Book Review: Nassir Ghaemi’s A First-Rate Madness is a first-rate read

As I have written about before, I am more than passingly familiar with the euphoria of creativity-filled up-cycles as well as the darkness of their unfortunate counterparts, those hideous depressive phases during which everything seems boring or bleak; tears and hopelessness are the order of the day; and even simple activities like picking out a shirt or brushing hair turn into loathsome, dreaded, and even inexecutable chores–forget actually doing anything productive. So it was with great interest that I dove into the literary results of Dr. Nassir Ghaemi’s intriguing research and analysis, A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness.

Mental illness–well, I like to call it being Mentally Interesting, for which descriptor I will thank the writer (and fellow Mentally Interesting Person) Jerod Poore–is not quite the taboo subject it was a few decades ago; it is no longer a hush-hush domain to which mysteriously disappeared classmates are consigned (“Where did she go?” “I don’t know, but I heard she had a nervous breakdown“); and–thank the Fates, along with relatively recent advances in neuroscience–it’s no longer a complete mystery (although, it must be said, the human mind is inarguably the last great frontier, and modern medicine has only just begun to embark on its journey toward solving the biochemical and behavioral puzzles therein).

The core thesis of A First-Rate Madness: Rational, calm, balanced, agreeable, reasonable, conciliatory, and sane people are lovely to have around. Ahem. But when all Hell breaks loose, you want a leader who can stand at the edge of the abyss, confront the monster within, and stare that horned and tentacled bastard down. For this kind of nation-saving and history-making leadership, only a Mentally Interesting person will do, knowing as he or she does (like the back of the hand, in fact) the precise reach of said monster’s limbs and the explicit scope of its awfulness.

At the outset, Ghaemi identifies the parallel nature of a clinician’s diagnosis (of a mentally ill patient) and a historian’s analysis. Both require a careful study of symptoms, of course, as well as an identification (if possible) of genetic components and an overview of indicated treatments–those sought, those avoided or not yet available, and those which succeeded (or failed).

Invoking the personal and fascinating stories of figures such as Winston Churchill, Abraham Lincoln, and Mahatmas Gandhi, Ghaemi then points to the qualities–conspicuous in their abundance–that variously characterize those leaders who suffer with (and also, to be sure, exalt in) mental illness throughout the course of their lives, those being: Creativity, realism, empathy, and resilience.

In the case of General Sherman, for example, we are shown a leader who wholly transformed warfare from the faltering Napoleonic model of concentrated frontal assault to a bold and creative approach which took into account the economic and moral aspects of rebellion and thus enabled a totality of destruction that was at once brutal and wildly successful. But he was not, despite popular myth, a glorifier of war. Ghaemi explains:

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