How one pediatrician overcame a misdiagnosis, impossible family expectations and the never-ending battle within his own mind

It took him 20 tries before he finally got accepted to medical school. 

Had he been trying to get into a master’s program for creative writing, Mark Vonnegut might have had an easier time. But for the eldest son of iconic American novelist Kurt Vonnegut – and this year’s guest lecturer at MUSC’s 16th annual Jason Pressley Visiting Professorship – he would have applied 200 times, if that’s what it took to prove he was more than the son of a famous writer – or a stigmatizing diagnosis.

 

His story is one seemingly right out of the pages of one of his father’s works: Boy graduates from college; gets a job at a bookstore; leaves to become chief of police, before a change of heart briefly leads him down the path to becoming a Unitarian minister. It was a chaotic two-year period for Mark Vonnegut, marked by poor dietary decisions and heavy drug use. This reached a breaking point in 1971, when, at just 23 years old, erratic behavior landed him in front of a doctor who diagnosed him with severe schizophrenia. He was immediately committed to Hollywood Hospital, a mental health facility in Vancouver. There, he was introduced to psychotherapy, a series of unsupportive medical personnel and what he would eventually call “rock bottom.”

“Once you’ve been talked to by voices, it’s not possible to go back to a world where those voices don’t exist,” he wrote in his second book (turns out he couldn’t escape the family literary gift), “Just Like Someone Without Mental Illness, Only More So.”

 

 

But through it all, he never gave up on himself and thanks to a little luck, a possible placebo (he was convinced he began to recover because of some vitamins he was taking) and the quest to educate himself on mental illness more fully, he began to improve. It was during this time that he felt his true calling was in an area where he had been so badly mistreated: health care. Which brings us to that 20th application, the one that resulted in his acceptance to Harvard Medical School, no less – a fact he “still can’t get over.”

Not long after graduating and becoming a licensed pediatrician, he arrived at the conclusion he had bipolar disorder, not schizophrenia. Bipolar disorder, formerly known as manic depression, is characterized by unusual shifts in mood, ranging from extreme highs to low lows. According to the National Institute of Mental Health, bipolar disorder affects approximately 5.7 million adult Americans, or about 2.6% of the U.S. population age 18 and older every year.

Thanks in large part to a better understanding of his own diagnosis, in the 40-plus years that followed, Vonnegut built a successful pediatric practice in Massachusetts, got married, had children and, naturally, became a best-selling author. To date, he’s written three books: “The Eden Express,” the aforementioned “Just Like Someone …” and “The Heart of Caring: A Life in Pediatrics,” which was published last year. Over his lifetime, he’s spoken at numerous conferences and has been published in the New England Journal of Medicine and the Boston Globe, among others, on topics ranging from Attention Deficit/Hyperactivity Disorder to mental illness.

On Oct. 6, Vonnegut served as the keynote speaker for an event that honors someone much like him, Jason Pressley, who died in 2000 at the age of 26, due to complications from bipolar disorder. The NIMH states that as many as one in five patients with bipolar disorder will die by suicide. During his talk, Vonnegut quoted writers, doctors and philosophers, using humor and wit to hit home many of his points. He also spoke about how, in a way, he understood why he was originally misdiagnosed.

 

"Fifty years ago [schizophrenia] wasn’t that uncommon of a diagnosis for someone with a first psychotic break, especially when they looked like an old testament prophet and is incoherent and combative, like I was," he said to the online audience numbering in the hundreds. 

The event was hosted by MUSC’s Department of Psychiatry and Behavioral Sciences and served as the first of two important contributions from Vonnegut. In the near future, department Chairperson Thomas Uhde, M.D., will join forces with Vonnegut on a project that is near and dear to both of their hearts: a Center for the Study and Advancement of Health and Well-Being in the Creativity Gifted. Uhde, who has spent a good portion of his career working with bipolar patients as well as a range of other creatively gifted people, hopes that the collaboration will lead to a unique facility, right here at MUSC.

As a part of that vision, Uhde sees a place where clinical scientists can investigate the neuroscience behind creativity as well as identify novel strategies to develop or enhance the creative process. Uhde's department has several faculty members – Bryan Tolliver, M.D., Ph.D.; James Prisciandaro, Ph.D.; Frampton Gwynette, M.D.; and Lee Lewis IV, M.D. – with expertise in the study and treatment of creatively gifted individuals who often suffer from mood, anxiety or substance use problems. It would be their goal to improve the health and well-being of these individuals using, for example, techniques such as improvisational theater or music as treatment modalities. 

 

Over the years, a substantial body of literature has linked bipolar disorder as well as other mood and anxiety problems with creative accomplishment. Biographical data suggests that mania, depression or anxiety may have affected the likes of Ernest Hemingway, Virginia Woolf, Vincent van Gogh, Sylvia Plath, Jimi Hendrix and Amy Winehouse, just to name a few. 

“There’s no question there’s a connection between mood disorders, especially bipolar disorder and creativity, which has led to some of the most phenomenal contributions in the world of art, music and science,” Uhde said. “I’m hoping that if we’re able to focus on the source of that creativity and get to better understand it, we might eventually be able to use things like music, art, poetry, you name it, as viable treatment options.” He also emphasized that the ability to think creatively is also a critical skill for physicians to develop because in their professional lives they will inevitably be challenged by patients suffering from medical illnesses who are resistant to standard treatments. "Accessing one's creative mind becomes especially important and potentially life-saving under such circumstances."