**First appeared in the Mail & Guardian on Friday, September 27 2024.

You shouldn’t have to survive your parents. You shouldn’t have to survive yourself. Least of all when you are fighting tooth and nail to survive South Africa.

Lesedi Molefi’s memoir Patient 12A, is a raw and emotive account of just that. But it’s not just that — intermingled with survival is a life underscored by candour, love and intense optimism.

Set at the Akeso Clinic in Parktown, Johannesburg, Molefi unravels his 21-which-turns-into-24-day passage at the private mental health institution and the two decades on the run from, and with, his family that necessitated him checking in in the first place.

Some of the factors include parental abandonment; managing the symptoms and consequences of undiagnosed mental health issues and constant uprootedness and hunger. 

Tipping the scales ever so slightly, and perched on the other side of these circumstances, is loyalty, creativity and unbridled self-belief.

With my previous insights into stays at mental health facilities limited to the accounts in Sylvia Plath’s The Bell Jar and Ken Kesey’s One Flew Over the Cuckoo’s Nest, I had braced myself for coldness and rigidity, but was pleasantly surprised and relieved when, instead, the walls that house this clinic were safe and warm. This is because of something unique — the people Molefi finds there, a “cross-section of ordinary South Africans”, as he calls them.

Together they parse their traumas, relate and commune authentically. 

Running alongside formal treatment sessions and various forms of therapy, this community of patients provides another lifeline to, and through, one another. 

But it isn’t all kumbaya — the clinic and its patients still mirror the stratified, unequal society they are sheltering from.

South Africa still slips under the doors and colours some tough discussions about who gets to hurt and be hurt based on their race, gender and prevailing stigmas, proving the South African condition is inescapable.

The circumstances that led other patients to the clinic include drug abuse, domestic abuse, grief and self-harm in its various forms. The trauma that informs their inner lives reflects the lived realities of millions of people in this country.

Abuse of power, the violence of poverty, chronic neglect and broken interpersonal and familial relationships are common threads. 

This external backdrop of extreme inequality, and the violence thereof, must be surmounted daily, an impossible task for anyone, much less someone without the socioeconomic resources that afford one relative safety, space and access to process with grace and dignity.

The most ubiquitous and immersive device in the memoir is “the noise”, the literary and internal universe Molefi steeps us in. 

The noise emanates both from him and through him. It is a whirlpool of his consciousness and internal struggles, used to transport us fluidly from the past to the present with careful clarity.

While he describes the noise as chaotic and disruptive, for those reading this work, the noise is an expert and intimate guide through the passage of his mind. 

The complicated thoughts and feelings that colour and blur his cognition help readers  to identify where and how they intersect, overlap and relate to the vast array of pain points chronicled.

At the launch of Patient 12A a few weeks ago, and in subsequent interviews, the author has been at pains to emphasise that this isn’t a self-help book. He goes out of his way to avoid listicles and passages filled with advice and definitions from medical and psychology journals.

But through the careful reconstruction of tobacco-stained conversations in an inner-city courtyard, he does the work of inviting people to see themselves through his personal anguish and through the highly relatable experiences of the other patients “doing time”.

Without spoiling it for anyone yet to read it, the memoir’s true heartbeat and nerve centre — and by extension Molefi’s — are his mother and sisters. From a very young age he is driven and compelled to protect them, but he can’t, and that inability taints every attempt at a semblance of normality — something he yearns for from their first uprooting through to their last.

Initially, one can be taken by the adventure that swirls around the first few “trips” their mother takes Molefi and his siblings on, the promise of greener pastures. But it soon turns into concern and quiet rage when you realise that the four of them are in fact being dragged from one terrible situation to the next.

Homelessness and hunger are always assured but not much else. The children try to grapple with their mother’s simmering mental illness and keep one another fed, educated and away from the monsters that lurk in the shadows as they move from one precarious place to the next.

The scars of their experiences play out in different ways and at different stages for each of them but Molefi articulates his payoff as “a strange education”. 

By the time he is in his twenties, he is a master of survival — not quite the education he wanted but the one that  has carried him thus far.   

My copy of the book is dog-eared, tatted up in orange highlighter, has travelled on planes and trains, and watched me drink copious amounts of coffee as I struggled to put it down.

What really carries one through the 408 pages is Molefi’s ability to write about pain and trauma with a level of honesty and vulnerability that invites one in and that, quietly, asks one to look at him in the context of “the facts of his life”, directly in the eyes — and not look away when he shows you who he is.

Through the whispers and shouts of the noise, Molefi speaks himself back to life. 

It is prose, it is poetry, it is beautiful.

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Patient 12A is published by Pan Macmillan South Africa.