by Ben Dolnick
[Admittance materials, Northern Dutchess Hospital]
Welcome to Sommers 11 North, a 26-bed acute care psychiatric unit, where your friend or family member has been admitted.
Visiting hours are daily, from 11:00AM to 4:30PM, except on Tuesdays between 12PM and 2PM, when all patients are required to attend Community Meeting.
The next business day following the admission of your friend or family member, a social worker will be available between the hours of 11AM and 1PM to meet with you. If you cannot make this session, a social worker will contact you to schedule an alternative time.
Please contact Dr. Gutman (see Staff Directory, page 2) immediately if your friend or family member expresses the idea of hurting himself/herself, hurting someone else, or running away from the hospital. If Dr. Gutman is unavailable, please ask to speak with the charge nurse or her/his designee and state that you have urgent patient information that must be acted upon immediately.
…
4
One of the staples of my fantasy life, when I was at the height of my musical ambitions/delusions, was the speech I’d give when I won my first major award. Sometimes this speech took place in a ballroom where everybody looked up at me from round tables, setting down their silverware in charmed amazement. Sometimes it took place in an actual Grammy-style theater, where I jogged down the aisle and up the stage stairs smiling in friendly fake surprise. A standard feature of these imaginary speeches, anyway, was that they contained a brief section on feeling humbled—how, while it might seem as if this were a moment for maximal ego inflation, this whole award-receiving experience had actually only made me more appreciative than ever of all the people whose help I couldn’t have accomplished this without and of just how much there still was for me to learn.
I would now support a constitutional amendment ordering anyone who claims to be humbled in this way to be transferred immediately to the fourth-floor Sommers Psychiatric Ward at Northern Dutchess Hospital. To be humbled is to wake up wearing an un-tearable plastic bracelet with your name on it; to find out you’ll have to earn “positive behavior points” in order to buy Combos from the vending machine; to sleep in a salmon-sheeted twin bed five feet from a fortysomething stranger who cracks his knuckles and farts poisonously in his sleep.
The specifics of how I came to enter the hospital are both tedious and depressing, so I won’t go too much into them except to say that if Sheriff Cole hadn’t been in the car that pulled me over, and if it hadn’t been for the understanding of Dutchess County Second District Judge Marilyn Everts—who, perfectly reasonably, deemed me a danger to myself—I would have ended up somewhere worse.
The hospital was half an hour north of Hibernia, a big gloomy campus of duck-less ponds and half-empty parking lots. The buildings—there were three or four of them—were painted yellow and looked like haphazardly constructed college dorms, rows of windows and sliding-glass front doors. My first thought, pulling in, was that it resembled the conference center in Connecticut where I’d once spent an ill-advised weekend listening to presentations about digital marketing for artists and entrepreneurs.
Checking in—that first morning of forms and information sessions and intake interviews—was a bizarre, bleak, indoctrination-type experience. Complicated Grief Disorder, people kept impressing on me, is a diagnosable condition. What I’d been going through, they insisted, didn’t have to do with Dr. Blythe’s notes, or Donna’s lies, or any cardboard box; this was grief, this was shock, this was despair, this was just how these things felt. I’d been, they said, the victim of a series of delusions. I shouldn’t be thinking about Hannah’s death while I was hospitalized, shouldn’t be trying to solve anything. My only job was to take my pills, to do the various therapies, and to wait for my mind’s vital signs to stabilize. I was, in other words, supposed to accept not just that I’d lost Hannah; I’d also gone some ways toward losing my mind.
The main thing that struck me those first few days—the thing other than the place’s incredible, soul-corroding grimness—was how hard life was for the patients there, and how little there seemed to be that anyone could do about it. It would happen sometimes that a group of trainee nurses or a few administrators from another hospital would sit in on a group, and the difference between the civilians in the room and the patients would be as stark and essential as the difference between a lightbulb that’s on and one that’s off. Something was gone from the patients at Sommers: some flavor, some force. Life for the non-patients was full of gossip, interest, jokes, projects that might or might not come through—life for the patients was an ordeal to be suffered through (or, if they could find the means, not suffered through). It terrified me to realize that I’d somehow slipped from the first category of person into the second.
I had plenty of time for this kind of reflection. You know those intervals in life when your plane has been delayed five hours and you’ve already finished your book, or you’re stuck in traffic so bad that you might as well turn the car off? Life in a psychiatric hospital, assuming you’re well enough to retain any sense of time at all, is one of those intervals stretched out to fill every minute.
I was, as a 5150, supposed to spend seven weeks at Sommers—this dictated the wing I was placed in and the privileges I was allowed (visitors, yes; day trips, no). Both of my parents came to see me, in that first week, and their stated position—I suspected they’d been prepped by a social worker—was that I was doing the right thing, I was in exactly the right place, that all they cared about was me getting well. But they looked, both of them, as if they’d found me living in a dumpster. It had only been a couple of weeks since I’d last seen them, and Jesus, Nick, what happened? was flashing on both of their faces. I’d lost weight. I hadn’t shaved. I was wearing plaid pajama pants Sheriff Cole had bought for me. I must, in other words, have appeared to them just as horrifying as my fellow patients had initially appeared to me. When they left at the end of the hour—there was a whole complicated system of sign-in desks and doors that needed to be buzzed—I felt the gruesome adult equivalent of what I’d felt when they’d dropped me off at summer camp; these strangers are now my people.
My roommate—our door was never allowed to be fully closed—was a man named Diego. Our bedroom was tile-floored, white-walled, anonymous in the way of rooms that see many unwell inhabitants. Diego was in the hospital because of a fight he’d had at his last job, at an auto shop in Poughkeepsie. I couldn’t get all the details—he spoke in bursts of vividness that didn’t quite link up—but there had been a pair of jumper cables, an arrogant college boy, a call to the police. Diego’s diagnosis of his own mental condition was: “I get sometimes so my thoughts don’t make no sense.” He had a short black ponytail and a bottomless supply of eucalyptus cough drops, and, because he’d been hospitalized twice before, he acted as my mentor.
“This is Linda. Good lady, born in Nebraska or someplace. Her husband, normal dude, they’re married for like twenty years, turns out he’s gay plus a crackhead, and he’s emptying her bank account. One day she goes to get money so she can take her mother to the doctor, finds out she doesn’t even own her house anymore.
“Over by the window, that’s Steve. Twenty-two years old, tried to kill himself last year with the cord from a air conditioner, ’cept the cord snapped, dude fell broke both his feet. I got no beef with him, but some other dudes, they don’t like the way he looks at people in group.
“This is Eileen. How you doin’, sweetheart? She don’t eat. She went one whole year before she came in here, didn’t eat nothing but water and five pieces of popcorn a day. Now they got her with tubes.
“Who else. Oh, that’s the professor. We call him that ’cause he just sits around all day and reads. He don’t even care what, dude would read a cereal box. I seen him do better on Jeopardy than the guys who make forty thousand. Hey professor, how many rivers are in Africa? How many legs do ants have?”
There was, in other words, enough collective suffering at Sommers t
o dissolve any of our individual misfortunes. After a week or so, my story—dead girlfriend, delusions, drunken car chase—became just another drop in the endless gray ocean. I would hear myself saying things like “And so I broke in and stole her notes,” and, “I found out she’d been thinking about breaking up with me when she died,” and the other people in the circle would just nod, sigh, say yeah, they’d had cousins who’d gone through things like that.
Every Tuesday morning at 10:30 we had a Coping Skills group. Each week’s session focused on a different patient, and my first week there was Diego’s turn. He was telling the story of a fight he’d had with his sister’s boyfriend.
“Okay,” Dr. Mital said. “Okay.” Dr. Mital was a young Indian woman with dramatic eye makeup and an engagement ring. “Do you know what your thoughts were, when he pushed you?”
“I was thinking What the fuck you do that for, I’m gonna cut you.”
“Okay. So”—reaching over to write illegibly on her whiteboard—“What the blank did you do that for, I want to cut you. Is that accurate?”
“Yeah that’s it.”
“And your feelings were anger, I think we can say. Would you say there was some fear in there?”
“I wasn’t afraid of shit. He was afraid.”
“Okay so anger. Maybe some annoyance? Is that fair to say? And on an intensity scale, how would you rate these feelings? How angry were you?”
“Ooh, way up here. Like about to blow.”
“Should we say a seven or an eight? Now, let’s bring in the group and talk about some skillful things you could have done when you were feeling anger at a seven or an eight.”
“He could have breathed?” Eileen said breathily.
“He could have bashed the guy in the teeth with his bike lock,” Steve muttered.
“Okay so let’s talk about whether that would have been skillful. How do we define skillfulness, in this context?”
“Effectively meeting our goals and values.”
“And what are our goals and values in this situation?”
Diego said, “Not going to jail.”
“Not going to jail. That’s a good goal. Any others?”
“Not being the kind of dude who has to jack people when they get in his face?”
“Nonviolence? Is that the value you’re describing?”
“Yeah. Nonviolence. Other people can be getting all wild on you and you just say, Uh-uh, you ain’t even worth one drop of blood.”
“And can anyone think of a behavior that might have served these goals and values? Not going to jail and nonviolence?”
No one said anything for a minute or two—these sessions, because of overmedication or just the strangeness of hospital culture, always contained long pockets of silence—and then for the first time since I’d been there, the professor raised his hand. “Would you mind if I went and found Nurse Carol?” he said. “I’m having an issue with my blood sugar. My cereal ran out at breakfast, and the only bananas they had were mush.” He talked with his hands by his mouth, rubbing his cheek through his beard. His notebook was bouncing in his lap.
“Go ahead, James,” Dr. Mital said.
The professor hurried out of the room, shaking his head as if to dislodge a fly. Diego, turning around in his chair, called out through the door, “What, my story’s not smart enough for you?”
. . .
Tuesdays and Thursdays I had individual counseling with Dr. Mital in the B Hall. We met in one of the glass-walled rooms across from the TV area (most rooms at Sommers were glass-walled, in keeping with the student center/panopticon vibe). We sat across a little round table from each other, close enough that I would sometimes accidentally bump her when I rearranged my legs. She wore her pantsuit, I wore my pajamas. A year ago, I’d think, she and I could have been colleagues meeting to plan a holiday party; now she was keeping one eye on the emergency button.
Dr. Mital had told me in our first session that one of our main progress goals was going to be coming up with a “good-enough story” of Hannah’s death. “Most traumatic deaths,” she said, “are, to some extent, mysteries.” (I rubbed Hannah’s papers in my pocket, the pages now as soft as the fabric of my pajamas.) “Survivors often find it more comfortable, emotionally, to focus on ‘solving’ the mystery—even if this activity is actually very unpleasant—rather than on facing whatever feelings they’re having. So we’re going to do our best to come up with a story that stays within the bounds of what we know, and then we’re going to practice saying, Good enough.”
The story we came up with, over a handful of dry-mouthed, silence-punctuated sessions, was: I had been engaged to a woman with a history of mental instability, and the stresses of thinking about marriage, plus a new job and living situation, plus some unwise decisions about her medicine, had pushed her into a crisis. (This is good so far, Nick, you’re doing great. I like that word crisis. Keep going.) And so one morning in November…What about the things Hannah had told Dr. Blythe about the Kemps? (Well, she was clearly in great distress. Can you bring in experience from your own life? Does your thinking become more or less clear when you’re extremely upset?) And so one morning in November, although we couldn’t know with a hundred percent certainty if it had been an accident (Yes, good. One hundred percent certainty is one hundred percent impossible), Hannah had gone out and walked into the river. What about the canoe, though? (Let’s not get hung up on that. This might be one of those details that we’ll never fully understand.) And she’d drowned, whether or not she’d meant to (Good, yes) and…What about her not leaving a note? (More than half of all suicides don’t leave notes. Let’s try not to speculate.) And we’d found her body that afternoon, much too late to do any good, and the downward-spiral portion of my life (Can we rephrase that less judgmentally?)—the recent difficult portion of my life—had begun.
So, this was the patchy and unsatisfying version of events that it was now my job to accept. Whenever I found myself disappearing down a mental alleyway—whenever I found myself reading and rereading the list in my pocket, wondering what Hannah had meant—I was supposed to check in by focusing for thirty seconds on the sensations in my feet, and then I was supposed to consult what Dr. Mital and I had written together in my notebook. The words Kemp and canoe and Donna and Wrighters were all supposed to act as warning bells now, indicators that my thoughts had drifted off into the unverifiable. I could—with the help of diaphragmatic breathing—make room for the uncomfortable thoughts and feelings, but I didn’t have to follow them.
This all sounds culty and soft-headed, as I write it out, but the truth is that I was sufficiently desperate for relief, and sufficiently skeptical of my own judgment, that I actually signed on to Dr. Mital’s approach, most of the time. Hannah had died because some people’s brain chemistry predisposes them to acts of self-destruction, and all the stories I’d been telling were clouds of fog around that simple fact. Go through anyone’s papers after they die and you’ll find fifty things that don’t add up, rabbit holes you could fall down. All but a tiny slice of the things that have ever happened, even to the people we love, we will never know about or understand.
So this was how I spent my time: feeling my feet, battling my brain, taking turns labeling one or another of the voices in my head as unreliable. And life in the hospital—medicated, joyless, airless—churned on. The institutional HVAC system roared and fell silent. Pancakes appeared and went cold in the cafeteria. I got used to the outside existing for me only as a series of brown-grass-and-pavement landscapes seen through sealed windows. Needing to wait for a staff member to swipe an ID card in order to get from one hallway to another no longer felt remarkable. At some point I’d even stopped noticing the slowness of everything—my inner settings had adjusted such that this was just life’s tempo. I had group counseling and individual counseling. Creative Arts Therapy. CBT for Distress Tolerance. Relapse Prevention. Ask the Doctor. Roles & Relationships. I was back in college, it occurred to me—a very un-prestigious col
lege—only this time I was majoring in Life.
And one of my main professors, appropriately, was turning out to be the professor, James. He wasn’t the patient I liked best—that was probably Linda, the heartbroken Nebraskan—but he was the one most capable of complex conversation, which acted as a vitality drip for me. At some point a ritual had evolved where he and I and a couple of other patients would gather, every afternoon, in the corner of the lounge farthest from the TV. (The TV—usually tuned to the Game Show Network—played incessantly, pitched so that you couldn’t quite hear it if you wanted to and couldn’t quite ignore it if you didn’t want to.) The lounge was carpeted, with heavy wooden tables and waxy potted plants. The chairs and couches had square cushions covered in scratchy red fabric. There were lines of masking tape on the floor, to mark off the areas where we weren’t allowed to go. This was our salon.
The professor, who I would have guessed was in his late fifties, liked to sit in the chair closest to the radiator. He’d set down whatever book he happened to be reading—once it was The Count of Monte Cristo, another time it was Rich Dad Poor Dad—and he would talk with me and Linda, or me and Diego, about whatever was going through his mind. He had crooked yellow teeth, and eyes that drooped in red-rimmed yolk sacks. He wore visibly stained khaki pants and too-big sweatshirts. He had a gray beard that covered his face about as completely as leg hair covers a leg. He looked, honestly, like someone who masturbates in the bathroom of Port Authority.
But he wasn’t a pervert; he just wanted to talk. And then, just at the point when you thought he had to be winding down, he wanted to talk some more (for the pathological blatherer, the catatonically depressed are an ideal audience). Among the things he wanted to talk about: his exercise regimen. He didn’t understand why people spent all this money on fancy gyms when you could just do what he did. A few squats, a couple of jumping jacks, a handful of those whatdoyoucallits with your arms, you were all set for the day. He also didn’t understand how anyone could fail to see the war that was coming. Ice caps melt, here come new shipping routes, here come the Russian tankers, here comes Obama surrendering to everyone who comes into his field of vision.