This novel prompts us to consider a family's story across generations and its influence on the emergence, manifestation, diagnosis, and treatment of illness in an individual. We routinely inquire about, and document, every patient's family history, but the simple listing of a diagnosis in other family members does not tell the whole story. We need to be curious about that story, because it can tell us much about our patients' strengths and vulnerabilities.
“Wolf Constellation,” by Lauren Small, tells the story of a young psychiatrist who is called in to treat a fifteen-year-old girl who has stopped speaking in the wake of her brother’s death. Dr. Gus Thaler’s search to cure Anna Glanz takes him deep into the past to a Romanian rabbi-healer who once treated Anna’s grandmother. Fifty years later, as Anna lies dying, her daughter, Claire, uncovers the truth her mother still can’t bring herself to utter.
“Wolf Constellation” is a powerful family saga spanning centuries and continents, from the Romanian pogroms of the late-nineteenth-century, all the way through to modern-day Baltimore, Maryland, via Providence, Rhode Island, taking in the history of psychiatry at Johns Hopkins along the way. Small’s elegantly written and compelling novel is woven with the thread of the bipolar illness that passes from one generation of the Glanz family to the next, and a hint of magical realism in the form of a wolf that follows the bearer. It spans the arc of our understanding of psychiatric disorders, from the days when “wandering spirits” were thought to cause mental illness, to our current state of knowledge and present-day ability to treat these complex and challenging medical conditions.
The novel presents a vivid portrayal of the effects of bipolar disorder, also known as manic-depressive illness, on families and patients and their struggles to overcome the illness. Most of all, “Wolf Constellation” does a wonderful job of showing how, as in life, an illness such as bipolar disorder is only one element of an individual and family’s greater story. It is one thread of many in this beautifully woven story of survival and catharsis.
“Wolf Constellation” prompts the clinician to consider a family’s story across generations and time and its influence on the emergence, manifestation, diagnosis, and treatment of illness in an individual. We routinely inquire about, and document, every patient’s family history, but the simple listing of a diagnosis in other family members does not tell the whole story. We should be curious about that story, because it could tell us much about our patients’ strengths as well as their vulnerabilities.