards

Bitter Medicine is but one of many works of Clem Martini. As a playwright, Clem has written The Colour of Coal (1988), Illegal Entry (1995), and Selling Mr. Rushdie (1997). Bitter Medicine was not the only work written by Clem that was influenced by schizophrenia. Nobody of Consequence (1990) was written by Clem and revolves around identity and losing one’s self. Influenced by an interview with a trainer at the Calgary Zoo, Clem went on to write The Life History of the African Elephant (1989) as well as Secret Life of the Octopus (2005). Feather and Bone: The Crow Chronicles is a trilogy of young adult novels that Clem wrote and the narration is done by Crows. Some of the works he worked on alongside his wife, Cheryl Foggo are: Turnaround (1999) and The Devil We Know (2012).

A Three Martini Lunch was nominated for a Governor General’s Literary Award. It is an anthology of three plays written by Clem, and consists of: Conversations with My Neighbour’s Pit Bull, House of Glass, and Up on the Roof. Clem Martini has won three Alberta Writer’s Guild Prizes as well as the National Playwriting Competition. Clem Martini is the head of the drama department in the University of Calgary as of 2008.

SOURCE: THE CANADIAN ENCYCLOPEDIA

Review on Bitter Medicine by John Estacio

ARC Award book champ John Estacio discusses Bitter Medicine with Ken Davis on Bookmark

Biography of Clem Martini

Born and raised in Bowness, Alta 1956, Clem Martini was a child who enjoyed the company of animals and spent most of his time running outdoors and reading. In high school, he began writing short fiction and won several awards and contests. Later on, he got into play writing and received a Bachelor of Fine Arts in play writing at the University of Calgary.

Clem Martini is a three time winner of the Alberta Writer's Guild Drama Prize, a Governor General Drama Nominee for his anthology "A Three Martini Lunch", a Seminovitch Prize Nominee, a National Play writing Competition winner for "The Life History of the African Elephant" and is the Past President of the Playwrights Guild of Canada. His trilogy of novels for young adults,"Feather and Bone: The Crow Chronicles" have been translated into French, German, Dutch, Swedish, and Japanese. He currently serves as the Head of the Department of Drama at the University of Calgary and is immersed in writing plays for live theater, film and television.

Clem’s characters are often praised for their unique perspectives and lively narrations, not limited to people, but also animals and the bond between the two kinds. The Life History of the African Elephant (1989) features an elephant keeper who balances a new romantic interest with his commitment to his beloved animal. Secret Life of the Octopus (2005) features a protagonist who befriends a depressed octopus. His other young novels, Feather and Bone: The Crow Chronicles, is narrated by crows.

Suicide and Schizophrenia

Clem specifically pointed out the relations between patients diagnosed with schizophrenia and their suicide rates. He expressed concerns about the lack of awareness the public had on this matter and quoted “The rate of mortality makes schizophrenia one of the deadlier diseases you’ll ever encounter. Nobody ever tells you that.” (Clem 47) He explained how schizophrenic people released from the hospital experiences the worst conditions from the first six to nine months “That’s when a good portion kill themselves. That’s when the medication had sufficient time to really kick in. The delusions disappear and people are able to see, really see with a kind of lucidity for the first time, the true scope of their illness. How lifelong a struggle it will be.” (Clem 48) These haunting words might feel discouraging but it also urges the need to take schizophrenic patients on a higher level of attention and care. If they can make it through those critical months, the hope can be slowly restored through mastering new skills and finding a new community that is accepting and supportive.

  

The link here provides basic information on schizophrenia and it's suicidal information. It states that suicide prevention can be difficult because people with schizophrenia can sometimes act without warning. In Ben's case, it ended with him shooting himself in the basement, which could be him acting out of impulse and totally unintentional, and most likely, could be avoided if family members and health care members were aware of the risk factors for suicide. 

Growing Up with the Martinis

The Martini siblings were nothing remarkable. They were four skinny boys with bad haircuts. They had a rabbit and a cat. “They grew up in a tiny grey house perched near the foothills and the town they lived in was small and dusty during summer” (Clem 11) Throughout the years, Clem had expressed his impressions of how his brothers would turn out. He concluded that Liv, his second oldest brother was destined to become a paleontologist. Nic, the eldest leader had a way with plants, and Ben the smallest and the smartest would have a bright future with his good looks and popularity.  

However, things changed after Ben graduated from high school. He became anxious and refused to tell anyone about his problems. It was not until he came to Clem for help, explaining his circumstances “He had been approached, he told me, by someone from another world. A hand had reached across dimensions and deposited a thumbprint on the lens of his glasses” (Clem 21) It was the most illogical explanation but no help was made until Ben’s conditions spiraled into suicide. From then on, the family never spoke of Ben or his mental illness. “My family became nearly invisible in the community. My father spent his days in long solitary walks. My mother attended business conferences out of town. My brothers returned to their retrospective workplace and I immersed myself in theatre studies.” (Clem 49)   There was nothing left to talk about their lost brother, and the scar in the family never did heal.

Visual narratives in bold strokes

The illustrations in the memoir were done by Clem’s brother, Oliver. There were sketches, doodles, comic strips and portraits illustrated between pages. Most of them were done in black ink while a small portion was painted in watercolor, printed out in black and white. Oliver would then scribble down a line or two to explain the contents of the pictures, often adding a hint of sarcasm to his art. The drawings themselves were minimalistic yet full of personality. They captured the essence of schizophrenia with its feral pen strokes, smudged ink and edgy style. It is almost as if they were the impressions of a child, keeping a visual diary and documenting bits and pieces of everyday life, from sleepless nights to even the tiniest details no one would pay much attention. The illustrations weren’t aiming to please the eye but rather documenting an honest and heartbreaking journey of the Martinis. It lent insight to the unconventional dimensions of a schizophrenic patient, the frustrations and hopelessness they experienced, knowing that there is no cure and that they would have to fight against their fate for the rest of their lives. The illustrations also provided an overall tone to the memoir. Without the drawings, Bitter Medicine would have lost its charm and atmosphere. 

WHY 'Bitter Medicine' ?

Bitter Medicine is an interesting title because it contradicts itself. Something that is bitter is (usually) not a pleasant taste and is disliked by some people. Medicine, the word itself symbolizes something positive, because medicine is something you take to cure what ails you. Throughout the memoir, Clem talks about the various medications that Liv takes. The drugs that Liv takes, Stelazine for example, “eliminated most of his hallucinations. It also diminished his paranoia and had a positive influence on his mood disorders.” (Clem 171). These were the positive effects of the drug and I would label them as ‘medicine.’ However, there are side effects to Stelazine which I would consider the ‘bitter’ part. Clem even says “it had a long ad nasty history of undesirable side effects. The tension generated in tis duality – benefit versus harm” (Clem 171).

So in this sense, Bitter Medicine is an appropriate title for this memoir because the road to curing mental illness walks hand in hand with risks and side effects, no matter what the medication is, there is always a bitter side to it. Bitter Medicine can also be interpreted as a statement towards the medical system and how it has treated mental patients bitterly. Treatment is received through the hospitals and doctors, and psychiatrists, and nurses, and institutions; but throughout this memoir, Clem expresses strongly what a bitter experience it was, having his brother Liv treated as a second class patient due to his mental illness. And that is the essence of Bitter Medicine, it is something that you need to cure what ails you, but at the same time it’s a bitter experience to take.

Swept Under the Rug, and Forgotten.

TIKI-TOKI is a website that has a timeline of the history of mental institutions in the United States. In 1977, the mental institutions in the U.S could only take in a collective population of 160, 000 patients; and in 1982, budget cuts were being made and among those cuts were the services for the mentally ill. Although this took place in the United States, Clem’s memoir expresses the same struggle and concerns in Canada. Clem talks about the ‘Great Closing’ which was a time when services for the mentally ill were being cut. “Governments concluded that the large psychiatric institutions were counterproductive. These impersonal, ineffective, very expensive institutions would be terminated” (Clem 149). The recession in the eighties incentivized budget cuts further, and the “essential financing that was supposed to follow people with mental illness into the communities never did.” (Clem 151). Many people with untreated mental illness, as a result of the lack of services for those mentally ill, ended up homeless and as beggars. Clem links the number of people with mental illness on the streets to day “directly with the Great Closing of the Eighties.” (153). Clem emphasizes this time because it was a hard time for his family, especially for Liv, because he was not receiving the proper treatment he needed. Clem goes on to criticize the concept that people with mental illness will do better in an integrated community rather than an institution; saying how the community’s “sketchiest, most criminalized districts” (Clem 159) are the “area where those with mental health issues live.” (Clem 160). And this is due to the culture we live in, and how the problems such as mental illness are feared and swept under the rug. That today’s culture will isolate those with mental sickness, not taking the time to understand and help them. Instead our culture “won’t make room for those who are ailing from it and does everything possible to exclude them.” (Clem 157). Clem gives examples of this unjust, second class treatment of mental patients when he returns for Liv at the hospital in the morning. “I returned to the hospital. He was no longer in the lobby, but when I inquired at admissions, I was told he hadn’t yet received a room.” (Clem 207). After Clem had found Liv, he asks the nurse “whether she thought it was wise to place someone paranoid, delusional, and potentially suicidal off on his own.” (Clem 215). This just goes to show the negligence that people with mental illness receive. “As of Day Three my brother was still perched, untreated, unsupervised, in a hallway.” (Clem 217). The statement that Clem is making in this memoir is clear: that the people with mental illness are treated as second class patients, and they are not receiving the proper services they need. Society treats people with mental illness as something to be isolated and as something that can’t be understood, and so they are swept under the rug.

Clem and Liv; A Narrative Duality

(Clem on the left, and Olivier on the right)

The theme of duality plays a role in Bitter Medicine. The memoir is split into two parts, the text and the illustrations. In the first part of the memoir, the illustrations accompany the text in a harmonious way. The reader is aware that Clem is the narrator. However, there is a turning point where the narration branches off into two parallel paths. The writing that coincides with the illustrations subtly separate, in terms of its point of view. The illustrations talk in the first person and the text talks in the third person. Eventually, it is evident that the text is being narrated by Clem and the illustration’s texts are being narrated by Liv, who has schizophrenia. This split is realized and recognizable soon after Clem says that Liv is diagnosed with schizophrenia. This is interesting because everything before Liv’s mental condition, the text and the illustrations, they were seamlessly harmonic. But now there are two perspectives which now the reader questions if the perspective of Liv is reliable given his condition. This is confirmed when Clem says that Liv got a job as a night watchman, and the corresponding illustration text read “I was working as a night watchman.” (Clem 100). Liv working at night and Clem working during the day adds to this duality split as a symbol between the two at this point of the memoir.

Interlude: The Circles of Hell

The interlude entitles ‘The Circles of Hell’ which occurs half way through the memoir is a very interesting part of it. I mentioned earlier that there is theme of being left in the dark, for both the mental patient and their families. However, the darkness for mental patients differs from their family’s darkness. The family is tormented by unknown facts, by the treatment, and other complications of the matter before them. The person with the mental illness, such as Liv, experiences darkness in his mind, as well as the darkness around him. The Circles of Hell is Clem’s way of immersing the reader into what is happening in Liv’s mind. This part of the memoir may be a fantasized part because Clem has not experienced schizophrenia or any mental illness himself, but he is writing this through the observation of Liv’s journey. “You wake up one day uncertain, sad, confused, and are diagnosed with a mental illness.” (Clem 135). Clem words these segments quite simply so that the reader can understand, but in the mind of a person with a mental condition, it can be much more complicated than that. Clem’s second circle deals with the social struggles of a person with a mental condition; saying that they are “Oppressed by cares and concerns, unable focus upon the necessities of life, you lose your job.” (Clem 137). Circle three deals with loneliness and how “Your moods and behaviors alienate family and friends, who now abandon you.” (Clem 139). Circle four deals with the materialistic issues of a person with a mental condition, saying “Your lack of income that you can’t continue to pay the rent or keep up with taxes, maintain car payments, afford groceries – or anything really.” (Clem 141). Circle five is the melting point at which a person with a mental condition is cornered. “Fearful, uncertain of where to turn, untreated, you become feral. You roam the city, living in improvised stick shelters and hillside hollows.” (Clem 143). This is rock bottom and the ultimate destination for untreated people with mental conditions. Notice how ‘You’ is used in each of these circles. By using ‘You’ instead of ‘they’ Clem is referring to the mental patient as the reader, so in this way, he is putting you, the reader in the mind of the mental patient.

Dancing in the Dark

Clem Martin’s, Bitter Medicine is structured in such a way that it leaves you in the dark and information is filtered as you read. Much like Clem who “knew little about schizophrenia” (Clem 33), we as the reader are assumed not to know much about it as well. The way Clem feeds us information is by telling us what the doctors have told him at that very moment. “A disorder of the brain, they told us. It could generate hallucinations, both visual and aural, paranoid behavior, passivity, and confusion.” (Clem 33). Clem references the doctors, psychiatrists or nurses when it comes to dealing with the facts of Liv’s mental condition. He does this because he is in the dark as much as we as the readers are. This adds believability to the memoir in a way because we are hearing it from the right people. “His community nurse and psychiatrist met, informed him that the security work was contributing to his illness, and urged him to quit.” (Clem 115). It is as if Clem is including the readers in that hospital room where they are getting the news revealed to them.

There is this notion of being left in the dark, and not knowing all of the facts that parallels the statement Clem is making on mental illness. The people who are afflicted with a mental condition are in the dark as much as their families who are hearing the facts from their doctors. The mental patient and their family walk hand in hand in the dark.

Bitter Medicine by Clem Martini and Olivier Martini; A plot summary

Bitter Medicine is a graphic memoir written by Clem Martini, and it recalls events from his childhood all the way through to his later years, focusing on schizophrenia; a mental illness that has plagued two of his brothers. We, as the reader, are introduced to Clem’s family, consisting of his mother and father, and his three brothers: Nic, Oliver, and Ben. In part one of the memoir, Ben is afflicted by schizophrenia which ultimately leads to him committing suicide at a tender young age. Clem was in Paris at the time and felt that his absence from home meant he was helpless in preventing such a situation.

From part two all the way to the end of five, Clem’s brother, Olivier develops schizophrenia much like his late younger brother Ben. It have been some number of years since Ben has passed away, and Clem helps and encourages Olivier, or Liv for short, to seek medical treatment. A person with a mental illness has a hard time integrating into society, and this is evident in this part of the memoir. Liv is struggling to find a job after losing his old one at the print shop. Eventually gets a job as a night watchman. This eventually does not work out for him as his work only contributed to his illness. “His paranoia grew. His mental situation deteriorated and delusions began to consume him.” (Clem 115). Liv’s father was the one who understood him the most. The two would take long walks together, but this all came to an end when Liv’s father passed away and he was the one to discover the body. This traumatizing and tragic event caused Liv to relapse. “Liv experienced another psychotic episode and a breakdown. The first relapse is disheartening, the second an epiphany. You realize how unlike other medical conditions schizophrenia is.” (Clem 127). In between parts five to six, there is an interlude titled ‘The Circles of Hell.’ In this segment, Clem describes the stages of mental illness, and the buildup of it. It consists of five circles in total and goes from being diagnosed all the way to fear and uncertainty.

In part six of the memoir, Clem makes a statement on the medical system, and how people with mental illnesses were treated as second class. He talks about how mental patients are swept aside and isolated in small, run down communities. In part seven, Clem goes to talk about Liv and his consumption of all sorts of medications. Olanzapine is one of the medications Liv was prescribed which ultimately led to his diabetic attack. In part eight, the final part, Liv changes medications and sadly they aren’t working for him. Clem continues to make a statement on the medical system by talking about how it took so long to get treatment for his brother Liv. Eventually a drug called Clozapine is introduced but there was a risk of death for taking it as it could attack the white blood cells. Liv, not having any other drugs work on him, applied as a candidate for the drug, but first he has to lose thirty pounds for medical reasons. With the support of his family, Liv was able to lose twenty five pounds in the span of six months and qualified for the medication. “In the end, the medication proved more successful than we could have imagined. Over time Liv’s energy picked up and his thinking grew clearer. He became more optimistic.” (Clem 241).