Brief Book Reviews: July 2025

BRIEF BOOK REVIEWS

Popular Books Relevant to Mental Health

The Best Minds: A Story of Friendship, Madness, and the Tragedy of Good Intentions

Jonathan Rosen; Penguin Press, 2023

576 pages; $15 (hardcover)

Reviewed by Edmund S. Higgins, MD

In this book, Jonathan Rosen writes about Michael Laudor, his best friend from grade school through college. Laudor was a gifted young man: brilliant, charismatic and handsome. Everything came easy to him. But after breezing through Yale in 3 years and winning all sorts of awards, he became convinced his parents were Nazis and started carrying a kitchen knife for protection. He was admitted to a locked psychiatric ward, diagnosed with schizophrenia, put on risperidone, and was not released for 8 months.

After a brief stay in a halfway house, Laudor was admitted to, and completed a law degree at Yale. While this is an extraordinary accomplishment for someone with a serious mental illness, reading between the lines, it seems that Laudor lost some cognitive skills due to the illness. To finish law school, he needed substantial help from his peers. Moreover, after graduation, he was never able to practice as a lawyer.

Laudor’s story captured the interest of the New York Times and Hollywood. Director Ron Howard bought the rights to the movie and Brad Pitt was hired to play the lead. Scribner Books from Simon & Schuster paid $600,000 for Michael to write his memoir . . . only, he could not. The film was never made. And worse, he stopped taking his medication, unraveling further and ultimately leading to tragedy.

For those of us in the field, it is a fascinating and heart wrenching in-depth case study of a gifted person who appeared to conqueror a serious mental illness. That being said, the book is on the long side with too many added side stories and fillers. To optimize your time, consider skipping the first 2 parts and start with part 3. You will easily integrate into the most interesting aspects of the story while preserving time for other projects. Regardless, it is a fascinating, heart wrenching story.

The Center Cannot Hold: My Journey Through Madness

Elyn R. Saks; Grand Central Publishing, 2007

368 pages; $14 (paperback)

Reviewed by Edmund S. Higgins, MD

Elyn Saks’ memoir of her life with schizophrenia is a phenomenal story that challenges our understanding of this disorder. Like Michael Laudor, Saks was diagnosed with schizophrenia and completed Yale Law School. Unlike Laudor, she has continued to excel. She became a tenured professor of law at the University of Southern California, and was awarded a MacArthur Foundation fellowship, affectionately called the “Genius Grant.”

Furthermore, she has had numerous, mutually-engaging, long-lasting relationships. In 2001, in her mid 40s, she got married and has remained so. To put it succinctly, she does not have negative symptoms of schizophrenia (for those who doubt, she shows her expressiveness in her Ted Talk titled, “A Tale of Mental Illness—From the Inside”). Saks understands that clinicians might believe she has been misdiagnosed, so in the final chapter she presents a concise analysis of her diagnosis. It appears Saks has a form of schizophrenia without the cognitive or social signs of the disorder. Is that possible?

Make no mistake, she has struggled with psychosis; It is not subtle. She has remained on high doses of antipsychotic medication: initially 36 mg thiothixene, later 40 mg olanzapine, and after that 600 mg clozapine. At times, she has been floridly psychotic and disorganized (less so as she has matured), and still retains residual delusions. For example, at her wedding she asked a friend, “Will aliens be attending the reception?” She was not joking. On the occasions when she was able to convince her doctors to lower the dose of her medications, the old symptoms returned with a vengeance.

It might be of particular interest for psychiatrists that her treatment was more than medication management. She remained in active, ongoing psychodynamic psychotherapy, sometimes as often as 4 times a week. The several therapists allowed her to “fall apart” and confront her most troubling delusions. Saks attributes success due to the human connections and unwavering support she received from these clinicians.

This is an outstanding book for psychiatrists. It a compelling story that is hard to put down, while at the same time giving a case study of a form of schizophrenia few of us will see in our careers.

Dr Higgins is an affiliate associate professor of Psychiatry and Family Medicine at the Medical University of South Carolina.