Sometimes Dr. Mark Vonnegut's telephone would ring, and he would pick it up, and one of the most famous writers of the 20th century would be on the other end.
"Too bad about your profession."
Dr. Mark Vonnegut would shake his head — Dad must be angry at modern medicine today — and hang up the telephone.
"Growing up in my family, I thought I was the closest thing we had to a normal person," the son of the late Kurt Vonnegut told an audience of doctors and medical students Wednesday.
And then Dr. Vonnegut smiled, and the audience laughed, because the 67-year-old is decidedly not normal. He is one of the best pediatricians in Boston. He is the author of two searing memoirs. He's part of a rock band called Septic Shock.
He has also been diagnosed as schizophrenic and then bipolar. He has been institutionalized, prescribed lithium, given shock treatments, gotten better, gotten worse, been manic, been depressed, and asked himself an agonizing question: "How do I stop the voices in my head from being so damn mean?"
Maybe most amazingly, he has been honest about all of it. He has written about his mental illness in his memoirs. He speaks about it during interviews and public appearances.
During the speech he gave Wednesday at the University of Nebraska Medical Center, he argued that the medical profession needs to be more honest about mental illness, too. Doctors need to be honest about their own mental illnesses. They need to be honest about how they treat and mistreat patients with mental illness. They need to be honest about the labels we place on those with mental illness, and the stigma that comes with those labels.
"I still believe that calling someone schizophrenic is a way to give up on them," he said Wednesday.
Mark Vonnegut grew up in a family of artists, and a family littered with adults exhibiting signs of mental illness.
His father, Kurt, authored three of the most famous books of the Vietnam era: "Cat's Cradle," "Slaughterhouse-Five" and "Breakfast of Champions." He was also a POW in World War II, an experience that scarred his life and might have ruined it if he hadn't found an outlet in his literary work.
"Without writing, my father would have been just another veteran with PTSD," Vonnegut said.
His mother, Jane Marie Cox, was a brilliant woman who successfully raised Mark, his two siblings, the children of a relative and "was a mother to the neighborhood," Mark said. She also couldn't leave the house without flipping on certain light switches and flipping off others, because she believed that if the light switch pattern wasn't right, the house would burn down.
Vonnegut recounted a conversation he once had about mental illness with his mother.
"Mom, I can't take the voices," he told her.
"Why don't you go along with them? I do," she replied.
As a child and teenager, Mark Vonnegut felt like the normal one. He felt like an older brother, and not a son, to his famous father.
Then, after graduating from college, he started hearing voices. He had his first mental breakdown. He ended up in a psychiatric ward in 1971, at the age of 23.
After recovering, Vonnegut got into Harvard Medical School, but only after an intense, hours-long interview focused almost solely on his mental illness.
It ended with Vonnegut's interviewer performing a impassioned bit of circular logic.
"If you were schizophrenic, we wouldn't admit you," Vonnegut remembers him saying. "We are admitting you. Therefore, you aren't schizophrenic."
Vonnegut graduated from medical school, worked nonstop hours as a resident at prestigious Massachusetts General Hospital, and then became a pediatrician.
Boston Magazine named him the area's No. 1 pediatrician in 1985. They did so not realizing that Vonnegut was hearing voices again.
It was his fourth psychotic episode. At some point, Vonnegut got an altered diagnosis: Bipolar.
Vonnegut's history has led him to a number of conclusions about how we label and treat mental illnesses, he told the Omaha audience at the annual Wilson lecture, an event co-sponsored by former University of Nebraska regent Dr. Charles Wilson and his wife, Linda.
Vonnegut thinks creative pursuits like art, writing and music are often the best medicine for the mentally unstable. He also thinks that the classic definition of the mentally ill artist — the one who eschews all stabilizing drugs and creates amazing art driven by his or her mental illness — is wholly untrue. He compared that idea to William Faulkner's famous quote about how there are many great drunk writers, but none who write great things while drunk.
"No one ever chucks their meds and writes great novels or paints great paintings," Vonnegut said.
He also thinks doctors are often too quick to diagnose a mentally ill patient, place them into a box, and then overtreat the patient.
Patients "don't want to be incapacitated by psychosis," he said. "But they also don't want to be assaulted."
And Vonnegut thinks doctors need to be more open about their own problems, their own insecurities. The truth, he thinks, is that doctors are more frightened by mental illness than the public at large.
Don't be afraid to be human to your patients, Vonnegut told the audience. Don't be afraid of looking fallible. And don't be afraid to be an artist as well as a doctor.
"If you have art going for you, you have a better chance to survive," he said.