Maybe this was just the depression talking. More self-hatred, self-blame. But that didn’t mean I was altogether wrong either.
Suddenly I was aware again of the television, of the ladies typing behind the desk, of myself sitting in that armchair. I wondered if I was making too much noise.
I must stop this. Stop the train of thought, too long, too arduous, too loud.
Let it stop.
I begged myself, because there was no commanding at this stage.
Let the relentless ideas stop. Let the judges stop pronouncing their sentences on me. In every free moment, in the shower, walking to an appointment, in the appointment, harping in the background, harpies overhead, shrieking and circling, in bed, in my dreams, in my teeth grinding themselves blunt in the night, I am pulverizing myself raw.
You. You. You. You. The finger points at you. Who is right? Who is wrong? Am I making an argument? Are we having an argument? Can’t we have this out another time?
FUUUUUCCCCCKKKK. Stop.
But it did not stop. It went on.
People say that depression is tears and lassitude and fear and self-loathing. But they do not say that it is a brain made of tacks, that it is a relentless passing of sentence.
Guilty. I am guilty.
And an equally relentless rumination and breaking down in response to it. Perhaps like autism, depression is a protective reaction to too much information. Too many thoughts.
In this context it’s interesting to ask: Why can’t a depressive get out of bed? Because if the minute you woke up, you thought of all the ways you could die or be injured or fail or cause death or failure or harm to others in any given day, you wouldn’t get out of bed either. If you thought too long and hard about all the people who die in crosswalks, you would never cross the street. If you thought of all the people who die in car accidents, you would never get in a car. And those are only the simplest considerations.
Life is lived on ignorance, on not thinking about all the possibilities, about ignoring the most basic fact, that you are mortal and that it is unreasonable to expect a sentient, self-conscious creature to live with the idea that she is going to die.
Life is lived on denial. Denial of the obvious and awful. Healthy happiness is the careful adjustment of the veil of obliviousness, the very same gossamer veil that acts of God and terrorist attacks punch a hole in. But only for a moment. And time stops. Life stops while the hole gapes. Because it must stop. Life cannot be lived full face. And that is what grief is. The stopping of life and time in the face of knowing, seeing too much.
And that is what depression is as well. A stoppage, or, as Nobel laureate John Nash called it when speaking of his own schizophrenia, “a mind on strike.”
And so I was pleading again with myself from underneath the pile of disputes:
MAKE IT STOP. Please make it stop.
And what would make it stop? What would expediently make it stop? Drugs. Wonderful, dreamy, ameliorating drugs. Legal drugs. Drugs that I could have because I, too, had been diagnosed, and because when it got that bad I didn’t care about anything but silence.
The kiss of the unconscious.
I had secreted a Klonopin in the change pocket of my jeans. I slipped it into my mouth and sucked the pill like a mint. Then I chewed, hoping it would work faster that way.
And immediately it did. It worked. Not the pill, of course, but knowing I had taken it. Just the knowing that help was coming helped.
Help.
Just then a greasy-haired, puffy-faced blonde appeared in the armchair across from me.
Meet Bunny Wags.
Bunny Wags would teach me to play rummy in the ICU to pass the time in the evenings. She would tell me many stories about the system, because, though she was only twenty-nine, she had been through it like a lab rat who just wouldn’t learn. Or maybe just wouldn’t stop pressing the lever for the drug. She looked like a hundred and fifty pounds of chewed suet, sitting there pasty, slumped, defeated, with her white hospital band still on her wrist. She had come from the emergency room of another hospital, one that had those kinds of facilities.
St. Luke’s didn’t. They didn’t get their hands dirty at St. Luke’s. They didn’t have an emergency room, or at least not the kind you’d find in a real hospital. They had an ICU unit, which was just another ward on the second floor, a ward just like the wards on the third and fourth floors, except that it wasn’t permanent for most people. As at Meriwether, it was where everyone went first thing, in order to be processed and evaluated by an MD. You only stayed there if you were especially disruptive and needed to be watched or managed more carefully. Otherwise, in a day or two, you went up to the main ward on the fourth floor, which was shared by the addicts, on one side, and the mentals, on the other. If you were a kid, you went to the children’s ward on the third floor and avoided all the rest.
St. Luke’s wasn’t like Meriwether. They didn’t take people right off the street. They weren’t on the front lines. They were a rehab clinic and small-time loony bin. All of it was coolly controlled. There was no triage in progress at St. Luke’s. When I had called to make my needs assessment appointment and asked explicitly about their admissions policy, they told me that insurance was not a prerequisite for treatment, but I got the strong impression that if you didn’t have insurance, they shipped you off pretty quickly.
That impression got a lot stronger later on when, while fantasizing aloud with a couple of other patients about how to escape or otherwise shorten our stays, a veteran of St. Luke’s said:
“You wanna get out? I’ll tell you how to get out in a hell of a hurry. Cancel your insurance.”
St. Luke’s was where they deposited you on the far end of a binge to dry out in clean quiet once they’d pumped your stomach or IVed your desiccated carcass back from borderline malnutrition—once the life threat was over and you were breathing on your own.
Bunny looked like that, like a body brought back from the brink by tubes and technology and cursed by the genes of generations to be a drunk for the rest of her life.
I didn’t say a word and neither did she. She was still a bit quivery from the treatment, and I was a pile of dirty laundry with legs, having a circular argument with myself about “the will,” so what the hell did I have to say to anybody?
Finally, Mary Jane came for me. Crisis over upstairs.
“They’re ready for you now.”
Did that sound deeply creepy to anybody else? I wondered. Like the thing the too-pleasant lady says in the slow-moving 1970s horror flick. The viewer’s first inkling that the hero is really in hell and all the staff are really demons.
But they were not demons there. At first, this worried me, as much as it surprised me. Everyone was just way too nice. Scary nice. The guy at the metal detector who searched my bag and wanded my body was that way too. Polite and accommodating.
It took him less than a minute to go through my things, which he handled with care and respect. He was just checking for anything blatantly dangerous—a knife—or illegal—drugs. The staff upstairs would do a more thorough job, taking inventory to make sure nothing was lost. He zipped my bag, handed it back to me and smiled, as if I had done him a favor.
“Okay. You’re all set.”
Then Mary Jane and I were walking through empty, carpeted halls and going up in an empty elevator, coming out on an empty floor, going through two sets of locked doors, passing along the way whole quiet well-appointed exam rooms with long-handled sinks and boxes of rubber gloves. We passed activity rooms and meeting rooms, too, all with intact tables and chairs neatly arranged. All perfect, clean, empty, new.
And then finally there was the third set of locked doors. The ward. The ICU.
Mary Jane turned the key in the lock, gestured me in, and followed.
The door shut behind us.
Click.
The unit was small, only six rooms, some double occupancy, all opening onto an octagonal dayroom at the center. The nurse’s station was
on one side of the octagon, so every room and the dayroom was visible from within it. Off to the side there was a kitchen, and a dining area with three round tables, each of which could comfortably seat five.
There was a full-size fridge stocked with bagels, cream cheese, bread, butter, cold cuts, bags of raw vegetables, broccoli spears and baby carrots, and various single-serving juices (grape, apple, prune, orange, cranberry).
The cupboards were stocked with Styrofoam cups, disposable plates and bowls, small boxes of cereal, raisin bran, cornflakes, frosted flakes, Cheerios, bags of microwave popcorn, bags of trail mix, graham crackers, pretzels, animal crackers, instant oatmeal, instant hot chocolate, tea bags, sugar, mayo, mustard, barbecue sauce, and almost any other condiment you could think of. In the freezer there were individual cartons of vanilla ice cream and orange sherbet, and more bagels, bread, and cold cuts.
Jesus. This is camp.
“Have you had supper?” they asked, they being the two ward nurses on duty who had introduced themselves, shaken my hand, and smiled.
Supper? This kindness was too quaint. I felt corrupt in the presence of the word, so anachronistic, so innocent.
Have you had supper?
“No.”
“Well, let’s show you around the kitchen and you can make yourself whatever you like.”
And so I did. Amazed. I put some of the raw broccoli in a bowl with a half-inch of water, covered it with another bowl and steamed it in the microwave. I melted a pat of butter over the top of it and salted it. I toasted a bagel (whole wheat; 4 grams of fiber) and slathered it with cream cheese. I took a Granny Smith apple and a banana from one of the bowls of fresh fruit that had been placed at the center of each table. There were individual servings of peanut butter in the cupboards. I spread some of it on each bite of the banana.
This and raisin bran was most of what I ended up eating while at St. Luke’s. Lunches and dinners were egregious, catered unwholesomely by the same company that served a local college. Often entrées were some form of semicongealed mash casserole consisting of hamburger, corn pone, peas, and potatoes. It was either that or macaroni and ham and viscous, ersatz cheese all served with an ice-cream scooper. Starch was the staple. At times even the vegetables were adulterated by it. One side dish of glazed carrots had soggy bits of bread mixed in.
But snacks! Snacks. God, how civilized. How good.
Of course there were always people for whom too much idle time in the octagon and too much access to the kitchen weren’t a particularly healthy combination, people like the 350-plus-pound, six-foot, four-inch mulatto whom I unoriginally nicknamed Fridge, not just because of the famous football player of the same moniker, but because this guy spent way too much time gazing into, and dwarfing, that particular appliance.
He was twenty-one years old and seemingly still afflicted with the near demonic munchies of the growing boy. The siren song of the sandwich was so strong in him that the whole ward eventually took to joking about the fridge itself being haunted.
“It’s calling to you, man.”
And he was indeed a comical figure standing there huge as a door himself, gripping the handles of both fridge and freezer, swinging them rhythmically as he rocked back and forth on his size twenty feet.
Fridge was MI. Some undifferentiated mood disorder that made him prone to attacks of rage. He was the one who had been “very upset” while I was waiting downstairs. He got upset fairly frequently, and when he did, he often kicked open the magnetic doors that were supposed to keep us all locked in. There were three sets of them. He never got past the second. Not that he would ever have made a run for it. I doubt if he could have run: his size alone hobbled him. But he also had an understandable tendency to trip over his own feet.
Fridge had been in St. Luke’s about ten times before, ostensibly to have his meds adjusted. He seemed to have some problem taking them when at home, or at least doing so consistently. He lived with his grandmother and was subsisting on welfare or disability or both. He said he was the victim of fetal alcohol syndrome, and that at least a good portion of his emotional difficulties were attributable to that.
When he wasn’t in a rage Fridge was a lapdog, friendly and sweet, always amenable to teasing. He did remarkably well for a large man confined in a small space.
As I sat there in the kitchen munching my bright green buttered broccoli, he was standing with a sandwich in one hand, head in the fridge looking for more. He said a chewing hello. I nodded and smiled.
Soon there was a parade of others coming into the kitchen, like Fridge, for a snack and a gander at me, the new meat.
There was Clay, a fifty-one-year-old father of four. He wandered in sighing, wearing scrubs and socks. St. Luke’s distributed scrubs to patients instead of pajamas, if they wanted them, though this was mostly just for the ICU, where people were more likely to have shown up without a change of clothes.
After a long look at me, Clay said quizzically,
“What are you doing here? You look great.”
“Appearances can be deceiving,” I said.
“I don’t know,” he countered. “You look like you work here.”
He wandered over to a chair and fell into it, grunting painfully.
He was paying what for him was attention, but he was not altogether there. His eyes were at half-mast, and he was swaying ever so slightly on his feet, as if he were standing on a boat. He was one of the addicts. Chemical dependency. CD. He was detoxing hard from a spree.
He had lost his job a few months back, just before Christmas. Then on Christmas day he’d had a terrible fight with his wife and stormed out of the house. He’d spent the next three months in what he called “the rubber room,” which meant that he’d holed up in a cheap motel on the edge of town, a place infamous for being a drug den, and had gone on a protracted 24/7 bender, drinking beer and shooting coke all day and night, bouncing off the walls until they had to scrape him off the floor, near dead, with a needle stuck in his arm.
You can have a mighty good evening on a couple of grams of coke. When they found him, Clay had done an ounce. An ounce is 28 grams.
They took him to the emergency room. Then, once stabilized, they transferred him to St. Luke’s. Now they were giving him 10 milligrams of Klonopin a day (1 milligram will make a novice woozy), plus trazodone (an antidepressant that everyone at St. Luke’s said made them feel like a wet noodle), Ativan (another benzodiazepine, or “benzo,” like Klonopin), and the famous sleep aid, Ambien. All this just so that he could cope, and pass out for a while at night.
Coming to see me in the kitchen was a feat at that hour, around seven. He’d had his evening meds, which is why he had the sea legs. Usually at that time, he was sitting on the couch in the octagon, his knees bouncing like they had a jolt in them, his face flushed, his eyes darting, his whole nervous system in overdrive.
I would see him in this condition fairly often over the next few days, but just as often he would be on the opposite pole. He tended to alternate between these two states. The one when he was on the edge of a panic attack, the coke making its hair-trigger way through his system, or the silly semistuporous one he got into about half an hour after he’d had his meds. Then, like now, he just smiled a lot, stated the obvious, and cheated very poorly at cards.
Clay, like Bunny, was still wearing a wristband. Seeing it, and having the same squeamish reaction to it that I had had with Bunny in the lobby, I was thankful that St. Luke’s didn’t use wristbands. To patients they are indicative of anonymity and neglect, and the doctors who owned St. Luke’s seemed keyed into that, or so I imagined, understanding on some level that being tagged is a gross insult to your dignity. It makes you feel like property, or a corpse, a body not a person, the implication of the tag—maybe the need for it—being that if you passed out in the hall, they’d know who the hell you were.
By the time the introductions with Fridge and Clay were over, Bunny had made her way into the unit as well. I looked over and saw her sl
umped in a lounger in the octagon.
She was as wrecked as Clay, but alcohol was her drug. As she told me later, she was only recently out of prison, where she had done a six-month sentence on her third drunk-driving conviction. Depending on the state, the legal limit for blood alcohol content (BAC) is either 0.08 or 0.1 percent. When Bunny was admitted to the hospital, her BAC (or so she said) was 0.59, a poisonous, quite possibly fatal amount.
Though obviously an alcoholic, Bunny was, by her own admission, primarily depressed and self-medicating. Her mother had died a few months back, and that was most of what had precipitated her recent binge.
She was a bright woman and had spent her life in this dinky prairie town going mostly nowhere. There was nowhere to go but out and away, very far away. But she never had, and so, like so many of the other addicts and depressives I met at St. Luke’s, she sank, and then did drugs and drank to pass the time, or obliterate it.
That part of the world would depress anyone—anyone with imagination or ambition. It was easy to see how it would happen, how slowly, over the course of years and many dull days, the landscape would destroy you.
The people were a mirror of that landscape. Flat, simple, but existentially in pain. They spoke plainly but liltingly, their vowels all attached to an e, as if transcribed from the Greek—ae, oe, ie. They were eager to help, and easy. Not southern sluggish, but in no particular hurry or busy snit either.
They were real, and rudeness was rare, but they would not let you into their hearts. They would not even let themselves. They were kind on the surface, but, as on the farms so plentiful in the region, the soil underneath was black. Not the black of cruelty, but of despair. The thing that nearly everyone around me was in the hospital for.
And the prognosis was not good. Not good at all. Because even if these people landed in St. Luke’s or places like it, there would be no lasting remedy for the disease—the disease of their lives. Even if you cleaned a person up and dusted him off and stanched the flow of immediate tears with a rub on the back and a pat on the head, there would still be the same world out there to confront when the treatment was over.
Voluntary Madness Page 12