Everything Here Is Beautiful

Part 1 of the novel is broken into four chapters, three of which are told from a first-person point of view. The only chapter written in a third-person omniscient perspective is Chapter 3, when Lucia is inside of the psychiatric ward of a local hospital. The change in POV gives the reader insight into how all of the characters are reacting to Lucia’s hospitalization and refusal of treatment. It opens the door to see and understand the complexities of handling the medical treatment of someone whose mental health condition interferes with their life. Each person involved in Lucia’s care, including Lucia herself, has a different perspective and a different degree of control over the situation. Unlikely many other medical conditions, which are strictly kept to a patient and their medical team unless the patient chooses to share, Lucia’s case requires outside involvement, particularly when Lucia’s baby is put at risk because of her condition. Lee’s depiction of Lucia’s situation illustrates the difficult and complicated reality of living with mental health conditions, particularly the balance between respecting a person’s autonomy and keeping them from harming themselves or others.

Lee uses one of the nurses in Crote Six, Nurse Bob, to provide insight into the way that healthcare workers compartmentalize their interactions with patients by labeling them as their mental illnesses: “Depressives, psychotics, addicts, abusers, borderlines in search of three hots and a cot, especially after the holidays. It wasn’t fair to label them, but he did. Everyone did. It kept things manageable” (93). This highlights The Stigmatization of Mental Health Conditions even in the medical field. Nurse Bob feels he must detach himself from his patients in order to do his job properly. He feels that reminding himself of their conditions, rather than bonding with them as individuals, will allow him to handle the mental taxation that comes with working in healthcare. However, this is ultimately harmful and dehumanizing to the patients. This practice directly juxtaposes some of the teachings in the ward that Lucia later points out: “Schizophrenia doesn’t define me. It’s not who I am. We learned that in Group today, didn’t you hear?” (121). Labeling someone as their illness invalidates their humanity and overlooks all of their other characteristics, placing them within a box built of stereotypical assumptions. This discourages many people with mental illnesses from seeking help.

Chapters 3 and 4 explore the theme of Balancing Self-Care and Family Obligations primarily through Miranda. Miranda, in her desire to help Lucia and the responsibility she feels for her, meticulously documents all of Lucia’s history with medications and her illness. Her desire to do this shows how much she cares for Lucia, and her ability to include so many details illustrates just how much of her life she’s devoted to Lucia’s care. Nurse Bob comments that, in contrast to Miranda, “[t]oo many family members came through their ward already wrung out by the system, slumped in their chairs, panning the room with dull eyes. No opinions, no hope, no fight” (104). Everyone’s experience with mental illness and family involvement is different; here, Lee points out that mental illnesses are often lifelong conditions that can leave families and patients alike feeling exhausted and helpless as they cycle through the healthcare system. The quote also comments on how little support people with mental health conditions receive within the healthcare system; this is later emphasized by the social worker’s desire to release Lucia from the ward as soon as she shows signs of improvement.

Multiple characters note the concerning degree to which Miranda devotes herself to familial obligation. Nurse Bob reminds her that “[she] can’t keep fighting [her] sister’s illness all by [herself]” (124). Not only is it unfeasible, since Miranda no longer lives in the same country as Lucia, but it is also too much pressure for Miranda to carry by herself. Because their mother entrusted Lucia’s care to her, Miranda feels solely and personally responsible for Lucia’s care, which means she blames herself for Lucia’s setbacks. She is reluctant to allow Lucia freedom, particularly the freedom to make mistakes.

Stefan echoes Nurse Bob’s thoughts, reminding Miranda that she is doing everything that she can to help Lucia, but Lucia needs to want to help herself. Stefan speaks out of care for Miranda, but Miranda rejects his advice and reassurances, which she feels are dismissive. Stefan does share her cultural understanding of familial obligation, nor does he know what it is like to be the primary caretaker of someone with a mental health condition. Miranda tells him, “This is not some fairy tale. Things do not turn out okay just because you want them to” (127), which shows her deep belief that she must be personally involved in Lucia’s care to ensure that Lucia is safe and well.

Miranda’s statement functions in several ways. First, it acts as a piece of foreshadowing for Lucia’s death at the end of the novel; things do not turn out okay despite everyone’s best efforts. Second, the line acts as a stark reminder of the realities of living with mental illness. While many people with mental health conditions are fully capable of living independent, fulfilled, and stable lives, some mental health conditions require lifelong treatment and management, which must be taken into account by the individual and everyone involved in their care.

Chapter 4 returns to first person point of view and is broken into non-linear sections. The chapter transverses between the events of Chapter 2, in which Lucia and Manny meet and have Esperanza, Chapter 3, her experience in the psychiatric ward, and the events following her release. The non-linear retelling of events combined with the use of a first-person point of view present Lucia’s own understanding of the situation, allowing readers to see her thoughts and feelings about her life and her mental illness.

Lucia remarks, “In Crote Six, they said I ‘suffer’ from schizoaffective disorder. That’s like a sampler plate of diagnoses, Best of Everything. But I don’t want to suffer. I want to live” (147), which speaks to the biases inherent in the vernacular used to discuss mental health conditions. Lee juxtaposes discussions of mental health with physical health through Lucia and Nipa’s discussion of postpartum depression: ‘In all these years, no one’s ever told me I suffered from cancer.’ […] It occurs to me that no condition covered in the DSM-IV is ever followed by the word ‘survivor’” (153). The DSM-IV is a diagnostic and statistical manual that outlines mental illness diagnoses. Lucia and Nipa observe that language reflects the way society perceives physical and mental illnesses, and the way that they are treated differently depending on which type of illness they’re dealing with.

The Stigmatization of Mental Health Conditions is further shown when Lucia remembers being told she “had a twenty percent chance of maintaining a full-time job, a twenty-five percent chance of living independently, a forty percent chance of attempting suicide, a ten percent chance of succeeding” (171-72). Lucia, at the age of 26, is told by medical professionals that she will not succeed in life and that she will struggle to live independently. The people who are supposed to help her have already written off the idea of Lucia having a long, happy, independent life. In presenting this information, Lucia describes her diagnosis as a punishment: “That first hospital stay, I was a compliant patient, a Sweet Asian Doll, and for this I was branded with a Severe Lifelong Mental Illness” (171). This suggests that, by acting in accordance with societal expectations, Lucia convinced the hospital staff that she was stable and mature enough to handle the reality of her diagnosis. This also speaks to the biases inherent in the treatment of mental health conditions: the goal of getting a patient to a certain behavior standard, which is considered “normal” by broader society.

Lucia’s description suggests that she genuinely believed compliance would get her released without further inquiry, indicating that she is aware of which behaviors are deemed concerning and which are viewed as normal. However, Lee casts doubt on Lucia’s reliability as a narrator by describing the way Lucia’s condition affects her life. This builds the theme Perception Versus Reality, as Lucia explicitly states that “[b]y the time it became obvious, [she’d] crossed the threshold, lost all capacity to distinguish what was real from what was not” (171). Lucia describes the way she stopped caring for herself, the way she began to believe certain things with no basis for them, and the way the “serpents” spoke to her in her mind. By presenting this information directly before Lucia’s hospital stay and diagnosis, Lee leaves the reader to decide on the accuracy of Lucia’s depiction of events.

The theme of Perception Versus Reality also comes into play regarding Lucia’s care, particularly with Miranda’s involvement. At the end of the chapter, Lucia thinks, “Jie always used to be on my side, but now all she sees is my illness” (197). Miranda’s worry over her sister is well-intentioned, but to Lucia, it represents an erasure of her individuality and independence. Miranda believes she is helping her sister gain the tools she needs to live a happy life, but in reality, Lucia is hurt by Miranda’s dismissal of her capabilities; on the other hand, because Lucia has endangered herself and Essy, the risk of allowing her to return to her family without medication and a treatment plan is substantial. Through this complicated scenario, Lee points out that there is no singular “reality,” and that multiple people perceive the same situation in different ways.