A Room with a Darker View

by Claire Phillips

  Pre-existing conditions

  A few weeks later, after I had returned to Los Angeles, my brother became overwhelmed by my mother’s frantic and unimproved state. She was writing obsessively to Bausch & Lomb, complaining that their eye drops had caused her to go blind. After another bitter argument over her refusal to eat—an ongoing dilemma—he dialed 911 with the intention of having my mother committed, but then, suddenly changing his mind, hung up before anyone answered.

  “Luckily,” as my brother tells it, “the police came anyway.” Deemed an imminent danger to herself, she was taken to a hospital roughly sixteen miles away for treatment and was involuntarily committed.

  It was here that my brother learned from the medical staff about a new law passed in 1992 by Governor Christie Whitman making it illegal for hospitals not to treat preexisting conditions. Researching her Blue Shield insurance policy, my brother discovered our mother had signed on after the new and historic law went into effect, therefore she could not be refused care after a short commitment period, a typical limitation of mental health insurance. The former hospital’s refusal to care for our mother had been illegal. This bit of information would be crucial going forward. Once it was clear that the staff could not care for our mother, she could not just be shuttled off to an expensive assisted living center or long-term care facility. The hospital was required by law to find her appropriate care. Another psychiatric facility in the same county was then suggested as a good alternative.

  January 2002

  It was here, at this third hospital, that she repeatedly made her terrifying pronouncement: I am going blind, Claire. Soon I will be blind.

  Each time I called the hospital that January, my mother’s distress was that much more acute, her impending blindness of even greater certitude.

  These terrifying delusions reminded me of the same paranoiac proclamations made by Nathaniel, the protagonist in E. T. A. Hoffman’s renowned fantastic story of 1816, The Sandman, who by story’s end will throw himself off a bell tower in an uncontrollable fit of outsized fear. My mother’s “blindness” was a delusion much like Nathaniel’s fear of a folkloric Sandman whose job it was to steal misbehaving children’s eyesight in the middle of the night. The event that precipitated my mother’s “blindness” had been an eye infection she contracted during what would be one of her many harrowing relapses. Despite the careful administration of the medicated eye drops by my brother’s wife, the infection returned. One eye would become permanently slatted. Even so, she was in no way going blind. The damage was not to her eye, but to her eyelid. In her paranoid state, however, the injury manifested as a powerful delusion. Just as concerning were the ensuing delusions of a painful broken arm and total paralysis of her spine.

  Greystone Park Psychiatric Hospital

  Days passed. Our medical options at this facility were exhausted. We were told she would have to be placed in an overcrowded long-term state facility ominously named Greystone Park. Built in 1876, it was originally dubbed the State Asylum for the Insane at Morristown. My mother was no happier about this than we were, but no matter the amount she was prescribed, no matter how many shots, Haldol no longer did the trick. New second-generation anti-psychotics were tried. None of these provided our mother with any relief.

  My brother did some research on the institution and called to tell me.

  “You would not believe how many of their patients have committed violent crimes. Greystone is not a good option for Mom.”

  “This is terrible,” I fretted, unable to fathom the horror of visiting my mother someplace she would never be permitted to leave.

  After months of false starts, we began to think that our mother might never recover and regain her independence. Then my brother took it upon himself to perform some independent research on our mother’s behalf, uncovering a new antipsychotic medication—Seroquel—through a brief Internet search. My brother persuaded my mother’s doctor, after much hesitation, to give the new drug a chance. Administered Seroquel, the mother we had lost sight of for a good part of a year began to resurface.

  “I don’t want to go to Greystone,” she confided to me over the phone soon after the drug’s administration. “If I end up there, I won’t ever see you or John again.”

  “Probably not,” was my blunt response.

  I couldn’t imagine visiting my mother in a psychiatric hospital where improvement or recovery was anomalous and highly unlikely. Perhaps selfishly, the institutional life was not something I wanted for our mother. For all of her daily constraints—the difficulty she had in placing her trust in other people, in driving back and forth on streets she had navigated for decades, in the making of the simplest decisions without sifting through endless, niggling worries—our mother had succeeded in leading a reasonably independent life. While she may not have been very organized (there was always that surfeit of blue jeans, papers, and sundry other domestic items that would eventually take over her living space), she managed fairly well on her own. For two decades, she had lived in New Jersey without the comfort or support of close friends or immediate family, on a modest budget. In a matter of days on this new drug, the powerful and persistent delusions that had dogged her existence for the good portion of a year would begin to recede.

  I knew she wasn’t actually going blind or becoming paralyzed. Even so, I agonized. If she believed this was so, then it might as well be true. It is well documented that people suffering from schizophrenia feel pain when in the grip of a powerful delusion, even when there is no actual physical injury. At night, I lay awake stricken, imagining my mother strapped to a gurney, trapped inside a failing body, on the cusp of going blind, fully conscious and unable to change her situation.

  No longer anhedonic

  On a new cocktail of first- and second-generation antipsychotics—Haldol, Seroquel and the anti-depressant Zoloft—Mom made a swift recovery. For the first time, she was no longer anhedonic. This “poverty of feeling,” one of the secondary features of schizophrenia, had been utterly perplexing. Rarely had my mother shown the enthusiasm for the kind of daily pleasures most of us take for granted. She had showed little interest in games, sports, any routine outdoor activities like walking or biking, shopping, or romance.

  Now that the apathy associated with her illness had just about lifted, my mother routinely called me to extol the virtues of her newly found interests.

  “Have you heard of Elton John? He’s fantastic!”

  “No, tell me about him,” I said. I did not remind her of my first music purchase at five years old and the gazillion times I listened alone to Elton John’s mega-hit “Crocodile Rock” on the small blue record player in the den, singing off-key to my first and favorite record.

  The popular Italian classical tenor Luciano Pavarotti was another favorite of my mother’s. She collected all of his performances on videotape. After so many years of embittered silence, my mother’s home was filled with the joy of music. A world once shrouded in darkness was now suddenly brightly accessible.

  We love Joy

  Perhaps the greatest benefit of this new cocktail came in the form of a new friend. For the first time since her diagnosis in 1983 my mother found close companionship in a recent immigrant from Ecuador, Anita, who worked for a number of wealthy patients as a private nurse, and had, along with her architect husband, come to live in the same Chatham Township apartment building as my mother.

  In no time, the two women grew inseparable. They lunched together, shopped, and shared tips on doctors and local sales. My mother was a welcome visitor in Anita’s apartment. She was included at almost all family holidays and gatherings. This was a boon, considering how infrequently we visited, or how infrequently Mom made the long journey to us. Love had even become a daily part of my mother’s vocabulary. Growing up, these kind of warm declarations had no place in our household. This could undoubtedly be said for many postwar households. Only after college, when I brought back the easy use of this expression, did it become a part of the f
amily vernacular. To hear my mother speak of love with anyone other than family came as a welcome surprise.

  Whenever I made the occasional visit to Chatham to see my mother, I would hear these declarations often. We love Joy, Anita’s adult children would frequently comment. They would then tease my mother over their little differences, most commonly her preference of horror movies and thrillers such as Tarantino’s Pulp Fiction, Natural Born Killers, Jonathan Demme’s The Silence of the Lambs, or any action movie starring Denzel Washington, over the more mainstream fare of rom-coms and sentimental foreign films. Strong in her convictions, Mom would rather spend days on end alone in her apartment than subject herself to a film she didn’t like. She was well understood by Anita’s family. In fact, so much so, it was not long before her children’s very occasional visits were up for review. Why don’t you come to see your mother more often? Your mother misses you, Anita would remark whenever my brother and I would finally show up for a brief stay.

  Of course, there was simply no way to rationalize our disturbing detachment: I never had a justifiably good answer for Anita and her family, and I doubt my brother did either.

  Thanksgiving weekend, 2010

  Another ten years would pass before our mother’s next relapse. This time, however, blindness would not be in the subject line. My mother, who was then about seventy years old, had flown in from New Jersey to be with us, a yearly tradition now that my brother and I were both living on the West Coast. This annual visit suited us. Without making the tiring mid-semester journey east, we could spend at least one holiday with our mother. To be frank, it was simply easier, less challenging, to spend the holidays with our father in Pasadena—his household was more intact, the reminders of dysfunctional family life not as readily discernible. However, this year would be no cause for celebration. From the outset it was clear that our mother was in the midst of a relapse.

  At my brother’s Westside apartment shortly after she arrived, it was obvious she had trouble keeping track of her pills. When I showed up that afternoon to take my mother to lunch, I found my brother and mother in the midst of an argument.

  “I told you already,” my brother said fitfully. “You can’t keep dropping your pills around the apartment.” As he uttered these words, I watched him capture a rolling pharmaceutical, shortly before he dug another out from the shag rug in her makeshift bedroom, my brother’s office. Her medication seemed to be flying everywhere. Laughing, Mom tried her best to scoop up the colorful pills.

  “Sorry,” she intoned, crouching to the bedroom floor.

  “My daughter cannot be around this,” he scolded, showing concern for his six-year-old whom he cared for on alternate weeks, now that he was recently divorced. My mother did her best to get her pills back in their prescription containers, but the genie was out of the bottle, so to speak.

  Earlier that day on the car ride back from the airport, she had begun to share conspiratorial thoughts with John, paranoid delusions of being persecuted by the legal team of a hip-implant company she was purportedly suing in a civil action, believing that her hip implant of several years back was faulty and had been recalled. Naturally, her belief regarding this particular implant proved to be false.

  In under a few hours, we realized we could not adhere to the original plan, and rather than host our mother in our respective homes, we checked her in at a local hotel. Recently refurbished and affordably priced, the Hotel Angeleno, renowned in the 1970s for its glamorous rock n’ roll occupants and sweeping panoramic views of Los Angeles, was minutes by car from my brother in Bel-Air. At $150 a night, the eyecatching, cylindrical-shaped, former Holiday Inn flanking the 405 Freeway seemed to be the perfect solution.

  The following day

  Neither my brother nor I felt comfortable staging a medical intervention even though it was patently clear that our mother had relapsed. We held out hope that she might suddenly stabilize, that her condition was not as bad as we thought. As I drove my mother from her hotel to the Beverly Center on that picture-perfect day, she shared with me unfortunate news. In an effort once again to lessen the extrapyramidal side effects of her medication, her psychiatrist had decreased her daily dosage of Haldol from five milligrams to two. It was a decision made without our knowledge or consent. In an unusually tender voice, one filled with gentle self-regard, she revealed to me what my brother and I had suspected but had not been able to confront.

  “My psych wants me to tell you that we made a mistake with my medication,” she said as I descended highly trafficked La Cienega Boulevard from the Sunset Strip with its celebrity hawking billboards. “But she says you don’t need to worry because I am on the right amount now, and I’ll be better soon.”

  As the rays of bright, unimpeded sunlight bounced off glittering glass-windowed boutiques, casting long shadows over clean and virtually empty sidewalks, I weighed the probability of my mother’s improvement against the prospect of another interminable commitment. I desperately wanted to believe her psychiatrist, all the while suppressing the truth.

  Paradise Cove

  On Thanksgiving Day, we took our mother to have a late lunch with our father and his wife. We met at The Paradise Cove Beach Café, an idyllic haunt, where popular television shows like the 1960’s surf-friendly Gidget had been shot. Another relentlessly sunny day, it was paradisiacal in only that respect. While we managed to make our way through the restaurant for a booth with an ocean view without incident, our mother wove the path somewhat erratically, her condition clearly worse than the day before. All during lunch, our mother looked tense, weary. Her eyes were strained. No one, however, commented. The charade of normalcy was making me very anxious. I had this childish hope that someone would intervene, declare my mother unwell, and help us get her to the hospital.

  My brother and I sat with her in this kitschy sun-drenched setting, remarkably obedient, making small talk, admiring through the big plate-glass windows the glittering Pacific and white sandy beach, and the thatched umbrellas under which patrons drank and laughed, as large oval dishes amassed with more holiday food than I had ever seen were plunked down before us. It stunned me, how competent we were at not addressing the elephant in the room: my mother’s compromised state. After consuming less than a quarter of the Thanksgiving Day food, the inordinate amount of turkey, potatoes, and stuffing that we were expected to eat, the bill arrived. We put down our five credit cards, paid the check, and headed back into the frantically bright sunlight to our respective cars.

  Nighttime driving

  With each passing day, Mom became more and more difficult, more argumentative and accusatory. A simple activity, like going to the movies, became burdensome, unsettling. At a showing of The Social Network, chosen for its legal drama and its potential appeal for my mother, my brother and I weathered constant complaints. It was as if someone had turned back time and we were suddenly children living with her under the same roof. Nothing we did was right. My brother’s driving was up for review. Our choice of movie, not right. As the night wore on, she complained of a strong pain in her hip inhibiting her ability to walk.

  “My hip is broken,” she kept insisting. “I am in a lot of pain.” The short walk after the movie from the theater to the parking lot was perilous, her rage intensifying with each step. Despite her obvious deterioration, we failed to get her medical treatment, instead treating her illness as if it were a feature of her person.

  “What a bitch,” I griped.

  “I can’t take it,” John said under his breath. “I’m never taking her to the movies again.”

  West

  On the last night of her stay, we dined at West, the top floor restaurant of her hotel, with its panoramic views of the Pacific Ocean and downtown Los Angeles. In the waxing dark, the flickering lights of the gridded metropolis suggested a prelude to my mother’s imminent airborne departure. Glamorous types occupied the neat upholstered booths: an immaculate, sultry young woman in a mini skirt and staggeringly high stilettos, whose physical presenc
e suggested whirlwind evenings of being feted in tinted-window limousines, enjoying courtside tickets at basketball games; rock musicians in t-shirts and low-profile jeans were indulging in bottle after bottle of champagne.

  While my mother had dressed elegantly for dinner, she seemed to be in a particularly agitated and disconnected state. We plodded through the meal as she struggled to eat a reasonable portion of her roasted chicken. Time seemed to drag. After paying the bill, we descended in the elevator for her room on the fourth floor. Once inside, I began to help her pack for her return home to New Jersey, when she promptly discovered that she had lost her house keys. While helping her search for her keys, I became privy to a host of traps set for her by the hip replacement company and their lawyers. These included acts of spying and the recording of her phone conversations. She was animated, energized, in a highly voluble state.

  “They won’t stop me. I know where they are hiding,” she announced. As I worked to keep up with her, darting back and forth between the bed and bathroom in the bordellolike lighting, I found her stories of subterfuge utterly charming: what I deemed to be evidence of a rich inner life. My mother rarely confided in me this way, if ever. Her admissions felt delightfully intimate despite their foreboding implications. Regardless of the “rapport,” I should not have permitted her to take that flight to New Jersey that following morning. Instead, I should have insisted that she be hospitalized in Los Angeles, where I would have been able to monitor her treatment. Once again, I let the disease win. Too afraid to confront my mother with the truth, too timid to call 911 and have her hospitalized, I left my mother that evening to prepare for her flight home in the midst of a deep, persistent psychosis: allowing her illness to play itself out an inconceivably long distance away. Wanting to believe her doctor would do her job and intervene.