The Recovering

by Leslie Jamison

  Hours earlier, on the ferry out to Bainbridge Island—surrounded by the outrageous splendor of the water, in the theater of Carver’s self-mythologized rebirth—I’d read letters Rhys had written near the end of her life, about her squalid cottage and her nightly whiskey. In the open spaces of Carver’s recovery, I thought of the barred windows of the Narco Farm, and how the fishing trawler offered Billy Burroughs Jr. something that a prison never could, though neither was enough to save him. He died of cirrhosis at the age of thirty-three, after even a liver transplant couldn’t keep him from drinking.

  When I arrived in Port Angeles, it wasn’t as quaint as I’d been picturing—and it was better that way. Rust-pocked cranes and lumberyards full of piled tree trunks flanked crane-shadowed commercial docks and marinas full of boats with names like Tinker Toy and Mermaid’s Song. One writer had called the town “pretty and hard, like a beautician in a Carver story.” A church marquee spread the word about a local 5K run called Hope Against Heroin, and a group of picketers across the street was picketing against hopelessness. NO MORE METH, said their signs. TAKE BACK OUR TOWN. Little neon crabs lit up the motel awnings. The farmers’ market sold magenta-throated collard greens and ribbed yellow squash. A shop called Necessities and Temptations sold egg timers and crockpots and not one single ounce of cannabis, which was for sale up the hill, next to a place hawking salmon jerky and ocean-frozen albacore.

  I had a Dungeness crab omelet at the Cornerhouse, the downtown diner where Carver and Gallagher had been regulars. I’d been told Gallagher still got what she called the Cyclops: an egg on a pancake. Every Tuesday night was still all-you-can-eat spaghetti. I wanted to find diner waitresses who would remind me of Carver’s diner waitresses, with twin pulses of cynicism and hope running through the varicose veins beneath their panty hose. My waitress was mainly kind. It was her birthday. I felt guilty for not getting up and serving her a crab omelet instead. She would be celebrating that afternoon by babysitting her granddaughter. The walls were full of old photos: loggers leaning against felled trees with diameters twice the men’s height. Grinning, all of them.

  Stuffed, I tried to leave the final third of my omelet on my plate, but my waitress refused to let me off the hook. “We don’t throw away Dungeness crab in this diner,” she said, no question mark in sight, and how could I disobey or disappoint her? I arrived at the graveyard full of crab. Carver had written that no one would be denied anything, on his boat. It was only right to arrive at his grave with a full stomach.

  His gravestone was near the ridge, high above the water: a black granite slab beside one set aside for Gallagher. On the marble bench beside his grave, I sat between curves of bird shit. There was a black metal box under the bench, like a mailbox for the dead, with a Ziploc baggie tucked inside. My heart started beating fast as I opened it, palms damp with sweat. The notebook was red and fat and marked with a price tag from Bay Variety, a general store I’d seen downtown, and I flipped through its pages with a lump in my throat, ready for the silent chorus of a hundred different voices.

  As it turned out, it was nearly blank. Gallagher had put a fresh notebook in the box the month before. This was the wounded owls all over again, never there when I needed them—the raptor center I’d tried to give a girl in early sobriety and hadn’t been able to find. Knowing somewhere, somewhere, the maimed turkey vultures were living out their soap operas in cages among the trees. Now I was here with a blank book, neatly tucked between parentheses of shit.

  I briefly, wildly imagined heading back downhill into town, driving to a bar or a meeting to rouse a few world-weary fishermen or loggers to write something in the notebook so I could quote them. Make it brutal, I’d say. Or perhaps the teacher in me would nudge, Make it specific. But it was just me and the dead, and Gallagher’s note on the first page, left for everyone else who might write, and addressed to Ray himself: There was a stubbed out cigarette on the bench and I brushed it away. I didn’t get the message. An eagle is crying. A red tailed hawk flew up to us as we approached the bench. Life is still amazing and you are my precious cargo. It gave me the goose bumps I’d imagined.

  On the next page, one message from a stranger said: When we pass we go where we believe. A few pages later, a North Carolina musician had written that his first time reading Carver was his first time in the presence of true art. He’d tucked one of his CDs into a plastic shopping bag and put it in the mailbox too. If Carver had believed in an afterlife of boom boxes, perhaps he was already listening to it. The most recent note was from someone visiting from South Korea: I walk my walk you have your rest. Thanks for what you have done and what you left for us.

  Nothing else. No eagle cried for me. I felt the old ghost of contract logic sitting beside me on the bench: If I make this pilgrimage, I’ll get the words. If I care about this sober girl, we’ll get the raptors. If I get sober while I’m with this man, we’ll make a life together that sticks. I’d found an empty book where I was looking for a full one, and almost brushed it away. I didn’t get the message. But the program Carver believed in wasn’t really about what you took so much as what you gave. So I flipped to the first empty page and wrote simply, Thank you.

  In Iowa, I found a librarian and a biker and a single mother standing in an alley behind a church. We said: Hello. What’s your name? Here’s my damage. In Kentucky, I sat beneath the gems of Christmas lights and listened to a man describe the burial ceremony he’d given his last bottle of whiskey. In Amsterdam, I put two euros in a porcelain clog and listened to a woman describe why her daughter wouldn’t speak to her. In Los Angeles, I listened to an old man weep when he said his cat had died.

  In Wyoming, in a room thick with Marlboro smoke, a twenty-year-old with a two-year-old said she wanted to become a geologist. In Boston, on Thanksgiving, a woman said she’d tried to kill herself, three years ago that day, and it hadn’t worked, and here she was. In Portland, an activist and an oil rigger bumped the scars on their wrists. It didn’t work, and here we are.

  In Iowa, in Kentucky, in Wyoming. In Los Angeles, in Boston, in Portland. I could say I wrote this book for all of them—for all of us—or I could say they wrote this book for me.

  In Minneapolis, a man shrank himself into the margins of his reading, becoming 1/500,000th. In a little brown notebook, a woman put herself on trial. In the open country of Texas, a man worried God could see him too clearly. In a Manhattan hospital, a dying woman was handcuffed. Beside a river in Washington, a man was increased. Beside a river in Minnesota, a man was dead. Behind a church in Iowa, a biker in leather said the journey was just beginning, and a single mother said she couldn’t imagine it continuing, and I heard them both, and the door was locked, and it did not stop us.

  AUTHOR’S NOTE

  This book devotes much of its attention to Alcoholics Anonymous, a singularly valuable grassroots organization that has become an important part of sobriety for many people. But twelve-step recovery isn’t the only approach to substance dependence, and it’s certainly not sufficient, or even helpful, for everyone. The problem isn’t twelve-step recovery in its own right—though every few years, as if by clockwork, a mainstream magazine runs a polemical think-piece arguing just that—it’s allowing twelve-step recovery to have a monopoly on our understanding of care. Any ethically responsible vision of treatment needs to include a much broader array of options, including medications like buprenorphine and methadone, as well as therapeutic approaches including cognitive-behavioral and motivational-enhancement therapy.

  For much of the second half of the twentieth century, many rehabs steeped in twelve-step recovery believed that medication-assisted treatment compromised sobriety. It’s as if medication became a sign of moral failure, a sign that someone was effectively still using—rather than confirming an understanding of addiction as a disease. But as journalist Lucas Mann writes in his essay “Trying to Get Right,” an article about the regulations and often-great risks that thwart doctors who want to prescribe buprenorphine in communit
ies facing addiction crises, medication is importantly different from still using, which isn’t a moral failure anyway. Buprenorphine, for example, works as a partial agonist, binding to opiate receptors in a way that blocks other opiates from binding, but stimulating them to a ceiling of only 47 percent—so patients experience a limited (often nonexistent) high. Its antagonist component blocks overdose even when it’s being “abused.” And it’s one of the most effective treatments we have, helping heroin addicts as they stabilize and rebuild their lives.

  Every single clinician I consulted as I was writing this book stressed the importance of twelve-step recovery and medication-assisted treatment, all of them articulating a desire for more open communication between the twelve-step and the medical communities. As Dr. Greg Hobelmann put it, “There are a hundred ways to skin a cat,” and over the course of writing this book I came to believe—quite firmly—in a pluralistic approach to recovery. For those interested in reading more about medication-assisted treatment and harm reduction, I’d suggest Mann’s essay “Trying to Get Right” (published in Guernica magazine); Sarah Resnick’s essay “H.” (published in n +1 magazine); Gabor Maté’s In the Realm of Hungry Ghosts: Close Encounters with Addiction; and Maia Szalavitz’s Unbroken Brain: A Revolutionary New Way of Understanding Addiction, an extraordinarily lucid book that reframes addiction as a learning disorder. If addiction is defined by its persistence in the face of negative consequences, Szalavitz argues, how can punishment ever be the most effective solution?

  The stories we tell about addiction have always had a deep impact on legal policy and social opinion. (The War on Drugs is only the most radical demonstration of this.) And when it comes to narratives of addiction, it can be tempting to focus on a single kind of happy ending—enduring abstinence. But abstinence is a limited definition of healing that threatens to ignore the necessary work of harm reduction: clean-needle programs, supervised injection sites, over-the-counter distribution of Narcan (a life-saving overdose medication), and medical care for addicts. Accepting other story lines besides abstinence means accepting the fact that not every addiction story is going to follow the same arc, and pursuing policy measures that don’t act as if abstinence is the only outcome we can imagine seeking.

  When I spoke about the process of writing this book with Lucas Mann—who happens to be a personal friend, in addition to being a journalist who has written extensively about addiction—he told me that I probably had a lot more faith in twelve-step recovery than he did. He’d seen firsthand the damage it could do. He told me he knew a guy who’d gotten kicked out of a methadone-maintenance program for having dirty urine. Was that treatment? To Lucas, it seemed like the draconian outgrowth of an abstinence-only culture that could not make room for the messier story of relapse. The man died of an overdose six weeks after getting kicked out of the program. Lucas was talking about his brother.

  Every addict is someone’s brother, or someone’s son, or someone’s lover, or someone’s father, or all of the above—or none of the above, and all alone—but always, still, someone in the midst of a valuable human life.

  We don’t always like the messy parts of sobriety stories, the epilogues and footnotes and afterwords: Bill Wilson’s experiments with acid; Charles Jackson’s returns to Seconal and booze; John Berryman’s relapses; Sober Carver smoking dope and snorting coke. But sometimes the story of getting better isn’t a story about absolute abstinence. Sometimes it’s a story about reducing danger and restoring health. As Gabor Maté told Sarah Resnick: “Abstinence is just not a model you can force on everybody. There’s nothing wrong with it for those for whom it works. But when it comes to drug treatment there’s an assumption that one size fits all. And if you’re going to wash your hands of people who can’t go the abstinence route, then you’re giving up.”

  Supporting harm reduction involves acknowledging that sobriety might not come immediately, or even eventually, for everyone—that it might not be the triumphant concluding chapter at the end of every addiction story. (And even when it is, it’s never a conclusion, and it’s never easy.) When we resist the tyranny of abstinence—the notion that abstinence has a monopoly on meaningful healing—we allow ourselves to recognize that there are still lives that can be saved, still sick people who can be brought to better health.

  On the level of policy, this book has already made its argument for shifting our national paradigm away from incarceration and toward decriminalization. But in this closing note, I’ll just say that there are inspiring precedents to follow in this vein: Portugal’s and Ireland’s drug decriminalization programs, as well as successful supervised injection clinics in Switzerland and Canada, and efforts to set up similar clinics in America—in Ithaca, New York, for example, under the mayoral leadership of Svante Myrick. Drug decriminalization is only one part of the work we need to do to tackle the epidemic of substance abuse in America, and only part of the work we need to do to tackle the moral stain of mass incarceration, but it’s the necessary legal infrastructure in which treatment can happen most effectively.

  It’s not just a question of policy, but a question of radically restructuring the way we think about addicts as villains—and, for that matter, criminals as villains—worthy only of punishment. It’s not just about compassion, but pragmatism: What will help people get better? It’s about adjusting our vision. Johnny Perez, a formerly incarcerated man now working as a criminal justice reformer, puts it like this: “If we see people as people, then we’ll treat people as people. Period.”

  ACKNOWLEDGMENTS

  The story of this book is the story of its sources. Because I wanted to write a book that worked like a meeting, I knew I needed to include the stories of others alongside my own. But one of my highest priorities in writing about recovery was preserving the anonymity of many of the people I was writing about. To this end, the people in recovery whose stories appear most extensively here—Sawyer, Gwen, Marcus, and Shirley—are all people I approached as a journalist, and their names have been changed. They agreed to have their lives become part of this project, and I am deeply grateful to them for their time, their honesty, their memories, and their insights. Their stories are based on telephone and in-person interviews conducted over the course of 2015.

  I have also changed the name of almost every contemporary person in recovery who appears in this book—except when they requested I didn’t—and, in certain cases, identifying details such as geographic location or gender. Whenever possible, I have secured the consent of everyone who appears as a figure in these pages, and if they are part of my narrative, I have given them the opportunity to read through the pages in which they appear. I’m grateful for their generosity and their openness.

  In order to preserve their anonymity, I have not written extensively about many of the people who were most important to my recovery. But my gratitude to them runs deep. Thank you to everyone—the unnamed, anonymous, glorious everyone—whose sobriety has become part of my own.

  In researching this book, I spent time at a number of archives, and I’m grateful to everyone who helped me navigate them: the Charles R. Jackson Papers at the Rauner Special Collections Library at Dartmouth College, Hanover, New Hampshire; the John Berryman Papers at the University of Minnesota, Minneapolis; the Jean Rhys Archive at the McFarlin Library at the University of Tulsa, Oklahoma; the Narcotic Farm Records at the National Archives in College Park, Maryland; the Stepping Stones Foundation Archive in Katonah, New York; the Center of Alcohol Studies Library at Rutgers University, New Brunswick, New Jersey; the David Foster Wallace Papers and the Denis Johnson Papers at the Harry Ransom Center at the University of Texas at Austin; and the William S. Burroughs Papers at Columbia University, New York City.

  I consulted three clinicians and researchers for their perspectives on the science and treatment of addiction: Meg Chisolm, Adam Kaplin, and Greg Hobelmann, all practicing clinicians at (or affiliated with) Johns Hopkins University Hospital. I also found several conversations with writer Lucas
Mann tremendously valuable in thinking about the relationship between twelve-step recovery and medication-assisted treatment. Carlton Erickson’s Science of Addiction, Carl Hart’s High Price, and Maia Szalavitz’s Unbroken Brain: A Revolutionary New Way of Understanding Addiction all clarified and reshaped my sense of the physiological and psychological complexities of addiction—as well as the ways addiction research has been skewed to tell particular stories.

  The literary and biographical analysis in these pages owes a tremendous amount to the work of literary biographers. I’m particularly indebted to Blake Bailey for his enchanting and impeccably researched biography of Charles Jackson, Farther and Wilder, and for his always convivial company, on the page and off. Blake’s feedback on my own work about Jackson went above and beyond the call of duty. We do not always agree, but my work is always strengthened by our disputes. I consulted D. T. Max’s thoughtful biography of David Foster Wallace, Every Love Story Is a Ghost Story, as well as his reported work on Malcolm Lowry and Raymond Carver, and he was kind enough to provide insightful and generous feedback on several sections of this book. A number of other biographies were invaluable: Douglas Day’s Malcolm Lowry; Carol Sklenicka’s Raymond Carver: A Writer’s Life; Carole Angier’s Jean Rhys: Life and Work; Lilian Pizzichini’s The Blue Hour: A Life of Jean Rhys; John Haffenden’s Life of John Berryman; John Szwed’s Billie Holiday: The Musician and the Myth; and Julia Blackburn’s With Billie: A New Look at the Unforgettable Lady Day, as well as Billie Holiday’s Lady Sings the Blues. I’m also grateful to George Cain’s family—especially Jo Pool and Malik Cain—for sharing memories of his life.