Most readers know Paul Gruchow as the Henry David Thoreau and Aldo Leopold of Minnesota. His essays and books ("The Necessity of Empty Places," "Travels in Canoe Country") are filled with micro and macro descriptions of the state's prairies, ponds, lakes and woodlands -- everything from the brightly colored fairy shrimp in roadside ditches to the "sweet stench of wet earth" after a killer hailstorm. The writings are philosophical, as well, lamenting a commercialized culture and extolling the virtues of bread-baking, gardening and canning tomatoes.

Gruchow, who suffered from debilitating bouts of depression, left behind a very different kind of book when he died by his own hand at age 56 in February of 2004. "Letters to a Young Madman" details his many psychiatric hospitalizations and his (futile) experiences with pharmaceutical, electroshock and other therapies. After a bit of legal and estate wrangling, the manuscript is now in the hands of Milkweed Editions in Minneapolis and will be published in the spring of 2009 (along with a paperback reprint of Gruchow's first book, "Journal of a Prairie Year").

"It is a painfully honest and incredibly moving piece of work," publisher Daniel Slager said of "Letters to a Young Madman."

The book is composed of entries (some only one sentence long), written in "an intimate, pleading" tone and addressed to a young sufferer (in the manner of Rilke's "Letters to a Young Poet"). By turns angry, funny, insightful and blaming, Gruchow details his decline with the same searing powers of observation that he had reserved for the natural world.

And with the same urgent call to think a little deeper.

The first entry, "Against Amusement," begins: "The primary difficulty in writing a book such as this is that it cannot meet the test of what is vulgarly known as a good read; it cannot be amusing. ... You could be amused forever and ever, and you'd need never know the heights and depths to which human beings are ordinarily called. But what purpose might this serve? Is life so awful that we can't be serious about it for a minute? Is nothing worth a quarter of an hour's sobriety?"

Slager, whose father is a mental-health professional, said that some of the manuscript's most convincing and compelling entries have to do with the "problem of the infantilization of patients in that situation -- right down to details, of what they're issued when they first arrive [at the hospital], how they're talked to, how they're empowered or not. It's not even really treating them like children. It's treating them like infants."

He worried, he said, at the harsh calling-out of some doctors and experts in the field, but decided that the manuscript is "quite fair and balanced, if incredibly critical."

Another worry, Slager said, was knowing that the book is "punctuated by a suicide." He said that staffwide discussions were held on the potential for a "Werther effect," named for the rash of suicides that followed the 1774 publication of "The Sorrows of Young Werther," Goethe's novel of unrequited love. "If this piece of work -- even if indirectly -- contributes to a suicide, that would be devastating for me," Slager said.

But even as Gruchow is narrating the destruction of human dignity, he also is reassembling it, Slager said, quoting from the book's humorous last entry: "Thank you, dear reader. I've been restoring myself through the agency of these words. Your attentiveness has been most helpful. Please do not, however, though you have earned it, send me a bill."

Said Slager: "It is such a powerful piece of work -- so empathetic, so sensitive and so understanding -- I think it can do far more good than harm. It's to my mind a no-brainer. It must be published, and we're the right publisher for it."

Saraht T. Williams is the former Star Tribune Books editor.