There was a caged-off balcony facing south, toward the highway and the water, which was open to inmates for a few minutes a day if we could successfully prevail upon the nurses. I gazed at the Gardiner Expressway and longed to be stuck among the glittering lines of vehicles stretching east and west alongside the shining surface of Lake Ontario. During one of these all-too-brief moments of fresh air I struck up a conversation with the woman in charge of the hospital’s psych wards, who’d come to the seventh floor for a brief visit. We talked about her responsibilities at the hospital, about her cat and her Thanksgiving plans. The exchange ended abruptly when the nurses ushered everyone back inside and I was reminded I was not an independent person, not a curious reporter, but a crazy person on a Form who could not be trusted on her own.
One exception to my studious avoidance of fellow inmates—a foray into the long-term psych ward’s common room to play Scrabble—ended abortively when my opponent’s word choices took a turn for the rapey. I freaked and retreated to my unlockable room. (I should add, in fairness, I was never given any concrete reason to fear for my safety while an inpatient. Most of the other psych-ward denizens were much more sociable and solicitous than I was. But this was an unnerving moment in an unnerving setting, so. On the bright side, I didn’t get a chance to lose: I suck at Scrabble.)
The ward psychiatrist would call each of us in for periodic chats in a cramped bright space between the elevator and the common room. “How is your mood?” she’d ask each time, and I tried to sound just upbeat enough for my reply not to ring fake (“I saw the sunrise this morning! It was beautiful!”).
I don’t know what kind of treatment most of my fellow inmates were getting. Apart from those psychiatric chats there were mandatory life-skills activities like the nutritional bingo delivered by an overly perky, heavily pregnant young woman whose cheery patience was wasted on most of us. I saw a couple of patients frighteningly woozy on meds, but that was it. More than anything else the place felt like a holding pen—a drunk tank for crazy. You could be there for weeks or months but it wasn’t a place you were meant to live.
I spent most of the vast empty stretches between visiting hours reading in my room or reading on the floor, tucked into a semi-sunny corner beside the glass balcony door, a sad-eyed hound hoping someone will notice her and let her out (it was here I fell in love with Esi Edugyan’s fiction). The lack of agency was the worst, of course. That, and the lack of privacy. That, and the lack of fresh air that almost drove me to start smoking so at least I could steal a bit of extra time outdoors for nurse-chaperoned nicotine outings. (I’ve since been informed those no longer exist. Too many elopees.)
Shortly after my move to 7M a senior editor from the paper came to visit. Old-school, in charge of something amorphous like the newspaper’s editorial standards, stern-seeming unless you knew her. She came in the late afternoon or early evening and I got my parents to sign me out of the nuthouse so I could meet her in the cramped ground-floor hospital coffee shop instead of the psych ward’s septic-antiseptic common room.
I was petrified. I’m sure it showed. But god, that visit meant so much it beggars verbalizing. She came and brought chocolate and newsroom gossip and we sipped coffee and talked about news and politics and who’d had a baby, who was out of his depth in a new job. And I remember palpably trembling, from meds or anxiety or both, and praying she didn’t notice and that I didn’t seem too crazy (Do I seem crazy now? How about now? Howaboutnow?). If I did she was gracious enough not to let on. At one point I tried to clumsily apologize without really specifying what for: neither of us had uttered the word “suicide” and I certainly wouldn’t be the one to haul it into a conversation teetering perilously on the cordially sane. She brushed it off: “Everyone’s allowed a couple of screw-ups.” “This is a pretty big screw-up.” She laughed. We talked about my return to work as though it were a real, imminent thing, not a delusional fantasy. I said the doctors thought being posted to a foreign bureau would be therapeutic. She laughed. I pretended that what I interpreted as the laughability of that ambition wasn’t breaking my heart. I don’t know what it took for her to come and visit me in hospital. But I experienced it as a gift, a superhuman act of kindness. It made me feel like a real person with a vocation and aspirations to return to. I grasped at that feeling in the days and weeks afterward, a bright thread in a dark labyrinth.
* * *
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DEMOCRACY IS THE BEST. I woke on Ontario election day with devastation down my insides: I was supposed to be covering this story, not watching it sidelong from a psych ward. But there was a silver lining, under the circumstances: freedom. Canadian inpatients, like prison inmates, retain their right to vote even while they’ve temporarily lost their right to freedom of movement. I unearthed my voter information card, requisite identification and proof of address; negotiated an extended leave—two consecutive hours!—from the psych ward and walked to my polling station to cast a vote. Most of my ward didn’t know an election was ongoing (notable exception: the wonderful lady who bellowed, “Who won the election?” from her room the following morning), or knew they could vote, or where they could vote, assuming they had a driver’s licence, health card, mail addressed to their permanent residence handy. Everyone who’d been committed would have needed chaperones. I had the good fortune of being accompanied by my parents, who took their guardianship role verrrry seriously. They all but held my hand as we crossed the street.
I’ve always loved polling stations and ballot-casting. But the normalcy, the heady sense of democracy in action is so much sweeter when there’s no one asking you if you’re planning to end your life, if you’ve taken your meds, if you’re allowed to be out. To the genial Elections Ontario workers I was just one more smiley voter, with a slight tremor you’d only notice if you looked really closely.
On our way back, aglow with the glory of participatory democracy and ready to leap to the barricades, we stopped at a No Frills to pick up toiletries. Conditioner was on sale (a big deal when you have long curly Wookiee hair) and I weighed the family-size bottles in my hands, wondering whether to buy a second. “Do it!” my mom urged. “You’re going to be alive a long time!” At that moment, in my mind, that cheery prognosis became a threat, a trap, a heavy door clanging shut. I wanted to scream and run away, evade my own powerlessness. I grabbed my conditioner and headed to the checkout.
Back on the ward, my best friend among the seventh-floor patients, a jokey, grizzled man who wore loose drawstring pyjama pants and little else, was kind enough to change the channel on the wall-mounted TV I couldn’t reach from hockey to the election coverage. He watched the results trickle in with me, making genial, racist remarks about the ethnic-sounding names of various candidates. He bragged about his near-death heroin overdoses, his karate-practising grandchildren, the pot he’d somehow managed to smuggle onto the ward.
Even an anti-social glued-to-her-book recluse like me needed an ally for the twelve waking hours every day without visitors. Grizzly Dude and I would bellow at each other down the off-beige hall, “What, are you crazy?!” and guffaw as though we were world-class comedians and not sad-sack psych-ward inmates. We tried and failed to muffle our laughter at the bizarre weekly discussion circles, meant as an opportunity for inmates to air living-condition grievances but really more like a parody of Ken Kesey’s One Flew Over the Cuckoo’s Nest. When I didn’t materialize to grab my breakfast tray (which was every morning: the food was consistently, comically awful; a mushy bland caricature of hospital grub) he sometimes brought it to my room.
And then suddenly it was Thanksgiving, and we each got a pass to escape the ward over the long weekend—he to stay with his mom and attend her celebratory dinner, me to stay with my parents in the place they were renting for the duration of my little meltdown. It was a weird weekend. I still had to be chaperoned everywhere by a putatively responsible adult. My dad jogged along when I went for a run in the morning; a coterie of friends picked me up and drove me to a hi
king spot outside the city and I stood in the parking lot with my face upturned to the sun like I was attempting photosynthesis. I had coffee with a co-worker who told me we couldn’t be friends anymore, not close friends, because it hurt too much. (Can’t say I blame her but that just about broke me.) I tagged along with Omar to a painfully awkward corporate PR party—“Do you want to come with me to this?” “Uh, this is Anna. Did you mean to call somebody else?”—where bands squawked under circling coloured disco lights in a fire-hazardous converted warehouse as I, newly teetotalling, nabbed miniature hamburgers off serving trays. I had less agency over my movements than at any time since I was eight years old, and felt it. But the people I loved who upended commitments and turned their lives inside-out for me made those days bearable.
“We all felt if we could just show you how much we love you, how much we need you in our lives…it might not make you better, but maybe it would make you think twice about killing yourself,” my dad told me years later.
The autumnal scenes from that weekend seem made for an idyllic montage in a cheesy movie. Misleadingly: outpatient downtime is a great opportunity to ruminate over your own monstrousness and mistakes and the hurt you’ve caused people you claim to love. I remember, vividly, lying on my side awake in bed, thinking for the first time post-antifreeze how best to kill myself, the need pressing like weight on a bladder. It was back.
My poor gorgeous siblings had decamped to school so it was a muted Thanksgiving dinner. My parents took the opportunity to ask me why I hadn’t left a note.
What do you say to that? I said it seemed presumptuous to try to explain something I could sense would be inexplicable to the explanation’s audience no matter what I said to try to justify causing this kind of hurt, knowing full well the hurt it would cause. I didn’t say that note-leaving was not top of mind for me at that moment. But it has been since then. It occupies my thoughts in the days and hours when ending my life seems most urgently imperative. Who needs a note? What do I say? Should I leave them in envelopes at home? Mail them? What if I mail a note and then change my mind or screw up my death? How gross would that be? I’ve asked my more morbid-minded friends if they’d rather I left them a note but no one’s been shameless enough to say. Does it make it better or worse, having a note from someone whose suicide has left you grieving? (I’m genuinely curious. Answer in the comment section below!)
We stopped on our way back to hospital to pick up a sack of bulk candy I’d promised Grizzly Dude. He was heartbreakingly pleased.
* * *
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THE LONG-TERM PSYCH-WARD residents were several levels crazier than the short-term ward’s patients. They also seemed to interact and pal around more, perhaps because they were there long enough to form friendships; perhaps because lunacy lowers social inhibitions (when it doesn’t socially incapacitate you, as it did me). One young man with schizophrenia paced the halls wild-eyed, swearing under his breath for hours a day. He discomfited me at first but was harmless, although he’s my primary suspect in the theft of a bag of Honeycrisp apples from my room, going solely on the hearsay of my grizzly patient friend. Most were comparatively subdued, moving between levels of lucidity. Most were men, most older than me. One of the only exceptions was a tiny young woman with close-cropped dark hair and a body of sharp angles, who had an eating disorder and a strained relationship with her family.
One loud, gangly man who stood in the common area declaring his schizophrenia (“I am schizophrenic, and so am I!”) was clearly a regular. (I should maybe note that people with schizophrenia don’t generally have multiple personalities.) He recalled previous incarnations of the ward’s amenities—apparently the TV had improved; the pillows had not—when he served as jumpy secretary during weekly patient meetings. He told everyone in detail about his fungally infected foot, which needed its own special sandal. He stopped me and a visiting friend one evening to loudly proclaim his views on gay people (strongly disliked) and then Toronto mayor Rob Ford (strongly liked, although he seemed to think Ford was premier). He had a habit of staring at your chest and making grandiose rambling compliments, then elucidating his love for his wife—same script each time. He called his teenage son sometimes from the wall-mounted phone outside the nurses’ station. Asked him to visit, bring him foot cream and other necessities. If the boy dropped by I didn’t see him.
I don’t envy anyone whose job it was to care for us in the long-term ward, babysitting a floor of complex, erratic, unwell individuals, many of whom would be better off elsewhere. There aren’t enough intermediate- or long-term facilities for people who can’t care for themselves but don’t need to be hospitalized (more on that later). And my west-end Toronto hospital abuts Parkdale, a gentrifying neighbourhood of new immigrants, rising rents, trending restaurants, scuzzy apartment buildings, huge old subdivided houses and one of the highest concentrations of people battling addiction and crippling mental illness in the country—the second-highest rate of psychiatric hospital visits in the fourth-largest city on the continent.2
A few months before my suicide attempt, in the spring of 2011, Parkdale was terrorized by someone (or several people) attacking mentally ill residents seemingly at random.3 I’d been living in the neighbourhood more than a year by the time that happened, a few lanes of highway between me and the blue dish of lake, and loved the community. I never felt unsafe but knew parents of young kids who’d found used needles in playgrounds. As so often happens, when the area cleans up, its most vulnerable residents get pushed out. In recent years rooming houses have been sold, rebranded and subdivided into micro-bachelor apartments renting for $1,300 a month.4 But this is still where the services are—the community health centres, the legal clinic, employment and language and other social services—and this is where people grew up and found community so, as in any big city, they stick around to the extent they can, to the extent there’s somewhere affordable and accessible to live or sleep or crash.
An inordinate proportion of my hospital’s psychiatric inpatients were (are) homeless; many brought there by police, who I’ve been told go out of their way to drop people off at this crisis unit rather than others because of its rapid processing times. The hospital gets more of these police drop-offs than any other facility in the city, despite having far fewer psychiatric beds than other places, such as the prominent Centre for Addiction and Mental Health.5 I once talked to a recovering lifelong alcoholic in Parkdale who, when he was going through a particularly bad withdrawal, which happened a fair bit, would try to get paramedics to take him to St. Joe’s rather than elsewhere because he knew he’d be treated compassionately. I still see people in the neighbourhood—walking down the street, waiting for a streetcar, grabbing a coffee or a sandwich—I recognize from the outpatient mental health clinic where I, too, am now a regular. And some people keep checking themselves back in. They’ve nowhere else to go. This is the home address they put on whatever forms they’re required to fill out because it’s the closest place they have. Many of the long-term ward’s inhabitants cycle through endlessly—too needy to live alone, not needy enough to need hospitalization, no one to advocate on their behalf for supportive housing and nowhere near enough social housing to go around. There are a hundred thousand people on that waiting list in Toronto alone.6 Housing, especially supportive housing—proven umpteen times to improve health care, corrections, social outcomes7—is still something we’re terrible at providing for those who need it most.
Surely, few groups of patients are as unpleasant by definition as those whose disease targets their brains. If it’s weird waking to find yourself in a different stranger’s care each morning, it can’t be much more pleasant to be charged with caring for a cycle of erratic nutbars with sub-optimal hygiene practices. One friendly night nurse told me he’d come to Canada to work in literature after winning awards for his writing and translating in China. Turns out it’s easier to get a gig as a nurse than as a Chinese–English translator though, so he went back to school and swap
ped planned translations of Atwood, Richler, Munro for shifts with pissy psych inpatients. I wish I’d asked what he was reading. A Filipino Canadian nurse I tried unsuccessfully to cajole into casting a ballot was worried her two kids would emerge from post-secondary with degrees and no jobs.
I forgot everyone’s name.
* * *
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AT THE END of my two-week Form 3, the “How is your mood?” ward psychiatrist decided I was free to go. I’m not sure whether this was motivated more by my progress or their need for beds. I didn’t feel better, particularly; suicide didn’t seem like an immediate option but nothing seemed like much of an immediate option. I hadn’t processed the prospect of putting my life back together. But I didn’t care. The feeling of being No Longer Certifiable was fantastic. My parents were coming to pick me up. They would help me find a new apartment and then decamp across the country to Vancouver. “The hardest thing,” my mom later told me, “was leaving you [in Toronto] by yourself. You were very independent and strong…but I also wanted to look after you and keep you safe. But I couldn’t….
“We came to realize how helpless we were, and that was—apart from the fact of knowing that we could lose you at any time—that was the hardest thing to deal with….[Being] powerless in a role where we felt it’s our responsibility to help you and keep you safe.”
Reading books about depression helped her feel informed, but also terrified.
“You never want to accept the fact that your kid could kill herself.” Long pause. “So I try to be positive. I don’t dwell on that too much.”
* * *
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“I HOPE I NEVER see you again,” my nurse of the day said. It was sunny. I got my bike back. Everything was going to be okay.
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