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 “The great gift Jamison offers here, beyond her honesty and the beauty of her writing, is perspective: a clear-eyed view of illness and death, sanity and insanity, love and grief.”— Reeve Lindbergh, The Washington Post

In this moving portrait of her marriage and the aftermath of her husband’s death, Kay Redfield Jamison explores the ties that held them close during times of uncommon challenges and unanticipated joys.  A clinical psychologist and the author of the acclaimed memoir, An Unquiet Mind, Jamison struggled with manic-depressive illness since early adulthood. Her husband, Richard Wyatt, M.D., who was impaired by severe dyslexia, became a leading researcher on schizophrenia and Chief of Neuropsychiatry at the National Institute of Mental Health. In his early thirties, he survived Hodgkin’s disease.
Wyatt was forty-five and Jamison thirty-eight when they met in 1985.  For nearly twenty years, they delighted in their love for each other, their shared interest in science and medicine, and the knowledge that each had been given a second chance at life. Wyatt saw Jamison through the mercurial moods of her illness and fully supported her decision to tell the truth about her life in An Unquiet Mind. Their professional lives were productive and often hectic, their personal lives filled with romantic vacations, Wyatt’s charmingly outlandish gestures of love, intensely satisfying physical affection, and quiet moments of reading and conversation. Both seemed to be enjoying good health until 1999, when Wyatt was diagnosed with lung cancer. Despite cutting-edge medical procedures, he died in the spring of 2002.
Nothing Was the Same celebrates the many different ways love is expressed and reveals how it survives painful situations and loss. The questions, discussion topics, and suggestions for further reading that follow are designed to enhance your group’s discussion of this remarkable book.

Questions and Topics for Discussion

1. How does the prologue set the stage for Jamison’s investigation into grief?  What does it convey about the narrative method she has chosen to employ? Does her expertise as a psychologist color her description of her immediate reaction to her husband’s death?

2. What personality traits contributed to Wyatt’s ability to deal with dyslexia? How did the circumstances of his childhood affect not only his intellectual development but also his ambition and choice of career? Does his experience with dyslexia both as a child and an adult provide insight into learning disabilities and how they are generally perceived?

3. Jamison writes, “We were temperamentally different in critical respects—his passion for work over people; my intensity and less settled ways—but at the start of our life together it was my manic-depressive (bipolar) illness that created the greatest misunderstanding and discord.”  To what extent does Jamison’s illness determine the nature of their relationship? What are the implications of her saying, “I could live with my mercurial moods, but it was not clear that someone else could, or should”?

4. What emotional and intellectual factors play a role in Wyatt’s response to Jamison’s illness, as well as his mechanisms for dealing with troubling incidents? What does his decision to keep antipsychotic medication at hand demonstrate about the conflicting pulls of trust and uncertainty in their marriage? Are Jamison’s feelings of betrayal justified? Does Wyatt’s response—“I am imperfect. . . . You are imperfect. . . . Love is imperfect”—define the foundation of successful marriages and relationships? 

5. Jamison writes,  “He kept fastidious notes on everything he could measure. . . . I clearly had become a project to him, one that was useful in figuring out patterns in my illness, as well as creating enough interest to keep his mind engaged.” Do scientists and doctors address serious illnesses differently from non-scientists? What are the benefits to both patient and caregiver of an objective approach like Wyatt’s? Is there a negative side as well?  What, for example, might be the unintended effects of regarding a patient as a “project”? 

6. “My brain, as Richard explained it to himself and to me, was a delicate ecosystem . . . which was kept alive through a finely honed mix of lithium and love and sleep, or as he imagined it, ‘water grasses and dragonflies, and a snail or two to tidy up.’” This is one of several metaphors for illness that appear throughout the book. What does the use of metaphors, analogies, humor (“[Richard] had, as he put it, the fine motor coordination of a clam”), and other devices reflect about the way we deal with disabilities or illness? 

7. Jamison records Wyatt’s physical reaction to chemotherapy and a bone marrow transplant in graphic detail and also describes his emotional state, writing  “he remained imperturbable and wryly engaged with life. . . . He did what I had always known him to do when he was hurt or worried: he turned inward, to his imagination.” How do his experiences compare to that of cancer patients you have known? Why do some patients manage the effects of cancer treatments better than others?

8. In writing about his impending death, Wyatt says, “Certainly there were many times I did things that hurt others or committed sins of omission, but by my accounting I stayed ahead and feel I am still ahead. For me, not being in debt means I do not have to be concerned about death.” Do you agree with the sentiments he expresses? What other aspects of a person’s life would you add?

9. What do her trips to California represent to Jamison? In what ways do they reflect her inner journey and her acceptance of the inevitability of Wyatt’s death?

10. “I realized that it was not that I didn’t want to go on without him. I did. It was just that I didn’t why I wanted to go on. It would have to be an act of faith.” Talk about how memories of Wyatt, the consolations of friends, and Jamison’s ability to imagine “a different way of being together” all help sustain her during the early days after Wyatt’s death. What other resources does she draw upon?

11. In the chapter that takes its name from Freud’s famous essay, “Mourning and Melancholia,” Jamison explores the things that depression and grief have in common and those they do not.  What do you see as the most salient differences between the feelings of loss suffered in depression and in grief? How do the words of C. S. Lewis, Robert Lowell, Edna St. Vincent Millay, Graham Greene, Tennyson’s In Memoriam, and Freud himself help clarify the ways individuals and society have learned to deal with grief?

12. Are Wyatt’s and Jamison’s attitudes influenced by their ability to take advantage of medical advice and breakthroughs not available to others? What does their story demonstrate about America’s medical system? What does it reveal about the possibilities, as well as the limitations, of modern medicine?

13. How much do Jamison’s needs as a wife and a widow affect her descriptions of Wyatt? How does she enhance and expand upon her personal feelings to capture Wyatt as a beloved man and respected professional?

14. If you have read An Unquiet Mind, in what respects is Nothing Was the Same a sequel? What themes or message emerge in both books? In what ways has Jamison changed in the years since An Unquiet Mind and what accounts for those changes?

15. The book’s title comes from the poem by Stuart MacGregor that appears at the beginning of the book. What images and allusions in the poem make it particularly apposite to the story Jamison tells?

16. Does Nothing Was the Same transcend Jamison’s personal story to illuminate the universal experience of grief? What practical guidance and emotional insights does the book offer to readers?

(For a complete list of available reading group guides, and to sign up for the Reading Group Center enewsletter, visit

About this Author

Kay Redfield Jamison is the Dalio Family Professor in Mood Disorders and Professor of Psychiatry at the Johns Hopkins University School of Medicine.  She is co-director of the Johns Hopkins Mood Disorders Center and a member of the governing board of the National Network of Depression Centers.  She is also Honorary Professor of English at the University of St. Andrews in Scotland and the author of the national bestsellers An Unquiet Mind and Night Falls Fast, as well as of Touched With Fire and Exuberance.  Dr. Jamison is the coauthor of the standard medical text on bipolar illness, Manic–Depressive Illness:  Bipolar Disorders and Recurrent Depression, and the recipient of numerous national and international literary and scientific honors, including a MacArthur Award.  In 2010 she married Thomas Traill, a cardiologist and Professor of Medicine at Johns Hopkins.
Kay Redfield Jamison’s Exuberance, Night Falls Fast, and An Unquiet Mind are available in Vintage paperback.

Suggested Reading

John Bayley, Elegy for Iris; Glenda Burgess, The Geography of Love; Anatole Broyard, Intoxicated by My Illness; Lynn Darling, Necessary Sins; Joan Didion, The Year of Magical Thinking; Sigmund Freud, Mourning and Melancholia; C.S. Lewis, A Grief Observed; Robert Lowell, Life Studies; Anne Roiphe, Epilogue; Alix Kates Shulman, To Love What Is; Abigail Thomas, A Three Dog Life; Calvin Trillin, About Alice
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