Voluntary Madness Part 12

She paused here before the punch line, her wimple rising.

"And Jesus said: 'Huh?' "

Her eyes went especially wide when she said the "Huh?" and then she grinned and started in on a long lilting laugh.

"That's good, Sister," I beamed, charmed as always by the pure joy Pete took in the smallest things. And I began to wonder whether true goodness wasn't, in this f.u.c.ked-up creation, a form of r.e.t.a.r.dation. Not an avoidance of vice but an ignorance of it, a lack of acquaintance with it that cannot be willed after the fall, no matter how strong the intention.

The temptations the rest of us are forever trying to elude are things that would never occur to Pete, wholly oblivious, in her tree house still, listening to the birds and blissed out on G.o.d. This led me to thinking something I had thought before, that perhaps mental illness is a form of brain damage or brain trauma. Maybe the upside of that is that it functioned, as it appeared to in Sister Pete's case, like a protective coma that kept the thinker from thinking too much.

And so in this vein, like a jacka.s.s, I said soph.o.m.orically: "Sister. Don't you ever feel the burden of existence?"

She c.o.c.ked her head to one side, brought up short from her laugh in true puzzlement.

"The burden of existence?" she asked.

Touche, Sister. Touche.

Now that I was upstairs, the program began in earnest. First thing each morning, as soon as I emerged from my room, perhaps of my own accord, perhaps coaxed by the gentle sarcasm of Nurse Maggie, who chirped, "Good morning, Sunshine," or Nurse Candy, who wheeled in a blood pressure monitor and said, "May I?"

However it happened, first thing, when I sat myself down in a chair in the octagon or the kitchen, someone, a nurse or a psych tech, handed me my self-inventory form.

This form was used as the basis for the first group meeting of the day, which began at 10 a.m. and was variously called process group or goals group or social work group. In this group, all the patients on the unit met with a nurse or a social worker or a psych tech to take stock of our progress or lack thereof.

Question 1: Target behaviors Depression CHECK ONE.

Not at all_____Not much ____Somewhat ____A lot ____Extremely ____ Anxiety CHECK ONE.

Not at all___Not much ...

Suicidal ideation CHECK ONE. . . .Question 2: How is your relationship with your family?

Improving ___The same ___Getting worse ____

Question 3: How did you sleep?

Well ___Fair ____Poor ____Required Medication ___ Question 4: My appet.i.te is: Good ___Improving ___Poor___

And so on down the line. My energy level is . . . my ability to concentrate is. . . . Have you had suicidal thoughts today? (If yes, please tell staff immediately.) What are your goals for today? Did you meet yesterday's goals?

Goals and groups were the backbone of the day, both a way for staff to keep meticulous records about each patient and an opportunity for the patients to vocalize their feelings as well as make requests and complaints. Keeping us occupied and checking in was useful, even if sometimes it was a great heaving bore for anyone functioning above a murmur. Naturally, a lot of it was going through the motions, the staff asking the same questions over and over again-How are you feeling today? What's your goal for the day?-and the patients, depending on their moods, usually giving answers that were either long-winded and peevish or prudent and angled to expedite their release. Still, it was better than being babysat by TV, and it did force each of us to mark the days in some meaningful way, however small.

After Meriwether's malign neglect, I respected the attempt at care, even if I made fun of it sometimes. When they asked me, for example, if there was anything I needed or would like, I wrote, "A heart, a brain, courage." Or on the sleep question, after the last option, "Required medication," I penciled in my own worst case, "Required bludgeoning."

Every day was the same. Process/goals group ended at eleven, with me and the rest of the crew having stated our purpose for the day ahead and condition of the night before. Then there was an hour before lunch during which most of us watched talk shows on TV, or doodled with the array of colored pencils that were piled in an old tin on the table in the octagon, or worked on a jigsaw puzzle that was spread accommodatingly on this same table. At noon we were lining up for the chow cart. They scooped the daily grub onto our outstretched paper plates and handed out plastic utensils. (Other than at meals, plastic flatware could only be had by special request.) At one o'clock, sometimes there was social work group. There we met with a social worker and bellyached about our prospects, or fidgeted about what we were going to do when we got out.

If it wasn't social work group it was medication group, where we bellyached to a nurse about how stoned we were or weren't, what kind of nightmares the meds were giving us, how shaky or sweaty or constipated we were, and so on, and she made notes to give to our docs.

Some days there was no group at one, in which case we all ensconced ourselves in front of the TV, or resumed work on the pastoral scene with skipping girl that we'd so a.s.siduously been coloring. Or, as in Gerald's case, we got back to counting the pile in the carpet.

At two it was either occupational therapy or activity therapy: OT or AT. In OT we headed into the art room and got all crafty-creative with beads and glue guns. For an hour, we made pieces of jewelry or wind chimes, or, in my case, a mosaic tile trivet, while listening to soft rock on the radio-"WDSM, the station everyone in the bin can agree on."

In AT, we either played a game like Scattergories or Cranium, or we headed down to the activities room in the bas.e.m.e.nt, where there was a foosball table, a Ping-Pong table, an array of Nerf b.a.l.l.s, a plastic Fisher-Price basketball hoop, and semifoam, semiplastic bowling ball and pins. There was also an Exercycle and a treadmill, though not the kind you could break much of a sweat on, or a limb, which was the point. Everything in the room was sue-proof, or as near as they can make it.

OT or AT finished at three, and the rest of the day was ours, not that there was much you could do with it, unless you had a pa.s.s. I used my hour pa.s.s at this time, from just after three to just after four.

The days went slowly, and as much as I found solace in my room, and in the company of the addicts, I found that working so often in groups with emotionally destroyed people only worsened my depression. The addicts were following their own program, based on a twelve-step model, and we never mixed in group therapy, so I was left to founder with my own kind.

Looking around the circle in therapy meetings, I often found myself going back to my ugly round of thoughts.

These are the palest, most rumpled, useless, yet somehow proudly despondent sacks of meal I have ever had the misfortune to call myself one of. The ent.i.tlement in all of us is appalling. My, me, mine. I'm unhappy. Fix it. Happiness is my right as an American. Not its pursuit, but its persistence, like an arc over my life, cradle to grave, a sheltering bough, for s.p.a.cious skies and fruited plains, the bounty of my country. America the beautiful. And happy. Except that the next verse of that song says, "Mend thine every flaw." Meaning make a f.u.c.king effort, you sloth.

Sloth. A deadly sin. I'll have to talk to Sister Pete about that. But sin is so unfashionable now anyway. Who needs it when you have the great exoneration of disease? h.e.l.l, that's better than nihilism. That is nihilism. Nihilism with a candy coat.

What's easier than, Everything is permitted? I'll tell you what. Everything is a disease. That's what.

I was not really making sense or being fair. I was p.i.s.sed off, rage being just another form of negativity to indulge at these crumpled people's expense, and my own. Yet, how could they expect the group therapy model to work for depressives the way it appeared to work for the addicts? They shared their stories, as so many other addicts did in twelve-step groups, and seemed to gain insight and relief from their fellow patients' articulated pain and reciprocated understanding. I knew this, in part, because of things I overheard in the dayroom, or things they told me directly when I asked them. But I also knew it because, despite the usual separations, I did manage to sit in on one of the addicts' sessions, an open AA meeting that met once a week in the bas.e.m.e.nt of the clinic.

There, among the resident addicts, as well as another forty or so outpatient former clients, people joked and laughed. They spoke seriously, too, of course, about their more sordid escapades and histories, and about the destruction they had brought to their own as well as others' lives. But even the hard ideas helped cement the bond of public confession and shared mistakes. There was a sense of forward motion and positivity even in the darkest stories. People were there to lance their boils and walk away relieved. They were not, as my fellow depressives and I seemed always to be, intent on stewing in their distemper.

Maybe it was just this particular crop of depressives-they were no one's dream team, to be sure, and neither was I-but I wasn't getting anything except more negativity and a heightened sense of alienation out of listening to Trevor talk about his devil dogs and watching Gerald become one with the wallpaper.

It wasn't that I couldn't see, in theory, how talking to other depressives might help me get some perspective on my own death spiral. It certainly had in the past, when I had spoken to depressive friends. But that had only been true when the depressives I had been talking to hadn't themselves been depressed.

Those conversations had helped me only because the person in question had recovered. They weren't in the hole anymore, which meant that (a) the hole hadn't swallowed them up, and so, by extension, it wasn't necessarily going to swallow me up either, and (b) they were standing aboveground and had some perspective on where they'd been and where I currently was. They could throw me a rope.

But these people on the ward were just as firmly in the hole as I was, so what rescue could they offer? To make things worse, it wasn't even the same hole. We were all in our own separate holes, so we couldn't even play blind patty-cake. The best we could do was overhear and cross-talk each other's pitiful wailing and griping. We were just blobs in sweatpants in dire need of dandruff shampoo. All those groups were just wasted time, as far as I was concerned. I got much more out of my individual therapy with my psychologist.

Not that that was transformative either. It was fine. It probably helped in the way that traditional psychotherapy is supposed to help, or at least in the way it has helped me in the past: by getting me to organize my thoughts through verbalizing them. But in the end it was just your basic three times a week for fifty minutes.

My stalwart therapist was very sympathetic, obviously thoughtful and caring. A practiced and expert listener. She always tilted her head to one side and slightly down, and tucked her long hair behind her ear. Her watery blue eyes looked up at me and blinked slowly at all the right times. She compressed her lips sorrowfully when I cried, or, as was more often the case, when I tried not to cry and failed, and licked the snot off my upper lip. When I choked on a word, she always waited for me to go on. She never spoke before I'd finished. She understood. She responded. She tried. She had all the right tools of the profession, except maybe that spark of the dark arts that therapists always have in the movies, and that I had always looked for in real-life therapists but never found. It was probably just as well that I hadn't, since the most appealing movie shrinks usually turned out to be serial killers anyway.

I don't mean in any way to denigrate her. I am grateful to her. She did well by me, such as doing well can be with bread and b.u.t.ter. She was the companion piece to my room. Another clear benefit of St. Luke's that I had not enjoyed elsewhere. A place to rest and confer with myself, a wall to bounce my riffs against, a small but true light to steer by. It wasn't her fault that I needed Hannibal Lecter as my therapist. Or thought I did.

But whatever the misfires of the treatment, the staff treated us with what I came to see as St. Luke's trademark kindness and concern, and sometimes staff members even made surprising and creative extra efforts to reach us.

On one occasion, for example, a psych tech named Mitch did something far more inventive and healing than I would have expected from anyone in a hospital setting. Just before wrap-up group one evening, he hid a remote-controlled fart machine under Teary Molly's chair. When it was her turn to blubber and whinge about her day, he hit her with a loud one. She looked puzzled. Didn't get it. The group, presuming she had lost control of her sphincter in her distress, decided to ignore it. But then very quickly he sent another. The machine was well designed, offering an inspired array of sounds from plappy to squeezed, and every permutation in between. This one was a percussive blurt, like a low note from a flugelhorn, followed by a long slow deflating wheeze. At this Sam could no longer keep a straight face. He dissolved in silent laughter. I, being me, took the helm on this one.

"Jesus, honey, do I need to move?"

Mitch sent another. A cla.s.sic whoopee-cushion bubbler.

"Okay," I said, "you have my respect. Peace."

Now the whole circle was roaring.

Mitch had done the impossible. He had tickled the walking dead. Like the employment of Sister Pete, this struck me as an awe-inspiring act of kindness on Mitch's part, and I was impressed anew with the quality of person St. Luke's managed to employ. Not only had the nostrum of laughter as best medicine managed to survive the pharmaceutical age, but it came sliding into that circle of pathetics on the whim of a young man who had no degrees or pedigrees, just some old wives' wisdom about what was good for a soul in pain.

Sister Pete was holding a black Grave Digger Monster Truck, a stuffed toy that a kid on the children's ward had given her to mend. She was planning to sew up one of the wheels whose seam was ripped and return it tomorrow. But for now, sitting with me in my night-lighted blue-walled room after supper, she was holding the thing like a baby, fascinated as usual.

I, too, was interested in this artifact. Where else but on a children's mental ward would you find a stuffed truck? No hard edges allowed, even in toys, which could be and no doubt were thrown. The children's ward was above us, and I had already heard loud pounding coming through the ceiling in the octagon on the addicts' side, where I had been spending most of my social time.

"What the h.e.l.l is that?" I had asked Fenske, who was watching the Lakers game with me on TV.

"Another kid flipping out," he said casually, as I wondered whether that strangely soft thumping was someone's head drumming the floor.

Aside from the monster truck, Sister Pete was also carrying something she called "the hem of Christ's garment." She carried this wherever she went, but this was the first time I had seen it, a conspicuously laundered-looking relic that she housed in a Ziploc bag. I couldn't quite tell whether she thought the tidy white swatch was two thousand years old, but still suitable for dry-cleaning or she just liked having something talismanic to place on people's heads while she stood over them and said her blessings.

She said she pressed the hem against the tabernacle for hours, praying feverishly to imbue it with, or replenish, its healing power, which I can imagine was sorely drained after a night on the ward. As I'm sure she was.

It must have taken a lot of energy to pump so much spirit into three wards full of people, especially when a third of them were kids. I actually wondered what she ate to make herself so round, when she claimed to eat a fairly healthy diet. There must have been some doughnuts and potato chips in there somewhere.

She said she ate her food mostly raw. Veggies for sure. Potatoes too. If she ate animal protein, it was usually at some public event, like the Lenten Friday fish fry at the community center, where clergy ate for free. She was living on a tiny budget, I'm sure, and so she was duly frugal. She could rattle off the price of celery at three different markets. Usually, when I was talking with her in the kitchen of an evening-say, about depression and the sin of despair-she would investigate the fruit bowls for brown bananas.

"They just throw them away," she'd say, slinging them like pistols into the hip pockets of her habit.

I was talking about despair with Pete because it was the theologian's version of depression, and I had been thinking about what they taught us in catechism as a child. Why is despair a sin-a mortal sin? I used to ask this of my teachers, it seeming unfair to d.a.m.n a person for feeling bad.

But as I watched so many of the patients at St. Luke's, myself most of all, indulging in depression as a form of bratty rebellion, and as I had fought with myself about volition, about how much of depression is a willful resignation rather than an actual absence of will, I had begun to understand why despair could be characterized as vice. It occurred to me first because so many of the patients around me were fat. Clinically obese, actually.

I thought again of the favored diabetes a.n.a.logy. "Would you begrudge a diabetic his insulin?" they say. "So, then, why begrudge a depressive his Prozac?"

But I began to think of the link between diabetes and obesity, one exacerbating the other, one biological, the other behavioral, and I began to see how fault and will could come into it. I thought of how eager we are, a society in which corpulence is an epidemic, to absolve ourselves of our own bad eating habits, how eager we are to locate obesity in the genes or blame it on a virus. Take this pill and be thin, says Big Pharma (how rich will the first company be that can really say that?) and we'll make billions telling you what you want to hear. Obesity is not your fault.

And so I was back to depression and Catholicism. Gluttony, like sloth, was one of the seven deadly sins, I recalled, and then it seemed clear. Despair was a mortal sin in the catechism, because despair was a gluttony of sadness and a form of spiritual sloth. An overindulgence of an appet.i.te or propensity. The people in St. Luke's, and I was just as guilty of this, consumed their depression, rolled in it like pigs. We were all so eager to decline responsibility for everything, to recline in the arms of a disease and quit, to take our failures, our gloomy, angry view of the world and make it into a fortress against that world. A defense.

That is what quitting is. It is not a pa.s.sive state. It is, to return to John Nash's a.n.a.logy, a very active resistance, a work stoppage, a throwing down of the spade in the face of adversity. Despair, in this sense, is not a giving up, but rather a taking up, a forceful "No" that says "I will not partic.i.p.ate."

This, in theology, is the rebellion of the fallen angel who says, Non serviam Non serviam. I will not serve. This is the soul that sets up a rival good to G.o.d's and makes negation his creed, the soul who will not struggle, the king of pain, the emperor of resentment gorging himself on sour grapes.

Depression is h.e.l.l. Indeed. But perhaps a partic.i.p.atory one, I thought. After all, the fallen angels didn't really fall. Like every high-rise successful suicide, they jumped.

Again it was the ugly train of thought at work. Convincing, to me at least. But right or wrong? I didn't know.

And so what? What did it matter? The better question was: What now? What was I going to do with my own gluttony of sadness, my own spiritual sloth, the nihilism with the candy coat that I was gobbling as greedily as Josephine devoured her trail mix, or Chloe her Skittles?

I was either going to have to convert some of this shoestring theology into action, or I was going to have to stop grinding the ringer. Either these thoughts led somewhere or they didn't. And if they didn't, I was better off medicating myself back to some sort of functional r.e.t.a.r.dation than I was sitting with the Don Quixote of nuns over a bowl of brown bananas finding cosmic truth in the last words of Lucifer.

I was becoming annoyed with myself. And this was a good sign. An impatience with thought. A dialing down of the navel gazing, and the first mild rejection of all my Cracker Jack college education running at the mouth. The first rays of perspective breaking through.

After I made my first trip out on an hour pa.s.s, I found that one hour wasn't quite enough time to exercise and walk into town to get a little something to eat, so I requested two hours, figuring that it would be turned down. But Magic Doc stepped up and gave me a two-hour pa.s.s every day from then on.

My run in the park across the street hadn't gone all that well on the first day, partly because it was a very small park, and running laps around it made me feel like a hamster, plus doing so in my white socks and brown loafers, the only shoes I had brought (because they don't have laces) made the young mothers in the playground pull their children closer.

There was a YMCA just up the road, and I could get a day pa.s.s for $12. For the rest of my stay I spent the first hour on pa.s.s working out on the StairMaster. Then I walked the ten minutes into town-I had to time this perfectly so as to be back on the dot of 5:06 or 5:08 or whatever minute was exactly two hours after the time I left.

In town I stopped at a brewhouse for a real meal of grilled salmon, sauteed veggies, and two beers. I only ate at the brewhouse because it was on the near side of the freight tracks, and I knew from experience that a train could take ten minutes to pa.s.s, blocking my return to the hospital when every minute counted.

The beer tasted like G.o.d's brew, especially since I was not supposed to have it, so cold and smooth first thing after a workout, a quenching buzz rushing to my brain, pumped express by an elevated pulse. There was a little joy in my loins, with the sweat and the blood and the delirious high of temporary freedom, which was at least as potent as any drug, the power of sitting at a barstool of my own accord, almost like a person.

Yet I felt like a criminal, sitting there incognito, the loon on the lam. Or did everybody know? Did the waiters all have jokes about this? A game? Spot the tuner on furlough? Shoes with no laces must have been a dead giveaway. I was grateful again for no wristband, but I couldn't help feeling marked nonetheless, like yet another kind of queer, like the d.y.k.e whose sartorial misstep or too rugged swagger gives her away as a weird sister, a genetic mistake faking it poorly.

"I mean really," says the normal, "who does she think she's fooling?"

Am I? Fooling? Or am I the fool? Like Lear's fool, all-wise in jocularity, my barbed jests cutting to the truths that kings will heed from no one else. Or am I, like every preening brooder, the self-styled Hamlet? Mad north-northwest, but knowing a hawk from a handsaw?

Are the mad so easily recognizable? Or are they only craftily off-kilter? Their screws not loose but loosened, like the hinge on a practical joke or the dousing bucket cleverly balanced over the door. What role does the madman play? And does he play it straight?

I was sipping my beer thinking all of this. Again. Did they know? Did I want them to know? Did I know? Did my being who I was serve a purpose for them? Did I play this role, rather than simply live it? Was it my job, like being the village idiot? Did they need me to be this way so that they could safely be that way? What was normal, after all, without contrast, without aberration? The extremes define the center. Not that I flattered myself that I was on the extremes. More just somewhere nondescript on the tapering of the curve.

As I paid and finished, I sent a few quick text messages on my phone (which I would have to surrender at the nurse's station when I got back). I did this just to let a few friends and family know that I was not in a Turkish prison having the bottoms of my feet pounded by a fat man with a length of pipe. On the contrary, I said, all was well. This was an enlightened penitentiary, where they (or at least my doc) understood the benefits of exercise and fresh air and private vices.

They had rules, like any locked facility, but I didn't have the sense that they expended much energy on the details. If I had been fifteen minutes or even a half hour late getting back, for example, I doubt if anyone would have noticed, much less said or done anything. I didn't test this, though, because my freedom meant too much to me. Likewise, I don't know what they would have done if they had smelled beer on my breath. But since I wasn't there for addiction, I wasn't on any medication, contraindicated or otherwise, and I wasn't getting drunk, it might not have mattered. At most, they would have revoked my pa.s.ses. But no one smelled my breath. The security guard downstairs put me through the metal detector and checked my bag every time I reentered the building, but he didn't pat me down or make me empty my pockets, so smuggling wouldn't have been hard. Still, what was I going to smuggle in that town? Library books?

For obvious reasons, the addicts only went on pa.s.ses accompanied by family or friends, and the involuntary MI people, especially the less cooperative ones, didn't go on pa.s.ses at all, for equally obvious reasons. But several of my vanilla fellow depressives, like Josephine and Teary Molly, did take advantage of the breaks and leave the grounds for an hour or two of an afternoon.

I was going to meet with Magic Doc when I got back and this put a little pace in my walk as I crossed the minigrid of spa.r.s.ely populated downtown streets and pa.s.sed through empty lots overhung by billboards advertising hotlines for the pregnant and the drug addicted.

As I turned a corner, I was surprised to see someone I knew.

Fridge was lurking in front of a shop with a friend. I said a booming h.e.l.lo, but he was less than enthusiastic, not eager to acknowledge a fellow St. Luke's alum, especially in front of a friend who hadn't been there. Unlike prison, there's no pride in doing time in the bin.

I pa.s.sed on, skirting the skateboard park where bored ruffians of Bard's approximate age and type were caroming off curbs and railings, honing a legal outlet for their rage.

Finally, I was back through the doors, through the metal detector, up in the cattle-car elevator, and back in the sanctum sanitorium.

As I was walking down the hall to the ward I heard a nurse announce over the loudspeaker: "Please take a moment of quiet reflection this evening. The thought for the day is: The essence of prayer is seeing everything through its life-filled dimension."

I just had the chance to shower and change before doc time.