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In conversation with Terry Shepard, award-winning broadcaster, narrator, and author, a deep dive into the writer's craft with the artists and support systems who create the stories we love.
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What if everyone around you insisted you were insane?
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Well, you became increasingly certain that someone was trying to kill you.
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That's the chilling question at the heart of Dr.
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Jess Wright's new novel, Dance in a Madhouse, a psychological thriller set at the dawn of modern psychiatric treatment when the boundaries between illness and imprisonment could be frighteningly thin.
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Jess brings extraordinary credentials to that world.
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He is a professor at the University of Louisville Medical School, an internationally recognized psychiatrist, and a pioneering researcher in cognitive behavior therapy, whose work on depression has been supported by the National Institutes of Health.
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He is also the award-winning author of the novel A Stream to Follow, which explored the psychological wounds carried home from war.
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In Dance in a Madhouse, we meet Owen confined inside Fairmount Lodge after typhoid fever, delirium, and a violent act leave doctors convinced that he is psychotic.
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But as his mind clears, Owen begins to wonder whether the greatest danger lies not within himself, but inside the institution holding him captive.
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Dr.
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Jess Wright, it's great to be with you.
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Welcome to the conversation.
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Thank you, Terry.
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A brilliant introduction there.
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I appreciate that.
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What made you write dance in the Madhouse?
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Oh boy.
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That's a long story I'm going to try to say in just a few words.
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I'm a psychiatrist by profession, and I've always enjoyed my work a whole lot.
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I still do it to some extent.
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I'm working about half time now, but I wanted to do something else in this part of my career and life cycle and life trajectory.
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And so I decided that, gee, I've had some success in writing medical things that are pretty staid, and I'd like to let my creative juices flow a bit.
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So I began to look around for some stories, and I came up with that story that ended up in the book, A Stream to Follow, which has done pretty well.
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And then I was looking for another story, and I one came to me from a friend of mine.
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That's just by chance.
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I don't know if this happens much to other authors, but a friend of mine's actually a very fine poet that's published a lot.
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And she said, Jess, would you write an introduction to my next book of poetry?
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And I said, me write an introduction to a book of poetry.
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That's pretty far stretch.
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And then she gave me the premise.
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And the premise was that she had discovered some letters from her great-grandfather, I believe it was, who was a brother of William Howard Taft, the former president of the United States.
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And she found that these letters were just heartbreaking.
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And they were from Peter Taft, who was deep-sixed, if you will, in a mental institution after he had some kind of a psychotic reaction with typhoid fever, and he was kept there.
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And her premise was that he was kept there because of the stigma.
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I just couldn't have a family member that was out in public that was potentially even psychotic at that time.
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So he was kept in an institution, and eventually his outcome was pretty tragic.
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But I thought this is a story that you could be told, you needed to tell in a different way.
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So I came up with this idea for the book Dance in a Madhouse.
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And I got the title from the lithograph by a famous American painter, George Bellows, who has a lithograph that's in the Museum of Modern Art, excuse me, the Metropolitan Museum of Modern, not Moderate Art, and other museums, and it depicts something called a lunatic ball, which is a terrible word to say, even for a psychiatrist.
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And I shouldn't even say those words, lunatic.
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But that's the words that were used back in those days.
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And what happened was that they would have a dance, if you will, for the inmates at these mental institutions, people that stayed there for months or years or their whole life.
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And then the townspeople could, I think, pay to get into see them and clock at them, having this dance, and have a good time of it all.
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And to me, this was like the uh quintessential example of extreme stigma.
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And I thought that that's probably a title I could use.
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And then part of me thought, I'm a psychiatrist, should I even title a book, Dance in a Madhouse?
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It's terrible.
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My colleagues will never want to speak to me again.
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So I ran it by some friends and other people, uh, my consultants,
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people I work with, and a few others, and they said, gee, you ought to use that title because it is unique in it.
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So that's what I did.
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So that's where the title and the book idea came from.
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What was happening in that early time in psychiatry, which made such fertile ground for this thriller?
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This was a time actually before Freud, which takes people back a while, but there were other experts at that time who were just flirting with the science of psychiatry, with hypnosis, with psychoanalysis in a sort of trying to understand the human mind.
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And so there's a rich history of psychiatry, and I was able to draw on that and weave that into the book.
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So there are real psychiatrists that were alive at that time that do appear in the book and that play a major role.
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So it's based to some extent on a true story of Peter Taff's life, and it's based to some extent on true stories of the history of psychiatry, but it's a fictional account of a big adventure in a mental institution at the turn of the century, the turn of the last century.
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Dr.
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Jess Wright is our special guest.
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We're talking about his new thriller Dancing in a Madhouse.
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His website is just right, W-R-I-G-H-T, just rightmd.com.
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One of the most compelling questions I found with the book is whether Owen can trust his own mind.
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How do you create that kind of uncertainty for the reader without making the story feel manipulative?
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That was a bit of the challenge here.
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I would make an observation that I think there are many people that have never been diagnosed with a psychiatric illness, never seen the inside of a psychiatrist's office or a telemedicine visit, who wonder about whether they're all put together in a hundred percent way, and may even have experienced things like paranoia.
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I don't know if you've ever had that, Terry, when you've been sleep deprived or you've had a lot of stress on you or something, and your mind begins to come apart a little bit, and you wonder could people be talking about me?
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Is somebody you know trying to do something to make life bad for me?
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And then maybe sometimes it's actually true.
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There was a study done in England a few years back that found that I think it was well over 50% of the people had experienced some kind of paranoia.
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So the idea of where sanity stops and madness or psychiatric illness begins is sometimes hard to figure out.
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And even in my clinical work, I've been doing this for decades, as I'm sometimes not sure when someone comes in and talks about some where some fear that they have or something that sounds on the surface to be delusional, whether it actually could be true.
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Yeah.
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I tried to paint this these characters, not just Owen, the main character, but some of the other characters as sympathetic characters, people that were very observant and together, if you will, but had some kind of a quirk or a problem that landed them in that institution.
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But really quite fine people, deep humanity, and ability to ascribe their dilemmas in ways that it would I think make the reader be very interested in their character.
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What made you decide on psychiatry as your medical specialty?
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I'm a liberal arts graduate, a guy that came out of a small liberal arts college, and I did theater when I was there.
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I sang in the choir, I studied art history, and I loved all that stuff.
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Yet I was a pre-med major, and I got into med school by some miracle because I was doing all this other stuff.
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And then when I got into med school and I realized that you had to really grind and grind to be really great at doing something like cardiology or internal medicine, which was what I initially wanted to do.
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I think that the call of the liberal arts came back to me, and integrating arts and sciences is much easier done than psychiatry than any other medical profession.
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So I think that's the main reason why I ended up doing that.
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And I'm glad I did.
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When I chose to be a psychiatrist, it was a while back, my family thought I was like going over the bend myself.
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Because why would you become a psychiatrist after you've borrowed all this money to go to medical school and you're here, you're on the cusp of doing whatever you'd like to do, and now you're going to be a psychiatrist?
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So anyway, I did it, and I'm sure glad I did because it's been a very rich and then interesting and adventuresome life that I'm still doing.
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And I hope that some of this I'm able to weave into my fiction writing.
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That because I've talked to lots of people, listened to lots of stories, as you might imagine.
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So I think I have maybe an ear or an eye for character that gives me some kind of perspective on that the average author might not have.
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How do you balance the elements of psychiatric drama with the mechanics of mystery in a thriller?
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This is probably unusual, but I carry over
some of my work in medical writing because I you know for that you have to outline it, you have to do a lot of research for it, you have to know what the literature says, what the references could be, and plot it out pretty carefully.
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And I do that to some extent for my fiction writing, but then when I get into it, I let my creative juices flow and let it go loose and see what happens.
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And so I might have some scripted out things that I think are gonna occur and have to occur because they all have to come together in some way toward the end of the book.
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But I want to see what happens.
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And sometimes I'm not quite sure what's gonna happen to various characters and how the end might even turn out.
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Is some gonna somebody gonna live or die, or fall in love or not fall in love, or get into trouble or not get into trouble?
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And I see where my muse takes me.
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And I hope it works out.
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I'm enjoying doing it.
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I must say that it's more fun by far than medical writing.
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Dance in a Madhouse is the book we're talking about with its author, Dr.
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Jess Wright.
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JessWrightMD.com is his website.
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One of my favorite characters in the story was Inspector Brumba, who becomes Owen's connection with the outside world.
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What interested you about pairing a confined psychiatric patient with a skeptical police investigator?
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I wanted to try to create an interesting detective.
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And since I'm from Pennsylvania, I latched on to this Broombaugh guy.
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He has a Pennsylvania Dutch name, and he has a Pennsylvania Dutch family background, and tried to set him up as somebody who would be somewhat unique.
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And you have to figure out the answers to these crimes that are going on in this hospital, and so we have to bring in an inspector, and I thought that they too could the two of them could become a good pair eventually.
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Although in the beginning, Owen is a suspect for all the things that are happening in this institution, and he's a new guy, and there are bad things that are happening, and sure, he did bad things before he got into the hospital under the curse of typhoid.
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But Broombaugh eventually figures out that this guy is pretty sharp and he can use him for his own purposes, and they have a shared agenda by the end of the book.
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And then they become a pair in my next book as a sequel.
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Celeste is also a very intriguing character.
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She's an opera singer.
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She survived tremendous emotional pain, and she carries clues to the larger mystery.
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Where did she come from?
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I created Celeste a long time before this recent news item about the woman who was on trial for the murder of her three children after a postpartum psychosis.
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But I had experience in working with women who've had postpartum psychotic episodes and who some bad things had happened.
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And was able to help, if you will, rehabilitate them and get them back with their children even after there had been abuse that occurred in the face of a psychosis.
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And the those experiences were very emotionally touching to me.
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this to see a mother who really loved her child become psychotic and believe that the child's the devil.
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Terrible kind of experience.
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And so I pulled from those experiences to create this cre this character of Celeste.
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And since I've had experience in studying voice, and and I've never been an opera singer, but I've been a lot of singing through the years, and so I brought that in to some extent to try to share that.
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And I thought that she could be a very interesting and puzzling character.
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So she does, in the beginning, talk in ways that are very hard to discern.
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Owen has to try to figure this out, but she does know a lot, and she helps him solve some of these things by the end of the book.
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Dr.
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Jess Wright is our special guest.
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We're talking about dance in a madhouse.
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It's a great read.
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You can learn about it at JessWrightMD.com.
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We live in a world right now that's very judgmental.
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And the question I love to ask people like you is how do we get away from this cancel culture and find our empathy?
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We certainly live in an era when I have so many of my patients that don't even want to watch the news on TV or read the newspaper or stay in touch with anything that could get online about the current news cycle because it seems like bad, malignant sometimes news.
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And we live in a polarized culture in the United States.
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In fact, in the world, what's going on in France, in Europe, far right and far left, an article I read I still read the newspaper, by the way, or in the New York Times yesterday was about the the center in in Europe is dying.
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There's nothing much left of it because it's all gone to the polarized sides.
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And that's something I really try to fight every day in my clinical work because my patients have that proclivity to do that in their own mind.
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Either they're all, either they've had a big success in their life or they've been a complete failure.
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And in truth, as we know, so much of life is in between.
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We have our times that things work out and times that they certainly don't.
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And I try to help people see their strengths and make the most of them and try to understand some of their weaknesses and bad things that have happened and try to work through those.
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So that's what I do on a one-to-one basis.
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But trying to help them with empathy.
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There are some therapies that encourage empathy training, and to some extent, this treatment that I specialize in and teach a lot about cognitive behavior therapy really does that.
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It helps people understand the stream of thoughts that pour through their mind.
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In cognitive therapy, we call those automatic thoughts because they occur autonomously.
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Just roll through your mind all day long.
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Think about how many thoughts do you have all in a 24-hour period?
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Thousands, maybe more.
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And they affect how you feel, your emotions.
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And if you have thoughts that are strident and absolute black and white thoughts, magnified thoughts, then your emotions tend to also be extremely strong and often full of emotions like anger and depression and anxiety instead of joy and happiness.
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And so learning to listen into your thought pattern and begin to question it and modify it with some techniques that we can teach can really make a difference in one sense of well-being.
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So that's one way that we can do it.
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There's another, if you don't mind me, just taking one more minute or two, I'll tell you about another kind of therapy that I think is really worthwhile.
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It's not there's not much known about it.
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It's called well-being therapy.
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And the idea on this is to try to teach people ways to stimulate a sense of well-being in their lives.
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And it can be very useful even in the face of all kinds of difficult situations.
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For example, somebody that has chronic pain, like I do, I actually have chronic pain.
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I've had a bunch of fractures in my spine and things like that.
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And I use my own techniques
on myself.
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Dr.
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Heal yourself.
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So I use some of this well-being therapy.
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In a well-being therapy, we go back to the teachings of Seneca from like 2,000 years ago, who advise us to keep a diary or some kind of a log of anything in our days that gave us a sense of well-being that we could savor and hang on to and learn how to burnish that sense of well-being.
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So that's one thing that we can teach in this sort of therapy.
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If you wanted to look at my one of my self-help books called Breaking Free from Depression, there's a whole chapter in there on how to use self-help techniques to work on your sense of well-being.
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And that helps with empathy too.
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I think if you have a sense of well-being and a meaningful, purposeful existence, that you tend to be more empathic for other people.
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Did writing fiction teach you anything about human resilience that uh clinical research can't?
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It's interesting that I think I've created some resilient characters.
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Certainly in dancing and that house, both Owen and Celeste are resilient because they both faced really tough kinds of things in life.
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So I guess that's something that I want to instill in readers and myself and the patients that I work with.
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But whether I find anything different in my fiction writing or not, I'm not quite sure.
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Perhaps I'll have to think about that.
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And I'll, as I continue to write, I'll take the question from Terry and see if that helps me in my writing.
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So thank you, Terry.
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How did you research those early years?
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Where did you find out about Fairmont Lodge?
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Fairmont Lodge is a made-up name.
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It comes from Fairmont Park in Philadelphia, where I was a medical student.
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But I knew a fair amount about this area, this era of psychiatry just because of my training.
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And we learn about the history of psychiatry.
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I've read books about the history of psychiatry.
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But I did do other reading, read about the famous French psychiatrist Pierre Jeannet, who was the progenator of hypnosis.
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I had courses on how to hypnotize.
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And I practiced hypnosis early in my career.
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I don't use it anymore, because I think there are better techniques now than the hypnosis.
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But I was able to put that into the book too.
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There are several hip scenes of hypnosis, including a couple that go awry.
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What do you hope people will take away from their encounter with dancing in a madhouse?
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Oh, I hope they'll enjoy it and find it uh adventuresome, thrilling to some extent read.
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It's not one of those thrillers where every minute you're hanging on the edge of the cliff with your fingernails.
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I didn't want to do that kind of a thing, but I didn't want people to get into it, have a sense of suspense, want to turn the pages.
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Whether they're going to learn anything profound that's going to they're going to take with them the rest of their lives, I'm not quite sure, but I'm not quite that pompous about what I might try to pull off with this.
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But I would hope that they would have respect for people who suffer from conditions like schizophrenia, catatonia, bipolar disorder, and realize through the characters that these are real people just like the rest of us.
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They just have an illness like some of us have diabetes, some of us have high blood pressure, some of us have multiple sclerosis, and it's really not our faults.
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And it's usually not even our parents' fault, even though we tend to blame parents and so forth for the way things turn out.
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A lot of it's the luck of the draw, and that the way people face up to these things, the resilience they show, the courage they show, the humanity they show, can mean a whole lot in in our life.
00:20:44.130 --> 00:20:52.690
So if they take that out of that and have a sense that they too can face some of these obstacles and overcome them, then I think that would have been a good outcome.
00:20:53.330 --> 00:21:00.610
One of my favorite mantras is that we all are carrying some sort of pain or burden that nobody else sees.
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How can we as human beings be more sensitive to that and more helpful?
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Listen to other people get to really know them instead of assuming get to know more people.
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Try to break through your pattern of loneliness or isolation, join a choir, be in a singing group, play mahjong with people, whatever take a cooking class, meet some people, try to understand all their perspectives, their different cultural beliefs, and and then learn from that.
00:21:38.289 --> 00:21:47.009
Instead of trying staying in your insular way of seeing the world, just has to be in a certain way that you've constructed it or you've been told the world the way the world should be.
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What's next?
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I'm working on a memoir.
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Which I had was very skeptical about.
00:21:54.610 -->
00:21:57.650
Could a psychiatrist write a memoir about being a psychiatrist?
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Because I certain above all I have to protect patient confidentiality.
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And my wife, who's also a writer, was very encouraging.
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She says, Jess, how many psychiatrists like to write or have done a bit of it, and have had as many adventures as you've had in this life and as a psychiatrist?
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And he said, You should do this.
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And I said, I can't do that.
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And so I for 20 years I said no and I've done other things.
00:22:21.890 --> 00:22:28.289
And then I read this book by Henry Marsh, he's a British neurosurgeon called Do No Harm, which I highly recommend.
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It's just a beautifully written book about his experiences doing neurosurgery in Britain.
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The chapter titles aren't very enticing.
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They're things like meningioma or astrocytoma.
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But in those, there's so much humanity and humility, by the way.
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He talks about his failures and the things that went wrong and the way he felt about it.
00:22:49.490 --> 00:22:51.170
And I was really inspired.
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And by the end of the book, I thought, gee, he must be writing about real cases because these things are so alive.
00:22:57.090 --> 00:22:59.330
And then I read the author's note, and they were real.
00:22:59.410 --> 00:23:02.930
He'd actually done this kind of work, but he'd masked all the identities.
00:23:03.410 --> 00:23:06.610
If I really worked hard at this, I think I maybe could mask identities.
00:23:06.769 --> 00:23:10.130
And I so I've my author's note at the beginning of the book instead of the end.
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I say, okay, here's what I'm doing here.
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I'm masking identities.
00:23:14.049 --> 00:23:21.970
These are these cases may be from different periods of time, genders, backgrounds, and but I'm and they might be amalgams.
00:23:22.289 --> 00:23:24.610
But these are experiences like the ones I've actually had.
00:23:24.690 --> 00:23:25.809
So that's the way I've done it.
00:23:25.970 --> 00:23:28.130
So now I'm about two-thirds of the way through it.
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So I'm enjoying that too.
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It's that's more of a challenge than anything I've written, by the way.
00:23:33.250 --> 00:23:38.690
The book is Dance in the Madhouse, a fantastic read by our special guest, Dr.
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Jess Wright, J-E-S-S-W-R-I-G-H-T-M-D.
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JessRightmd.com is the website.
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This has been wonderful, Jess.
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Thanks so much for the conversation.
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Thank you, Terry.
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I love speaking with you.
00:23:49.890 --> 00:23:54.210
In Conversation with Terry Shefford is a copyrighted presentation.
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All rights reserved.
00:23:55.970 --> 00:23:57.330
I'm Lisa Davis.
00:23:57.490 --> 00:24:00.769
Join Terry Shefford next time in conversation.