A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addiction

by Patrick J. Kennedy

  On Sunday, August 24, my father flew into Denver with Vicki, hoping he would be able to address the Democratic National Convention the next evening. He had such severe abdominal pain on the flight that they went directly from the airport to a hospital—where he was diagnosed with kidney stones, a common side effect of chemotherapy. Once they knew what was wrong—and that it was something he could tough out—he was even more committed to appearing at the convention. His staff worked with him to cut the original twenty-minute speech he prepared in half, but he refused to let them cut it further. He wasn’t going to just give a three-sentence speech and wave. But he knew he was going to walk onstage in excruciating pain and still at risk for a seizure.

  I remember standing in the wings with my father and Vicki and my siblings—there were a number of us back there, although some family members chose to watch from the audience. And, as we waited, I was having this interesting and incredibly random conversation with the guy who was in charge of the teleprompter. His company had been in charge of the teleprompters for a lot of previous conventions, and he was telling my father and me how proud he was to have done this for so many Kennedys over the years. And just before my father was ready to go out, the teleprompter guy said, “I appreciate your work on mental health.” People affected by this truly are everywhere.

  My father was still incredibly strong, but his symptoms were unpredictable. During every second of that very long standing ovation when he came in, and when he started speaking, every time the audience burst into applause, I worried how long he could hold up. But then I realized that he was using those applause breaks to regather his energy and get focused on the next page coming up on the prompter.

  He was magnificent, inspirational, resilient. Even with all that medication in his system, he was on fire out there. He was really sparkling and in his moment.

  He didn’t make it look easy; that wasn’t what my father was about. He was always the hardest-working senator in Washington, and that’s who he was that night, doing his job for his family, for his country.

  Of all the things I was ever honored to watch him do, I was most honored to be near him on that stage as he spoke these words:

  When John Kennedy thought of going to the moon, he didn’t say, “It’s too far to get there, we shouldn’t even try.” Our people answered his call and rose to the challenge. And today an American flag still marks the surface of the moon.

  Yes, we are all Americans. This is what we do. We reach the moon. We scale the heights. I know it. I’ve seen it. I’ve lived it. And we can do it again!

  There is a new wave of change all around us. And if we set our compass true, we will reach our destination. Not merely victory for our party, but renewal for our nation. And this November, the torch will be passed again to a new generation of Americans. . . .

  The work begins anew.

  The hope rises again.

  And the dream lives on.

  Chapter 22

  Ten days after my father’s speech at the convention—and exactly two years, four months, and one day since my last drink—I had a beer on a Thursday night after work. And the next Monday after work, I went out to a bar and got drunk. Scared by what I had done, I immediately went to meet with Jim Ramstad and Dr. Ron Smith to try to get my bearings. I was starting to feel anxious all the time and often bursting into tears about my father. I felt sore all over but honestly couldn’t tell if I was in pain or just wanted pain meds.

  I seriously considered going back into inpatient care immediately, but we were at a very fragile moment in the parity bill process. The legislation had the full support of the Senate and the full support of the House, and we had just held another big rally in front of the Capitol to get it passed. But every time congressional leaders tried to tie it to another bill, something went wrong.

  Every day that this dragged on, I became a little more unglued. Those lobbyists and advocates who were also in treatment or recovery probably knew. But they didn’t feel comfortable saying anything to me. The mental health advocates assumed I was having breakthrough symptoms of my bipolar disorder, because that was their medical worldview. The addiction-care advocates assumed I was drinking or abusing drugs again, because that was their recovery worldview.

  They were both right, but here’s the larger issue: everybody knew that I was a train wreck except me. Everybody around me was walking on eggshells. I was, at this time, really upset with my stepmother, Vicki, because I thought she was limiting my time with my dad for no reason—and like a lot of children of divorce, I was still jealous of the new family my father had made with her and her kids.

  In reality, Vicki was probably doing my father and me a favor. I realize that now because I remember a very specific moment early that fall, when I saw her at some Capitol Hill healthcare function where she was substituting for my father. I remember the look on Vicki’s face when she saw me for the first time in a couple weeks. Without saying anything, she let me know: “You’re not healthy, you’re uncomfortable to be with.” There was a little moment of clarity in the way she looked at me, and I remember that startling me.

  When I asked about seeing Dad she basically used the legitimate excuses she was using on everyone—“He needs time alone,” “It’s too much,” “I’ll let you know when it’s better”—but to me this was all a kind of euphemism for “I can’t bear to have your father see you like this.”

  —

  THE CLOCK WAS TICKING ON parity and what was left of my sobriety. I was able to come to work each day and basically function, and I did sneak away to a quick weekend at the Caron Foundation near Reading to see if that would help. But I was still drinking at night, and using too much caffeine and Adderall during the day to stay awake.

  Politically, the economy was sinking deeper and deeper into distress. Both the House and Senate were deeply conflicted about the idea of passing a massive bailout bill, the Troubled Asset Relief Program (TARP), which could cost up to $700 billion. We had, up until that point, been looking to attach the parity legislation to a bill that absolutely had to be passed—a spending bill, a tax bill. As the days of the session dwindled, we were beginning to realize that the continued debate over TARP was going to destroy our chance to pass parity—which, ironically, had already been approved solidly by the House and Senate.

  I remember just calling everybody, desperate for some solution, some action. Finally I called my father, who was living at the house in Hyannis Port with Vicki and, generally, reaching out when he felt able. Since his illness, it was harder to just call up and get him on the phone, but this time I did talk to him.

  “This is the last chance we’re going to have for parity,” I said. “Is there anything you can do to help?” He said he would call Chris Dodd and see what they could do. And Chris, who was not only filling in for my father on the HELP Committee but was also chair of the banking committee, came up with a brilliant Hail Mary solution.

  What if the toxic TARP bill was actually attached as a rider to the beloved parity legislation, instead of the other way around?

  What if the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act became too big to fail?

  There were a handful of people who had to get on board—especially Nancy Pelosi and Harry Reid. And, then, suddenly, it was a done deal. The parity bill, HR 1424, had the TARP attached to it, in a way that could guarantee quick passage on the very last day of the legislative session.

  Who was going to care that mental health parity could cost $3.4 billion over ten years? It was delivering a bill that, depending on how many other financial institutions failed, could cost $700 billion in ten months.

  I still cannot believe the confluence of events that made this happen. If any of this had taken place during ordinary times with a normal calendar and the opportunity for people to dig in and mess everything up, it probably never would have passed. I can’t take credit for the va
rious iterations and twists and turns; you could never have organized or ordained the way this happened. For anyone to claim credit for this would be an insult to the fates.

  It was a miracle. An incredibly quiet, deft Washington miracle, with the power to improve, or in some cases save, millions of American lives.

  Chapter 23

  I just barely survived the year after the signing of the parity act. Four weeks after the bill became law, Barack Obama was elected president in one of America’s most historic campaigns. I was reelected in a campaign I barely participated in—but the voters in my district, thank goodness, felt I had been doing a good job for them and took my obvious problems (my hand was now visibly shaking during public appearances) as a sign of my justifiable reaction to my father’s illness. As soon as the election was over, I quietly checked back into the Mayo Clinic for help with benzodiazepines, alcohol, and Adderall.

  Among all the other issues that came up in group, there was one I had been discussing privately with my therapist since the parity bill got signed. When I felt really depressed, there was a question that haunted me, something I had never had the guts to ask my father before he became ill. And now it was probably too late.

  Did he realize that one of the families that this bill was supposed to help destigmatize was ours? Did he know that making sure that the bill wasn’t only about mental illness but about alcoholism and drug addiction was about us, too? He never, ever described it to me that way, and whenever I had tried to broach that subject before he got ill, he would always tack in a different direction. I was never going to know for sure.

  I ended up leaving rehab early because of something my dad’s office arranged. For some time, my father and I had been complaining that the parity act never got the deserved presidential attention because of the drama of the TARP and the upcoming election. Now that that was over, and both Domenici and Ramstad were retiring, we agreed it would be nice if the President did something to commemorate the parity act.

  My father reached out to the President’s staff and let them know he would be interested in coming back to Washington if the President would agree to a commemorative signing ceremony. And on November 21, the Friday before Thanksgiving, we met in the Oval Office. My father came in walking with a cane that he explained had been used by his father. President Bush was sitting behind what he reminded us was the most famous desk any president had ever used, because it was the one JFK sat at, the one that John Jr. had famously crawled out from under. We talked for a long time—about politics, about baseball—and then the President signed a copy of the bill. At a typical signing, he would have used several pens so each of us could have one. But since this was ceremonial, he announced he was going to use just one pen—which, because of all the history the bill represented, he said he wanted for his presidential library. And then, at the last minute, he gave the pen to my dad anyway.

  During the course of the ceremony, my father couldn’t help making a little joke at my expense. He teasingly said to the President, “Don’t you think these young people should have some respect for their elders?”

  I turned to President Bush and gave him a look that only a second-generation national politician could possibly understand, like we would always just be the kids, full of existential fears of being loved and living up to expectations. The President had these issues with his dad as a young man. And, of course, my dad had those issues with his own father. It was political déjà vu all over again.

  I said to the President, “You know, it’s pretty tough to follow your father in public life.”

  “Boy,” he said, “don’t I know it!”

  —

  I HAD A NICE THANKSGIVING with my father and my family in Hyannis. And three weeks later I was back at the Mayo Clinic again. I had hoped to be finished there before Christmas, because we knew every family holiday was likely to be the last, but when the day came I was nowhere near ready to leave treatment. I got a day pass to spend Christmas at Jim Ramstad’s house. It was really hard, and when the anxiety reached a level I couldn’t stand, I did something I knew I wasn’t supposed to do. During my first couple days at Mayo, I had pocketed two pills of the tranquilizer Librium instead of taking them like I was supposed to. I took them at Jim’s house.

  When I got back to Mayo several hours later, I admitted I had taken them. So they wanted to give me a drug screen—in rehab!

  I left Mayo in early January and was invited to live in an apartment that Dr. Ron Smith has at his house, where many others have stayed during difficult periods. I was still staying there when Inauguration Day arrived—a very special day, because my father had sworn he would be with Barack Obama when he was administered the oath of office, and I was going to accompany him on the dais. Because of my father’s health, he had to be in a chair with arms on it and they put him very close to the President. So I’m in every major picture of the swearing in—it’s my Forrest Gump moment.

  After the swearing in I walked back up with my father, who needed some help on the stairs. We went into the old House chamber, where the luncheon was going to be, and he collapsed. He was saying, “I’m cold, I’m cold,” and then he had a seizure.

  After so many years of making sure that my father was never, ever seen in a vulnerable position in public, here he was having a seizure in front of the entire nation’s leadership, who were already being seated for the lunch. I remember looking up and seeing the shocked face of Orrin Hatch, who was watching his friend and main political rival for all these years lying on the floor. It must have been a startling experience for him. Luckily, one of President Obama’s best friends, Dr. Eric Whitaker from the University of Chicago, was a guest at the lunch, so he helped us until we could get my father into an ambulance.

  I rode with him, and since I had never seen anyone have a seizure before, it was terrifying until he started coming around. He was still a little confused, but when we explained what had happened, he said, “I caahn’t believe it!” That was one of his go-to lines, “I can’t believe it,” and it was often associated with something that was bad, but he managed to say it in a way that made it sound like we got caught doing something mischievous. He had a great sense of the absurd and surprising in life, because he had seen so much of it.

  And then we looked out the window to see where we were. The ambulance was making great time to the hospital because it was going down the cleared path of the inaugural parade that was about to begin. And given everything that had and hadn’t happened in my father’s political life, that seemed even more surreal, more worthy of another, “I can’t believe it.”

  —

  BY VALENTINE’S DAY I WAS back at Mayo again for a week. Besides all the things I had been talking about in rehab for years, and the obvious issues brought up by my father’s illness, there were two new ideas starting to occur to me.

  First, I wondered if I was ever going to have a real life: if I would ever really fall in love, have a family, have what really matters. And, second, I wondered if I should leave politics—because while everyone around me assumed that politics was the only thing keeping me going, I wondered if being in elected office was, in fact, a big part of what was killing me. Or was causing me to kill myself.

  That Mayo visit—and my ongoing consultations with my doctors there over the next months—helped me stay focused on my recovery and on making sure my remaining interactions with my dad were positive, not regressive. Not long after one rehab stay, I spent the weekend with my dad, Vicki, my sister, Kara, and some of my cousins as we went sailing on the Mya. Back at the house, my father made some time for us to speak privately—which we hadn’t done in a while—and while much of the conversation was about politics and legacy, it was warm and moving. I sent him a long letter afterward, thanking him for letting me come, letting him know I would always have his back, reinforcing that he had always been my “emotional sustenance,” and saying, “There is no one I know who could have endure
d more emotional heartache than you have in your life and yet you’ve managed to keep living and loving your family.”

  What I didn’t mention, but continued to pray for privately, was my hope that one day someone might say all that about me.

  —

  I DOUBT THAT IT WILL come as any great surprise to my House colleagues or staff, or my family, to learn how much I was struggling during my last term in Congress. In the spring of 2009, as my father’s condition worsened and I was clearly losing control, both Vicki—on behalf of my dad—and Jim Ramstad were begging me to go back into rehab. One day, I took a water bottle to work that was filled with vodka. I was growing afraid to leave the house in fear I would screw up in public. I had my car put in storage so I couldn’t drive it. Between April and June, I missed more than half of my House votes, but I was still up and down enough that I had plenty of days I could get work done.

  Then, on Thursday, June 4, I was on the floor of the House in the early evening and the last vote had been finished. The session remained open for members to make speeches on the record, and I was planning to get up soon and speak. I had taken a handful of Ativans—I don’t know how many, but by then my tolerance was pretty high—and clearly people recognized that I was starting to become impaired. They decided they needed to get me out of there before I did something really stupid live on C-SPAN. A call was made to the congressional physician’s office, which reached out to one of my doctors to report that I was “stuporous—not walking in a straight line.” My office was contacted.