Rating: 2.5

“Weirdly, of all the diseases you could get, I would have picked you for this,” he [my friend] said at last. He then immediately considered what he’d just said. “Well, I wouldn’t <u>pick</u> you for this, but I mean, it fits.”

I laughed. “Really?”

“You’ve always loved all that neurology stuff,” he said. “There was that thing you told me about memory a while back.”


Donlan’s book is a hybrid memoir/nonfiction piece about multiple sclerosis, a disease characterized by the body’s own immune system attacking myelin, the fatty covering of nerves that both protects them and ensures the rapid transmission of impulses along them. Chapters in The Unmapped Mind alternate between the personal and subjective (in plain font) and the more objective (in bold): The odds give an account of the author’s own experience, while the evens provide some history and basic facts about the condition. Donlan’s first strange symptoms were related to his hands. He reached for and regularly missed door handles, but didn’t think too much of this. He and his wife were expecting their first child and had purchased a home; they had other things to occupy their minds. When his daughter was born and her neurological and cognitive repertoire expanded—or, as he aptly puts it, “came online”—Donlan’s were going offline in stages. “It is hard to spot the things that happen when your brain starts to go wrong” he observes, “because your brain is the last thing that is going to tell you about it.” Ultimately, the classic MS symptom, L’Hermitte’s Sign—an uncomfortable electrical sensation that runs down the back and into the limbs when the head is flexed forward—proved impossible to ignore. He saw his GP, who subsequently referred him to a neurologist.

Donlan generally writes well and fluently about the many changes— physical, psychological, cognitive, and social—he has experienced with MS. The reader learns of diplopia (double vision); trigeminal neuralgia (a condition that causes extreme cheek and jaw pain in sufferers, though Donlan’s discomfort does not reach that intensity); generalized cognitive dulling; the resetting of the author’s default from anxious to unconcerned, from meltdown-prone to mellow-minded; his inability to discriminate been classes of objects—when sorting the laundry or recycling, for example; strange periods of high, almost manic energy; possible hallucinations (though hallucinations are not commonly documented in those with MS), and disinhibition—times when the internal editor of speech and actions is no longer monitoring and the patient speaks too fast, too loud, and in too much detail. Donlan later recognizes that at times he may have wrongly attributed subjective experiences to MS. So much of the disease, at least in its early stages, cannot be seen by others.

The Unmapped Mind occasionally suffers from distracting, fanciful, or overblown writing. Donlan’s wife, for example, “shuffle[s] . . . in the occasional crooked smile and hint of that gorgeously wonky incisor . . . .” A railway coffee shop in Cairo he once sat in apparently offered “quietly disappointing cakes”. Donlan gives MS the ability to “reach . . . forward in silence and place . . . a shushing finger against the base of . . . [his] neck.” His description of the experience of double vision turns into a baroque ode to an IKEA wingback armchair: “a masterwork of tasteful retro design, blessed with fine lumbar support and capable of transforming even the least reflective of sitters into a Victorian consulting detective, all crossed legs and templed fingers.” Is this really necessary? At times (particularly when he gives a very lengthy account of being in hospital for five days to receive drug infusions), I found myself wishing he would cut the embellishment and just get to the point.

Along with the overwriting, Donlan’s fairly persistent self-dramatizing often rubbed me the wrong way. Informing his friends and family of his condition, for example, becomes quite a production. His wife wisely counsels him to wait until there is a firm diagnosis before he shares any details with others, but he cannot. He seems bizarrely eager to achieve special status as a patient with an incurable illness. For the performance in which he shares the news with his friend Simon, he gives himself a rating of 6/10; he judges his later notification of his friend Brian by text “classy”. “I knew exactly what I wanted to do in the days and perhaps weeks following my diagnosis,” he writes. “I would go to bed for about a fortnight, luxuriating in the warmth of some self-prescribed compassionate leave from work. Then I would flop around the house in a dressing gown, bony arm flung across my face, and maybe I would quote T.S. Eliot out loud until someone noticed how resolute I was being.”

Donlan acknowledges his “self-involvement” and a certain theatricality in his personality before his diagnosis. He mentions that on an early date with his wife, he “was desperate to appear unusual.” After the diagnosis, he admits to a “grotesque smugness” and “egomania”. Maybe as the middle child of five, he only ever received attention when ill? Whatever the case, I found his response unusual, and apparently his wife did, as well. She confronted him on his endless reading of neurological texts to distract and distance himself from the hard reality of the diagnosis. I don’t know a lot of people with MS, but a high school classmate once surprised me by revealing that his mother had it and life at home was very hard. As an adult, I’ve seen students of mine lose parents in their thirties and forties to the disease, and I have a cousin who suffers from it—first she used a cane, later a walker, then a wheelchair, and now she is bedridden. Yes, there are several types of MS and its course can be highly variable, and, yes, Donlan may have a bad (i.e., highly active) case of the best type (relapsing and remitting) of MS, but, still, the disease is not a joke. Eventually, he comes to realize this when an MRI reveals the disease is progressing, even though he was sure the medication was working. He subsequently chooses to be treated with Lemtrada, which can have significant side effects, including kidney damage.

The Unmapped Mind is a personal, reflective, and rather rambling read. Given some of the things I’ve mentioned, I am not sure how representative Donlan’s experience is of those with MS. The disease is highly variable, and this is one person’s take on it, presented with some solid factual information and a good notes section.