BMJ

4.48 Psychosis by Sarah Kane

Review by: Richard Hurley
BMJ: British Medical Journal, Vol. 340, No. 7756 (22 May 2010), p. 1143
Published by: BMJ
Stable URL: http://www.jstor.org/stable/40702262 .
Accessed: 22/06/2014 21:42

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Thecostofreading MEDICAL CLASSICS
4.48 Psychosis Written
bySarah Kane
A famousauthorwho as ifyou held certain Published2000
was also a doctor, BETWEEN Britishbank shares Ί have become so depressed bythefactofmymortality that
SomersetMaugham, THE LINES (though you would I have decided to commitsuicide."Theplay4.48 Psychosis
at least have had is a bleak,oftenangryexaminationofclinicaldepression
once wrote that he Theodore Dalrymple
was so devoted to the pleasure of pos- and suicidalideation.Theplaywright, Sarah Kane,was a key
session of the book figureintheBritishMin-yer-face theatre"ofthe 1990s, which
readingthathe would was characterisedbyprovocativeand confrontational writing
rather read a train meanwhile). and depictionsofexplicitsexand violence.Kanecommitted
timetablethan noth- On yet another suicidein 1999 at theage of28; 4.48 Psychosis,herfifth and
ingat all. I understand hand, I could have finalplay,was firstperformed almost18 monthslater.
this state of mind boughta veryearly Kanehad attractedcontroversy whilealive. Herfirst play,
well. Once, in a hotel k edition(1644) of Blasted,was describedintheDailyMailas a "disgusting
roomin Los Angeles, f Descartes'sMed- feastoffilth"foritssurrealand disturbing imagery ofmale
I had nothingbut the itationesde Prima on male anal rapeand eyegougingset ina Leeds hotelroom
amida civilwar- and foritsunapologeticmisogyny, racism,
telephone directory Philosophia at the and homophobia.ButnowmanycriticscelebrateKane's
and spent two hours nominellprice ofmy contribution: each ofherplaysis an experiment innew
happily reading it. I copyofthecatalogue theatricalform, challengingtraditionalnaturalistic writing.
was most impressed (once owned by an Kaneconcludedthisinnovationbypresenting4.48 Psychosis
by the number of One doesn't acquire irasciblebibliophile, withoutcharacters,plot,orstage directionsbutas freetext,
private detectives books forthe monetary who angrily scrib- intheformofdiaryentries,doctor-patient dialogues,longer
(none called Philip return-a booksellerwill bled "should have 2 prose,passages fromselfhelp books,and poeticdreams.
Directors are freeto presentthese wordsas theysee fit.
Marlowe). arriveafteryourdeath plates!"againstHon-
Awomanis miredinmentalagony,fullofselfhatred,
The other day I and offeryourrelict oré Fabri's Tractates
despair,and thoughtsofselfharmand death. Fragments
was on a train with Duo: Quorumest de
yardage,whichis to say oftextmergeina relentlessstreamofconsciousnessthat
nothing to read but Plantis et de Gen- can be readas a conversationbetweenthewomanand her
£5 per bookshelfyard
a bookseller's cata- erationeAnimalium; suicidalmindoras thevoices
logue, from 1960, of Posterior de Homine, offriends, family, lovers,
"Old Medicine and Science." This, too, I Paris, 1666), namely£6. doctors,and otherpatients:
read happily fortwo hours. Ah, ifI had "I am a completefailureas
But, of course, one doesn't acquire
a person.""Butyouhave
onlyhad thenumberofpounds thenthat books forthe monetaryreturn-a book-
friends.""Takean overdose,
I have now or that old books were the sellerwillarriveafteryourdeathand offer
slash mywriststhenhang
pricenow thattheywerethen. yourrelictyardage,whichis to say £5 per myself.""It's notyour
On average,antiquarianscientificand bookshelfyard. fault.You'reill.""Myfinal
medicalbooksnowcost60-100 timeswhat No,one wantstolearn; and who would submission.Myfinaldefeat."
theycost then,thoughifyou buy froma learn nothingfrom,say,twoofthebooks Doctorsareviewedentirely
loveofmonetaryappreciationratherthan forsale by the Swiss physician Samuel- unsympathetically: "I dreamt
frombibliophilia (or bibliomania) you AugustreTissot,Onanism,a Dissertation I wentto thedoctor'sand
she gave me eightminutes
mustexercisediscrimination. on theDiseases Caused byMasturbation
to live- Td been sittingin
On the one hand, Be Dissectione Par- and An Essay Incidental to Literaryand
thefucking waitingroom
HumCorporisHumani, by Charles Esti- SedentaryPersons! halfan hour."Listsrecall
enne (a pupil of Sylvius, of the Sylvian Myfavouriteitem,though,was In Vino symptoms, diagnoses,drug
A theatrical suicide note?
fissure,and scion of a famous French Veritas:Or a ConferencebetwixtChipthe regimens,and theirfailure:
printingfamily),would have cost you Cooper,and Dash theDrawer(Being both "Lofepramine and citalopramdiscontinued. . . Delusional
£300 (€350; $435), but now it would Boozy), a pamphlet of 1698. An extract ideas-believes consultantis theantichrist . . . Fluoxetine
costyou £30000 at theleast. Published to whet the appetite,as itwere,explains hydrochloride, tradename Prozac,20 mg,increasedto 40mg
. . . homicidalthoughtstowardsseveraldoctorsand drug
in 1545, two years after Vesalius, it whytheEnglishpreferthefortified wines
manufacturers. Discontinued."Amidthehorror, momentsof
would have been published earlier but of Portugal to the unfortifiedwines of darkhumourandtendemessdo littleto liftthemood."100
for legal problems. Estienne died in France: aspirinand one bottleofBulgarianCabernetSauvignon,1986.
prison,sent there(according to various "Theyhave the body,thatis strength, Severestomachpain. No otherreaction."
sources,and perhaps accordingto taste) and that now a days pleases, for our Kanereportedly oftenwokeat 4.48 am ina depressed state,
fordebt or heresy.Of course, forsome, People love to have their Heads and and itis simpleto see 4.48 Psychosisas autobiographical,
debtis heresy. Stomachs hot, as soon and as cheap as a suicide notethatKaneintendedto be performed
On the other hand, you might have theycan." posthumously. Whatevertheintention, and regardlessofher
subsequentaction,Kanedescribesa harrowing and intensely
bought H W Haggard's The Lame, the Now does thatremindyou ofanything,
personalbattlewithseveredepressionthatis movingand
Halt and the Blind of 1932 for£1 15s, I wonder- forexample, casualty on a
unforgettable.
whereas you could now easily buy it for Saturdaynight? RichardHurley,
assistant magazine editor.BMJrhurley@bmj.com
less than £10: thatis to say, you would Theodore isa writer
Dalrymple andretired
doctor ( üetnis.isißM/JOlO^AQicrhi)1)

have lost almostas much ofyourmoney Cite this as: BMJ2010;340:c2665

'
I 22 MAY2010 1VOLUME
BMJ 340 11«

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