Part of my need to tell the story of the Nazi euthanasia programs, and subsequent abuses in U.S. psychiatry, was the haunting refrain of “the perpetrators were never punished because society could never decide whether these were really crimes.” So many historians made this comment, in one form or another, about the killing of the neurodivergent. And it’s true. In the trials of German doctors who participated in the euthanasia Aktion T4—many of whom killed thousands—judges themselves would interrupt proceedings to make comments like, “Even in classical antiquity the elimination of life unworthy of life was a complete matter of course.” “Life unworthy of life” meaning, of course, the neurodiverse. I asked myself, are we so different now? We let our neurodiverse population die on the streets and languish in jails. We allowed lobotomy, mostly of American women. It didn’t take long to discover how the historical eugenics behind much modern psychiatric thinking harms this population, to this day.

I had an early conversation with someone I’ll just call a publishing professional, who told me, “Decide if this book is history or memoir. It can’t be both.” I was, then, deep into my research on the incredible German woman Dorothea Buck, Nazi survivor and psychiatric critic. We the patients, she wrote again and again, are the real experts in our own care. 

I found Buck’s statement to be profoundly true. No biological basis of mental distress has really panned out, as when medicine finally gave up blaming serotonin levels for depression. The medicalization of mental distress has only led to people getting worse while at the same time more are being treated, often with strong drugs. What we have left—what we haven’t tried—are people like Buck, and like me. As a lifelong patient, diagnosed bipolar, I wanted to let that focus into this book. My history holds a mirror to U.S. psychiatry over the last half decade—its promises and its perils, particularly for females. At the same time my story is used insofar as it supports the research, always. I love knowing I was in the psych system at the same time as David Rosenhan, whose faked admission of himself into the horror that was a psych hospital became a “sword plunged into the heart of psychiatry” in the 1970s.