72 Hour Hold • Mr. Muo's Travelling Couch

The novels 72 Hour Hold and Mr. Muo's Travelling Couch cast psychiatrists and professionals in related mental health fields in a strange light indeed. From novelist Bebe Moore Campbell, author of three New York Times bestsellers and a woman who has been active in NAMI, I had expected a fine, sensitive product. What I read was bizarre and not very engaging. I wasn't sure what to expect from Dai Sijie, a Chinese filmmaker and novelist who has lived in France for the past 20 years and who wrote Mr. Muo's Travelling Couch in French. What I found was a quirky main character in a quirky tale told in a quirky fashion.

In 72 Hour Hold, Keri, a divorced working mother, is struggling to keep her only child, Trina, on track to start her freshman year at Brown University after a one-year hiatus due to Trina's decompensation from bipolar affective disorder. Keri's ex-husband is upwardly mobile and asset oriented. She also has an off-again/on-again struggling actor lover/ex-lover. Other characters in her life include two women who work in Keri's business, an upscale recycled women's clothing store.

The first half of the book will be familiar to anyone who works with individuals with chronic mental illness but will provide a reasonable education for the uninitiated. The plot is centered on Keri's difficulty in getting adequate treatment, particularly acute inpatient treatment, for her daughter. Keri rarely achieves the 72-hour hold she seeks, and on the few occasions she does, her daughter is discharged without that 72-hour stay being extended. The mother's anguish is clear; the daughter's pain is perhaps underplayed. Keri describes her daughter: "My daughter's smile was bright and expectant, manipulative. Regardless of what it had taken away, mental illness had conveyed to her a kind of protracted childhood. A long pause filled with delusions of grandeur, no responsibility, very few apologies, and endless adventure."

The second half of the book is inexplicable. From out of nowhere, Campbell adopts an Ian Fleming mode, with a renegade psychologist playing her James Bond. Unable to obtain the treatment that Keri would like to get for her daughter, she finds a cohort of psychologists, psychiatrists, and former clients' families who are running an underground railroad type of operation to illegally hustle individuals who don't want psychiatric treatment to secret locations where they are involuntarily treated. This cohort of practitioners proclaims, "We are a group of psychologists and psychiatrists who believe that the mental health system in this country is a sad joke." This group's remedy is to break every rule; violate enumerable statutes; abuse individuals' rights; and treat them at the remarkable cost of $12,000 a month for an average stay of six months to a year—hence, a cost to the family of $72,000 to $144,000.

Imagine that! In upscale Los Angeles, Keri could not find any private psychiatric hospital that would have managed to provide treatment to her daughter at a $100,000 price tag. And 72 Hour Hold, besides degenerating into a cat-and-mouse pulp fiction thriller, has other surprising problems. From my read, it stigmatizes mental illness through its use of demeaning language. For example, when Trina takes up with a boyfriend who has a psychiatric history, Keri wonders, "What was he, a bipolar on a manic tear? A schizophrenic with just enough meds in him to silence his inner voices? A crack-head, a speed-freak, an alkie? How has his mental state undermined my child's thought process?" And although perhaps not politically correct, I thought Campbell's efforts to insert African-American history into this tale of an African-American family seeking good psychiatric treatment was forced. I was emboldened to include this in the review by finding that other reviewers had the same take (1).

Campbell has made it clear that although her book is fiction and not autobiographical, she has a family member with mental illness and has, for the last nine years or so, been involved with that family member's efforts to get adequate psychiatric treatment (2). If 72 Hour Hold is an attempt by Campbell to decrease stigmatization to, as she has said, "get people to come out of the closet about having mental illness" (2) and explicate that recovery is possible, she fails in 72 Hour Hold. As much as I am sorry to say so, I can't recommend this book.

In Mr. Muo's Travelling Couch Dai Sijie presents the tale of Mr. Muo, "a Chinese-born apprentice and psychoanalyst recently returned from France." The tale is not told in chronological order, which sometimes makes it difficult to follow. The plot through the first one-third of the book is mostly an introduction to Mr. Muo and his prowess as a psychoanalyst. Psychoanalysis, however, is somewhat mixed up with shamanism and fortune telling, often by the uneducated populace of China, with whom Mr. Muo interacts, but sometimes by Mr. Muo himself. Mr. Muo, who is a small bespectacled man, more naive than even the barely pubescent female peasants who have never left the commune and with whom he has many interchanges, is a little bit like Charlie Chaplin, bumping into himself at every turn.

Mr. Muo's Travelling Couch also departs radically from its opening chapters. Much of the book is written as if the author were a Cervante emulator writing about a Don Quixote variant in China. Mr. Muo seeks to obtain the release of the woman on whom he has had a crush since childhood, who is a political prisoner. In his quest to get her released, Mr. Muo participates in getting his first and only sexual partner imprisoned in the same prison. The means by which he can obtain their release? He must present a virgin to the judge who can be bribed not by money but by the deliverance of this virgin.

Mr. Muo is probably one of the few bicycle psychoanalysts that one will encounter either in literature or in real life. He makes a banner, attaches it to his bike, and rides out into the countryside to drum up business for instant dream analysis. Everywhere Mr. Muo goes, misfortune befalls him: he is robbed, beaten, mistaken for a dangerous escaped psychiatric patient and psychiatrically hospitalized, proposed to by the most unattractive woman he could imagine, doubted, discredited, and jeered at.

What does one learn from Mr. Muo's Travelling Couch? That an educated man can know nothing? That a psychoanalyst can be a fool? That persistence doesn't pay off? I really don't know.

The last line of Mr. Muo's Travelling Couch is, "Tell me, my dear, are you a virgin?" While the reader travels all over China with Mr. Muo and hears lots about his days in France, that last sentence tells the reader that we haven't gotten anywhere. One thing is for sure, Mr. Muo's Travelling Couch should have psychoanalysts quaking in their offices.

Dr. Geller is professor of psychiatry and director of public-sector psychiatry at the University of Massachusetts Medical School in Worcester.