If They Only Knew: “Odes to Lithium” by Shira Erlichman

Reviewed by Hannah Page

Alice James Books 100 pp.

It was last summer, I believe, when I saw Shira Erlichman’s Odes to Lithium on display at Book Culture and snatched it up greedily—mainly because of the title. I have been on psychiatric medication since early adolescence and my current cocktail actually includes lithium. The poems floored me. I carried the book around like a safety blanket for a year, kept it close so I could reach into my bag and touch it to remind myself I wasn’t alone. It saw me through late nights unable to sleep. It saw me through an entirely sleepless night in the mental ward. Most recently, I brought it with me into another hospital for a longer stay, and as I shuffled around in my standard-issue socks, I clung to it hard enough that there were indents from my fingers. That book helped me realize the project of my life: to make more visible the experiences of a few to both validate those experiences—to make those suffering feel less alone—and to make those experiences more legible to those who might not understand.

Erlichman’s familiarity with the subject and her general talent allow her to sculpt the poems that populate the book around the theme of mental illness versus “normality” (she’s not simply painting pictures; this is a visceral act). The book opens with “Snakes in Your Arms,” a narrative that rubs the speaker (and reader) up against a rigid psychiatrist who seems satisfied so long as the speaker believes in his version of reality, a reality where there are no snakes in the speaker’s arms. The snakes are a metaphor she employs to illustrate a problem that eludes words. Because of this, Erlichman suggests, and even though it’s physical, it’s a problem that cannot be treated, because the psychiatrist will not recognize the symptom beneath the metaphor. The dream-language of the neurodivergent is incomprehensible to the neurotypical.

The rest of the collection further tries to capture mental illness, a Herculean task, demonstrating how it exists in and interacts with the quotidian world—sometimes strangely, and sometimes so routinely that the sickness feels like just another fact. Getting blood drawn on a regular basis to check lithium levels, for instance, is a detail that is slightly irregular but not quite strange until Erlichman writes about it in an expansive way: “my dark syrup filling / one vial, two. / I watch the slow reddening, / rendering of human sap.” Later, in “89 Lines on a Bruise,” she makes this ritual as workaday as possible when alternating between the image of the bruise left from a recent blood test (a damning mark, perhaps, like a mole on a witch) and contemplation of a poem by the Former Poet Laureate of the United States. But the bruise begins to take over the poem, modeling the way mental illness and its strangeness pollute every aspect of life, from the symptoms themselves, to unending doctor’s visits, to weathering grueling dinner parties, the pain of that which “They” exposes: “I didn’t throw a chair, identify myself. I didn’t educate, or look at Kit.”

The prose poem “They” gets to the heart of “normal” versus mentally ill. From the first reading, it pulled at a thread in me—a thread of familiarity, of grief, and most of all, of recognition. “They” is a bite-size poem, taking up not even half a page: a mere eleven sentences, many consisting of a single word. But that doesn’t limit the power of this piece, which embodies a primary theme in Odes to Lithium: What happens when mental illness chafes against the normal, the rigid, the real?

Let’s analyze. “They” begins: “I was two days out when Kit threw a small dinner party.” This seemingly innocuous sentence, when diagrammed, reveals a few secrets: The speaker “was,” while Kit—a shadowy figure hovering over the piece but never taking her seat at the table, content to rattle around in the background, apparently neurotypical because it is never intimated otherwise—well, Kit “threw.” That’s a lot more active than the form of “to be” that Erlichman allots her speaker, whose agency comes into question, for example with the “misassigned drugs” taken as prescribed (one assumes) only to get puked back up. If the speaker were to throw a chair, it would be in defiance of her desire to pass as “normal” and in the service of her desire to finally be seen. But is she even capable of such an act of defiance? The climax of the poem might be chair-throwing, but it takes place in the speaker’s head.

The prose form works well for this interiority throughout the poem, visually mimicking the crowdedness of a mind taken over and apart by thought, and then the tragic moment of deadening clarity—“They. / I guess. / Need”—given so much space to breathe, set apart from the two framing stanzas and with each word on its own line, because this is the crux, “They” is what others the speaker. “I guess”is as in this is a half-baked opinion, but I feel entitled to give it anyway under the assumption that there are no theys here to make a scene (does anyone ever really assume the presence of the they?). And then there’s the “Need,” the element that makes my whole body flinch. The speaker may devour a small world at the end, but here we have worlds upon worlds of trauma—Erlichman draws on the collective experience of self-selected readers, every one of whom would also flinch at any hint of suggested neediness. You develop a certain sensitivity to a word when it’s been constructed around you so many times, and that’s some free context I will provide you to add to the reasons behind the subjunctive chair throwing.

It makes sense that the chair-throwing takes place mentally, since this is a poem about the speaker’s head (and, very slightly, how much more interesting it is than the external world). It is a poem about mental illness, about the invisibility of that state and the consequent small traumas this particular sufferer must undergo, but only as part of a larger social fabric wherein it is acceptable to other—to they—those who share the speaker’s plight. Meanwhile the speaker is busy not keeping quiet but rather maneuvering undercover, with all the subterfuge and obfuscation that entails.

Internally, the speaker does have some limited agency after all. After everything—after the ignorant guest speaks, after the sparked memories of the mental hospital—she chooses to narrow the scope of her world: “I focused my fork on a single pea, threaded the tiny planet, and examined it in the always changing light.” This, the reader realizes, is all the speaker feels she has control over. The narrowing of focus to the “single pea” and then the exploding out of calling it a “tiny planet” both shows her desire for complete control over everything (as a fellow sufferer of mental illness I can attest that when you can’t control yourself, you sometimes try to control everything else) as well as throws into question the relationship between scope and narrative in this piece. The pea is a pea, but it’s also a planet.

What to make of this line: “I wouldn’t be the one who days earlier wandered electric hallways, or slept in a foreign bed, who vomited the misassigned drugs and sparked with slinking visions”? This, really, is her explaining why she didn’t throw the chair or do something else to out herself. I have to say, again, as someone who’s been in mental wards, she nails the feeling. The hallways feel electric because of the fluorescence against so many sterile surfaces. The bed is foreign because they use those vinyl-coated dorm room mattresses then make them worse with the thinnest, scratchiest blankets you could possibly buy. And the drugs and the visions? Well, during my last hospitalization I lost three days after hallucinating a row of ants marching across the floor by the nurses’ station. Lithium poisoning, or at least that’s what was decided.

For Erlichman, the prose poem is a format that allows her grammatical manipulations to take center stage (although of course she loses the ability to play with line breaks). “Wander[ing] electric hallways” and “slept in a foreign bed” are positioned in “They” as equal—connected by the “or” conjunction. They are also aligned with “vomited the misassigned drugs and sparked with slinking visions,” as if the latter—taken wholesale—were only as bad as the former two instances of hospital behavior. This latter quote equates (“and”—no Oxford comma) “vomit[ing] the misassigned drugs” with “sparked slinking visions,” and I would guess that Erlichman, by packing two jarringly vivid nuggets together in one clause, intended to unnerve or maybe even scare a little. This is because mental illness is not trivial, not something that should be easy to write or read or talk about, and it’s important that she included elements in this piece that might come off as excessive or overwhelming (just the way those who suffer from mental illness can often come across as too much). The rest of the poem, despite the dramatic and painful narrative, lets the reader off pretty easy, something that isn’t true of every piece in the collection.

Erlichman does let the reader off the hook more than once, however, seeming to strike a balance between holding them accountable as witness and allowing them the freedom to connect, to even relate. “Portrait of a Release,” a painful piece about getting out of the mental hospital, ends by musing that the speaker’s mother loves color (which does, admittedly, hold more weight within the world of the poem than it appears to out of context, but it’s still rather soft). It’s a rapid de-escalation. And “Needle” ends impactfully but without much of an edge, veering almost off-topic: “I know what the sea knows / with the bottom of its mind / unfathomed.”

Still, Erlichman is versatile and sometimes ends a poem with a necessary gut-punch, following the energy she’s mustered in the poem all the way through, as in “Unwished For,” which treats the speaker’s reaction to a couple on a flyer looking for egg donors with “No history of mental illness”: “In my jean cutoffs, finishing what’s left of a soggy cone, drugs in my blood, unwished for by strangers.” The sheer aloneness of it! Or in “Dear Dr. Stone,” when the psychiatrist won’t listen to the speaker’s prior experience with Abilify (I have certainly experienced this lack of agency as a patient, and it is criminal), so the speaker ends up vomiting the drug on the carpet just like she said she would. There are centuries of neglect of mental health patients wrapped up in Dr. Stone’s final statement, which shows she only believes scientific evidence and that the lived experience of the mentally ill does not count as such: “Well, now we know.” “Now,” as in “we” didn’t know before. Compared to “They,” this is a similar if not disbelief then burying of mental illness.

In “They,” within the line “A few friends, tough meat, mapled carrots and soon talk turned political,” the lack of an Oxford comma is revealing. I am a scrupulous advocate of the Oxford comma for its clarity and precision, but that same clarity and precision allow for its conspicuous absence to speak. “Mapled carrots” has been tossed in the same sauce as talk turning political, thanks to the conjunction “and,” and as if (and for some, especially the guest who speaks, this may be true) politics are as easy to digest as a good meal. This hearkens forward to the vomiting imagery, and the reader may wonder whether the speaker’s illness will allow her to digest anything quotidian at all.              

They. / I guess. / Need,” works like a list. The whole poem functions somewhat like several lists sewn together, in fact. The plethora of commas serve to set apart or throw together, as commas do, and all this iterative energy creates a sort of halting feeling, contriving brief moments of stillness. In the first stanza the commas keep a sense of rhythm, creating cohesion in the speaker’s observations, though after the break in the middle that is the break(down) of the nameless guest’s language they more vocally partition, coming across with more of a weighted oomph than you might expect from such a slim curved figure.

These two are fairly innocuous-sounding sentences (despite the chair-throwing), at least divorced from the context of the collection: “I didn’t throw a chair, identify myself. I didn’t educate, or look at Kit.” I’m declaring this a list, too, on account of the commas and the way they function. The former sentence is missing a conjunction (although of course it’s not missing, as everything Erlichman does is deliberate). This, to me, equates the two clauses, much like an and might. As someone who also lives with mental illness, I can say that the syntax deployed above explodes what the mentally ill know all too well: sometimes, disclosing one’s illness might as well be throwing a chair in the middle of a small, apparently civilized dinner party. And throwing a chair, for the speaker, is identifying herself (as mentally ill). No wonder she’d rather stay under the radar.

The “or” in “I didn’t educate, or look at Kit,” set off by a comma, keeps the two clauses about as separate as possible while holding them in the same sentence. Educating the others about (her) mental illness is possibly diametrically opposed to looking to her friend (for support, presumably). The speaker in this poem, despite having had a (apparently safe, one assumes) place to go after the hospital where she wouldn’t be physically alone, is about as alone as humanly possible—at least in this particular piece. She is being attacked, and the only person who knows this is Kit (and Kit has the agency to stop it!). The guest attacking her doesn’t even know that he’s doing so, which is just the kind of erasure that those with invisible illnesses face daily. And the ease with which he uses such othering language mimics the effects of the quotidian world scraping against the many independently orbiting worlds of the mentally ill. Not only does the speaker lack agency in his presence, but she also has no one to defend her, and is as alone as if she were back in the hospital. I wouldn’t blame her for throwing a chair after all.


IMG_0912Hannah Page grew up in Minnesota, but likes to point out that her actual birth took place in Manhattan, where she has always felt most at home. She has resided in her beloved city since she moved there to attend Columbia in 2011 and is currently studying for her master’s in poetry at Columbia University School of the Arts. She considers herself a poet more than anything else and plans to teach university after she graduates. She writes to help erase the stigma against mental illness, to increase the visibility of the mentally ill in order to validate their internal battles and to make such experiences more understandable for the neurotypical. She lives near Columbia with her black cat, Draco. This is her second published work.