54 pages • 1-hour read
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Content Warning: This section of the guide includes discussion of mental illness, substance use, addiction, and sexual content.
This chapter is presented from Leonard’s point of view. He recalls being diagnosed with bipolar disorder early in college. At that time, he began therapy and learned that his mental illness stems from genetic sources from both of his parents. His parents divorced when he was 15, and his father moved to Belgium. Leonard subsequently always felt that his mother resented him because he reminded her of his father. His mother was addicted to alcohol and reclusive, and Leonard and his older sister learned to care for themselves. Suddenly, their mother decided to get a job and became a director at a local YMCA. She was rarely home after this.
As a teen, Leonard often felt melancholy but was certain that this mood was something that he intentionally cultivated and controlled. He grew to like dark metal music and spent time with his best friend, Godfrey. One day, Leonard suddenly felt ill and had no appetite. He cried for no reason. The next day, he could not get out of bed. He missed a week of school. By the end of the week, he had grown angry. When Godfrey stopped by with some marijuana, the drug caused Leonard’s mood to lift slightly. He began self-medicating with the drug each day. When he began his junior year, his sister left for college, and something inexplicably shifted in Leonard: He became determined to be a better student. He excelled at school like never before, acing increasingly challenging honors courses. He applied to three East Coast universities and decided on Brown. After his diagnosis, he would realize that this was a period of intense mania.
Leonard’s first year at Brown brought constant drinking and very little sleep. Women found him attractive, and his grades were good. At one point, he did not sleep at all for an entire week. His mania increased, and he became irritable. After an incident where he blacked out—a combination of substance use and lack of sleep—a woman he was with at the time took him to Health Services, where he is diagnosed with bipolar disorder.
The narrative shifts to Leonard’s arrival at Pilgrim Lake. He is certain that the lithium is not helping and frustrated by its side effects—especially the way it makes his mind fuzzy and causes him to have difficulty thinking. It decreases his libido and upsets his stomach, also causing a tremor in his hands. He researches lithium, eager to understand it from a scientist’s perspective. He recalls the time of his hospitalization: He dutifully adhered to the mandatory schedule, participating in the group therapy even though he found no use in the notion of seeking a higher power. His father called a few times, each time encouraging Leonard to “hang in there.” His mother also called, but she insisted that she could not travel to see him because of a herniated disc. She voiced frustration at Leonard’s inability to take care of himself and then impressed upon him that he would need to quickly obtain his own health insurance.
In the time between when he was released and when he and Madeleine moved to Pilgrim Lake, he was relieved that Madeleine moved in. Leornard felt frantic each time she left the apartment, desperate not to be alone. He recognized that the power dynamic between them had shifted and that he was now the one needing Madeleine instead of the reverse. He recalls, too, a religion class that he had with Mitchell Grammaticus as a freshman and then later learning that he and Madeleine had been friends. At times, post-hospitalization, Leonard becomes paranoid that Madeleine is sleeping with Mitchell, though she repeatedly emphasizes that their friendship is platonic.
Arriving at Pilgrim Lake, Leonard feels a momentary sense of excitement, as if he is finally getting on with his life. Though he had hoped to work on cancer research, he is assigned to the team of a researcher he has never heard of—Dr. Bob Kilimnik—who is breeding yeast cells. Leonard finds the work rote and counts down the minutes until each workday ends. Kilimnik pays no attention to Leonard or the other research fellows.
Leonard dreads the day that Madeleine’s mother and sister are scheduled to visit, relieved that he has avoided meeting Madeleine’s parents thus far. Despite his worries, the visit goes well, and Leonard likes Madeleine’s mother more than he expects, appreciating her intelligence and the interest she takes in his work. He can tell, however, that Alwyn is unhappy, and this makes him uncomfortable.
Shortly after, Madeleine drives him to Boston for his weekly psychiatrist visit, as has become their routine. While Madeleine browses the Harvard bookstore, Leonard makes a case to his doctor about lowering his lithium dose, explaining how badly the side effects are impacting him. The doctor refuses, insisting that the side effects are still within a normal range and that he expects them to subside soon. On the drive home, Madeleine tells him that while browsing the bookstores, she came across a magazine article about bipolar research. Leonard becomes angry when he learns that the article appeared not in a peer-reviewed science journal but in Scientific America. He yells at Madeleine and then throws the magazine out of the car window.
Back at Pilgrim Lake, he returns to the lab, only to have Kilimnik yell at him for mixing up some of the yeast samples. He returns home, dejected, to find Madeleine cradling the telephone in her lap. She has just spoken with her mother, and she confronts Leonard about the rage he displayed earlier. Madeleine feels that it is unfair for Leonard to take out his rage against his condition on her. She also reveals that her mother does not like Leonard. Leonard becomes upset, certain that Madeleine’s mother is judging him for his mental illness and unfairly disliking him because of his lack of wealth. Madeleine leaves the apartment, and he lies on the couch, thinking about his parents. Suddenly, Leonard has an idea. He takes his nightly lithium but intentionally takes a smaller dose.
Leonard gradually winnows down his dose, carefully tracking the dosage and the corresponding changes in side effects and mood in a small notebook. He feels the brain fog begin to lift as he begins jogging, exercising, losing weight, and feeling less sluggish. He helps Madeleine study for the GRE, working the logic problems quickly while she struggles with them. He becomes certain that the solution to his condition is to be able to exist on the edge of mania—this is when he functions the best and feels most like himself.
One day, he walks around Provincetown, his mood light. He orders a Guiness at a bar and observes the women there. He feels like walking more, so he does. It is December, but he does not wear a coat. He pops into a saltwater taffy shop and strikes up a conversation with the young salesclerk—the shop owner’s daughter. As the conversation unfolds, Leonard feels an erection developing. The girl chats with him but then grows nervous as Leonard increases his flirting. Leonard decides to buy some taffy and then asks for more. Finally, he purchases so much that he needs a large garbage bag to hold it all.
He walks home and immediately has sex with Madeleine. She is stunned but glad that he is better. Then, Leonard asks Madeleine to marry him.
For the first time, readers view the relationship between Madeleine and Leonard from Leonard’s point of view. This provides insight into Leonard’s view on their relationship as well as a more thorough picture of the depth of his mental illness.
Leonard’s family history and socio-economic background contrast with Madeleine’s. Madeleine’s familial wealth, coupled with her father’s role as a college president, makes her attendance at an Ivy League university expected. While her parents are highly involved in her personal decisions, Leonard’s are absent. This neglect creates an environment in which his illness flourishes.
Leonard’s parents’ failed marriage impacts him greatly. He suggests that his mother developed disdain for him because Leonard reminds her of her ex-husband, Leonard’s father. In this way, she seeks to divorce herself from her son in much the same way she has removed her husband from her life. Her refusal to visit Leonard when he is hospitalized before graduation is representative of a refusal to accept that Leonard’s mental illness is, in fact, an illness, not a choice that Leonard has made. She insists that Leonard himself is solely responsible for the results of his condition and is unwilling to help him. Her lack of support for her son places an additional burden on Madeleine, who finds herself stepping into the role that Leonard’s mother has abdicated.
Much of what frustrates Leonard about his condition centers on his lack of control. He is certain that the lithium is not only not helping him but also making his daily life worse through its many side effects. His doctors are unsympathetic to his pleas, and their refusal to lower his dosage plays a role in Leonard ultimately deciding, with disastrous consequences, to take control of his own medication. Initially, Leonard approaches this act with the rational approach of the scientist he is: monitoring the dosage and recording the effects just as he records scientific research and the corresponding findings. Carrying out the plan gives him the illusion of control, and he feels hopeful for the first time in a long while. Leonard’s actions signify a desperate desire to retake control of his life and his mind: He knows that there is a better version of himself that he is desperate to return to. The happiness he experiences as he becomes free of the negative side effects of lithium portray his decision to winnow down his dosage as a smart one: For the first time in a very long time, Leonard is able to function more effectively in all aspects of his life, and this results in a greater enjoyment in life in general. As the chapter comes to a close, however, it becomes evident that his happiness is likely a manic state.
From Leonard’s point of view, Madeleine becomes not a caring and concerned girlfriend but an obstacle to his newfound freedom. Her attempts to help him—such as seeking out a magazine article about research into the condition—only anger him further: He regards her actions as stemming from an unwillingness to allow Leonard to be the person he is and, ironically, as an attempt to control him.



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