by Hannah Paige
April had tried, tried valiantly and tirelessly, to reach out to her sister-in-law when Pam’s downward spiral had really started its downward course about six years ago. But Pam wouldn’t see her, shoved her back in an attempt to save her own emotional strength. It hadn’t helped. When Pam tried to kill herself for the third time in a year, three weeks ago, to the day, she’d finally checked herself into the hospital. She’d walked in barefoot, with wrists gushing blood all over the linoleum floor.
She hadn’t felt like ‘one of the strong ones’ in nine years, eight months, and one day.
One of the nurses—blonde, almost white, hair, skinny, tall; Pam thought of her as Barbie, since she could never remember her name—approached Pam before she could get to her room, “Hey, Pam. How was group?”
Pam sighed in response and hung her head. Group therapy meetings, psychologists, therapists, independent meetings: nothing helped. She wished every single day that she could tell the poor nurses what they wanted to hear; ‘It was great! I feel like a million bucks!’ But Pam was stuck; stuck in this throbbing, shaking, trembling, hopeless place, and she didn’t have a way out, at least not one anyone around her approved of.
Barbie frowned, “I’m sorry to hear that. On the upside, I have some good news. Dr. Chase has some extra time today and he was hoping that you would be open to meeting with him for a bit?”
“When?” Pam asked.
Barbie parted her bubblegum-pink lips into a broad smile, “Right now! Come with me, please.”
She ushered Pam down the hall, around a corner, and through a wooden door—nicer than the sealed, white hospital doors that guarded the patient rooms—where Dr. Chase sat inside a dimly lit office. His legs were crossed and he was swiveling rhythmically in his padded, brown chair.
“Hello, Pam. Thank you for agreeing to meet with me. You may take a seat, if you like.”
Pam stayed standing as Barbie left the room, closing the door behind her. Pam stacked one foot on top of the other, scrunched her toes together, then uncrossed her feet, repeating the action over and over. Her fingers picked at one another, irritating the already inflamed cuticles.
“How are you feeling today, Pam?” the elderly man asked softly.
His voice was so soothing, flowed out of his lips like fresh cream being poured into a glass bowl. It made it hard for Pam to be frustrated at him for asking her the same question that she’d been asked every day, several times a day, for three weeks.
When she didn’t respond, he continued talking, “I was hoping we might try an activity today, Pam.” He pulled open a drawer from his desk and withdrew a yellow legal pad and a box of pens, setting them both on the desk in front of him, “I would like you to take the paper and pick a pen, any color you like.” He didn’t hold them out to her but made her come closer to the desk to retrieve the materials.
She swallowed, crossed and uncrossed her feet, ripped at the skin on her thumb, and forced herself to move forward. She snatched the pad of paper off the desk and unclipped the lid from the box of pens. Her eyes moved over the colored caps, the different levels of ink in each of the pens. The black pen was almost out. Her hand hovered over the bright red pen before she grabbed it.
Out of the corner of her eye, she saw Dr. Chase smile and lean back in his chair, “Interesting, Pam. Would you mind telling me why you chose such a vibrant color?”
Pam moved the other chair to the far wall, away from his desk, before planting herself in it. “Why does it matter?” she asked.
He folded his hands over his chest, “If you really didn’t care, you would have gone for a black pen or maybe blue. Those are the colors that are considered ‘normal’. But you chose red, a lovely color, I might add.”
Pam rubbed her nose and tapped the pen against the paper in her lap. “Red was Darin’s favorite color,” she whispered, barely audibly, “He—he wanted to paint our bedroom red, but I said no, because,” she shook her head at herself, ashamed at how stupid she had been back then, “because it would have been too hard to paint over again once we moved out of that apartment.”
“Did you like that apartment?” Dr. Chase asked.
Pam shrugged, “I guess so.” She thought a little more and her mind, for whatever reason, chose for consideration the yellow cabinets that she’d painted one Saturday afternoon. It was right after they had moved in. Darin had taken an extra shift and Pam wanted to surprise him when he got home. She remembered the scuff on the stair railing from when she and Darin were trying to move their bed frame upstairs and she had dropped her end, exposing the grey metal that lay under the black paint on the handrail. Darin had laughed at her, teased her about being so clumsy. When he slipped getting out of the shower a few days later and cut his chin on the counter, Pam never let him hear the end of it. As far as Pam knew, the blood stain was still there, and it occurred to her how fragile she was, how incapable she had always been. She couldn’t even manage to get a blood stain out of grout. How was she supposed to ring her life up from the bottom of the well with nothing but a few inspirational talks and elastic pants for tools?
“Pam?” Dr. Chase nudged her memories aside, pulling her back to the room where he waited, patiently, with his mocha-brown eyes on her.
“I’m, I’m sorry.”
“That’s quite alright. What were you thinking about, just then?”
Pam crossed her legs, pumped her top foot back and forth, “I was thinking about our home, the apartment. I really liked it there.”
“It made you happy,” Dr. Chase added, and Pam nodded, her eyes drawn downward at the grey carpeting.
“It’s nice when memories make you happy, isn’t it?”
Pam couldn’t keep her negativity from slipping out, “Too bad that’s not usually the effect they have on me.”
Dr. Chase nodded, “Yes, memories operate on a swinging door. It’s up to us to determine how the contents on either side of that door make us feel. That’s why, today, I want you to start thinking about what’s ahead of you. Look down at the paper in your lap.”
Pam obliged, seeing the blank, blue lines on the faded yellow page.
“It’s empty, isn’t it? The paper is new, completely clean of markings.”
Pam looked back up at the psychiatrist, “Yes, it is.”
“Sort of like your future, isn’t it? Clean, new, blank. You can make it whatever you want it to be.”
Pam saw where this was going now and sighed, “But you’re going to tell me what to write on it. Because I can’t be trusted to plan my own future, because I don’t want one.”
Dr. Chase cocked his head, hesitating, “I think you do, Pam. You want to know why I think that?”
“Because it wins you awards. People just eat that blind optimism right up. You think that because it gets you articles written about you and medical journals praising you and plaques glued on your desk.” She muttered. She didn’t want to play this game. She wasn’t an independent player, let alone a team player.
“No. I could care less about the plaque on my desk or the awards that I have on my bookshelves. I have more in my desk, but I don’t display them because I don’t care about them. They’re not important. You are important, Pam.”
She scoffed.
“I know you think I’m just saying that. But let me ask you this, if I’ve won all these awards and all this praise, so you say, don’t you think you should trust my opinion?”
“Touché.”
The silver-haired man looked pleased at her, “Thank you. Now, back to you. You grabbed a red pen. Do you know what the color red symbolizes?”
Her mind went blank; analyzing colors wasn’t exactly what she wanted to be doing right now, “No, I don’t.”
“It can mean a lot of things. Of course, the most common is love, but it also stands for strength, courage, desire, and willpower. People who don’t want a future don’t have any of those qualities. They grab the black pen, thinking that’s the easy way out. But not you, Pam.”
“Yo
u’re deciphering my future based on a pen?”
He smiled, “No. You are. Now, with that red pen and your blank slate, I want you to write down three goals. They can be long term or short term, whatever you feel comfortable with. But I want you to write three.”
Pam thought this task was much easier than most of her therapy activities had been, “Just three? There’s no catch? No other part of the therapy session?”
“Just write three goals, Pam,” he answered, an annoyingly knowing smile on his face, as if he was playing with the rules in front of him while Pam played blind, “And when you have all three written down, I want you to come see me again. Then, we can discuss how you plan on filling your blank slate.”
Pam stood up from her seat, gathering her materials in her arms, and started towards the door.
“Pam?” Dr. Chase called and she turned around once more, “Remember, these are your goals. Don’t just write down what you think I want to hear. It’s your future, remember that.”
Chapter Two
To get better, Pam couldn’t be alone. That was what they all told her. Community, partnership, and ‘reaching out to others’ were major concepts that every doctor that treated major depression stressed. To further the sense of community among the hospitalized patients in the psych ward, the ‘family room’ was created. It was a room with games, tables, TVs, books, even a furry rug on the ground for people to sit on if they preferred that over one of the couches or chairs. Patients were encouraged to congregate there during meal times, before bed, between group therapy meetings, really any time that they weren’t seeing doctors.
The family room was positioned conveniently across from the kitchen where the patients filed through a line to get their three-square meals a day. Pam received her tray of food and headed over to one of the corner tables by the window. The woman seated there, like Pam, had arms resembling a carved Christmas ham. She had grey, saucer-sized circles around her eyes and barely glanced away from whatever held her attention out the window as Pam gestured to the seat opposite the woman.
“Is this seat taken?” Pam asked, hoping that she would either shake her head, or say ‘of course not’: any confirmation that meant Pam didn’t have to fend for herself with the other mental patients. Anywhere besides a crowded table. This woman was one of the few hospitalized tenants that suffered from the same thing that was gnawing through Pam’s body. Others had various issues besides wanting to kill themselves, issues that made Pam’s mental state seem positively sublime.
Pam breathed a sigh of relief when the woman shook her head, resembling someone that had just responded to a question posed by the trees outside. She slid her tray onto the table and sat down. While Pam ate, there was a complete and empty silence that seemed to deserve a third seat at the table. She was almost done with her salad and about to move on to the brownie for dessert when the woman finally spoke. She spun in her seat to face Pam and smacked her hands flat down on the empty space on the table in front of her,
“Do you sometimes see things that aren’t really there?”
Pam hesitated for a second; around here, a person needed to be cautious with that kind of question, “See things? Like hallucinations?”
The woman, obviously disappointed by Pam’s answer, slumped back into her chair and threw her hands up, “That’s what my doctor calls her.”
Pam thought for a second. If she asked about ‘her’, then the woman’s story might lead her into a whole new world of crazy. If she didn’t and got up and left, then she would be badgered by curiosity, always wondering what the woman had been referring to, but she would avoid possibly poisoning her brain with more facets for psychotic breaks.
Pam grabbed her brownie and left the empty tray on the table.
Within seconds, she returned to her seat, unable to deny her question gnawing at her, “Who’s ‘her’?” she validated giving in with the concept that this place had been drilling into her since she’d walked through the doors; talk to others, you are not alone.
The woman, a little older than Pam, sniffed, rubbed a rim around her mouth, “She’s my daughter.” Her eyes took on a hazy hue as she dove head-first into the pool that every patient here entered when they were coaxed into telling their story; it was the pool filled with longing for better times, for whatever or whomever had been lost that drove them all here.
“She was seventeen. She was driving home one night.”
Pam had a feeling she knew where this was going, but the woman surprised her as the story went on.
“It was cold, the week before Christmas break. She’d been studying for finals at a friend’s house and it had gotten late. She hit a patch of black ice on the way home and crashed her car into a telephone pole.” The woman was trembling, biting furiously at her raw thumbnail, “It was so late, I,” she shrugged helplessly, “I had gone to bed. When I got up that morning, I just—I just assumed that she had made it home safely. I got in the car to go to work. Back then, I worked for the stock market, so I was up and out early. I didn’t bother her, didn’t even check to see if she was in her room. Her door…” Tears ran down the woman’s face and Pam felt her own heart breaking at the poor mother’s story.
“Her door was shut and I didn’t open it. I left for work and got to the stop sign at the end of our street and saw her car. She’d been there, she’d been right—right there, all night. She was down the street.” Her head fell into her hands and she shook with heavy sobs.
Pam didn’t know what to say. For years she had prayed for the knowledge that only a mother could possess. For so long she’d wanted, more than anything, to be able to understand a mother’s love, to empathize with their stories instead of nodding, listening, sometimes sympathizing. Now that she was too far gone to wish for children, she just wanted the pain to go away.
“I’m sorry. I didn’t know,” Pam said, hearing the weakness in her own voice and wishing that she could have mustered up a better response as the woman across from her dabbed at her eyes.
She waved her hand aside, “I don’t know why I told you all that.” She shook her head and a look of puzzlement filled her face.
Pam shrugged, “Maybe you just needed to talk to someone. Maybe you thought it would help.”
The woman laughed, “Hah! Don’t tell me you’ve given into the Kool-Aid they’ve been spooning down our throats.”
Surprisingly, the woman’s sardonicism made Pam feel better about herself, and she broke her brownie in half, handing a piece to the woman, “I’m Pam.”
She accepted the dessert, “I’m insane.” She laughed some more, “But most people call me Ingrid.”
Pam felt herself want to smile—which was as close as she got these days to actually completing the feat—and nodded, “It’s nice to meet you.”
“So how long have you been here?” Ingrid asked, breaking off a bit of her brownie.
That was an easy question for Pam. Contrary to what she had believed prior to being hospitalized, people here bore their scars on the outside for everyone to see. They didn’t skulk around in corners, brooding about how they didn’t belong, at least not the patients that Pam had been exposed to. Most of the people here knew they needed help, either because their family members had finally gotten through to them, or they had accepted the fact all on their own. As a result, stories were shared fairly frequently. ‘Depression’ wasn’t a word that made people flinch or one that they tried to avoid, like the word ‘sex’ in a seventh-grade science class. Patients, on occasion, gave in to curiosity—if they were still lucky enough to have any—and asked about each other.
“Well, I’ve been here for about three weeks. But before that I was just…” she didn’t know the best way to say it: alone? struggling? desolate? “by myself for about six years.”
“What got you thrown into the pit?” she asked.
Pam had never come up with that analogy before, and found it slightly bitter but all-too accurate, “Ten years ago: my husband.”
That was all sh
e needed to say for Ingrid to nod, not requiring more of an explanation. Sometimes the spiral down was simple.
“And do you see him sometimes? My doctor says that it’s not right for me to see my daughter, but I’m also on nine different kinds of medication. I’m not sure there’s anything ‘right’ with me anymore.”
Pam shook her head, crumbling the brownie into her hands; she wasn’t hungry anymore, “No. I can’t say that I’ve ever seen him, is that normal for, you know…”
“People like us? I think we’re past being ‘normal’. There’s what you feel and what you do and that’s about it. Chad, over there, sees people all the time. That’s I guess what you could call normal for him. That’s just Chad. You’re lucky, though, if you don’t see your husband. It’s torture.”
She shook her head and Pam watched her eyes shift a shade darker once more. Ingrid’s bitter smile fell, and she sunk back into her seat. Pam left her alone, seeing that she had started on her trip down. Pam knew the feeling all too well. One minute she would see something or hear something that would make her want to laugh or smile, the throbbing would stop, and she’d think she’d be alright. But then she would blink her eyes, the pain would come back, and she’d be right back to believing that she’d never be okay again.
Breakfast was served promptly at 8:00 am. But before then, vitals were taken. Pam was checked over to make sure that she hadn’t found a way to make a couple more lines on her body. She was asked if she had been eating well—her weight was taken to testify her answer. Her sleeping patterns were discussed, and she was scolded for never getting a full eight hours. Pam was ushered to breakfast, then to morning group therapy. She brought her pad of paper along with her but hadn’t written anything down on it yet. During free time that morning, she colored with Ingrid. She wasn’t nearly as talkative towards Pam as she had been the evening prior, but that was alright with Pam, talking usually made things worse for her. When one of the nurses came into the family room and put on a children’s movie with gaudy colored characters and PG comedy, she left to go outside. She’d earned her outside time by not drawing on herself with anything sharp in a week. There were other med. techs out there, walking around with more severe patients from the ward next door. A young girl sat under a tree, feeling her ribs, while an older man scratched at his arms with a nurse beside him, trying to talk to him. Pam guessed that he didn’t hear a word the nurse said.