In between, she sat in the company of Evelyn Silverstein. Short brown hair laced with silver strands surrounded an impassive face. She wore the called-for uniform of authority: a charcoal-gray suit over starched white blouse and red silk tie. When she spoke, her diagnosis was unequivocal. “After initial evaluation, we’ve diagnosed you with borderline personality disorder.”
“We, as in a consensus we? Or we, as in I, that is, you?”
The doctor didn’t suffer psychosis gladly. She was a journeyman—a plumber or a carpenter—not of pipes or planks but of mind and spirit. A smirk delivered the readymade answer. “BPD, for short.”
“Neat letters for an untidy package,” Kendra said. “Weren’t you able to come up with a sexier diagnosis? Manic-depressive, for instance? I hear it’s in vogue. Or paranoid schizophrenia, the gold standard.”
“Like your mother.”
“Yes. Like my mother,” Kendra admitted. “There. I said it.”
The doctor’s office was closed off and private, an island paradise for the sick of mind to seek shelter from internal storms. Wood-slatted blinds cut off every pinprick of natural lighting, but incandescent light bulbs set inside coffee lampshades illuminated tweed carpeting and toasted walls, everything welcoming and warm. To leave behind antiseptic sterility and replace it with mahogany opulence jolted Kendra. She had entered the gypsy’s caravan, inveigled by an arthritic finger, a crone’s wizened visage, and stage props. Truth was to be dissected upon a leather couch using words as scalpels and mind games as play. The decisive moment was at hand when she must either face her demons and regurgitate them upon a platter or forever hold her peace.
“Meals have come twice in the form of a white pill.”
“That’s the Risperdal.”
“I see. And the prognosis?”
“Up to you.” Doctor Silverstein let Kendra think about it before saying, “You don’t want to be here.”
“The short answer is no.”
“Your commitment is voluntary. You can walk out at any time.”
“But at what price?”
“You’ll have to figure that out for yourself.”
Taking advantage of the couch was out of the question, but a well-used leather chair—sinking in the center and enclosing Kendra inside a burnt sienna calm—felt right. Diplomas on the wall attested to Evelyn Silverstein’s credentials though not necessarily her skills as a psychiatrist. Yet the message was unambiguous: Kendra was in the care of someone who knew what she was talking about. “And the symptoms that led you to my diagnosis?”
“Odds are,” the doctor explained from a grander leather chair, “that on more than one occasion you met someone who assessed you as the most intelligent, vivacious, and striking person on earth. And ten minutes later, changed his or her mind, deciding you were the most depraved scum he or she ever had occasion to run across.”
“You’re speaking of my husband.”
“A hypothetical.”
“Well, hypothetically, I went to bed wondering what the hell I said or did to offend him.”
“That’s BPD.”
The logical side of Kendra thought it over. Since confinement in strange surroundings had cut her off from familiar reference points, she was forced to rely on the fractured parts of herself to tell her how to react and what to say. The pills may have been responsible, but she pinpointed the disassociation to a fall from the top of a staircase. “Maybe I’m out of my mind, but doesn’t your diagnosis make everybody borderline personalities? Including you?”
“The reason being?”
“Most people I know are absolute shits once you get to know them.”
“I like that, Kendra. You have a keen sense of self.”
“Maybe. But the only way I know who I am is by looking into someone else’s eyes. Even then ...” Her phony smile came and went in a second. “... the revelation is short-lived. It’s like being morphed from one image into another according to other people’s whims.”
“That’s also part of BPD.”
“Is that what separates you from me?”
“In a sense.”
“I do know one thing that separates doctor from patient. The doctor’s chair swivels; the patient’s does not.”
Evelyn cocked her head for explanation.
“You can gaze in every direction. I, on the other hand, have only one choice. To look straight ahead. Though I suppose sitting in this chair is a powerful inducement to truth telling. If I can’t hide from your stare, I must submit to your will. And see what you see. But are there no subtleties of personality, Doctor? No poses and postures that will yield a different diagnosis?”
“Delusions, illogical thoughts, paranoia, that’s what you’ve been suffering from.”
“In other words, it’s all in my head.” In the dark space behind her eyelids, the scene of the previous night replayed. In it, she saw her hands shoving Joel, but not so hard as to push him over the edge ... literally or figuratively. In the next frame, she saw him throw his vision over the railing. The blue eyes were bright with excitement. He may have seen himself as a tragic figure. Or imagined himself a comic book hero impervious to the normal hazards of mortal man. Whatever his motive, he calculated distance, speed, and the likelihood of injury in a split second. In the next split second, he decided the odds were in his favor, at which point he released his hands from the banister. Almost as soon as he was airborne, he reached back for salvation. But since he was already in free fall, it was too late. As he plunged below, terror spilled from those cocky blue eyes. Joel was afraid he’d made the biggest mistake of his life. He had.
“What comes after Risperdal? Prozac? Xanax? I hear Zyprexa is effective. Which one makes you incontinent? I suppose I could put up with wetting my bed. In the end, I’ll be a threat to no one, including myself. A vegetable. Isn’t that how it goes?”
“Not at all. The newer psychotropic drugs don’t carry the same side effects as the traditional ones. Do you have any more questions?”
“Ah, our time is up.”
The doctor smiled.
“I promise, Doctor. Next time, I won’t be so belligerent. By then, I’ll be on the orange pill.”
When Kendra returned to the ward, she encountered the newest patient. Giddy, scatterbrained, and pissed off, she was sitting on the foot of Kendra’s bed and picking at her fingernails. The greeting she threw out consisted of a grunt and a finger wave. After thinking it over, she decided the occasion called for a more formal introduction. “Like, you can call me Jody.”
“I’m Kendra.”
Eyes constantly on the move, Jody zoned in on every gesture, every detail, and every noise. “Sure, only first names around here. If they could get away with it, they’d use numbers and tattoos, but the visitors would think Auschwitz, so they don’t.” She laughed because it was called for, like a punctuation point at the end of a sentence. “They’re waiting for you in crafts. I hear they’re braiding lanyards today, but you won’t be able to bring your work of art back to the room. You could hang yourself with it, and we can’t have that. Bad for morale. Theirs, not ours.”
“What’s the point of making them?”
“Busy hands make for vacant minds. You’ll like it. Won’t have to think. Don’t want to be late, though. Lobotomies are out and straightjackets are déclassé, but they have other ways.”
“Aren’t you coming?”
“Like, I’m on lockdown. They ran out of beds. Getting one ready for me now. Only kept the door open for you. See the gorilla outside?” She wore a tank top over omelet breasts and running shorts above macaroni thighs. A row of earrings scalloped the edge of a single ear. “I’ll be gone by the time you get back. What stage are you: orange or yellow?”
“White.”
“You have a ways to go. Like me. We’ll become bosom pals. Then we’ll say, Hasta la vista, and never see each other again. Should I take a shower?”
“You can use my soap.”
Jody came to lunch in the co
mmon room, damp hair hanging from a side part. A sweat suit replaced the tank top and shorts. She slid her tray opposite Kendra’s and sat with assurance, punching her fist beneath a bruised chin and casting bloodshot eyes at her peas. When a yawn attacked her, she was near to tears, yet her expression didn’t change. “So like, what are you? Bipolar? Antisocial? Posttraumatic? My favorite is briefly psychotic.”
“Borderline.”
“Sisters to the core. With a mother who never understood you?”
Kendra had to smile.
“A distant father?”
“My God.”
“Mercedes in the garage?”
“Different generation.”
“Cadillac,” Jody corrected herself. “Only the best of schools but a glorious failure, isn’t that how it goes? Everybody else is pretending, but you’re the one who’s confused.” She yawned again. Her world-weariness remained. Whatever was going on inside Jody’s head wasn’t rising to the surface. One of the patients waved to her from across the room. She returned the greeting with a vacant stare. “Not getting much sleep?”
“Same as you.”
“Reason for that. Not what you think. Not the meds. Full schedule. Therapy, arts and crafts, sing-a-longs. Have they given you the unofficial initiation rite?” Off Kendra’s quizzical look, she said, “Group therapy?”
Kendra nodded.
“They’ll gang up on you. Won’t let you cut and run. After you let the cat out of the bag—the big deep dark secret—you’ll cry crocodile tears and all will be forgiven. Kisses, hugs, and a snow job. Sometimes even a blowjob. Don’t you want to know about my messed up childhood?”
“Who hasn’t had one?”
“Very good, Doctor,” Jody said. “Or how I sabotage relationships?”
“Don’t we all?”
“By having fights at one in the morning?”
“Have you been spying on my house?”
“Punched out my boyfriend with a hairbrush.” Jody played with her mashed potatoes by using the tines of her fork to make crosshatch patterns. “His name’s Tommy. Tommy’s like very straight arrow. Never had a parking ticket even. Didn’t know what hit him. When he came to, he called the cops on me. Let’s say I wasn’t too happy. I let him know it with my fingernails. See? Broke one. Cost me five bucks, this nail. Paid him back good. Left a thousand scratches on Tommy’s sweet face. Last time I saw him, he was a bloody mess. And crying like a jerk. So were my parents. Even the fucking cops. They know me by name. The cops, not my parents. We’re getting married, Tommy and me. When I get out of here. The ticket out of my parents’ house. You don’t believe me.”
“Should I?”
“Not unless you’re a pussy. How’d you wind up here?”
“Pushed my husband down a flight of stairs.”
She whistled. “Inspired.”
“I thought so. At the time.”
When an attendant sauntered by, Jody leaned conspiratorially toward Kendra. “They carry hypos in their back pockets. You don’t want to know what it does to you. You drool. Talk to yourself. Wake up swimming in your own shit. There’s a special room with blankets and restraints. They leave you there for as long as it takes.”
“For what?”
“For you to foam at the mouth. It’s like medieval. They never broadcast it, not to the newbies. You think I’m lying.”
“Or your friends are.”
“We who are about to die salute you.”
Though she slept like the dead on her second night in the psych ward, upon waking to sunshine and piped-in mood music, she felt like shattered glass. People couldn’t really see the whole of her for the jagged edges. And she couldn’t properly see them through the distorted prisms. Her name might have been written down on a chart, but she was just a number and a diagnosis. She had lost the knack to be real.
She never made that decision of whether to stay or leave. It seemed simpler not to think about anything.
Kendra discerned little difference between chatting with Jody over lunch and exchanging banal dialog with Doctor Silverstein after breakfast. Both women talked. Neither listened.
“It’s a matter of degree as to how much psychological damage occurred during your childhood and whether the damage caused severe enough personality disintegration to bring you here.”
“Disintegration,” Kendra repeated. The word fit.
“I take it borderline personality disorder has a borderline.” The patient had built up enough courage to vacate the leather chair.
And the doctor trusted her sufficiently to join her on the couch. “In a way, yes. Most people can function, to a degree. You yourself have gotten by, despite the impediments.”
“On the block where I grew up, not counting my family, I can count at least one schizo and three manic-depressives.”
“Mental illness cuts across every socioeconomic boundary.”
“I thought it must be in the water. But if that were true, the entire city would be in a psychiatric ward.”
The doctor propped an elbow on the armrest and leaned into her hand. “What are you thinking?”
“That having a label gives me an advantage. Now I can explain to my friends why I’ve been such a bitch. Do you think they’ll forgive me?”
“They usually do.”
“Yes, but will they come running back? Insanity explains the inexplicable. Then again, it’s the perfect excuse for them to trust their instincts from now on. I don’t think they’ll rally around me like a cause. Hell, it’s not as if I have a respectable disease, say breast cancer. You don’t see carwashes or fundraisers for the mentally ill.” Kendra fit her rounded back into the bolstered end of the couch. The gulf between doctor and patient was big enough that at least three sumo wrestlers could have lined themselves up between them and the conversation would have gone on without interruption. The trick, she decided, was putting enough distance between her and the unacceptable truth. “The insurance company needs a label. To reimburse you and the hospital. Otherwise, you wouldn’t be so chummy.”
“This isn’t a mercenary exercise, Mrs. Swain. We’re here to make you better.”
“You can call me Kendra. My worst enemies do. My husband, for example. He’s screwing around, but I suppose that’s in my head.”
“It may be.”
“I don’t see how. Either he is or he isn’t. And I know he is.”
“It may be a matter of interpretation.”
“Oh, you are funny, Doctor. But I really wish you wouldn’t take his side against mine.”
“If I’m on anyone’s side, it’s yours.”
“The perfect answer.” Kendra had a lot in common with the doctor. Nothing fazed either one of them. Ever since Joel took his tumble over the railing, she wasn’t afraid of him anymore. Or sad about what happened to their love. Or mad about him deceiving her these last few months. Or even of tricking her into attacking him while he stood at the precipice of his own madness. She conjectured whether the drugs had anything to do with excising her emotions with a surgical knife and throwing them over the banister with her marriage. Or if Joel did it when he showed her just how far he was willing to go to put her in a loony bin. And then she realized something profound. Kendra wasn’t the crazy half of a marriage gone wrong. Joel was. “How come Joel’s behavior doesn’t measure up to mine?”
“Because his isn’t self-destructive.”
“He’s the one with the concussion.”
“You observed him acting in a certain way and assumed the worst.” The doctor was a study of how years turned a woman from youthful bloom to wilting middle age. At one time, Evelyn Silverstein must have been a passable beauty. But time and the absence of collagen left chiseled lines in a sagging face. Maybe this is what happened when women stopped looking in the mirror. “You can blame your husband for everything, but it won’t help you get well.”
“What if I don’t want to get well? What if I thrive on madness?”
“By viewing a warped version of the truth
?”
Kendra tilted her head in thought. “El Greco was reputed to be astigmatic. The people in his paintings were stretched out and elongated, like those funny mirrors at carnivals. I say he wasn’t astigmatic. If he were, his brain would have compensated for his vision by reproducing on canvas what it saw in nature. And everything would have come out in the right perspective.”
“A trick of the eye?” Dr. Silverstein asked.
“The artist’s eye. But we, as viewers, would observe no difference.”
“Then he meant to exaggerate his subjects.”
“To heighten the drama, yes. As an artist, he knew exactly what he was doing.”
“Even if that were so, what does it have to do with you?”
“I’m not sure.”
“Forgive me for being naïve at my own expense,” Evelyn said, “but I interpret what we do here as having meaning, even if you choose to ignore what’s plainly in front of you.”
“You’re speaking of truth again. But whose?” Kendra glanced around the doctor’s office. The dark setting didn’t fit its stated purpose: to make patients look on the bright side of life. Instead of institutional browns, the office should have been decorated in colors of the rainbow. “I suppose, at the most optimistic, the patient is provided with enlightening discoveries. Prescribing a pill or two may actually improve her quality of life instead of dulling her spontaneity. But for this patient, your psychotropic medications leave me feeling disconnected.”
“The effects will smooth out over time.”
“In days? Or weeks?”
“Days. And if not, we have other remedies. We’ve made great strides. Ten, twenty years ago, a patient often left a facility such as ours with upwards of seven medications.”
“But if I’m to believe you can help me, first you must convince me that I’m sick.”
“I think you’ve known it for years.”
“I’ve been afraid of it for years. There’s a difference.”
“The difference,” the doctor said, “is in perception.”
“Like El Greco.”
Dr. Silverstein sat forward, the signal that their session was ending. “You’re impulsive, Mrs. Swain. And unpredictable. You seek sexual gratification outside normal societal limits.”
Trick of the Mind Page 16