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In medicine, we tend to think of certain biological events as impressively complex, such as the role of sodium channels in heart rhythm disturbances. But when viewed through the lens of psychiatry, these molecular interactions seem rather simple. An aberrant heart rhythm is a straightforward electrochemical process. An aberrant thought process, however—hallucination, delusion, personality disorder, psychotic break, impaired judgment, lack of insight—is far harder to dissect. Scientific strides over the last century have changed the face of psychiatry and we have a much greater understanding of the biological underpinnings of many mental illnesses. Nonetheless, deciphering the anomalies of the mind and brain remains challenging.

One aspect of this is that many symptoms of mental illness intersect with the spectrum of "normal" behavior. There are people who seem quirky, some who appear odd, others grandiose or in their own world. Are the mechanisms of mental illness distinct unto themselves? Or are they, at times, merely a broader expression of our complex personalities? The elusive nature of human behavior is frustrating but also tantalizing—both from a scientific and a literary perspective.

When we announced this special issue of the Bellevue Literary Review—"Landscapes of the Mind"—focusing on the broad continuum of the mind and its maladies, we were inundated with submissions. The dizzying variation in how the brain can go awry is clearly a potent stimulant for creative expression.  Of course, this is not surprising; if novels were written only about problem-free people, the literary canon would be dull indeed. Every unhappy family, as Tolstoy famously noted, is unhappy in its own way.

Lauren K. Alleyne's poem, "On January 24th," illuminates a battle against depression, worsened by seasonal misery. The poem "In the Briars," by Colleen McKee, and the essay "By My Own Hand," by Anita Darcel Taylor, are two views on the life-and-death questions that serious depression can precipitate. In the story "Nobody Walks," Sarah Hong writes of a Korean Canadian teenager, abandoned by both parents, stranded in a bitter, surreal Dallas, Texas.

Love, or fractured attempts at love, is a consistent theme in many of the stories. Mental illness strains all manner of relationships. In Ami Sands Brodoff's story Brother's Keeper, two Costa Rican brothers are riven by alcoholism. Another pair of brothers in Kentucky wrestles with the emotional fallout from bodily damage in Jim Tomlinson's "Lake Charles." In "Translation Memory," by Midge Raymond, a husband and wife are saddled with conflicting responses to tragedy during a visit to Japan. In Alex Bartel's story, "Crackers," a daughter debates responsibility for her father's increasingly bizarre behavior. In "World's Fair," by Kathleene Donahoo, a man's guilt and responsibility for his unstable ex-wife spill into his new, seemingly settled, life.

The psychiatric experience is explored in this issue, from both sides of the couch. Peter Schmitt's poem, "Thanksgiving: Visiting My Brother on the Ward," is a poignant look at the healing and the loss of freedom that a psychiatric hospital can offer. The protagonist of Elizabeth Downs's story, "In Lieu of a Better Plan," has a failsafe strategy to escape from the hospital, if only she could remember it.

Two psychiatrists have the opportunity to reflect upon their own immortality. Ralph Crawshaw, in his essay "Pushing the Geriatric Envelope," considers the implications of shifting from caring for others to caring for himself. In "The Room of Small Gods," Paula V. Smith offers a fictionalized account of Sigmund Freud's last days, from a rather unusual point of view.

This special issue of the Bellevue Literary Review is supported, in part, by a generous grant from the New York State Council on the Arts, for which we are very grateful. We are also indebted to the cadre of BLR reviewers who volunteered their time to help us read the outpouring of writing that was submitted for this issue. We hope you enjoy the variety of styles, topics, interpretations, and viewpoints on the vast landscape that separates—and unites—human minds in health and in illness.


Danielle Ofri, MD, PhD, DLitt (Hon)