Madness

by Marya Hornbacher

  Here on the ward, the pacers pass through the main room on their way up and down the halls. Some of them mumble to themselves, or shout and fling their arms, only to be shushed by the staff. Others are quiet, heads down, thinking whatever thoughts they think. The twitchers sit for a second, then bounce up, turn circles, sit back down again, twitching, in contrast to the ones who are motionless, hunched over their laps, staring dully at their feet or the floor. Then there are the people like me, wrapped in blankets or robes or hospital gowns over their pajamas. Some of us have loved ones in our lives who will bring us things like slippers, or clothes; some of us get dressed, but others stay in pajamas all day. Occasionally you'll have your screaming, your frenzy, your drooling torpor, your bizarre, loud commentary, sometimes delusional, sometimes threatening, and then you'll have your padded room. From that padded room, you hear muffled screaming, or muffled roars, and the dull thump of the person inside pounding on the heavy metal door.

  I am sitting here on my heater, peaceful, bothering no one. I am listening to the hum in the room and in my head. My mind is slow and sticky. Sometimes a thought tries to go through it, but its feet get stuck as if in mud. I don't remember if I came in manic or depressed. I have always felt this way. I have been in here forever. There was no life before this life, here where the twitchers and the pacers and the still ones wash over me like a stream, and I am a small stone, worn smooth.

  From out of nowhere a woman comes flying at me. She wants my seat. She wants to be by the window. She is shouting, waving her arms. She is leaning toward me, and her face seems to veer close and then far away. It is not attached to her body. Her body is near, threatening. She is angry with me, furious, she hates me, she will kill me if I don't move, I am looking at her funny, I am watching her, she says, she knows what I'm thinking. She hits me. It takes me a minute to register this fact. I watch her hand move toward my face, batting me with her fist the way a cat bats a ball with its paw. The feeling of being hit comes to me, delayed. I find I have lifted my hand to my face as if to be certain that it's there, that it has been hit. Magically, instantly, the staff is hauling her away. Where did they come from? They drag her by the arms, she is still leaning toward me, her face contorted and red. Her shouts fade away and I sit looking at my hand.

  "How was your day?" my mother asks, patting my knee, later that evening. We are on a couch. I have my feet up under me.

  "A girl hit me."

  "What?" my mother asks, sitting up. "Who hit you?" She looks wildly around the room.

  "Her," I say, pointing. I don't see what the fuss is. So she hit me. So what? It seems like nothing spectacular or unusual to me. The woman I point to is now curled up in a chair, her arms over her face.

  "When did she hit you? Why did she hit you? What did the staff do about it? Are you all right?"

  "I'm fine. Obviously." My mind slogs along, trying to keep up with my mother's words and her anxiety, which exhausts me. My eyes are heavy, it's a struggle to hold them open, though I am not what you would call tired, in the traditional sense. I simply am. It doesn't matter to me whether it is night or day. All I know is that in the day, we shuffle from group to group, and sometimes meals come on trays that are stacked on metal carts that are wheeled onto the unit by men in blue scrubs, and sometimes I eat the meals and sometimes I stare at them and don't, and sometimes I go back to group and sometimes I wander down the hall and lie on my bed. The bed sags in the middle but I have come to love it anyway. I get under the covers and curl up in my little sphere of warmth, the sheets pulled up over my nose. I listen to myself breathe. In the evening, visitors come. My mother comes and stays a little while, until I get confused and the effort to track what she is saying gets too exhausting and then she knows without my telling her to go away. When she leaves, she always tells me she will be back. I always forget, and call her the next day to be sure. Sometimes it is my father who comes, sometimes my friends, and on weekends my friends Megan and Ruth or my mother or father or aunt or uncle stay all day. There is somehow always someone there. When they come, I am relieved at first, and they think I am doing better, because I am good at pretending, and I pretend to follow the conversation, and I laugh at the jokes, which set off a tiny spark of recognition in my brain—for a moment a thought connects with another thought, and I feel a surge of hope, and sit up, lean forward, now I will follow, now I've got it. But then, after a minute or two, my mind goes wandering off and the conversation around me surges ahead. I lose my place, they slip off into their world and I into mine.

  The first few times I am in the hospital, Jeff is unsure of what's going on. Later on, when I've been in and out several times, the staff will get to know him, and they'll tell him how I am, what's happening, what's going to happen next. But not at first, so he's confused. He says, "But you were all right, a few days ago. You were better than this."

  "I don't know what happened," I say slowly, my mouth struggling to form the words.

  "Did they change your meds?"

  "Maybe. I'm not sure."

  "Did you talk to the doctor?"

  "I think so."

  "What did she say?"

  I think as hard as I possibly can. "I don't remember," I say.

  "But they won't tell me."

  "No," I say. "Sorry." I brighten up. "You can make an appointment to come in and talk to her with me."

  "All right," he says. "I'll do that."

  I am relieved. If he talks to the doctor and she tells him what is going on, then he can tell me.

  Hospitalization #2

  April 2004

  My room looks like this: there are two single beds. One of them is mine. I make it perfectly every morning, and it stays perfect until I crawl back in, defeated, in the early afternoon. I make it so tight that the thin white blanket, which has black print on the edge that says Property of Regents Hospital, even though we are here in Abbot Northwestern Hospital, holds taut across the sag in the center of the bed. The corners are folded and tucked under the mattress. These are called hospital corners. My grandmother taught me to make the bed this way, and she said it needed to be so tight you could bounce a nickel off it, and when I made it that way, she let me have the nickel, and I secreted it away in a sock.

  The other bed is unmade, a soft tangle of thin blankets and sheets. Sometimes there is a person in the tangle. She is softened, like the blankets, and lies there in a pile of limp limbs. Her arm is over her face. Her hair spills over the pillow, thick oily hunks of it. She hasn't showered in days.

  There are two industrial metal chairs, straight-backed, with black plastic covers on the seats. For some reason, the chairs are not usually pulled up to the cheap, wobbly desks, but are backed against the white plaster wall. The desks are made of plywood and covered with woodgrain-patterned plastic sheets, and why they are in here is beyond me. They become merely a place to put things—your hospital-issue toothbrush and toothpaste, deodorant, discarded used bandages if you have cut yourself or slit your wrists. I myself line these things up very precisely, the toothbrush and toothpaste and the many pens and pencils I collect, in case, and the books and magazines I cannot read, and the folder full of multicolored worksheets they give you in the groups, the worksheets with the emotion faces, rows and rows of line drawings of faces, each with an emotion word written beneath. At the top of the page it says What Am I Feeling Today?, and shows the faces illustrating the options. The clock ticks loudly while the group leader waits for each of you to come up with a word, any word, and always the same words are chosen: I feel agitated, anxious, angry, sad, elated!, confused, the last of these with a little wavy line drawn for the mouth and crossed eyes.

  Also in the folder are the Dialectical Behavioral Therapy worksheets. These show two overlapping circles, one of which is labeled Rational Mind, one labeled Emotion Mind, the overlapping center (it looks like the MasterCard logo) reading Wise Mind, which is the mind you are supposed to use, as if you have any control over your mind whatsoever. Then there are the
sheets with bullet points outlining the symptoms of depression, from your lecture on that topic. This is given by the irritable woman who dresses in the most unflattering clothes possible and has terrible, tightly curled hair. She doesn't like me because she is sick of seeing me and sick of my saying, Isn't this all fairly self-explanatory? And she smiles the tight smile and looks put out and says, We all need education about our illness. As if she is included in this we, as if she will not go down to the cafeteria at lunch with her friends and complain about the obnoxious woman who keeps showing up on the psych ward questioning the value of her work, and as if she will not at the end of the day leave the locked world and go home. Working with crazy people is exhausting. Mental health workers burn out quickly, and some of them keep working and start hating the patients, who know that they do.

  And there are the Self-Esteem worksheets, and the Alternative Activities worksheets from occupational therapy, where people bend over the paint-stained table and struggle with their medunsteadied hands to thread the dull needles with which they will make yet more leather coin purses, or paint sheet after sheet of thin paper watery black, or scribble enormous, angry explosions with red and orange pencils and crayons, the force of their scribbling tearing the pages. When time is up the occupational therapist will ask us to rate on a scale of one to ten the degree to which this alternative activity helped distract us from our current situation, and to rate how we feel now as compared to how we felt when we came in the room.

  Abandoning our pictures and coin purses behind us, we walk empty-handed back to the main room, where some of us will collapse in front of the television, watching the pretty flashing colors, comprehending little and caring less. Others will resume our twitching or pacing or sitting dead still. I myself will stand in the middle of the lounge trying to figure out where I want to go, and will eventually shuffle down the hall to my room and get back in my bed, still wearing my slippers. I will gaze across the narrow space between my pillow and the pillow of the woman in the other bed. She will open her eyes for an instant, her face squished against the pillow, and say, Is it morning yet? And I'll say, No, it's afternoon, and she'll close her eyes, tears leaking from the corners, and turn over on her other side and face the wall, and I will turn over and face the opposite wall, and this is what the room looks like: two cheap desks, on which sit two green folders holding the worksheets, two metal chairs, one window that lets in only enough light to expose the narrow stretch of tile between the two single beds, leaving them in shadow, along with the two indistinct lumps that lie on them, the rise of hip and shoulder under the thin white blankets, faces obscured by lank, heavy hair.

  The day begins with decaf. I tunnel through the confusion that closes in on me when I wake up and go down the hall to the main room, where our breakfast trays sit on the metal cart, getting cold. I take the plastic cup of decaf and the plastic silverware—plastic so we cannot stab ourselves with forks or dull knives—from my tray and wander over to the heater under the window and climb up. The cup of decaf is my ritual. It's how I mark the time. There is coffee at breakfast, lunch, and dinner. The coffee is slightly above room temperature, smells sour, tastes like water flavored brown. Coffee is the high point of my day. I wait for my visitors to come, for they will bring my beloved decaf Americano, my treat.

  After breakfast, we file down the hallway, those of us who have got some of our wits together, a motley crew wearing sweatpants, pieces of pajamas, stocking caps, torn T-shirts, shorts, heavy coats, or wrapped up in blankets that trail behind us, making us look like little girls dressing up in our mothers' nightgowns and pearls. I wear the fuzzy purple pajamas Jeff has brought me from home. The staff person unlocks the door and we are in the no man's land of freedom, between units, and then the staff person unlocks another door, and we go through and that door locks behind us, and then we are on Unit 48, where the older psych patients are kept and where we have group.

  The only group for which we don't get handfuls of worksheets is group therapy. We go to group therapy after check-in and sit in a circle of chairs. Though when I am well I am an extremely talkative person, when I am sick, I lose the power of speech, the desire to speak, any sense of what I would say if I opened my mouth. And so I listen intently to the ones who do talk, feeling as though I am trapped inside my skull, a mute, disconnected from the others, from the world. Group therapy is mostly taken up by the chatter of the manic, the sobs of the depressed, the agitated associative ramblings of the schizophrenics, and the mumbling of the men who have just come down from psychosis, who mutter at their shoes and when they're asked to speak up, So we can hear you, so we can help you, either look away and fall silent or explode into tirades of insults and foul language that startle the criers and set them off weeping again. These tirades rattle me, here in my skull, and I wrap my blankets tighter around me, pull my feet up onto the chair. I fit perfectly in this chair. Here, I am safe from the creeping, sucking neediness of the talkers, the chattering swells and falls of the manic monologues, the sharp laughter, crowing cries, outraged roars, and the contagious, dizzying flights of associations and electric wild insights and fears.

  Then there is lunch. This is usually where I get off, crawl down the hall to my room, and lie in a heap, staring at the plaster wall. Eventually I turn over to watch the clock, and I stare at it for hours, waiting for it to be six, for my visitors to come.

  Time moves erratically here. Sometimes a day passes without my noticing that time has begun or stopped, and sometimes I look at the clock and then look at the clock hours later and only a moment has passed. From three, when groups end, until six, when Jeff comes, time moves in infinitesimal increments, the minute hand ticking forward only once every few days. But then he comes. In summer, he strides in, confident, elegant in his creased white pants and bright polo, looking a little like Gatsby, but older and, well, balding. In winter, he comes blustering through the door, bulky in his jacket, his face blown cold by the wind outside. He wraps me up in his arms and squishes my face between his shoulder and his cheek. I cling to him like a monkey, my feet dangling off the ground. He puts me down. Jeff is kind of like a puppy, all energy, bouncing around, carrying bags of food and clothes and magazines, which will give me something to look at, bright pictures and sprays of words, when he goes. Every time I go to the hospital, he brings me a pair of new pajamas as a present. I love the new pajamas. He finds the ones with the softest, fuzziest fabric, and they are either purple or red, purple in summer and red in winter, and they are my favorite thing about the hospital, and I put them on immediately and rarely take them off for the first couple of weeks. They remind me of Jeff when he isn't there. When I get home, he washes them and I put them right back on.

  When Jeff comes, he brings dinner and an entire grocery bag of fruit. When I am in the hospital, I crave fruit desperately, and that is usually all I eat all day, until he comes in the evening with dinner, and then I furrow my brow and try to organize my fork in the direction of my mouth. He tells me about his day. He leans forward, holding my hand in both his hands. We face each other on the couch and I curl up very close to him. He is the center of the universe. Every few minutes a fear comes over me that he will leave soon, and I clutch his hand and ask him if he's leaving, and he always says, Not yet, not yet.

  Hospitalization #3

  July 2004

  I sit down next to a very tall young man. He is handsome and young and his hair is gold, not yellow or blond but gold. I ask him if I can cut it and keep some. He looks upward at his bangs.

  "Okay," he says agreeably. "Where are the scissors?"

  I go to the desk and ask for the scissors. They say I can't have them. I say why not. They say, not safe. I say yes they are. There is nothing wrong with scissors. They aren't sharp enough to cut your throat. They remark that saying things like that is why I can't have the scissors. I shuffle back to the young man and flop into my chair.

  "They won't let us have any."

  "Why on earth not?"

&nb
sp; "Because I have been known to cut myself."

  "Did you use scissors?"

  "No. Exactly."

  "Exactly," he repeats. "The help here isn't what it used to be."

  I nod.

  "Maybe you could just yank it out," he suggests.

  "No," I say, sighing. "Then it would be uneven."

  "True," he says. He looks down at his notebook. It is warped, as if he dropped it in water. The pages are completely covered in tight black scribbles and little pictures and hieroglyphs here and there. He turns the notebook around and starts writing in the white space, which is so small I can barely see it. "I'm writing down the system," he says.

  "Show me," I say.

  He looks at me, deciding if I can be trusted. "It's secret, you know," he says.

  "Oh." I sit there, trying to read it upside down, but realize it's written backward. "That's cool," I say. "Backward."

  He looks down. "Yes," he says. "I'm very talented."

  "You are," I agree.

  He ducks his head, shyly. "Oh, okay," he says, scooting his chair over and showing me the notebook. We peer at the page, which is completely unreadable. He points out lines and pictures as we go.

  "So what this is is the explanation. You see here, where I've written down the beginning of the system—the man is explaining it a little bit at a time, and between times I work out the equations, which are an advanced physics-calculus-history of the system, which is mathematical, which is the answer, to the questions I have—we all have, rather—about the ways in which the plan is worked out."