What follows is the record of that dual journey, shot through with observational inexactitude. This is what I saw and what I thought. It is what happened to me, inside and out. That’s all. It is not, nor was it intended to be, an argument, a polemic, or an investigative report, though it is, at times argumentative, conjectural, and raw. It draws no hard-and-fast conclusions. It asks. It surmises. It prods. It also wanders, meanders, spirals, and circles back. But in the end, it does no more and no less than take you with me. And that, after all, is really what you’re here for, isn’t it? To come along for the ride.
That much I know I can promise you. A bumpy, loopy, sideways, up-and-down ride.
A journalist I once knew had a saying about our profession: The most you can hope to do is inform and entertain.
As an invitation to these pages, that sounds about right.
BEDLAM
Meriwether
Pseudonyms. It began with pseudonyms. Hastily scrawled on the dog-eared pages of a paperback book. Words circled, underlined, then crossed out by the exuberant young man who sat next to me that first long night in the ward.
His given name was Kristos, or so he said, but his pseudonym was Nil. Nil, as in nothing, nullity, none. It signified the end point of his quest, the resignation of his ego, and, as he said, “A far, far better name for a Buddhist, wouldn’t you agree?”
We could not hit on a name for me. Or he could not sit still long enough to do so, and I didn’t feel quite comfortable with the exercise. I was undercover, after all, but using my own name.
I still have the sheet of paper. “Possible pseudonyms,” it says, written large and slantingly in Nil’s hand, leaning sideways across the orderly printed text beneath. I am looking at it now, and in the light of day, or perhaps, healthful dissociation, the two p’s seem too large, the sibilant s’s too small, yet so inspirationally precise, and, of course, so blatantly—well—insane.
Written so imposingly, as they are, in that distinctive fecal brown Crayola marker—the only pen psych patients at Meriwether hospital are allowed—these are unforgettable words to me, words as indicative, damning, and, admittedly, histrionic as “Abandon all hope.” They are the words above the doorway, the words of my descent and of Nil’s. They say everything and mean nothing.
You could make a diagnosis on that basis alone, I suppose, if you were so inclined. As an artifact, Exhibit A, this page would not work much in Nil’s favor in court, or in a doctor’s hands. Nor does it pasted in my notebook.
It is the thing I turn to when I want to go back to my first night in Meriwether. Immediately back, as if transported to the all-night fluorescent lights of the hospital ward shining down on the off-white page, Nil scribbling and cocking his head interestedly at his own wild script, all the while explaining dharma, string theory, and the four noble truths.
Nil couldn’t sleep and neither could I. He, because he was manic. I, because I was terrified, though trying hard not to show it. And because I was bedding down for the night in a foldout chair. All the gurneys in the hallway were taken, and the hallways were all that we had: U-shaped and lined with gurneys, with small alcoves on each end. One side for the women, one side for the men, the nurse’s station in the middle, and alcoves at either end. The alcoves were filled with the chair beds, and each had a small picnic table with a TV mounted above it.
My chair was commodious as chairs go, like the contraptions you see in business class on a plane. It probably wouldn’t have precluded sleep had it not been for the loud talk and laughter going on just feet away at the picnic table, which the night staff had colonized. They were flipping through tabloid newspapers, trading jokes and insults.
Their noise resounded in my head, the noise of a public place.
And that is very much how a big-city public hospital feels. Like an ugly big-city public place, a bus station, say, or a restroom in a vagabond park where everything is a bilious green or degraded shade of gray and nothing quite works the way it’s supposed to, or is ever really clean, except in the strictly antimicrobial sense, as when you scorch cement and porcelain with bleach.
The noise wasn’t the only barrier to sleep. It was freezing in there, too, and all we had to cover us were sheets and paper-thin sky blue pajamas. Hospital issue, all of it, including the Acti-Tred socks with stickum on the soles. I was wearing two pairs of those, and I had layered on a few extra johnnies for warmth.
Seven hours before, all of my possessions had been taken at the door, put in a gray metal locker, and tagged. I had been sitting in my chair ever since, pretending that I was on a flight to Australia instead of locked by my own doing in the holding pen of emergency psych.
I had been working my way up to this for weeks. I hadn’t wanted to go. Who wants to go to a psych ward, much less one of the grungiest, scariest ones you can think of?
Dumb-ass journalists doing experiments, that’s who.
Despite having been to the bin before, I hadn’t been at all sure how to commit myself to Meriwether. That first time around, at the end of Self-Made Man, I had arranged it through my doctor, and I had only agreed to go because she knew the place—had trained there, actually—and because, according to U.S. News and World Report, it had been rated one of the best facilities in the country. I had been given the admitting nurse’s number, had called, and had been told where and when to present myself for treatment. And, of course, I had needed/wanted their treatment. This, on the other hand, was self-inflicted and clinically unnecessary.
It was altogether different. I knew no one. I had no connection with the place, and, understandably, I was intimidated by its size and what I expected would be its desperate, unclean, cavernous recesses where the unwanted were lost and forgotten. Though I had put myself there purposely, and purposefully, the urge to flee set in immediately, nonetheless. I didn’t want to get lost there, or even unduly detained for however long it might take, once I’d gotten my story, to convince the doctors that I didn’t really need to be there.
That was the trick. Convince them that I did need to be there. Stay for at least ten days. Then convince them that I didn’t need to be there anymore. And do all of that without seeming crazier than anyone.
I had a history of depression with occasional mild hypomanic episodes, or so the diagnosis of my former private psychiatrist had indicated, but when I checked myself into Meriwether I was feeling good. Quite good, especially when you consider how scary it is to throw yourself anonymously into what you can’t help thinking of—per the liberties of one too many Hollywood movies—as the darkest heart of darkness in the concrete jungle.
I was not actually depressed, but I had to pretend that I was. A strange exercise for anyone, but especially for a depressive who has spent the bulk of her adult life trying to escape bleak moods, not court them. I wondered: Could I talk myself into a trough, when I had never been able to talk myself out of one? Would faking the mood bring it on for real? Was my “disorder” that suggestible? And, more to the point, were the doctors?
Certainly, I knew what to say, and how slowly and disconsolately to say it. Whether I was really well or ill, no one but I could really know. How would the docs tell the difference? As in all psych wards, when you check yourself in with only a backpack to your name, saying you are suicidally depressed, they take you at your word. There is nothing else to go on. Diagnoses are made on hearsay. What you say is what you are, even if you are not a reliable narrator. There is no test, nothing independently verifiable. Just the swordplay of soft interrogation.
I might have told them I was hearing voices, but then they might have given me Seroquel—which is what Nil was taking—or Haldol, or Thorazine, or some other heavyweight antipsychotic that makes you drool and twitch and doze off at the dinner table. But I didn’t want to put myself in for that.
I could have told them that I had slept with five people in the past day, heard the birds speaking Greek, sold my mother into white slavery and spent the money on dinner. Then they might have opted fo
r Depakote, the big gun of mood stabilizers. But again, I wasn’t ripe for that. I’d been on Depakote before. I had gained way too much weight, for one, and didn’t trust what it would do to me. That wasn’t the way.
But the things you say in psych wards can become a menu for drugs. You have to be careful. I wanted to keep drugs to a minimum, so I reported the virtual truth of my history. Depression, possibly bipolar. I was on 20 milligrams of Prozac, and hoping to get away with nothing more than a dose boost on that—the devil I knew—and maybe a sedative for the p.m.
As it turned out, the medication question was going to have to wait for “upstairs,” the ward itself, spookily referred to, where a team of pros could look me over and make the chin-stroking, wisely nodding call.
Down there in emergency that first night, I had managed to get some Klonopin by request, but I still hadn’t managed to fall asleep.
Nil had migrated to the picnic table, and so was contributing to the noise. He was playing a highly unorthodox game of chess with one of the orderlies, who was complaining loudly and incessantly about Nil’s strategy, which apparently entailed moving more than one piece per turn. His amped-up brain was skipping ahead three moves and making them all at once.
“You can’t do that,” the orderly kept saying, his voice rising in irritation.
The bright lights were kept on all night, so it was like trying to sleep in an interrogation room. The staff, too, went on all night, gabbing and laughing as if there weren’t stranded sick people lying all around them trying to rest. We were invisible, discounted, like baggage or the dead, stowed and impervious. We could tell no stories, the assumption being, I expect, that we were all too drugged or nuts to notice or lodge a complaint.
There were four rooms in there, actually, with beds even, two of which were empty. Who qualified for them or why I wasn’t sure. Perhaps the violent. After I’d been there for a few hours, I would have killed for a bed, or even just a closable door. I asked, at one point, if I could crawl away to one of the vacants for some privacy and quiet, but was told in typical bureaucratic futility-speak that it was impossible. I was, they said, not being formally admitted there, but only being held until a bed opened upstairs.
Somewhere around 3:00 a.m., however, one of the loud gaggle on duty announced that he could use a nap, and crawled off into one of these rooms for a snooze, pulling the curtains and all. Three hours later, just in time for shift change, he emerged, sighing and stretching satisfiedly.
I had managed to drop off somewhere around one o’clock, but had been woken at two for a chest x-ray.
“Why do I need a chest x-ray?” I asked the man who wheeled me in a seat-belted, wooden-backed wheelchair through a maze of green hallways and mauve doors.
“To check for TB,” he said.
Oh, right. As you do.
In the middle of the night?
Passing back through the locked door that said Patient Elopement Risk and Triage in big white letters, I knew that I would not do well if I had to stay in the psych ER for another night. But I had no choice. It would all depend on when a bed became available on one of the main wards upstairs. This special, sequestered, locked ER was where they held you until then, where they processed your insurance or lack thereof, where they kenneled you, like it or not, because you were a risk either to yourself or others. It would take as long as it took.
We were in the bowels of the hospital. There were no windows. No air but the recycled variety, wheezing through vents. No light but bright fluorescents, unforgiving and somehow worse than shadows. Had they not secured my valuables, I might well have made a run for it from radiology. But then, of course, they knew where I lived, and I felt sure they would have followed up if I had made for home in my mad rags.
“Eloped” was priceless, though I suppose only we loons were inclined to do it alone and from a wheelchair, streaking through the streets in our blue issue, like B movie extras run amok.
But, God, it was a strong urge—run!
I thought—and I had this thought many times in the coming days—who wouldn’t look crazy doing that? Yet who, under the circumstances, wouldn’t do it, or at least want to?
I had given them urine at ten, films at two, and blood at six. I was, it seemed, contagion-free, excretion-wise anyway. And the lungs, I was told after breakfast, were clear.
Some time in the night, the cops had brought in a shirtless man in handcuffs. He had, apparently, threatened his family. I saw him come in, but since we were separated by sex, I did not see him again.
Somehow, though, perhaps because of his long hair and Zen demeanor, Nil had managed to stay on the women’s side with me for much of the night. He told me he had been to the bin many times before. Since adolescence, he said, he had been in and out of places like Meriwether. He knew the routine well, which was a great help to me, who didn’t.
I had managed to smuggle in a pen but had forgotten that I should not be seen with it, and so it was promptly taken by a nurse, officious and smug.
“You can’t have that,” she sighed, flicking her fingers to her palm impatiently. “Give it here.”
I was a kid to her, cheating at school. And that is how it felt. I was not yet practiced at subterfuge, and surrendered the pen with a shrug. This was a false position, though, since I was not indifferent. Losing the thing made me panic. It was not a small loss to me, though, a petty one on her part, and she knew it, took pleasure in it.
Or was that the beginning of paranoia?
I didn’t know what I was going to do if I couldn’t write. Nil knew this feeling, and reached into the paper bag he had found to house his few pilferings from around the ward. They included, aside from the brown marker, the dog-eared paperback book that he was using as a notebook, some rolls and milk kept from dinner, and a small square blanket someone had snatched from the maternity ward, which he was using as a meditation mat. This was when I saw and used my first Crayola, the blunt tip acceptable in a place where a ballpoint was a weapon, or could be.
“You can do a lot of damage with one of these,” a nurse had said to me, holding up her pen. As soon as she said it I had visions of stabbing a person in the neck, maybe myself. The jugular is pokeable and fatal, and what’s more, neatly self-inflicting if you’re so inclined. Just then, I was not. But too long in that place and you might be—probably would be. That was clear.
They had a metal detector at the door, though they did not put me through it. Maybe this was a perk of being white, or of being thought too thin to hide weapons in my flesh. Or maybe the guards were too busy with the fat Muslim woman in hijab to bother with me. They put her through twice. They didn’t even pat me down. But as I told the admitting nurse, I’ve never been violent, so who’s counting?
“Have you ever lost your temper?” she asked.
Was that a test? A bout of cognitive lock-picking? A measure of my faculties? Later, in this vein, they would ask me: Who is the president? What day is it?
Don’t get smart, I decided. Be as honest as you can.
“Um . . . yes.”
From where I was sitting, I could see another sign I enjoyed. “Please do not walk through triage area while triage in progress.”
Was this triage in progress, or was that when you lost your temper?
“Do you have a psychiatric history? Do you know your clinical diagnosis?”
“Yes and yes,” I said, looking away.
A man in the hallway had crapped himself, a brown seep the shape of Lake Michigan hanging low in his bottoms. He was shouting into the nurse’s station, which was a fort of Plexiglas from which the RNs rarely emerged unbidden. Patients tended to loiter there and stare, ignored. If you needed something, you had to knock. Or shout. Or crap your pants, I guess.
I had gawped there, too, earlier, just for something to do, mesmerized by a computer whose crawling screen saver said—ungrammatically—“Always borrow money from a pessimist. They never expect it back.” I spliced it like a chant in my head, coding it for m
eaning. “Always borrow . . . never expect . . . money, money . . . a pessimist’s back.”
This was one of those nutty hallmarks that began to make sense to me in there. Babbling. Boredom was a scourge and the enemy. You fended it off with anything, the brain leaping on word games for food: scrambles, iterations, puns. It was, oddly enough, a defense. Not so much the evidence of a mind gone awry, as the ditch of a mind trying not to, like a verbal rocking that puts confusion to sleep, the language center calming itself, whistling a tune in the dark.
No one moved to help the befouled man, so Nil, ever eager to be of service, offered shampoo.
“I need a towel,” the man grumbled ungratefully.
“Sorry. Just shampoo.”
“Can’t you get me a towel?”
“I’m a patient, too.”
The nurse put a statement in front of me. It said that I would not harm myself or others while being evaluated. I signed it—smiling—with her ballpoint pen.
Time had passed slowly after that. Sitting. Staring. And then more questions. The questions were much the same. Condition. History. Temper. First the nurse, then the doctor. The doctor explained what voluntary meant: (a) you can be discharged if and when the doctors agree; (b) if the doctors disagree, you can be discharged against medical advice—though how or if this ever happens is unclear, given that (c) if you insist on being discharged and the doctors still disagree, you must write a three-day letter expressing your wishes, in which case, you will be brought before a judge within seventy-two hours. In theory, at least, this is the law, but I made no use of it.
Voluntary Madness Page 2