Schizophrenia and family caregiving   

A Book Club Discussion Guide to Shot in the Head, a Sister’s Memoir, a Brother’s Struggle

This story can impact the reader at several levels. However you approach it – as personal memoir, curiosity about the reality of schizophrenia, or as a simple story of how a family came together to care for a loved one with a serious mental illness,  I hope these questions will help to stimulate some good discussions.

1.    Some of the scenes in Shot in the Head take place more than fifty years ago.  Others involve emotionally-charged situations.  The author states that the book’s dialogue and sequence of events are her “best efforts to present what really took place.” How is its accuracy important to your experience of the book?  What do you expect when you read a book classified  as memoir?

2.    The author describes her lack of involvement in Paul’s care in the first few years of his hospitalization.  What factors contributed to that distance?  How does she change over the course of Paul’s illness?

3.   As much as this book is about Paul and Katherine, it is also about the whole family, especially the other siblings – Monica, Ilene, Patrick, Sheila, etc.  Did you identify with any of the siblings? Which one?  How did ​their relationship with their brother change during the course of his illness?  Where do you see the changes?

4.     Paul’s care changes dramatically over his lifetime.  How do Federal and State legislation impact his care?  What role do you think public agencies, the medical community and insurance companies should play in the care of someone like Paul?  What role should be played by the family – parents, siblings, children? What help do family caregivers need?

5.    How is the care received by people who suffer from brain diseases different from the care received by people who suffer from malfunctions of other body organs such as the kidneys, heart or pancreas?  What factors have led to these differences?  Do you think a person with serious mental illness should be forced to accept treatment? 

6.    Society also deals with brain disease differently than other types of illness.  For example, if your neighbor has breast cancer or a heart attack, you bake the family a cake or offer to help get the patient to medical appointments.  How do you react if you find out a neighbor has bi-polar disorder or schizophrenia?  Why?  How can this change?  

7.    Which of the stories about Paul- things he did, things that happened to him – touched you the most?  

8.    When Paul begins to suffer pulmonary problems, he is diagnosed first with pneumonia.  How do you think his cognitive impairment impacted the level of care he received?  How did it impact his care from the oncologist?

9.    How did his care change when his sisters had him transferred to a nursing home?  How did his behavior change?  Why do you think it changed?

10.    The author uses several genres to put forward her story – narrative, emails, poetry, pictures.  How do these different genres impact the reader’s enjoyment and understanding of the issues and the characters?

11.    Do you believe Paul is better or worse off when he is released from the state hospital?  Give examples of how his life changes.  How do we balance the trade-offs between a person’s desire for freedom and the knowledge of the medical establishment that he or she needs supervision?  Where else in our lives do we see similar trade-offs?

12.  Has your perception of mental illness changed since reading Shot in the Head?  If so, how?


Memoir of caring for a sibling with Schizophrenia

Using prose, poetry, emails and family photos, Shot in the Head a Sister’s Memoir, a Brother’s Struggle, is a mixed genre memoir by Katherine Flannery Dering that follows her family’s efforts to care for her younger brother, who first exhibited signs of schizophrenia at age 16. It is a personal tale of trying to make sense of our country’s disintegrating system of care for mental illness, while dealing with the aftermath of her loved one’s struggle.

It has earned 4.5 out of 5 stars from 19 ratings and 12 reviews on Goodreads and a 4.8/5 stars rating on 25 reviews on Amazon.

“enlightening and educational work!” New York Journal of Books


Here are links to three web  pages with more information:

Click here for:    Publisher’s information about Shot in the Head

This is a direct link to  Amazon Reviews, (which were great) The book is on sale for the gift buying season.

This site provides several pages of information, including where to buy the book, some reviews, information about the book’s cover art, and additional pictures and information about the family:

Indie Go Go: From family caregiving to a documentary

My brother, Paul, developed schizophrenia at age 16. Seemingly overnight he became psychotic, going from charming, handsome high school junior to someone unable to differentiate between reality and horrifying delusions.  He could not believe that he was actually mentally ill, and often told people his brains had been damaged when he’d been scalped, or that someone had shot him in the head. He once cut a large gouge into the flesh behind his ear, trying to find the radio someone must have put into his head. He was carried out of the house by EMTs, bleeding heavily. He needed psychiatric care for the next 32 years, but often suffered needlessly, due to the shortage of hospital beds for mentally ill people. Hundreds of thousands of our fellow Americans are suffering, often homeless or incarcerated for the simple crime of having a brain disease.

The Meeting of Activists

Not everyone realizes how difficult it is for families who are struggling with the often impossible burden of caring for someone like Paul. I wrote about caring for my brother and the impact it had on our family in my book, Shot in the Head, a Sister’s Memoir a Brother’s Struggle. Ilene, his twin sister, travels and writes to promote changing laws to enable families to get better care for the loved one.  We are not doctors, but we have faced this illness on a personal level.  Both of us have become mental illness activists.

A psychiatrist named Dr. Stephen Seager came across my family’s story in a blog written by Ilene.  Steve met up with us when we were in California for a NAMI conference–a large convention for the National Alliance on Mental Illness–in SanFrancisco.  He then interviewed us for a documentary he is producing called Shattered Families, the Collapse of America’s Mental Health System.  Dr. Seager is convinced that if America sees how devastating serious mental illness is for the whole family and how our current system of care doesn’t help properly, that our lawmakers will become convinced to change things. He is interviewing people across the country and contributing an account of his own chilling experiences at a state forensic hospital, which he has also described in a book called Behind the Gates of Gomorrah.

Our stories are heartbreaking, but Dr. Seager has ideas on how to make it better. Won’t you help us get the message out?

This is where Indie go go comes into the story, and your chance to be part of it.

Getting the family stories on film is only part of the project.  The rest is getting some post production work done and then doing the marketing.  Making copies, traveling to talk in person with distributors.  This is totally different from going to a bank for a loan or applying to some government agency for a grant.  This is a grass roots, please help us fight a terrible terrible disease one-on-one effort. Dr. Seager has brought our documentary to the crowd sourced funding world.  I hope you will join us.

 Everyone who contributes to the cause will get their name included in the credits at the end of the film.

Please join our cause. Go to the indiegogo web site or click on our video on youtube.  Listen to Ilene talk about Paul, and make a contribution to the Shattered Families cause.  Put your name next to mine, and join our effort to make the world a little bit better place.

Katherine Flannery Dering