ffMfe tate*. Patton tried to slap a shell-shocked solder back to his senses, the nation’s understanding has not progressed by much. “Mental illnesses” are illnesses. Schizophrenia is a real illness with every indication of having a physical basis just as real as that of diabetes. Alzheimer’s is a real and ultimately fatal disease that can be demonstrated in an autopsy just as clearly as cancer or heart disease. The thought that mentally ill people are really suffering from some spiritual disorder or flaw of moral character is what might be called the conservative error. But there is a liberal error, too. Some mentally ill people really are crazy. There is a physical cause of their craziness, but they are crazy nonetheless. It is not that they have an odd or unusual view of the world, that they have chosen an alternate reality or lifestyle, or that they have found some other plane of consciousness; they are crazy, they are lunatics. And from time to time one of them does grip a barred window and shriek to get out. A person with a severed spinal cord is not having an alternate lifestyle choice or a spiritual experience, and neither is a mental patient. Alzheimer’s, of course, has no ultimately effective treatment. As palliatives go, there are now several for schizophrenia, which are very good at least by comparison to what came before. But we fault mental patients who refuse to take their medications in a way that we do not fault people who refuse to take their blood-pressure medication or who mismanage their insulin or who stray from their diets. We still have a long way to go. Lars Eighner is the author of Travels with Lizbeth, a memoir of homelessness, the novel Pawn to Queen Four, and other books, and is a frequent contributor to the Observer. Pick up your FREE copy at over 200 locations in Austin & Houston. 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