And he is better than ever, for he has come down with a case of that wonderful nineteenth-century disease, "brain fever." The symptoms of this illness always, conveniently, are exactly what the author needs them to be. I say that's a good thing. Not to pick on Ian McEwan or Richard Powers again--but what the hell--I think there's a potential loss when a writer builds a character around a specific diagnosis of mental illness. In McEwan's Saturday and Enduring Love, and in Powers's Echo Maker, I sense that diagnosis takes the place of character. It's as if diagnosis itself drives the story; I picture the authors scouring a detailed list of symptoms, seeing what else has to be covered. Now, I hugely admire both of these authors, and I am certain my suspicion of their meticulous research can be partly explained by my own laziness. But this clinical style of novel, while interesting and valuable in itself, does not so easily leap into the metaphysical, which is where I, personally, like to end up.*
Whereas Dostoevsky, or more precisely his narrator, gives himself carte blanche to do with Ivan's brain fever what he will:
I am not a doctor, but yet I feel that the moment has come when I must inevitably give the reader some account of the nature of Ivan's illness. Anticipating events I can say at least one thing: he was at that moment on the very eve of an attack of brain fever. Though his health had long been affected, it had offered a stubborn resistance to the fever which in the end gained complete mastery over it. Though I know nothing of medicine, I venture to hazard the suggestion that he really had perhaps, by a terrible effort of will, succeeded in delaying the attack for a time, hoping, of course, to check it completely. He knew that he was unwell, but he loathed the thought of being ill at that fatal time, at the approaching crisis in his life, when he needed to have all his wits about him, to say what he had to say boldly and resolutely and “to justify himself to himself.”
He had, however, consulted the new doctor, who had been brought from Moscow by a fantastic notion of Katerina Ivanovna's to which I have referred already. After listening to him and examining him the doctor came to the conclusion that he was actually suffering from some disorder of the brain, and was not at all surprised by an admission which Ivan had reluctantly made him. “Hallucinations are quite likely in your condition,” the doctor opined, “though it would be better to verify them ... you must take steps at once, without a moment's delay, or things will go badly with you.” But Ivan did not follow this judicious advice and did not take to his bed to be nursed. “I am walking about, so I am strong enough, if I drop, it'll be different then, any one may nurse me who likes,” he decided, dismissing the subject.
Perhaps fortunately for Dostoevsky, the MRI and psychopharmacology had not been invented, so illnesses of the brain did seem more existential--or as special connections to God or the devil. (Dostoevsky's own epilepsy allowed him to think of himself as a kind of seer, although he well knew it was an illness too.) Still, I see no reason why our technologies should bind us. A few disclaimers, admitted conjectures, a "new" but unseen doctor who predicts "hallucinations," and you're good to go. Is Ivan schizophrenic? Does he have a tumor? It doesn't matter. Better not to know, because the real suggestion is that Ivan has driven himself mad, by trying to understand God intellectually. It's this intellectual madness, rather than any plausible illness, that has given us "The Grand Inquisitor," and now, Ivan's fascinating conversation with Satan himself--who both is, and is not, a figment of Ivan's imagination.
The whole conversation with the devil as a "poor relation"--dapper but shabby on closer inspection--probably requires a post of its own. For now, I'll leave you with this suggestion: in fiction, there's nothing wrong with making up your own mental illnesses. Your story might even suggest to you the type of illness it requires.
*I do not think this is the case with Atmospheric Disturbances, Rivka Galchen's wonderful novel, which, like The Echo Maker, deals with Capgras Syndrome: the belief that other people are imposters. While Galchen, a medical doctor, understands the syndrome thoroughly, her touch with it is lighter, more lyrical. Her interest in the illness is primarily aesthetic and existential, and not so much in the plot entanglements such a condition might lead to.
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