Girl, Interrupted

by Susanna Kaysen

  “Fuck you,” said Daisy, who was passing by.

  “Hey, Daisy,” said Lisa, “you ever fuck on five-minute checks?”

  “I don’t want to fuck these assholes in here,” said Daisy.

  “Excuses,” Lisa whispered.

  “You’re not fucking anybody either,” said Lisa Cody.

  Lisa grinned. “Georgina’s gonna lend me Wade for an afternoon.”

  “All it takes is ten minutes,” said Georgina.

  “They never caught you?” I asked her.

  “They don’t care. They like Wade.”

  “You have to fuck patients,” Lisa explained. “Get rid of that stupid boyfriend and get a patient boyfriend.”

  “Yeah, that boyfriend sucks,” said Georgina.

  “I think he’s cute,” Lisa Cody said.

  “He’s trouble,” said Lisa.

  I started to sniffle.

  Georgina patted me. “He doesn’t even visit,” she pointed out.

  “It’s true,” said Lisa. “He’s cute, but he doesn’t visit. And where does he get off with that accent?”

  “He’s English. He grew up in Tunisia.” These were very important qualifications for being my boyfriend, I felt.

  “Send him back there,” Lisa advised.

  “I’ll take him,” said Lisa Cody.

  “He can’t fuck in fifteen minutes,” I warned her. “You’d have to give him a blow job.”

  “Whatever,” said Lisa Cody.

  “I like a blow job now and then,” said Lisa.

  Georgina shook her head. “Too salty.”

  “I don’t mind that,” I said.

  “Did you ever get one that had a really bitter taste, puckery, like lemons, only worse?” Lisa asked.

  “Some kind of dick infection,” said Georgina.

  “Yuuuch,” said Lisa Cody.

  “Nah, it’s not an infection,” said Lisa. “It’s just how some of them taste.”

  “Oh, who needs them,” I said.

  “We’ll find you a new one in the cafeteria,” said Georgina.

  “Bring a few extra back,” said Lisa. She was still restricted to the ward.

  “I’m sure Wade knows somebody nice,” Georgina went on.

  “Let’s forget it,” I said. The truth was, I didn’t want a crazy boyfriend.

  Lisa looked at me. “I know what you’re thinking,” she said. “You don’t want some crazy boyfriend, right?”

  I was embarrassed and didn’t say anything.

  “You’ll get over it,” she told me. “What choice have you got?”

  Everybody laughed. Even I had to laugh.

  The person on checks put her head out of the nursing station and bobbed it four times, once for each of us.

  “Half-hour checks,” said Georgina. “That would be good.”

  “A million dollars would be good, too,” said Lisa Cody.

  “This place,” said Lisa.

  We all sighed.

  Do You Believe Him or Me?

  That doctor says he interviewed me for three hours. I say it was twenty minutes. Twenty minutes between my walking in the door and his deciding to send me to McLean. I might have spent another hour in his office while he called the hospital, called my parents, called the taxi. An hour and a half is the most I’ll grant him.

  We can’t both be right. Does it matter which of us is right?

  It matters to me. But it turns out I’m wrong.

  I have a piece of hard evidence, the Time Admitted line from the Nurse’s Report of Patient on Admission. From that I can reconstruct everything. It reads: 1:30 P.M.

  I said I left home early. But my idea of early might have been as late as nine in the morning. I’d switched night and day—that was one of the things the doctor harped on.

  I said I was in his office before eight, but I seem to have been wrong about that, too.

  I’ll compromise by saying that I left home at eight and spent an hour traveling to a nine o’clock appointment. Twenty minutes later is nine-twenty.

  Now let’s jump ahead to the taxi ride. The trip from Newton to Belmont takes about half an hour. And I remember waiting fifteen minutes in the Administration Building to sign myself in. Add another fifteen minutes of bureaucracy before I reached the nurse who wrote that report. This totals up to an hour, which means I arrived at the hospital at half past twelve.

  And there we are, between nine-twenty and twelve-thirty—a three-hour interview!

  I still think I’m right. I’m right about what counts.

  But now you believe him.

  Don’t be so quick. I have more evidence.

  The Admission Note, written by the doctor who supervised my case, and who evidently took an extensive history before I reached that nurse. At the top right corner, at the line Hour of Adm., it reads: 11:30 A.M.

  Let’s reconstruct it again.

  Subtracting the half hour waiting to be admitted and wading through bureaucracy takes us to eleven o’clock. Subtracting the half-hour taxi ride takes us to ten-thirty. Subtracting the hour I waited while the doctor made phone calls takes us to nine-thirty. Assuming my departure from home at eight o’clock for a nine o’clock appointment results in a half-hour interview.

  There we are, between nine and nine-thirty. I won’t quibble over ten minutes.

  Now you believe me.

  Velocity vs. Viscosity

  Insanity comes in two basic varieties: slow and fast.

  I’m not talking about onset or duration. I mean the quality of the insanity, the day-to-day business of being nuts.

  There are a lot of names: depression, catatonia, mania, anxiety, agitation. They don’t tell you much.

  The predominant quality of the slow form is viscosity.

  Experience is thick. Perceptions are thickened and dulled Time is slow, dripping slowly through the clogged filter of thickened perception. The body temperature is low. The pulse is sluggish. The immune system is half-asleep. The organism is torpid and brackish. Even the reflexes are diminished, as if the lower leg couldn’t be bothered to jerk itself out of its stupor when the knee is tapped.

  Viscosity occurs on a cellular level. And so does velocity.

  In contrast to viscosity’s cellular coma, velocity endows every platelet and muscle fiber with a mind of its own, a means of knowing and commenting on its own behavior. There is too much perception, and beyond the plethora of perceptions, a plethora of thoughts about the perceptions and about the fact of having perceptions. Digestion could kill you! What I mean is the unceasing awareness of the processes of digestion could exhaust you to death. And digestion is just an involuntary sideline to thinking, which is where the real trouble begins.

  Take a thought—anything; it doesn’t matter. I’m tired of sitting here in front of the nursing station: a perfectly reasonable thought. Here’s what velocity does to it.

  First, break down the sentence. I’m tired—well, are you really tired, exactly? Is that like sleepy? You have to check all your body parts for sleepiness, and while you’re doing that, there’s a bombardment of images of sleepiness, along these lines: head falling onto pillow, head hitting pillow, Wynken, Blynken, and Nod, Little Nemo rubbing sleep from his eyes, a sea monster. Uh-oh, a sea monster. If you’re lucky, you can avoid the sea monster and stick with sleepiness. Back to the pillow, memories of having mumps at age five, sensation of swollen cheeks on pillows and pain on salivation—stop. Go back to sleepiness.

  But the salivation notion is too alluring, and now there’s an excursion into the mouth. You’ve been here before and it’s bad. It’s the tongue: Once you think of the tongue it becomes an intrusion. Why is the tongue so large? Why is it scratchy on the sides? Is that a vitamin deficiency? Could you remove the tongue? Wouldn’t your mouth be less bothersome without it? There’d be more room in there. The tongue, now, every cell of the tongue, is enormous. It’s a vast foreign object in your mouth.

  Trying to diminish the size of your tongue, you focus your attention on its
components: tip, smooth; back, bumpy; sides, scratchy, as noted earlier (vitamin deficiency); roots—trouble. There are roots to the tongue. You’ve seen them, and if you put your finger in your mouth you can feel them, but you can’t feel them with the tongue. It’s a paradox.

  Paradox. The tortoise and the hare. Achilles and the what? The tortoise? The tendon? The tongue?

  Back to tongue. While you weren’t thinking of it, it got a little smaller. But thinking of it makes it big again. Why is it scratchy on the sides? Is that a vitamin deficiency? You’ve thought these thoughts already, but now these thoughts have been stuck onto your tongue. They adhere to the existence of your tongue.

  All of that took less than a minute, and there’s still the rest of the sentence to figure out. And all you wanted, really, was to decide whether or not to stand up.

  Viscosity and velocity are opposites, yet they can look the same. Viscosity causes the stillness of disinclination; velocity causes the stillness of fascination. An observer can’t tell if a person is silent and still because inner life has stalled or because inner life is transfixingly busy.

  Something common to both is repetitive thought. Experiences seem prerecorded, stylized. Particular patterns of thought get attached to particular movements or activities, and before you know it, it’s impossible to approach that movement or activity without dislodging an avalanche of prethought thoughts.

  A lethargic avalanche of synthetic thought can take days to fall. Part of the mute paralysis of viscosity comes from knowing every detail of what’s ahead and having to wait for its arrival. Here comes the I’m-no-good thought. That takes care of today. All day the insistent dripping of I’m no good. The next thought, the next day, is I’m the Angel of Death. This thought has a glittering expanse of panic behind it, which is unreachable. Viscosity flattens the effervescence of panic.

  These thoughts have no meaning. They are idiot mantras that exist in a prearranged cycle: I’m no good, I’m the Angel of Death, I’m stupid, I can’t do anything. Thinking the first thought triggers the whole circuit. It’s like the flu: first a sore throat, then, inevitably, a stuffy nose and a cough.

  Once, these thoughts must have had a meaning. They must have meant what they said. But repetition has blunted them. They have become background music, a Muzak medley of self-hatred themes.

  Which is worse, overload or underload? Luckily, I never had to choose. One or the other would assert itself, rush or dribble through me, and pass on.

  Pass on to where? Back into my cells to lurk like a virus waiting for the next opportunity? Out into the ether of the world to wait for the circumstances that would provoke its reappearance? Endogenous or exogenous, nature or nurture—it’s the great mystery of mental illness.

  Security Screen

  “I need some fresh air,” said Lisa. We were sitting on the floor in front of the nursing station, as usual.

  Daisy passed by.

  “Gimme a cigarette,” she said.

  “Get your own, bitch,” said Lisa. Then she gave her one.

  “Lousy cigarette,” said Daisy. Lisa smoked Kools.

  “I need some fresh air,” Lisa repeated. She stubbed her cigarette out on the brown-and-beige-speckled rug and stood up. “Hey!” She put her head into the nursing station, in through the open half of the Dutch door. “I need some fucking fresh air.”

  “Just a minute, Lisa,” said a voice from inside.

  “Now!” Lisa banged on the sill that divided the top and bottom halves of the door. “This is illegal. You can’t keep a person inside a building for months. I’m going to call my lawyer.”

  Lisa often threatened to call her lawyer. She had a court-appointed lawyer, about twenty-six, handsome, with almond eyes. He hadn’t been able to stop her being committed. His name was Irwin. Lisa claimed to have fucked him a few times in the lawyer-client conference room at the courthouse.

  Whenever Lisa threatened to call her lawyer, the head nurse got involved.

  Now she came out and leaned on the sill. “What’s up, Lisa,” she said, sounding tired.

  “I want some fucking fresh air.”

  “You don’t have to yell,” said the head nurse.

  “How the fuck else am I going to get any attention in this place?” Lisa always called the hospital “this place.”

  “I’m right in front of you now,” the head nurse said. “I’m paying attention.”

  “Then you know what I want.”

  “I’ll get an aide to open your window,” said the head nurse.

  “Window,” said Lisa. She turned briefly to look at us. “I’m not interested in some fucking window.” She hit the sill again. The head nurse moved back a bit.

  “It’s window or nothing, Lisa,” she said.

  “Window or nothing,” said Lisa in a singsong. She took a few steps down the hall, so that all of us, including the head nurse, could see her.

  “I’d just like to see how you’d manage this place, never going outside, never even breathing fresh air, never being able to open your own fucking window, with a bunch of sissy cunts telling you what to do. Valerie, time for lunch, Valerie, you don’t have to yell, Valerie, time for your sleeping meds, Valerie, stop acting out. You know? I mean, how the fuck would you manage, hunh?”

  The head nurse’s name was Valerie.

  “I mean, you wouldn’t last ten minutes in this place.”

  “Fucking bitch,” said Daisy.

  “Who asked you?” Lisa pointed at Daisy.

  “Gimme a cigarette,” said Daisy.

  “Get your own,” said Lisa. She turned to the head nurse. “I’m going to call my lawyer.”

  “Okay,” said the head nurse. She was pretty smart.

  “You think I’ve got no rights? Is that what you think?”

  “Should I put the call through?”

  Lisa waved her arm dismissively. “Nah,” she said. “Nah, open the window.”

  “Judy,” said the head nurse. This was a young blond aide we enjoyed tormenting.

  “Valerie!” yelled Lisa. She called the head nurse Valerie only when she was upset. “Valerie, I want you to open my window.”

  “I’m busy, Lisa.”

  “I’ll call my lawyer.”

  “Judy can do it.”

  “I don’t want that fucking sissy cunt in my room.”

  “Oh, you’re such a bore,” said the head nurse. She pressed the security buzzer that unlocked the bottom of the door and came out into the hall with us.

  Lisa smiled.

  To open a window, a staff person had to unlock the security screen, which was a thick impregnable mesh on a steel frame, then lift the heavy unbreakable-glass-paned window, then shut and relock the security screen. This took about three minutes, and it was hard work. It was the sort of thing aides did. When the window was open, air might make its way through the mesh of the security screen, if it was a breezy day.

  The head nurse returned from Lisa’s room, a little pink from exertion. “Okay,” she said. She rapped on the nursing-station door to be buzzed back in.

  Lisa lit another cigarette.

  “Your window’s open,” said the head nurse.

  “I’m aware of that,” said Lisa.

  “You aren’t even going in there, are you?” The head nurse sighed.

  “Hey, man,” said Lisa, “it passes the time,” She touched the hot end of her cigarette to her arm for a second. “I mean, that took up twenty minutes, maybe half an hour.”

  The buzzer sounded, the head nurse opened the door, went inside, and leaned on the sill again.

  “Yes, it does pass the time,” she said.

  “Gimme a cigarette,” said Daisy.

  “Get your own, bitch,” said Lisa. Then she gave her one.

  Keepers

  Valerie was about thirty. She was tall and had tapered legs and arms. She looked a lot like Lisa, though she was fair. They both had lean long haunches and flexible joints. Lisa was good at curling herself into chairs and corners, and so
was Valerie. When someone was upset and had tucked herself between a radiator and a wall or behind a bathtub or into another small secure spot, Valerie could curl herself into a compact package and sit near that person.

  Valerie’s fair hair was beautiful, but she kept it hidden in a braid that she twisted up on the back of her head. This braid-in-a-bun never came undone or slipped out of place. Rarely, Valerie could be coaxed into undoing the bun and showing us the braid, which reached to her waist. Only Lisa could convince her to do this. She never released her hair from the braid, though we begged her to.

  Valerie was strict and inflexible and she was the only staff person we trusted. We trusted her because she wasn’t afraid of us. She wasn’t afraid of doctors either. She didn’t have much to say about anything, and we liked her for that, too.

  We had to hear a lot of talk in that place. Each of us saw three doctors a day: the ward doctor, the resident, and our own therapist. Mostly we had to hear ourselves talk to these doctors, but they did a fair amount of talking themselves.

  They had a special language: regression, acting out, hostility, withdrawal, indulging in behavior. This last phrase could be attached to any activity and make it sound suspicious: indulging in eating behavior, talking behavior, writing behavior. In the outside world people ate and talked and wrote, but nothing we did was simple.

  Valerie was a relief from that. The only phrase she used was acting out, and she used it correctly, to mean “getting in my hair and driving me crazy.” She said things like “Cut that out” and “You’re a bore.” She said what she meant, just as we did.

  The doctors were men; the nurses and aides were women. There were two exceptions: Jerry the Aide and Dr. Wick. Jerry was willowy and worried. He had one good trick. Now and then, someone with a lot of privileges was allowed to leave the hospital in a taxi. That person would say, “Jerry, call me a cab.” Jerry would say, “You’re a cab.” We loved this.

  Dr. Wick was another story.

  Dr. Wick was the head of our ward, South Belknap Two. The wards had boarding-school names like East House and South Belknap, and Dr. Wick would have been a good boarding-school matron. She came from Rhodesia and she looked like the ghost of a horse. When she talked, she sounded somewhat like a horse as well. She had a low, burbly voice, and her colonial English accent gave her sentences a neighing cadence.