Review: The Best Minds, by Jonathan Rosen

There was a time when Michael Laudor was one of the most prominent mentally ill people in the United States, and by extension, the world. The youngest son of an upper-middle-class family in Westchester county, Laudor was marked as a brilliant mind from childhood, frequently referred to as a genius. He breezed through the curriculum in high school, impressing everyone around him with his eccentric and sharp mind. He finished his undergraduate education at Yale in three years, then got a job with the prestigious (and well-remunerative) financial firm Bain Capital. But in his early 20s, Laudor was beset by hallucinations and paranoia, experiencing sometimes-violent delusions that frightened his devoted parents. He was diagnosed with schizophrenia and spent eight months in a psychiatric facility. Undeterred, he emerged to attend Yale Law School, where he became a favorite of the dean and championed by the faculty. He was profiled in a glowing New York Times piece that represented his resilience as a symbol for the mentally ill everywhere. This inspiring story led to a $600,000 book deal with Scribner, as well as a $2 million Hollywood development deal, one that attracted the interest of luminaries like Ron Howard and Brad Pitt. Laudor was frequently contacted to comment on issues of mental health and became a kind of citizen activist, calling for autonomy and respect for those with mental illness. He was a symbol of success for a whole community of vulnerable people.

Then he hacked his pregnant girlfriend to death with a kitchen knife.

The forthcoming book The Best Minds: A Story of Friendship, Madness, and the Tragedy of Good Intentions is author Jonathan Rosen’s account of Laudor’s story, and it’s one he has a valuable perspective on: Rosen and Laudor were best friends in late childhood and adolescence. They shared a neighborhood, the status of bookishness and academic precocity, and parents who embraced academic life and a certain Jewish perspective tinged by the old country and the Holocaust that lay in contrast with the easy integration into American culture of their sons. They were, as is the norm with these relationships, both friends and rivals, each possessed of the vague literary aspirations that are common to smart kids and inclined to drift towards the inevitability of graduate education. The first part of the book is a straightforward exploration of the life of two somewhat-secular Jewish high school students in the Westchester suburbs in the 1970s and 80s. It’s an important portrayal, both because it establishes the unique character of Michael Laudor and sets the (mostly) idyllic backdrop for Laudor’s tragedy.

“The best minds” of the title refers to Laudor, who’s brilliant by wide affirmation and whose intelligence and intensity are now inextricable from his illness, at least in the popular understanding. But it also refers to the people who created the medical and social context in which the murder occurred - the mental health advocates who fought (and fight) against the effort to hospitalize patients who are psychotic or otherwise dangerous, the anti-psychiatry movement that has demonized treatment of debilitating medical conditions, the media that wanted to see Laudor in nothing but facile storybook terms and so of course could see nothing else, the various authority figures and community members who had enabled Laudor’s uninterrupted descent into madness because they thought it was the right thing to do, and the family members and friends who were unable to see how obviously, cripplingly sick he had become near the end. These are the good intentions of Rosen’s subtitle, and though none of those people are to blame for the death of Laudor’s girlfriend, a dedicated and kind woman named Caroline Costello, they collectively created the conditions that made her death inevitable. For a variety of political and cultural reasons - ones I have been trying to document in this space for years - they had arrived at a place where avoiding stigmatizing Michael Laudor was more important than protecting the life of Caroline Costello. The Best Minds is the narrative of a troubled life, but it’s also a quiet and quietly damning indictment of the magical thinking that has ruined contemporary mental healthcare.

Rosen tells Laudor’s story, and his own, in an unhurried fashion, hanging period details liberally and engaging in various forays into the history of mental illness, legal education, and the greater New York metro area. Rosen speaks about his Judaism with a combination of commitment and veiled detachment that I know well from my childhood surrounded by the children of Jewish professors. The Best Minds is in its own way a deeply religious text, though a polyglot and ecumenical one. Its overt interest in religion, albeit more in terms of culture and myth than theology, helps to bring moral questions to the fore. The story of Cain and Abel preoccupies Rosen and serves as a grim symbol for his connection to Laudor, who appears to have been more conventionally observant than Rosen. Throughout, religion serves as a subconscious influence that speaks to lost traditions and the demise of community. What happened to Michael Laudor could have happened to anyone who was brilliant and sick, and yet The Best Minds is a deeply and richly Jewish story.

The book is also an excellent primer on the glories and failings of elite academia, portraying Yale as a kind of magical place where Michael was sheltered and nurtured and where his problems were subject to benevolent, willful neglect. The gothic walls of Yale seem to have created a space of comfort for Laudor, and the many colorful personalities from his law education remind me of the absent-minded professors I grew up around. It’s hard not to wish that Laudor could have stayed at Yale forever, where the standards were high but the pressures low, where he had a sympathetic and progressive community filled with people inclined to make accommodations for his needs. But the story also demonstrates that academia, particularly in the august halls of the Ivy League, is no preparation for real life, and that its smiling permissiveness was for Michael Laudor a kind of abandonment. The academic romance for beautiful madness can be an awful trap, and it’s all bound up with the university’s definition of worth. As Rosen writes, “it was easier to be brilliant than smart, and easier to be smart than competent.”

The powerful, subtly despairing final section of the book pulls apart the threads of pathology that run throughout our “conversation on mental illness,” as I have tried to do in the past. With Michael’s story effectively ended, culminating in his now quarter-century-long commitment to a high-security psychiatric facility, Rosen is free to look at what we’ve made of our responsibility to the mentally ill and lament. His perspective is ruminative and unhurried; the book can’t be said to be polemical. But Rosen has a point of view, and it’s one that’s badly needed in a culture that’s throwing itself deeper and deeper into a pleasant fiction.

The point of this kind of book is to take a particular story, narrativize it effectively, and in doing so make some larger point about our society. The beauty of the Michael Laudor story, so deeply unbeautiful, is that the argument makes itself. Laudor was a symbol of what people with severe mental illnesses could be and do, when he was being celebrated in the pages of the New York Times, and in killing Caroline Costello he was also a symbol of what people with severe mental illnesses can be and do. There is none of one without the other. Rosen shows an expert hand in synthesizing these realities - the great heights the mentally ill can climb to, and also the rare but very real acts of unspeakable violence they can commit. The problem isn’t that his argument isn’t compelling. The problem is that it’s an argument that the tastemakers in our culture simply don’t want to hear.

Consider deinstitutionalization. Few things could be less popular or esteemed in the public imagination than long-term mental healthcare facilities. People with no personal experience with mental illness themselves often have a visceral reaction to the very idea of institutions, assuming them to universally be houses of horror. And so deinstitutionalization, in a crude sense, is quite popular. It’s impossible to say if deinstitutionalization contributed to this story’s tragedy; after all, Laudor was committed to an institution for eight months and was released when his doctors felt he was suitably prepared to return to the world. But still, deinstitutionalization haunts the book as it does American mental health care, sixty years since John F. Kennedy signed the bill that forced so many long-term care facilities to close and which ushered in a new system of community mental healthcare - a system that we never bothered to build, forcing thousands of severely ill patients out of the institutions and into the jails or onto the streets. It’s the reality that underlies everything else that happens in this space, and a record of deadly optimism and witless good intentions, which still plague us. Rosen captures this brilliantly.

Money had replaced community mental healthcare the way medication had replaced state hospitals. Medication did not go looking for those who resisted taking it, and money could not administer itself. Neither came with counseling or support. The SSI checks Michael received, and the Medicaid requirements he was eligible for, did not create a caring community or even an indifferent one. Nevertheless, checks and pills were what remained of a grand promise, the ingredients of a mental healthcare system that had never been baked but were handed out like flour and yeast in separate packets to starving people.

Rosen references testimony from the late 1980s, when the National Institutes of Mental Health was queried by Congress as to where those released during deinstitutionalization had gone. They could not account for almost 60% of those patients. Which should not be surprising: then, as today, the pressure is not to throw away the key but to “street” patients as quickly as possible. The biggest problem in American mental healthcare is not people getting stuck in the system but those who need to get in and can’t. (Ask Bailey Hamor’s parents.) Spots in halfway houses and supportive housing can be brutally hard to secure; stays in those places are always temporary and rarely free. Peppered throughout the remarkably well-researched volume are real-life stories of suffering people caught in the undertow of good intentions. Like Joyce Brown, a violently schizophrenic homeless woman who displayed all sorts of nakedly unhealthy behaviors. She was freed from long-term care thanks to the dogged efforts of the ACLU, which opposed her continued treatment - in defiance of the strenuous and repeated objections of her sisters, who had struggled to care for her for years and who knew her to be too deeply sick to be set free. But set free she was, set free onto the streets to experience homelessness, heroin addiction, and early death. Again, the central question of deinstitutionalization rings out: what did you think was going to happen?

As Rosen unsparingly documents, the efforts to “destigmatize” mental illness have created a perverse scenario in which mental health advocates - who will tell you that their goal is to make mental illness more visible - push the darkest parts of mental illness deeper and deeper into the closet. You see, the fact that mental illness indisputably increases the odds of committing certain acts of violence could be said to stigmatize the mentally ill, so it must not be mentioned; that some mentally ill people commit sexual offenses could be said to stigmatize the mentally ill, so that must not be mentioned; that some people with mental illness commit hideously brutal acts of self-injury could be said to stigmatize the mentally ill, so it must not be mentioned; that some people with mental illness play with and eat their own excrement could be said to stigmatize the mentally ill, so it must not be mentioned. I beg you to understand what’s happening here: the further we go with the normalization and destigmatization of mental illness, the more the most severely mentally ill must be avoided, marginalized, dismissed, disappeared, explained away. An effort that ostensibly exists to help the mentally ill has washed its hands of the most debilitated. Every day that people with Ivy League degrees, laptop jobs, and ADHD nominate themselves as the face of mental illness, while others dismiss the prevalence of very ugly behaviors that very much do occur, is a day that the violent homeless schizophrenic person who needs our sympathy the most loses more and more of it. It’s a despicable reality.

Rosen points out that newspapers tended to say that people like Laudor had “a history of schizophrenia,” rather than that he was schizophrenic, as if embarrassed to acknowledge that for some people this was a lasting and defining affliction. As Rosen writes, “What did it say about stigma if you had to denature something before you acknowledged it?”

Even Rosen repeats the well-worn trope that the mentally ill are more likely to be the victims of crime than to commit it. As I will go on pointing out, this is true but entirely trivial: because a small percentage of offenders commit a large majority of violent crimes, almost any identifiable group will be more likely to be the victims of violent crime than the perpetrators. This tells us literally nothing about the underlying prevalence of violent crime among that group or how that prevalence compares to the population writ large. And as the link to the National Institutes of Health above shows, some populations of mentally ill patients - those with psychotic disorders, those with paranoid ideation, those who resist treatment - sometimes do very bad things. Rosen’s book is admirable in its unflinching portrayal of those things. Like, say, the man in an institution who strangled his roommate to death with a pair of tied-together socks and then proceeded to break every one of his roommate’s fingers before they were found.

Awhile back, I pointed out an essay in which the author went to great lengths to deny that any of Kanye West’s instability, any unfortunate behavior at all, could ever be related to his mental illness. Later, she said this.

This is, I think, the inevitable, rotten conclusion of social justice norms about mental health. You see, if mental illness is normalized as it should be, then mentally ill people are normal, and if mentally ill people are normal, then behavior that is abnormal cannot be caused by mental illness. QED.

The district attorney in charge of the prosecution of Michael Laudor was vociferously opposed to his evading prosecution or imprisonment in a correctional facility due to his schizophrenia. The prosecution wanted him to go to regular jail, and fought to achieve that outcome for months. The question that should immediately demand our attention is, what’s the difference between that district attorney’s perspective and that of Jody Serrano? The former is the product of a conservative, tough-on-crime, no excuses attitude towards mental illness; the latter is the expression of a witless, condescending, self-righteous, social media-derived definition of “mental illness” as a series of adorable personality quirks, found in otherwise totally unobjectionable and high-achieving professionals. But the ultimate moral and legal place where they land must be the same: Michael Laudor should not have avoided a conventional criminal trial and ordinary state prison thanks to his mental illness. After all, we must not dismiss someone’s poor behavior as the result of mental health conditions. I’ve used the example of James Holmes before, and I will again: a single juror spared James Holmes from execution for his crimes because that juror recognized that he had been in the grips of crippling schizophrenia. Well, here’s Jody Serrano to tell you that James Holmes should have been put to death. Otherwise, we facilitate stigma. 💜

This book felt like a glass of cold water because I’ve pushed against this awful movement for a long time and see no reason to believe it’s going to get any better. I look and look for some grappling with the messy, sad, sometimes tragic reality of mental illness in major media and I find nothing. I’ve tried to pitch stories to prominent places myself; they don’t even email back to say no. Meanwhile a new doctrine of “destigmatization” gains power every day on TikTok, Twitter, and Tumblr, driven by people whose mental illnesses seem never to have seriously inconvenienced them in any way. So you can imagine how (if you’ll forgive me) therapeutic it felt to read Rosen say things like “when Jeanine Pirro told a newspaper that ‘it would be an insult to every mentally ill person in this country to say that because someone is mentally ill they are more prone to violence,’ I did not feel she was championing the rights of people with mental illness.”

The book is not perfect. My galley copy exceeds 500 pages, and the pace is sometimes off, particularly in the early going. I think something like 25 or 50 pages could be trimmed without losing any of the book’s remarkable accumulative force and in so doing adding a little more momentum. In particular, I think the book’s opening depiction of the shared childhood and adolescence of Rosen and Laudor could stand a little pruning. I get it; the book is not a manifesto, and it has to build its argument with the steady accumulation of sad details that lead to the tragedy of Caroline Costello’s death. Establishing exactly who Michael Laudor is and was, obviously, is key to that effort. But that portion of the book is a little slow, and there are moments elsewhere in the book where I would also cut a page or three.

I half suspect that Rosen spends so much time talking about the early days of his friendship with Laudor in part to burnish his credentials as someone uniquely well-suited to tell the story. This is relevant because, as Rosen admits, he and Laudor had drifted apart even before Laudor’s schizophrenia diagnosis. What’s consistently unclear to me is just how far apart. When Rosen described his own wedding as an intimate affair, I understood why Laudor had not attended. But when we later learn that Rosen had not gone to Laudor’s father’s funeral, I was genuinely surprised. The two boys, and the two families, had been so close. I understand that there was a little bad blood with Laudor’s father over a controversy regarding the high school newspaper, but, well… it’s the high school newspaper. The high school newspaper shouldn’t permanently estrange people. It suggests that the rift was wider than the book wants to admit, given that its marketing heavily stresses Rosen’s relationship with Laudor. Which is unnecessary; Rosen clearly does have a unique and valuable perspective, and anyway the book’s great feat is not a triumph of memory but of research.

At times, a part of me wanted Rosen to be a little more explicit, to more directly and unambiguously look into the camera and tell us how he felt. I wanted him to say “this is what a healthy, fair mental health discourse would look like.” But I understand that The Best Minds isn’t that book. Instead, it’s a brilliantly realized American tragedy, one that argues obliquely and emotionally rather than in speeches. When it does come right out and say it, the result is stirring and sobering. Near the end of the book, Rosen writes “Violence and mental illness have been legally entangled ever since dangerousness, rather than illness, became the necessary prerequisite for hospitalization.” And this really is the heart of it: in an effort to ensure the autonomy and rights of those with mental illness, we created a system where you have to be violent to be taken seriously, and where absent violence the people who love you most and know you best have no recourse for forcing you into treatment when you desperately need it. If ever there’s been a tragedy of good intentions, there it is. The Best Minds is a chronicle of that tragedy. I think it’s the best book about mental illness I’ve ever read.