The thumbtack-sized black bodies danced on the windows, hundreds of them. The night before I’d gone on a rampage with an industrial-grade flyswatter I’d picked up at Walmart. After a half hour the sills of every window were filled with dead flies, but they kept coming, boiling out of the drywall. There was something rotting inside the house, some rancid thing generating these bastards. I’d slept with the covers over my head and tucked tightly around me. I woke up confused, sweaty, and depressed, the damp cotton of my thin sheets plastered against my face.
I pulled the lawn chair up and decided to sit outside for a while. I could still see the tops of the mountains, but to see the lower parts I had to peek in between the two-by-four studs. Every day the construction took a little bit more of my view away.
I called my parents. My dad answered.
I told him what the shrink said.
He laughed. He asked if I was going to start seeing anyone else.
“I don’t see what the point is,” I said. “I’m not getting any better, and I’m just exhausting everyone around me.”
My dad said that I wasn’t exhausting him and that he knew my friends cared a lot about me. He told me that I had more people in my corner than I knew, that people really—
I cut him short. “I’m draining people. It’s like instead of having a personality, I’m a virus. I clamp onto people and leech off them. I just need and need and need. I’ve ruined every relationship I’ve been in.”
This is the way my depression works. When I’m in it, I’m always trying to define it, as if naming it correctly will make it disappear. But in the same way that knowing water’s chemical composition doesn’t help you to swim, this casting out of definitions does nothing.
“David. You’re not a virus. You’re an incredible young man who remembers things wrong. Do you remember when you were doing street performance with your friend from college?”
“The fortune-telling stuff?” My friend Duncan and I had lined a box with black velvet and put a baby doll’s head inside of it. From behind the box we could manipulate the doll’s mouth so it looked like he was talking. There was a switch that made him light up and a bulb that made him spit out a stream of reddish liquid. We called him the Child of the Apocalypse, and people would pay us a dollar for one of his prophecies.
“You called me after the first time you did it, and you’d made enough money to go drinking on; you had a big crowd of people, strangers, and they were all laughing at you and your friend. You went out again the next week—”
“And the guy spit on me.” I lit up a new cigarette.
“Some old asshole spat on you.”
“He was at a restaurant, sitting outside, and we were loud, and he said we ruined his meal and yelled at us. And when we left, he spit on me.”
“Right,” my dad said.
“This isn’t helping,” I said.
Sally came over and stood four feet away from me, her ears cocked forward and alert. She smelled something in the wind, and her whole body leaned toward the source.
“You’re only remembering the guy spitting on you, Dave.” Dad sighed. “All those other people didn’t spit on you. And you forget about them being part of the story.”
Sally started barking like crazy, and there were voices. Voices very nearby. But there was no one around. I went up to the gate, peering up and down the road: no one. The voices were still there and getting closer. Was I hallucinating again? Was Sally hallucinating, too? I told my dad I’d call him back. I circled the house looking for the voices. Nothing.
When I looked up, there was a wicker basket hovering right above me, and above it was a massive striped bubble. How long does it take the brain to recognize and name things? There are two sets of connections that leave the eye, and they’re routed through different parts of the brain. One connection recognizes shape and line and shadow. The other connection names things. The first connection is a millionth of a second faster in a normally functioning brain. So for just a fraction of a moment I saw “brown square underneath large striped circle” before my other connections did their job and said, “hot-air balloon.”
It was massive and hung just fifty feet above me. I could make out the edge of an elbow or a slice of haircut here and there as the passengers shifted about, gabbing. It was making a slow descent into the empty housing development across the street. I put Sally on the leash, and we crossed the street and watched the thing land, watched the people disembark, and watched it slowly collapse. The handlers arrived in a minivan with the company’s name in neon yellow across the side. They gathered the balloon as it fell, grabbing fistfuls of the fabric and pulling it toward them, folding that riot of color against their bodies, then reaching out and grabbing more. They were sweating. This was real work.
I sat down with my back against the inner wall of the development, and I didn’t want a truck to lose control on the highway and smash into the wall, leaving me bleeding and concussed until the ambulance came and spun around the cul-de-sac, pulling into the nearest driveway, collecting me and putting me on a stretcher, tying me down, and letting other people make all of my decisions for me.
No. I wanted to stay and watch this instead.
Things warmed up slowly between Anne and I. She had stopped lugging around her giant mug of water and was only swimming every other day. I heard from friends that she was eating almost normally. It was right before spring break, and the writing center was empty. We ran off extra evaluations and sharpened pencils.
Clark didn’t drop by. I felt like asking Anne how things were going with him, but didn’t. I’d never be someone she could talk to about relationships. I’d heard that they were going to spend spring break together, so maybe he was getting his car checked out, maybe he was doing the billion little sweetheart errands that a person would do to spend a week in the company of Anne. He had stopped drinking as heavily. She was carrying fruit around with her to munch on. I was becoming an extra in the movie of their love.
As we busied ourselves with chores, the room was thick with the conversations we should have been having. I needed to tell her about Halloween and the woman with the cat ears. I wanted to ask what she thought about the gifts of the scarf and the childhood book I’d received. I needed to know if I had respected her when we dated, and if I hadn’t, I needed to apologize. I wanted to know what our relationship had been like, what I had been like. I never got up the nerve to ask any of these things. The words that were shuffling around in my head wouldn’t fall into an adequate order for me to speak them. The shift ended.
Over the weekend, there’d been an assault in a parking lot on campus, so I walked Anne out to her car. She didn’t have a parking sticker, so she parked across the street in a church’s lot. In Las Cruces, the parking lots are the size of football fields. It was spring, and the winds had come barreling down off the mountains, sandblasting everything with tiny detritus. We walked sideways with our backs to the wind and were talking about the English building, so named because no one who had graduated from it had enough money to rename the building after himself. We mocked the furniture, the paintings in the hallways, the lousy nubby carpet, the terrible lighting.
“It is the single most unerotic building ever constructed,” I said.
Anne laughed and said, “We had sex in that building.”
“You’re lying.”
She went on to tell me that my sister Katie had been in town visiting, and Anne had had a friend staying at her place. So we met at the English building and had sex in her office.
As she told the story, I remembered, not the day she was talking about, but the day that I first asked her out. I remembered her in a gray sweater, V-neck, and she was wearing glasses. She looked up at me over her glasses, and it was like someone had twisted my stomach around. I remembered wanting to be with her because of how she had looked up over her glasses at me. I remembered what that had felt like. It hadn’t been lightning or thunder or fireworks or even a V-8 engine. It had been breathtak
ingly pleasant. I missed her. I was walking beside her and I missed her, missed us, missed that pleasantness. I had some of the memories, but they were static images. I had the where, the why, and the what she was wearing, but I didn’t have the emotion. I knew the logistics of our relationship, but everything else was vacuum-sealed in plastic, stored somewhere I couldn’t access.
We continued to walk sideways, sheltering ourselves from the gusts. She folded herself into her burgundy Civic and drove off, and at that moment I could finally make out the shape of what I had lost. And that thing that I’d been feeling, that lump of absence about the size of an apple that sat underneath my rib cage and pressed onto my stomach, that thing, while it didn’t disappear at that moment, it did show signs of making the slow transformation from chest crushing to the slow pressure that Sally exerted when she leaned into me when I petted her. This pressure of absence and the anxiety that surrounded it would never leave me, but perhaps it could become just a quirk of my breed. My new breed.
In the story of my experience with Lariam I am always quick to point out how unlucky I was. Even though studies dating from 2002 say that 25 percent of people who take the drug have adverse psychological side effects, only a slim minority of that percentage reacts to the drug like I did. The specificity of my biology interacted with that drug and deleted whole sections of my life, leaving me alone and bewildered on a train platform thousands of miles from home.
When my mom tells my story, she always points out how lucky I am to have made it through alive.
After Anne drove off, the wind picked up more, and my jacket flapped around me, bits of flying debris pecking at it. The empty hooks on the flagpoles clanged and clanged. As it was dusk on the Friday before spring break, the parking lot was deserted, just yellow lines on cracked asphalt limning where things should go with a faith that someday they’d be filled up again.
I was alone, but I knew where I was going because Sally was at home and needed to be let out.
PART 6
I know this isn’t much.
But I wanted to explain this life to you, even if
I had to become, over the years, someone else to do it.
—Larry Levis, “My Story in a Late Style of Fire”
NEUROPSYCHIATRIC ADVERSE EFFECTS OF MEFLOQUINE
Table 1. Various clinical presentations of neuropsychiatric effects of mefloquine. Exhaustive listing of reported adverse CNS reactions observed in people who received mefloquine.
Major psychiatric disorders and symptoms Delirium, delusion, hallucinations, illusions, megalomania, paranoia, psychosis, schizophrenia
Disorders of affect Aggression, behavior disturbance, character change, depersonalization, depression, euphoria, hypomania, logorrhoea, mania, mood swings, oppression, personality disorder, suicidal, suicide attempt
Neurosis Hypochondriasis, malaise, mutism
Other psychiatric symptoms Abnormal hunger, agitation, aggravation, amnesia, angor mortis (the feeling of imminent death), anorexia, anxiety, apathy, asthenia, disturbed awareness, reduced concentration, confusion, dazed, disorientation, dreams, drunken state, excitation, exhaustion, fatigue, fear, hyperventilation, insomnia, memory impairment, nervous, nightmares, panic reaction, restless, somnolence, speech disturbance, sweating, tiredness, decreased alertness, vegetative dystonia, weakness
Seizures Aggravated seizure, convulsion, clonic seizure, epileptic seizure, epileptiform fits, generalized seizure, grand mal epilepsy, fits, tonic-clonic seizure
Disturbances in level of consciousness Acute brain syndrome, cerebral edema, cerebral ischemia, clouded consciousness, coma, encephalopathy, encephalomyelitis, obnubilation, semiconscious, stupor, unconscious
Dizziness Abnormal coordination, ataxia, balance disorder, dizziness, unsteady gait, lightheaded, loss of balance, uncoordination, vertigo, walking difficulties
Neuropathies Anomia, cranial nerve disorder, abnormal EEG, twitching eyes, foot or hand paresthesia, general spasms, hearing disturbance, hypesthesia, leg paresis, leg pain, lip paresthesia, muscle weakness, myalgia, neurological disorder, neuropathy, numb fingers, numbness, paralysis, paresthesia, paresis, polyneuropathy, Raynaud’s disease, sensory disorder, slow reactions, tinnitus, tongue spasm, vision disturbance, weakness
Headache Aggravated migraine, cephalgia, eye pain, headache, head pressure, migraine
Other neurological disorders Abdominal pain, back pain, chest discomfort, chest pain, cramps, dystonia, fall, fever, gastric colic, hot flushes, incontinence, intestinal spasm, limb pain, lumbago, muscle tremor, edematous legs, esophageal burning, oropharyngeal spasm, pallor, rigors, shakiness, shivering, stomach pain, tetany, thirst, tinnitus, trauma, trembling, tremor, twitching, visual disturbance
EEG = electroencephalogram
(Adapted from Francois Nosten and Michele van Vugt, “Neuropsychiatric Adverse Effects of Mefloquine: What Do We Know and What Should We Do?,” CNS Drugs, Volume 11 (1999): pages 1-8, Table 1, with kind permission from Springer Science+Business Media B.V.)
In late July 2007, I was living in Houston, Texas, and one night I had a series of seizures that lasted until morning. They were accompanied by minor visual and auditory hallucinations.
Clark and Anne were still together. They had moved to Portland and were teaching up there, making a real adult life of it. Veda had finished his dissertation, and he and I had stopped writing each other. His daughters were teenagers, and his life was much busier than it was when I knew him. The world had moved on, but I was still having side effects. I was unable, at a biochemical level, to get over it already.
My doctor sent me to a neurologist. I told the neurologist that years before I’d had an allergic reaction to Lariam.
“No, you didn’t,” he said.
I explained to him that I had elevated levels of immunoglobulin E in my blood right after the experience.
“That may be true,” he said. “But what happened to you had nothing to do with those levels.”
I had memorized immunoglobulin E and kept that information handy for all of these years. And it meant nothing. No one could tell me what had happened to me, though they could tell me what hadn’t happened. It was maddening.
I got an MRI, another day spent undressing, removing all metal, and being slid into the tiny clanking tube, but when it ended up clean, I skipped the EEG and the three follow-up appointments. I didn’t have the money for it all. I went to a writers’ conference in New England instead. Because of the seizures I scored a single room. I met a woman there named Emily. She hated smoking, so I quit.
Back home, I made an appointment with a new therapist, who gave me sleeping pills for my insomnia. I bought a pair of running shoes, and when the traffic had died down and my mind was running at full carousel, I’d go out into the humid Houston night and run until my nipples bled.
The US military, after years of claiming that Lariam was perfectly safe, stopped prescribing the drug as its primary malarial prophylaxis for its troops as of October 2009. They still use it in special situations, though. As of spring 2012, the DOD acknowledged that Lariam was still being given to US soldiers stationed in sections of Afghanistan. On June 6, 2012, Dr. Remington Nevin, an Army epidemiologist, testified to the Defense subcommittee of the US Senate Committee on Appropriations that Lariam was the “Agent Orange of our generation” and that we will be seeing its effects on our veterans for years to come.
In 2008, the DOD released a slew of documents pertaining to suspicious suicides that took place at the prison in Guantanamo Bay. Deep within these documents was evidence that beginning in 2002, upon arrival each new inmate was given an initial dose of 1,250 mg of Lariam—a massive dose (five times the prophylactic weekly dose)—before they were tested as to whether or not they were infected with malaria.
Guantanamo Bay doesn’t have malaria. Cuba doesn’t have malaria. None of the soldiers or contractors working at the base were prescribed anything for malaria. Not to mention, why would you give someone a massive dose of any drug be
fore you knew whether or not they had the disease you were treating them for? Especially if the drug you were administering had a track record of awful psychological side effects?
Professor Mark Denbeaux, director of the Seton Hall Law Center for Policy & Research and legal counsel to Guantanamo detainees, believes that since there is no sound medical reason for administering such a high dose to every detainee, then the psychological side effects were the intended primary goal. In what has been called “pharmaceutical waterboarding,” the megadose of Lariam given to each detainee upon arrival, regardless of malarial status or of past medical history, was administered with the knowledge that the incidence of side effects goes up with the level of dosing. In the guise of preventative medicine, the military found an efficient way to psychologically terrorize prisoners and soften them up for interrogation.
In 2009, the woman I had met at the writers’ conference in 2007, Emily, came to Texas to visit. We’d been dating on and off since we’d met. She and I were driving around in the hill country of west Texas, a mile or so south of a famous giant telescope. We were new enough in our relationship that car silence was still a novelty for us. Among that incredible undulating landscape, there we were, seeing if it was tenable not to always be talking. Emily was driving.
We came up over a little rise, and there in the opposite lane was a woman sitting in the road. We saw her first, then the thirty yards of scattered metal and plastic wreckage, and then saw another woman one hundred yards farther down the road, lying next to a motorcycle. A man up a ways was climbing off another motorcycle and running toward the second woman. Emily pulled the car to the side of the road and jumped out.
The Answer to the Riddle Is Me Page 19