This is the autobiography of a member of a professional, artistic Irish family whose promising career was devastated when, at the age of 20, he developed schizophrenia. In lucid prose, and with deep sensitivity and insight, Anthony Scott outlines the perplexity, anguish and isolation he suffered, and the confusion this brought to his family and friends. He communicates very clearly and in the context of his everyday life not only his paranoid delusions and terrifying anxieties, but the equally debilitating inability to concentrate and to organise his thoughts, and the sheer inertia. The immediacy with which he communicates his pain makes it almost unbearable. He identifies a number of features in his life which supported him and which contributed to his ability to cope with the ravages of his illness. Firstly there was his childhood in a caring family, where he developed as a self-assured, well-educated, socially adroit young man. He believes that this background was a positive resource, and that his family's continued love and support was a central feature. We can readily understand their bafflement as in coming to know and accept the nature of the illness, they are confronted repeatedly with the severe limitations it imposed.

Recoiling from the prospect of their son being relegated to a back ward, they were fortunate in being steered to Dr David Clark, the pioneering social psychiatrist, at Fulbourn Hospital, Cambridge. Here, the traditional custodial mental hospital apparatus was being dismantled, and the therapeutic community approach forged and implemented. As with the other patients, Tony Scott's individuality and personal skills were recognised and fostered. His next break was his relationship with Nancy, a divorced fellow patient. Courageously (this was the early 1960s), this was supported, his family's understandable reservations were addressed and they were married.

The book continues as a remarkable love story, and is dedicated to their son. The couple set up home in the Cambridgeshire fens, where Tony worked as a bus conductor. The new psychotropic drugs were prescribed as they came on stream and although they kept the psychosis at bay, the side-effects posed very real problems. Nevertheless, the two patients overcame these as they grappled with the increasing complexities of everyday life. The author supplies vignettes where his misreading of social situations and his inaccurate perceptions of others’ intentions resulted in misunderstandings, and at times evoked hostility or derision. His core personality, his decency and his good humour shine through as he repeatedly picked himself up and returned to the fray. He subsequently trained as a teacher, and at the age of 36 spent 3 years at Leeds University, where he took an Arts Degree in French Language and Literature. He derived great satisfaction from writing this book, which he hoped would help his fellow sufferers. Then shortly after returning the proofs, he died from natural causes.

This is an important work for psychiatric professionals. It should stop us in our tracks and centre us again on our patients’ humanity. It offers both a headline and a challenge, and indeed provides many, many lessons and causes for reflection. Not least, we should listen carefully to what our patients say. From a neuropsychiatric perspective and unlike the computer, they can tell us about their cognitive functioning. As Professor Anthony Clare writes in the fulsome Foreword, ‘psychiatrists, nurses and community health workers will never read a more revelatory and illuminating insight’.