Book Review: A Bitter Pill to Swallow by Tiffany Gholar

I received a free e-copy of this book in exchange for an open and honest review.

TW: suicide ideation, depression, depictions of mental illness treatment centers

A Bitter Pill to Swallow by Tiffany Gholar is a young adult novel set in Chicago. The story follows multiple characters in story lines that intertwine as the novel progresses; however the main story follows Devante and Janina and their experiences at the Harrison School for Exceptional Youth. Janina has been at the school for four years, while Devante started attending the school recently after experiencing a traumatic event. The story explores individual journeys as well as the relationships that form in between the characters. This includes Dr. Lutkin, one of the founders of the school, Dr. Gail Thomas, a medical resident with her own traumatic experience, the other students attending the school, and of course the big bad evil company who owns and influences the Harrison School.

I have one major gripe and I will get it out of the way up front. The one story line I felt did not add to the overall experience with the novel was the one about the evil company controlling the school. There were two or three shorter chapters on this story line before the issues were resolved. I felt this really did not have an impact of the overarching plot because the subplot line was not developed as in depth as I was hoping. Why was the decision to sell the school to the company made in the first place? Why didn’t the company provide any resistance in the final outcome? I think the author was trying to illustrate and expose that companies in real life do control treatment facilities with the sole goal of profiting. For me, this could have been a more intricate and powerful story line, but without much focus on it, the interactions with the company and Lutkin’s decisions around sacrifice fell flat.

I am not an expert on mental health and mental ability, and definitely do not have statistical knowledge around diagnosis, misdiagnosis, and over-diagnosis. There are narratives around diagnosis and misdiagnosis in A Bitter Pill to Swallow. While the plot seemed to work out too smoothly, in the sense of how Dr. Gail Thomas found a particular article that pointed to one of the resolutions, I think it worked to talk about how systemically we diagnose and assign treatment plans to folks. Do I think representation of marginalized communities was done well? Yes and no. All the characters were people of color, yet the author did not harp on those facts. To me, this is a nice and refreshing way to experience diverse characters -> yes, they are people of color but the story is not solely about race or because of their race. I am still unsure how I think ability was represented in the book and I recognize I am a part of the privileged temporarily able-bodied community. Throughout my reading, I saw both personal narratives and general stereotypes when it came to certain characters and their experiences. I see the Harrison School as a piece of the story to challenge dominant narratives around mental ability whereas the Haven House, another “school” talked about in the book, represented the dominant narrative. As I mentioned in another recent book review, it is important to remember these stories are not the entire experience or the only experience of a community. These stories may reflect certain individuals experiences or even general struggles; however, these communities are complex and diverse within itself.

One of the aspects I was hoping the book to address more in depth is the socioeconomic disparity between different communities seeking help. There was a piece in Dr. Gail Thomas’s story about this disparity when she worked at the Haven House. This facility lack resources and competent professionals, and was portrayed as a  heartless facility that provided outdated treatments with a “get in, get out” mentality. This is contrasted with the Harrison School that provides customizable treatment and curriculum for students with no time crunch. I cannot even begin to imagine the cost of a bed at a facility like the Harrison School. And even if the cost was waved (paid for by government grants or another means), the knowledge of how the system works is limited. Only a select group of people might have the money or connections to get into the Harrison School and further, we know that access to quality resources is not equitable across communities. This mainly and disproportionately affects communities of color, folks from low socioeconomic status, and the LGBTQ+ community. As I read about the Haven House and the Harrison School, I was hoping for more of a dive into a critical look at the disparity.

The title of the novel works on many levels and sums up the book well: the literal bitterness of the medicine administered to the students and the bitter situations each character finds themselves in. By no means did I dislike the book, but between the multiple points of views and story lines that did not intertwine as much as I expected, I found myself disengaging for many of the characters. There were times throughout the book where I felt like the stories were all over the place with no common thread to bring it together. I tend to like books with multiple perspectives, but for some reason I could not get into A Bitter Pill to Swallow in the same way. The two main characters, Janina and Devante, I felt the most connected to and it is in their narratives is where I think the book shines. While I am critical in my review, I do think this book has value. If it seems interesting to you, I would encourage you to pick up a copy!

Final Rating: 3.7/5