* I later learned that Honoree independently shared this torture-dream with me.

* Audio from the digital device was played at the trial of Bryon Vassey and small portions were quoted in the region’s newspapers, but at this writing, the Boiling Springs police department has not released the recording.

* Records suggest that Kraepelin himself diagnosed it; and scientists have speculated that he allowed his new colleague to take the credit because he did not want to be seen as the only psychiatrist successfully on the trail of mental illnesses that had organic sources in the brain.

† These are acronyms for computerized axial tomography, positron emission tomography, electroencephalography, magnetic resonance imaging, and magnetoencephalography.

* Just in case the reader is beginning to hope that these progressions are leading toward final enlightenment, a small monkey wrench of further ambiguity should be tossed here. In their paper “Schizophrenia: A Conceptual History,” published by the International Journal of Psychology and Psychological Therapy in 2003, the psychiatric researchers German E. Berrios, Rogelio Luque, and José M. Villagrán write: “It would seem that no crucial experiment has ever been carried out to demonstrate that ‘latest means truest’ or that ‘high usage’ constitutes adequate evidence for validity. Indeed, the only support for the ‘recency’ assumption is the view that in this paper will be called the ‘continuity hypothesis.’ By the same token, peer and medico-legal pressures are a better explanation of ‘high usage’ than ‘truth-value.’ In fact, there is no ‘objective’ or ‘empirical’ way to decide which of the various definitions (referents) of ‘schizophrenia’ should be considered as the definitive RRUS.” Have a nice day.

* Torrey, the research psychiatrist who has covered nearly every aspect of mental illness in his books, is among those who believe that psychosis is on the rise and has been for more than three centuries. His 2001 book The Invisible Plague: The Rise of Mental Illness from 1750 to the Present, written with Judy Miller (New Brunswick, NJ: Rutgers University Press), will be discussed later in some detail.

† Whitaker is a leading critic of the profusion of antipsychotic drugs, which, he points out, are highly profitable to the pharmaceutics industry. (In this and other arguments, he differs from Torrey.) His 2010 book Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness (New York: Random House) offers statistical evidence that instances of schizophrenia are on a dramatic rise, and speculates that “psychiatric drugs are… fueling the epidemic of disabling mental illness.” (See chapters 13 and 15 for further discussion.)

* Similar exchanges have been attributed to Albert Einstein and Marilyn Monroe, Monroe and Arthur Miller, George Bernard Shaw and Isadora Duncan, Winston Churchill and Lady Astor.

* “Indefatigable” in part because, as Spiro reports, Grant’s relatives destroyed all his personal papers after his death in 1937. Nearly all of the hundreds of thousands of letters he wrote to prominent people are missing. Grant himself remained aloof from reporters, rarely granting interviews. He rejected the idea of an autobiography; Spiro quotes him writing, in a 1927 letter, that “the things of real interest and importance would have to be omitted.”

* Associate justices who joined Holmes in the majority were such progressive eminences as former president William Howard Taft and the great Louis Brandeis, the “people’s lawyer” who had helped pioneer the principle enshrined in law as “the right to privacy.”

* Faust had its full part 1 premiere in Braunschweig in 1829. The wild and chaotic part 2, which brings the play’s onstage time to twenty-one hours, has never been produced in full.

* All three films are adaptations of the 1895 novel The Island of Dr. Moreau, by the literary science-fiction writer H. G. Wells.

* The Health Insurance Portability and Accountability Act was created in 1996 to protect the privacy of hospital patients and jail/prison inmates by withholding their medical records from anyone outside their institutional caretakers, such as private investigators and predatory insurance companies. Critics have charged that its unintended consequences include shutting family members off from knowing the condition of their loved ones in hospital or jail, and from allowing clergy access to their parishioners.

* Post-structuralism, among its many other applications, interrogates language for its inability to convey truth, and for its concealment of power hierarchies. Deconstructionism, actually conceived in the 1960s by Jacques Derrida but not influential in the United States until the 1980s, seeks to discover ideological biases in traditional language.

* One study appeared as an editorial in the American Journal of Psychiatry in November 2000. It was written by Jeffrey A. Lieberman, who is director of the New York State Psychiatric Institute among many other affiliations, and the late Wayne S. Fenton, who was an associate director of the National Institute for Mental Health, and a psychiatrist well known for his courage in dealing with severely psychotic and often dangerous patients. On September 3, 2006, Dr. Fenton, fifty-three, was found dead in his suburban Washington office, having been fatally beaten by a nineteen-year-old patient whom the doctor had been counseling to resume his antipsychotic medications.

Lieberman and Fenton’s study had drawn the following conclusions, among others: “If patients are treated promptly and effectively, good outcomes can be achieved. However, these same studies have revealed that throughout the world, individuals suffering a first episode of psychosis experience an alarming delay between the onset of psychotic symptoms and the initiation of treatment. More than 10 studies conducted on several continents have described typical durations of untreated psychosis that average 1–2 years.”

While acknowledging new studies that cast doubt upon a prevailing belief that prolonged untreated psychosis inevitably results in “measurable neurotoxicity and lifelong disability,” the authors continued:

Undiagnosed and untreated psychosis imposes a significant burden of terror, suffering, and bewilderment on patients and their families. Impairments in functioning that accompany untreated psychosis wreak havoc on the normative processes of young adult development. The maturational tasks of establishing and maintaining a peer group, achieving independence from family, cultivating romantic interests, acquiring independent living skills, and preparing for productive work may all be disrupted at a most critical stage of development. These disruptions too often alter the trajectory of a young person’s life in a way that is not easily repaired. In addition, an untreated person with psychosis is at risk for episodes of behavioral dyscontrol, including violence, with the potential for long-lasting consequences for himself or herself and others.

* Dean had earlier confessed to me his regret that he probably would “never be an intellectual.” It was an insight into the damage done to his self-esteem.

* The boy’s name was Laird Stanard. In 2015 he was furloughed, with restrictions, from a Vermont correctional facility after serving fifteen years of a twenty-five-years-to-life sentence. As closely as I can determine, he was never given a psychiatric evaluation. His jailhouse tutor, the writer Theo Padnos, included Laird’s story in his underrated 2004 book about adolescent murderers, My Life Had Stood a Loaded Gun: Adolescents at the Apocalypse (Miramax). Laird told Padnos that he had developed a fantasy reinforced by the film American Beauty, which he had watched several times. The movie offered a vision of murder as a gift of transcendence, because a character who is killed—an adolescent’s tormented father—does not seem to really die: he narrates the film, commenting on the plot. He is serene, still sensate, hardly inconvenienced by his own demise.

* “Antipsychotics,” “psychotropics,” “psychoactives,” and similar terms are somewhat interchangeable, but with a few distinctions. “Psychoactives” and “psychotropics” both refer to any chemical mixture that reduces activity in the neuron-transmission process in the brain and spinal cord—the central nervous system. They produce tranquilizing effects and moderate thoughts and behavior. The same holds true for antipsychotics, the difference being that these compounds are far more potent than the others, designed as they are to control psychotic breaks.

* The name, as is true of most synthetic compounds, is an amalgam of its components. Examining those or any synthetic’s components can be an eye-opening excursion into the unexpected, usually counterintuitive range of adaptations for natural substances.

Thymox, for example, is an oil extracted from the herb thyme that has been used for cleaning dental equipment and the hooves of cattle. Ethyl is extracted from sugarcane. Its derivatives are used as an extraction solvent in pharmaceuticals, as artificial flavoring in industrial foods, in treatment for arthritis (in Chinese medicine), in varnishes and lacquers, and of course as the intoxicating ingredient in liquor. Diethyl is a distillation of ethanol and sulfuric acid and has been around since the sixteenth century. It is a component in starting fluid for diesel engines, is used in anesthetics, and is a recreational inhalant. Amine refers to an organic dye extracted from tropical plants. When modified and injected with its companion elements into the bloodstream, it (and dyes of other colors) adheres to the tissue under examination, making the tissue easy for scientists to identify. Amine’s fumes are said to stink to high heaven and to be fatally toxic when inhaled in its pure state. It has become an important ingredient in treating cancer, syphilis, and other diseases. In the 1950s it was a component in rocket fuel.

Bovet himself alluded to this, in an understated way, in his Nobel speech on December 11, 1957: “The origin of many drugs must be looked for in substances of a biological nature, and in particular in the alkaloids. The elucidation of their structure has been a starting-off point for chemists to synthesize similar compounds.” (See http://www.nobelprize.org/nobel_prizes/medicine/laureates/1957/bovet-lecture.pdf.)

* Later in life Lehmann, who in fact was an admirer of Freud, expressed his dismay that psychopharmacology led to what he called “cook book” psychiatry, in which the necessary intimate relationship between therapist and patient is lost.

* A more limited understanding of “intellectual property,” the international copyright protection of books and other artistic creations, was contained in the treaty created by the Berne (Switzerland) Convention in 1886.

* These dynamics were studied at an October 2015 roundtable discussion among researchers and developers sponsored by the Tufts Center for the Study of Drug Development. Ken Getz, director of sponsored research at the center, told the group that “drug development cycle times have not gotten faster, costs continue to increase, and drug development has become riskier than ever with only 11.8% of products that enter clinical testing receiving regulatory approval, about half the rate of the 1990s.” Adding that advantage would accrue to companies able to reduce “clinical time and cost” of this cycle time [which another Tufts study estimated at nearly nine years from the start of human testing to the marketplace], Getz offered a figure that by itself illuminates the true breadth of Big Pharma’s swollen financial stakes: that the total capitalized cost of bringing a new drug to market averages out to $2.6 billion. http://csdd.tufts.edu/news/complete_story/rd_pr_october_2015.

* The case, known as Diamond v. Chakrabarty, pitted Ananda Mohan Chakrabarty, a microbiologist employed by General Electric, against Sidney A. Diamond, commissioner of Patents and Trademarks. Chakrabarty had developed a genetically engineered bacterium capable of disintegrating the elements of crude oil toward the goal of rapidly cleaning up oil spills by tankers in the ocean. He filed to patent the compound, but was rejected on the ground that living entities were not patentable under historic congressional understanding. The high court ruled in favor of Chakrabarty.

* In 2011, the FDA warned that Saphris users can suffer serious allergic reactions. Merck agreed to revise the drug’s label to include this information.

* Ortho-McNeil-Janssen Pharmaceuticals, Inc.

* By contrast, the largest Western force in history until the Imperial Russian army of six million men was the “Grande Armée” of Napoleon, organized in 1805. It reached its numerical apogee of 680,000 prior to the invasion of Russia in 1812. This thrust proved a disaster for the French general, as it would for Adolf Hitler’s invasion force in June 1941. Battle attrition and the brutal Russian winter vitiated both forces. Napoleon retreated with only 120,000 men.

* The colleague was Edwin E. Witte, the executive director of Roosevelt’s Committee on Economic Security. It was Witte, an economist and passionate advocate for social justice, who crafted the wording of the bill that became the Social Security Act of 1935.

* A barometer for public understanding of combat stress could be found in the thousands of letters to President Roosevelt inspired by the incidents. Most of the letters supported Patton. General Eisenhower, however, forced the general to apologize, then relieved him of duty for nearly a year.

* This is not to say that eugenics was obliterated. No panacea that promises so much in terms of man’s perfectibility, and that has proved workable even in limited degrees, could ever be uninvented. Eugenics theories continue to be refined and practiced today, in fair uses and foul. What is called “modern eugenics” seeks to identify and, if possible, repair diseased genes. Gene therapists now envision the eventual cure of cancer, as well as blindness and many childhood diseases. Genetically modified crops and foods are now commonplace on a planet that faces severe shortages in the decades ahead, but concerns about side effects cause many of these products to be banned, especially in European countries.

* The first known intrusions into living human brains were performed in 1892 by a Swiss physician and insane asylum supervisor named Gottlieb Burkhardt. Burkhardt removed portions of the cerebral cortex from six patients thought to be schizophrenic. Two of the six died, and no one tried it again until Moniz.

* “Optogenetics” defines two parallel methods for monitoring and influencing neurons in the brain: genetically encoded sensors and light pulses. Named the Best Method of the Year 2010 by the journal Nature for its use of fiber-optic cable to normalize certain brain circuits, optogenetics has been radically improved by a unification of the two methods. The team leader in achieving this new stage is Michael Hausser, a neuroscientist at the Wolfson Institute for Biomedical Research in London. Hausser has reported that now the system can record complex neuron signaling codes and “play” those codes back so that the brains of animals will recognize and respond to them. This represents an important step toward controlling human neurons and eliminating or changing the faulty ones.

* The acronym covers most of the words in “Imaging of Neuro Disease Using High-Field MR and Contrastophores.”