Voluntary Madness Part 11

Forget reporting. Forget guinea-pigging myself and submitting to whatever they might or might not see fit to prescribe me. I was in full-on patient mode. I was being stubborn because I knew that I would probably have to go back on some drug to dig myself out of this hole. But for now it was on principle that I refused. I wanted to do it when I I was ready, not when the "for your own good" brigade decided. was ready, not when the "for your own good" brigade decided.

I had met with the on-call doc over the weekend, a cursory Turk who finished my sentences and scribbled his two cents in my binder. MI. Yep. Sure enough. Depresso domesticus Depresso domesticus. Run-of-the-mill.

"You want something to sleep?" he said.

"Sure," I'd said. "Why the h.e.l.l not."

But today, I was meeting my keeper/king of the hill, the guy who had power. That was how it usually worked in these places, at least the ones I'd been to. The MD psychiatrist sat at the top of a pyramid and delegated everything down.

Beneath him (at St. Luke's anyway, where there were such luxuries) were the psychologists, the PhDs accorded the respect of their educations, though they were largely symbolic and without real pull. They did give you therapy, however, three times a week for fifty minutes. Actual one-on-one talk about your problems, believe it or not.

Then there were the social workers, the nurses, and finally the psych techs. Psych techs were babysitters. They had no degrees, no real qualifications but youth and optimism. They took you on smoke breaks, they led formality wrap-up discussion groups at the end of the day, and they told you to stop gambling with Skittles.

But the doc was the man. Everyone else was really a peon with pretensions. Everything you wanted came through him. To every significant question the stock response was: "You'll have to ask your doctor about that." So, if your doctor was a d.i.c.k, you were screwed.

Still, I was going to fight like with like, if need be, and get myself an hour pa.s.s to leave the hospital, even if it meant sucking up to his expertise and burying fathoms deep my resentment that my life had been reduced to a file under his arm.

But as it turned out, there was no need.

h.e.l.lo. My doctor was not a d.i.c.k.

He was like the dad on a sitcom, extra large, warm, even cuddly, six-foot-four, bald and bearded, roomy and soft in the middle, big paws, and a smile that got into your veins like homemade gin.

I could tell in the first exchange-"So how are you?" for example-that he really wanted to know, and didn't think he already knew the answer. He was so wholesomely paternal that I wanted to crawl into his lap and talk about my investments. I was so pleasantly surprised I could have s.h.i.t myself right there and happily sat in it. He was a keeper.

I said this right out.

"Wow, you're actually intelligent and not arrogant. How'd you manage that?"

He told me he was dyslexic and thought that maybe that was why he was humble. He knew what he didn't know. I admitted that I couldn't spell, and often made h.o.m.onym errors. We bonded over the grammar school challenges of language that still somehow persisted. He submitted that English is really backward, and I added that, yes, wasn't it interesting how, for example, in German, the verb came at the end of the sentence.

He agreed.

"Yes. Instead of 'He fell down the stairs,' it should be, 'He down the stairs fell.' "

This was going well.

It got better. I told him I didn't want drugs. I rattled on a bit about this, as planned, expecting that once I'd nixed the SSRIs as being too mania-inducing, the favored Lamictal would come floating into the conversation like a bellwether balloon, and the phrase "no side effects aside from the rare but serious rash" would follow hard upon, like a bandwagon.

But no. To my great and glorious surprise, when I finished-he had actually let me finish-he looked at me respectfully and, without a spark of hesitation, said: "Okay."

Okay?

This shut my smart mouth effectively and melted my sa.s.sy little heart. Had the doctor just rolled on his back? Doctors I knew didn't say okay, except maybe to themselves, and then only as the coup de grace. As in, "Okay, we're gonna take off this limb."

But this guy had just used it in context to actually mean what it said. Okay. You got it. Your call.

Now I was quite possibly in love.

And then the capper. I told him I needed exercise if I was going to get back on the stick. He nodded knowingly. Got it.

"I need an hour pa.s.s to go running in the park," I said.

I expected I would have to lobby for this each day, but he shocked me again.

"I'll put an order in your chart for an hour pa.s.s every afternoon. Will that work?"

That works nicely. Very nicely.

He was trusting me with freedom, giving me back a piece of my will with faith, believing that I could handle it, or if I couldn't, believing that the failure would help me to measure where I was.

Wisely, he said this when I again expressed amazement at his willingness to grant the request.

"Day pa.s.ses are a useful tool. They tell both you and me whether or not you're ready to go back into the world, or to what degree you're not ready. If, for example, you go out and find yourself totally overwhelmed in an hour, then you know you need more time."

He was making me part of the process, giving my mind its necessary role in healing itself. He was listening to me when I told him what I needed, and giving it to me, because, unlike so many of the other deadheads in his profession, he could make a distinction between someone who said exercise would do her good and someone who said a ritual murder or a hit off the crack pipe was just what she needed to get back into the swing. He saw that I knew what I needed, or at least I knew in part; what's more, he saw that I was right. He had the power to make it happen and did, because he also knew that the simple act of giving me what I asked for, when it was reasonable, made me feel enfranchised and heard, a partner in the treatment plan, not its bound-and-gagged recipient.

He was a wizard of common sense.

Our meeting was short, as short as the meetings at Meriwether had been, about fifteen minutes all told. But it served its purpose. He knew his role. He wasn't there for therapy. The psychologist was for that. He wasn't simply there for himself either, to impose his smarmy better judgment, or, per his job description, to a.s.sess and "treat" me. He was there responding to me. He was empowered to make things happen, and he used that power beneficently without personal agenda.

We shook hands and parted laughing, he, because I'd said how nice it was to meet a doc who was smart enough to know that he was stupid, and I, because he'd said that maybe the only good doctor was a dyslexic one. Per Magic Doc's suggestion, I went up to the main ward that day.

My good-byes to Clay, Bunny, Bard, Fridge, Chloe, and the others were abrupt and strange, as abrupt and strange as the immediacy of our acquaintance, which went deep and narrow very fast, like a vein of precious metal in rock, and died that way too, a dead end, deep in drilled recesses, greedily mined and abandoned.

The h.e.l.los and good-byes were redundant, they always were, more pleasantries of the outside world dispensed with in there because what was encountered within those walls was already known and as quickly forgotten, but a.s.similated somehow nonetheless, like knowledge of a prior life. Like all the characters in the Jungian dream, everyone was you and you they, manifestations, internalizations, combined, recombined, recycled, made superficially to appear as another, but all the while simply more of you.

But you, reader, are the sane person reading this now, and you are thinking that these people on this page are not you. By no means are they you. They are the other, put away, out of sight-and yes I, too, laugh at this expression newly now-out of mind.

It is a significant expression in this context-out of sight, out of mind. But out of whose mind? Who is out of whose mind? The lunatic is out of his mind and so we put him out of sight-not because being out of sight is necessarily good for someone who is out of his mind, but because when the lunatic is out of sight he is out of our minds. We can forget him, forget his resemblance to us, forget that he is a member of the family. Thus he is made into not just "an," but "the" other.

That is what pathology means. Other. Over there. Not me. Not mine. Another path diverging in the wood, going off, erring, deviating from the main. The road not taken, the path to wrack and ruin. Keep to the road, the main road, the mainstream. Stay out of the woods, the bracken, the mire, and most of all, forget. Forget that I am one of yours and that you know me.

In much the same way, I had known them, and then I forgot them. I saw them on smoke breaks a few times in the next couple of days, but we had less and less to say to each other. Bunny got out a few days later. Her first night home she called me. I took the call on the pay phone in the main ward. She was drunk and going on and on about how she and Clay and Bard had had some kind of weird love triangle going on in the ICU. She said she missed everybody and didn't know what to do. I didn't know what to tell her, so I just listened until she tired herself out.

Then we hung up, and I felt terrible.

Clay made it up to the main ward on the addict's side a couple of days before I left, but again, the magic intimacy of our time in the ICU was gone. He was still shaky, and he didn't know what he was going to do when he got out. He was still unemployed, and to make matters worse, he'd had a call from his mother who'd told him that his cousin had robbed his apartment while he'd been locked up. He'd taken Clay's TV and a few other things to sell for drugs. Clay's mother had called the cops and had him arrested. It was all in the family.

I thought, sadly, that given what he'd be facing when he left, it wouldn't be too long before Clay was back in here, or in jail along with his cousin.

I heard that Karen left in much better condition. She'd rested. She'd adjusted her meds, and she seemed to have tamed the worst of her flare-up. I held out hope for her success. Fridge left, too, presumably to go home to his grandmother and stop taking his meds. But maybe this time he'd stay away longer. One could always hope. Bard, of course, was stuck for a while. They kept him in the ICU because he was disruptive and because, or so he said, they were working on transferring him somewhere else to sit out the rest of his time. He was still in the ICU when I left.

Chloe's parents came and got her the day I went up to the main ward. She went back to school, as far as I know, and went on as before, overachieving and probably cutting, though maybe doing so less obviously, so that she wouldn't end up in St. Luke's or someplace like it again. Still, I didn't worry about her. Of all the people I met at St. Luke's, I thought she was the most likely to recover, stay out of trouble, and go on to have a productive and mostly fulfilled life. She had never belonged at St. Luke's in the first place. All she needed was a good therapist and some time to put a little distance between herself and her father's expectations. She was going to be fine.

A depressive ward has a very different feel from a psychotic one. They don't confiscate your pens, for one. Though I had come prepared, with felt-tips and retractable Sharpies, I needn't have troubled. Never mind ballpoints, there were enough sharpened pencils in the dayroom to riddle yourself like St. Sebastian if you were so inspired. But n.o.body in here had that much energy or imagination. They hardly spoke.

I felt it the minute I walked in. Heaviness in the air, like some kind of spiritual humidity bearing down on my bones. When I stepped through the ward's main magnetically locked doors, I came into a short T-shaped hallway. To the right, twenty or so yards down, there was an octagon exactly like the one in the ICU, though its set of locking double doors was propped open. This was the MI side. To the left, again, twenty or so yards down, there was another octagon, also with its doors propped open. This was the CD side. A short hall ran between the octagons, and, though the doors were almost always left open, we were not supposed to cross back and forth, so the wings were like two docked s.p.a.ceships, with separate species looking warily across at each other.

The addicts' side, though filled with people who were primarily depressed and only secondarily addicted, had a lighter feel than the depressive tank I was in. It had the levity of creative self-destruction, and the people had the charm of self-hatred. The addicts were people fighting their natures, clobbering their malaise with a high, and laughing over their resultant lost limbs, whereas at my end of the hall, there was no fight at all, no bite, just the occasional whimper of the unwashed or the gla.s.sy eye of the defunct.

Gerald was the worst case on the ward, by far. Even among the cave dwellers, he was unique. A person utterly destroyed. Psychic pain taken to the point of psychic absence. His eyes were dead. They did not fill with tears or recognition or response. He spoke only when spoken to, and then only in Bard-style monosyllables: Yes. No. Don't know. Unlike Teary Molly and me, and a lot of the other depressives I would meet in this ward, he was not stubborn or childish, or self-indulgent, or complaining, or sorry for himself. Those are remnants of dissent. He simply wasn't there.

He wore the same clothes every day, a pair of black jeans and a plaid b.u.t.ton-down shirt. He was grossly overweight and shuffled along the walls half-bent at the waist. He was about sixty, and his hair was turning from dirty blond to gray, though he never bathed, so it was hard to tell what was actual color and what was just oily buildup matted to his skull.

There is not much else to say about Gerald, because despite repeated efforts to engage him, he would not talk to me, or to anyone. I'd try a joke, but he'd never smile. He would not even look at me. He just said in his usual distancing monotone, "Yeah," and resumed his hollow contemplation of the carpet, or the walls, or whatever else wouldn't look back and ask for contact.

Aside from Gerald there was Teary Molly, of course. She was often to be found at the small table in the dayroom, drawing or coloring while she talked with another of the more taciturn patients about the overwhelming burdens of her life and tried to swallow yet more rising sobs.

There was Trevor, a tragically ugly, infantile man afflicted with bloodless, pale dry skin that fell in large flakes from his bald spot into the long, stringy grayish brown hair on the sides and back of his head and lodged in clumps in the waxy porches of his ears. His ungroomed mustache cringed stiffly above his startlingly red wet lips. When he spoke in group therapy meetings, he had the unfortunate habit of knitting his scaly, long-nailed clawlike fingers together, resting them on the table in front of him and looking down at them gravely, as if he were a trauma counselor delivering the bad news. Thus he displayed his unkemptness, all in a row, from the top of his head to the tips of his hands, and people in the circle averted their eyes.

In the feeble voice of a boy who still wets his bed, he spoke of having nightmares every night, filled with flying "demons and devil dogs," and he complained of having to leave the light on at night to banish them.

There was Josephine, who stomped around the ward wearing a permanent puss face. She was in her early twenties, but she whined at the nurses like a grounded fifteen-year-old who wanted to know why she was being punished for crashing Daddy's car. She was constantly eating and drinking, shoveling fistfuls of trail mix or Cheerios into her mouth from a bowlful she carried wherever she went, and gulping 24-ounce bottles of hypercaffeinated Vault soda, which she purchased at the mall when they let her out on a two-hour pa.s.s.

There was Delilah, a dumpling-shaped, impish sixty-five-year-old who, like Trevor, appeared to be functioning at the maturity level of a second-grader. In our daily group therapy sessions her contributions took the form of transparent attempts to tell the staff what they wanted to hear so that she could get out sooner. That or giggling interjections, as when she pointed at Gerald and said, "His zipper's down."

There was Celine, a small, quiet, feisty woman with a tart smile and a keen eye. She was in her late seventies and lived with her son's family. She had what Herbie had-the depression of old age, the acc.u.mulated despair of feeling useless and having nothing to do or look forward to, as well as the added humiliation of feeling like she was a burden on her family. Interestingly, like Herbie, she retained a sense of humor and perspective in her depression, contradictory as that sounds. She seemed resigned to waiting it out and enduring it as she had obviously waited out and endured so much else. She was one of the few people in the octagon, aside from Gerald, whose depression didn't manifest itself as a kind of prolonged childish snit, or a one-note chorus of "Woe is me."

At the sight of all this, you can imagine why I took to my room right away, and thanked Christ that I had a single. For others, especially those inclined to self-harm or night terrors, a room of one's own might not have been the best option, but for me, this private realm turned out to be the very best thing about St. Luke's.

Again I had my own bathroom, though there was no shower this time. Still, it was cleaner than clean. The communal shower was down the hall between the octagons, a tiled room with a locking door. Half the room was a changing s.p.a.ce, with a chair to put your clean clothes on and hooks for your dirty ones, and the other half was a large open shower with powerful water pressure and a wonderously efficient drain.

My room was painted blue, each wall a different shade, sky to cerulean, and the walls were at odd angles, so that the bare-bulb night-light that was set in a gla.s.sed-in niche near the floor threw a strange light. Weak, diffuse, yet penetrating.

This private little room that money could buy-that money, or actually insurance, had bought-very quickly became a refuge and retreat for me, and I came to think of it as the best that any hospital could give you when your mind was what ailed you. I had control of my light. The night-light as well. And so on rainy days, which turned out to be most of them, I usually had the night-light on in the afternoon, like a beacon in the gloom. And the room, like the prow of a ship, seemed to seep through fog, like fog, to Patagonia or somewhere else mysterious, far away and lonely.

I sat in there often with the night-light, and I did it because I could, the benefit of privacy and cleanliness and a little trust. I could do it because the bathroom did not stink, and because I was not afraid to do yoga on the linoleum floor next to my bed. In fact, I liked it, the alone time, the V-shape of the room, tapering toward the entrance, holding me, helping me find the deep mystery of the world in a secret place.

At those times I was not afraid or depleted. I was full. I was sitting inside my brain, up behind my eyeb.a.l.l.s, buzzing, washing the day's thoughts off my shoulders in waves.

The light came in from the dayroom, filtered to a calming glow by the frosted gla.s.s in the top of the wooden double doors. (The gla.s.s was shatterproof, with embedded chicken wire.) I was allowed to keep these doors closed, another luxury denied me at Meriwether. This made time alone in the room even more recuperative and cherished.

On the outside of the door the nurses had stuck a small white tag with my name on it, handwritten, not typed. We learned each other's names quickly that way, as did the nurses, and we were granted a small piece of property as our own. And so I could say to myself: This is my room. My s.p.a.ce. Tomorrow or next week it may be someone else's, but for now it is mine and I am safe in it. I am respected in it. This is my room. My s.p.a.ce. Tomorrow or next week it may be someone else's, but for now it is mine and I am safe in it. I am respected in it.

It's hard to overestimate how much this meant, how much healing it actually allowed, and could potentially allow anyone in similar straits.

The room or partial room you occupy, if it is clean and quiet, and you are left to yourself when you want to be, if you can shut the door and turn off the light, or turn it on if that is your preference, if you can exist in this place in a suspended state, separate from the stressors of your life, alone, but knowing that just outside the door there are people who will talk to you, or play cards with you, or help you if you are shaking-if all of this is true, then that room becomes a type of sanctuary. In it you can get a version of what people get on religious or spiritual retreats, what fleeing emigrants of catastrophe and danger desperately seek. Asylum.

That is how things began to change for me a little. That is how I managed to get some actual benefit out of being in St. Luke's, even though I was supposedly only there as a journalist, getting the feel of a small, rural private hospital. I did, at times, achieve a state of vacancy that I could not have achieved at home, both in my person and in the s.p.a.ce around me. Expectation fell away with the scenery. The familiar and often burdensome trappings of my apartment, my life, and my personality were at least intermittently replaced by a friendly, clean medicinal emptiness. Not the painful emptiness of exile or imprisonment or the shut-in's disheveled bed, but the paradoxically full emptiness of relinquished expectation.

I knew that I could hibernate in my room. But I also knew that I could walk out into the dayroom, and walk down the hall to the addicts' side (as I often did, despite the rules, because I found my fellow depressives' company too depressing), and chat, or watch TV with someone like Fenske, who didn't want anything from me. I had the option, and it was this luxury of choice between the easy fellowship of cheap distraction and the reprieve of a good, long, soulful gaze at the ceiling that began to give me some partial shelter from my despair.

Sister Pete appeared on the ward each night after dinner, wearing her generous brown habit and beige sneakers. Around her neck there hung a four-inch crucifix that glowed in the dark. When she talked to you, her soft brown eyes were always widened in surprise, her hand always moving to adjust the headband of her wimple, which jumped and slid as her scalp crinkled in response to whatever you were saying.

Though she was in her sixties, everything was news to Sister Pete, and a cause for wonder. She called me Norah Baby and sought me out wherever I was hiding, though I didn't hide from her explicitly. She was too good to pa.s.s up.

She was addicted to the Eucharist and went to ma.s.s three times a day to partake. In her theology, you were what you ate. Literally. The more of Christ's body you consumed, the more like his body your body would become, until, she said, you were thirty-three (and presumably bearded and olive skinned) forever.

It was notable how small a deviation this really was from received Catholic doctrine. The transubstantiation was orthodox. So was the cannibalism. It was only with the look-alike age regression that Sister Pete ran off the rails.

She grew up on a farm in a town about ninety miles from St. Luke's, and spent her childhood sitting in a tree house dreaming of G.o.d and the contemplative life. She entered a local convent at eighteen, and lived there for forty years, at which point she came to St. Luke's, took up residence in an efficiency apartment on the grounds, and became spiritual adviser to the patients. It was a job she loved and took very seriously, and by all accounts performed very well.

She was a kind of savant in this regard, giving mad solace to the mad, living every moment in the moment, happy and at peace, even if she was permanently out to lunch, or probably because of it.

This use of Sister Pete was the single greatest act of kindness and therapeutic intelligence that I saw among the inst.i.tutionalized mentally ill. It had made Pete whole and beloved, given her a sense of usefulness, the guiding purpose that is the cornerstone of any person's emotional well-being.

I imagined how Mother T would have flourished in this kind of role. I thought of all the people I saw at Meriwether, and I wondered how their lives and conditions might have changed for the better if someone had made even the smallest provision for them, had given them a blithe sinecure to occupy their time, to make them feel useful. What might have been accomplished?

What might happen if we as a culture took even the most minor responsibility for the lost among us, rather than consigning them, and quite possibly ourselves, to the ravages of the system? The indifferent system.

Have we abandoned each other to "the professionals," pushed ever on by our definitive work ethic to perform or sink, to behave as though we do not live in bodies, do not have emotional lives, have no ties to community? If we are healthy, we get the benefits of family and a place in the social order, a place that reinforces our mental health, makes possible our continued ability to hold that place in the social order.

We are pack animals sustained by companionship, bonds, and our position in the web of human contact. But if we fall, if we fail, if we succ.u.mb to the breakneck pace and onerous demands of our lives-too much work, too much family, too many responsibilities and natural, normal fears-then we are cast out, shut away, ripped from the sustaining web, and expected, alone and abandoned, to recover.

What about a community that makes a place and takes personal responsibility for the impaired, accepts them as part of the larger civic body and takes the burden on itself, spreads it among the healthy to lighten the load? What about a community that says, "We will care for our own"? Instead there is the alienated demi-apocalyptic world that detaches signified from signifier, piece from whole, and sends the wounded off to languish in the psychic poorhouse.

It is the difference between public and private solutions, the cold grasp of the inst.i.tution, and the warm fold of a refuge where people have names and not wristbands.

This reminded me of Meriwether again, and Mother T.

I remembered Mother T trying to say the word "psychosis." She never stumbled over other English words, but this one she did. Psychosis. She said it like she was trying to get her mouth around it, like it was too big a bite taken from a burger. She'd learned it from her doctors. Her diagnosis. Psychosis.

That's how Sister Pete said the word "kerygma," uncertainly, but with gusto nonetheless.

"What is that again, Sister? Kerygma?" I inquired.

"Yes, kerygma."

She was telling a joke about Jesus.

"Is that what you get when charisma meets enigma? Jesus as charismatic enigma?"

I liked my own bad joke. She did, too. She laughed.

"No no. Kerygma."

I asked her to write it down. The whole joke with the word in context. She produced a piece of sc.r.a.p paper from a memo book she was carrying. The memo book was full of sc.r.a.ps, none of which was much bigger than a gum wrapper. Some were blank. Some had old jokes or reminders written on them.

She told the joke as she wrote.

"Jesus asks the modern-day apostle: 'Who do you say that I am?'

"Answer: 'You are the eschatological manifestation of the ground of our existential being, the kerygma, in which we find the ultimate meaning of our interpersonal relationships, the pristine quintessence of Him whose very essence is to be, the primordial sacrament exerting a transcendental holding on our becoming.' "