I’m so glad to see you, I’d say to someone I loathed, and up went the shoulder. I was good enough at incorporating the involuntary movement into the regular, casual movements of my body that people swore they didn’t notice, but after months passed, and the symptom stayed, I traded olanzapine for quetiapine, and my shoulder stayed down.
Antipsychotics bring the risk of a variety of weird side effects. Impaired spatial orientation. Impaired responses to senses. Akathisia, which is harder to explain because the words used to describe its subjective experience are uselessly abstract: torment, restlessness, pulling or drawing or twisting sensations, a desire to move, a difficulty in staying still.
The word was coined by a Czech doctor, Ladislav Haškovec, in a French medical journal in 1901. Its objective indicators are perversely indistinguishable from those of anxiety. Haškovec reported two cases of a curious movement disorder. In one case,
the patient’s gait was normal, but as soon as he sat down, he would start jumping as if he were on horseback. For two weeks, he also experienced “pins and needles” in his fingers, and for a shorter period felt a twisting movement in his mouth. When forced to sit down, he would suddenly jump, and then regain his seat. His movements seemed automatic, involuntary, driven, and the patient experienced them as such.
In the other case,
the patient could not remain sitting down for any length of time. Upon doing so, he would violently jump in the air. The same occurred regardless of whether he was on his own or in a public place. He sometimes had to hang on to the table so as to stop himself from jumping up. When he was able to sit down, he still had the sensation that he was jumping in the air.
Haškovec wrote, If the phenomenon in question proves to be common … it can be suggested that it is called akathisia (α, privative + καθíζω, sitting).
* * *
The phenomenon Haškovec called akathisia had been recorded anecdotally for a long time—in fact, one of the chamberlains of Napoleon III suffered from severe restlessness of the legs, and when in court, and even in the presence of the emperor, he had to walk around every few minutes.
Akathisia became clinically relevant in the 1950s, when the first high-potency antipsychotic medication was discovered. The condition seemed to result more frequently at higher doses. Some studies now show upwards of 75 percent of patients suffering akathisia with clinical doses. Extraordinary suffering. Intolerable restlessness. Unbearable discomfort. These are the words the journals use.
Second-generation antipsychotics, which had less risk of extrapyramidal side effects—those related to the neural network in the brain involved in the coordination of movement—were introduced in the 1990s and have begun to replace first-generation antipsychotics.
Akathisia still exists, though. By now it’s a recognized side effect of antipsychotic drugs as well as antiemetic drugs once used as antipsychotics. It’s possible that some people are more prone to it than others.
The phenomenon is recognized, but it can be difficult to diagnose when symptoms develop gradually or without adequate clinical supervision. Patients often find it difficult to explain in words, and as a result it’s easily misinterpreted as acute anxiety, depression, psychosis, agitation, mania, terror, or anger.
If there were a way to describe the experience of this disorder more clearly, clinicians might better be able to diagnose it, treat it, and prevent its common outcomes, which in the literature are overwhelmingly identified as homicide and suicide—specifically by jumping.
* * *
There are hours of recordings that I can’t listen to, in which Harris speaks, laughs, and plays music, and there are six hundred and fifty photographs. My favorite ones depict Harris playing the violin—not because of his obvious joy but because of the way his hands hold the instrument. They were competent hands. The bow and the body of the instrument were obedient to them. Everything else I can say about the way he played music is the regular sort of thing. The music he played was good. The feeling he showed was delight in what was good.
The person who sat with a famous musician as he died reported that his last words were I can hear the music all around me.
On Harris’s thirtieth birthday, he beams so brightly he looks uncomfortable, as if the joy needs some greater outlet than his mouth, his eyes, his face. Everyone he knows stands around him.
In the photographs from the last year of his life, his face looks doughier than I remember it. His eyes focus on something very far away. The month before he died, he was photographed drinking coffee, wearing a blue shirt, and squinting into the sun.
It is impossible not to read the photographs as summaries: Harris drinks coffee now because he is trying to waken from a terrible dream; Harris wears blue because it suggests heavenly grace; Harris squints at the bright light of the next world, at the headlight on the diesel locomotive.
* * *
I moved to Italy for a year and fell out of contact with my friends back home. From time to time I spoke with an editor of some publication or other. No one visited. I spent most of my time in my studio, avoiding the receptions and the teas, and developed an eye twitch, migraines, and eczema.
On my way to the hallway bathroom I always ran into someone who would greet me with some well-meaning banality that wrapped me in frustrated loathing and prevented me from writing for the rest of the day.
One day I took an expensive trip—two cabs, two trains, and a funicular—all for a little lasagna on a terrace and a stroll through a medieval town, even though all of Tuscany and Umbria looks the same to me. I spent the day walking around half numb, wishing I were in my studio, working.
During my travels I dutifully described in my little notebook all the things I saw in Paris, Barcelona, Valletta, Stuttgart, Vienna, Naples. Afterward none of the descriptions interested me.
A linguist told me serenely that when writers go mad, they go mad in interesting ways, but the rash on my eyelids was not interesting. I scratched at it and smeared cream on it for months, knowing it would make the skin weaker, the rash worse. The symbolic ruination of my eyes was wretchedly trite. I visited new cities and towns and collected descriptions of all there was to see. I never reread them.
Instead of transcribing my travel journals I spent most of my fellowship year trying and failing to write a novel about a research prison where people are monitored invisibly until they go insane. I went a little mad, up in my cell in the villa on the highest hill in Rome. After dinner I often walked down into the cryptoporticus, lifted the heavy trapdoor, and descended the ladder into the first-century aqueduct, which was always quiet, damp, and cool.
The others sat in the living room amid tapestries, eating cookies and fruit, discussing engravings and the sites in the country where stones used to be.
* * *
I went to a psychiatrist who lived and practiced a few blocks from Vatican City.
His eyelids were blankets on an unmade bed, his eyes hidden. He was tiny, ancient, and known in his field for a study he’d published in the 1950s. His half-grown-out red-dyed hair looked satanic. At our first meeting he wrote down everything I said. At our second meeting, after he told me his hourly rate, I immediately apologized and said I wouldn’t be able to return. Clever girl! he sneered.
Eventually I sent him a cashier’s check via certified mail, which in Rome is approximately a weeklong errand. Hundreds of euros later, I was adrift in a foreign country for a year with no doctor and three empty pill vials.
The pharmacists on Via Carini, bless them, tried to take care of me.
* * *
After a month in Rome I went to the Great Synagogue for the Kol Nidre service, the holiest of the Jewish year. I went with a new friend, one of the only Jews in town I knew.
At the first checkpoint we were frisked. The Italian sneered at my friend’s Israeli passport, Non vuol dire un cazzo qui. (That doesn’t mean dick here.) At the second checkpoint we were interrogated in English. Are you Jewish? Is he your husband? Why are y
ou here together? Why are you in Rome?
We moved past the second checkpoint and my friend entered the synagogue. I entered through a side door and climbed a lot of stairs. The balcony was half-filled with chattering women. They held prayer books on their laps but didn’t look down.
From the fourth balcony row I could see the men downstairs in their shawls, davening, could hear the low echo of their prayer. The prayer book was in Hebrew and Italian, and I was illiterate in both, neither sufficiently Jewish nor sufficiently Italian. A woman dressed in a shabby turtleneck sweater and jeans and a dirty dress greeted me in English. I turned to her, wounded. How did you know?
Well, I speak only English and Hebrew, and it’s unlikely anyone in Rome speaks Hebrew. She was from Israel, in Rome on vacation. While she and I tried to make small talk, another woman laid a blue scarf over my knees, scolded me in a language I didn’t understand. I was dressed in my one black suit with a skirt that showed my kneecaps when I sat. The scarf might as well have been an American flag.
The Israeli woman leaned over the railing and followed the service, beating her chest at the right moments.
A Roman woman addressed me in English and smiled at my question. She said, I can tell you are a stranger. She meant that I was foreign, una straniera.
After half-believing all my life that if I ever went to Italy I would immediately become Italian, that my name would anchor me there, that the word Manguso would radiate from me in a language transcending language, I understood then that no Italian would ever think I looked Italian.
Weeks later I learned that outside Sicily, my Sicilian name non vuol dire un cazzo.
* * *
I went to France and found Paris’s slowness grand, languorous, not lazy like Rome’s maddening crawl. On the Left Bank I passed a table of used books—all color, clothbound books about animals except for one, a history of the Jews.
I am aware of accuracy as an abstract goal, but I don’t know what it looks like or how to find it or how I would know it if I found it or what I would do if I did.
* * *
The man who wasn’t yet my husband and I went to Malta. I’d been invited to give a talk at the university for American Culture Week.
We registered in the hotel as Mr. and Mrs. Manguso. Since we knew Catholicism was the country’s state religion, we didn’t correct the register to reflect that we were in fact an unmarried man and his Jewish companion.
Later in the week, when we asked a woman at the university what percentage of the country was Catholic, she assured us that only about 90 percent of the country attend mass regularly.
In fact, 98 percent of the population identifies as Roman Catholic, and according to the most recent census, there are twenty-five Jewish families in the entire country, most of them elderly. When a male child is born to one of the twenty-five families, a mohel is flown in from Italy to perform the bris.
In those last few months before the euro became the official currency, coffee cost seven cents, a pea-filled pastizz cost eleven cents, an expensive dinner a few Maltese lire. The signs on the buildings were Victorian relics—House Furnisher. Gilders. General Store, Est. 1828. The key to our hotel room was a large iron five-lever item that could have been a theater prop.
After I ate bad fish and swelled up and my face turned purple, and we watched the purple tinge creep slowly down my chest, the man who wasn’t yet my husband ran downstairs to the concierge and said the first thing that occurred to him—My wife is ill.
A doctor was summoned. He gave me a shot in the arm that cost twenty-five lire. The purple faded. Then I got dressed and went to the university and gave my talk.
That was the first time my husband ever called me wife.
* * *
In the novel I failed to write in Rome, the protagonist writes in his journal,
The historian walked the halls like a young war hero. Since the first time we met he hailed me in the same way, the inflection unvarying. His head turned toward me in a rictus of courtesy. If I saw him in the morning, that day’s work was ruined.
When I arose early I found him in the laundry room ironing a pile of shirts, with a perfectly shaven neck, standing upright as a soldier. He stood for hours in handsome alignment, one arm moving back and forth over the hateful stripes.
The hallway greetings were shouted out, the faces turned toward each other, then away, the atoms of scent hanging in the air as human debris collected on the wine-colored carpet runner, miasmic clouds hovering like devil-masks, and I wondered at the contentment of the historian to contain nothing, mean nothing, say nothing, show nothing, be nothing.
Instead of working on the Anagram Notebooks now I spend the days writing lines of script and then blacking out parts of them. The pages need to be rewritten and re-blacked and rewritten and re-blacked many more times, but there is always more to remember and more to write.
* * *
The man who wasn’t yet my husband spent weeks visiting the Fascist-constructed suburb Esposizione Universale Roma, or EUR, pronounced ehh-urr, at dusk each day, in order to take visual records of the swarms of European starlings, which assemble an hour before sunset to dance in the sky.
He stood for hours under an umbrella, a million and a half sphincterless animals flying above his camera and his head. They fill the sky with pointillist accumulations—rotating funnels, whipping sails, dense black stones. It might mean something, if we could read what they write on the blue page of the sky. They could be avoiding hungry raptors, strengthening flock bonds, warming their bodies, maneuvering for roost position, or celebrating. We don’t know why they do it.
* * *
All year in Rome, I missed my real life so much, I couldn’t bring myself to visit or to write home more than a few lines. I dreamt I was still there.
Then, after a year, the dream was real.
I wept in New York City subway cars in gratitude for their languages, their music, and their people’s benign tolerance. The city swelled hot with love. It was summer. Everything would be the same as before, except that now I would appreciate every sandwich, every good song I heard on a train platform.
During my first week at home I ate my last little sack of a particular candy I ate all through the year in Rome and only ever found at one candy shop, Confetteria Moriondo e Gariglio—tiny cordial drops, candy spheres the size of currants, filled with sweet liquor in two dozen colors and flavors: blueberry, violet, grape, almond, honeydew, banana, rose, anise. I am told the liquor has to be hand-dropped onto starch, and that they are impossible to mass-produce.
They were always displayed in an arrogant pastel heap on a footed glass dish. If one of them broke and spilled its liquor, the entire pile would be ruined. That’s how perfectly they were made.
They are called lacrime d’amore, tears of love.
* * *
On my ninth day home from Rome, I was told Harris had disappeared, that he’d already been gone three days. I hadn’t spoken with him in a year.
He had run away—eloped, as it’s said—from a hospital and left his wallet, keys, and cell phone. The police had begun a search. I hadn’t seen him since I’d come home. I couldn’t remember the last time I’d seen him before I’d gone away. It seemed like a puzzle on the back page of a magazine, absolutely separate from the real New York, where Harris lay in his apartment sleeping, waiting until morning to call me.
Where’s Harris? He’s somewhere on that back page, hiding in a crowd of Harrises, walking among them, Harrises all over the Brooklyn Bridge in bright sun. It’s just a game. I could throw away the magazine, the puzzle left unsolved, and it wouldn’t matter.
I spent the day getting used to the idea that Harris had disappeared from the real New York, that he might have gone where no one would ever find him. One day wasn’t enough time to get used to the idea that he might be absolutely gone. I was still reattaching myself to the city, relocating myself in the crowd of it. I felt as if time itself had made a mistake. The disappearance seemed
not so much impossible as just wrong.
The next morning, just before I learned Harris was dead, the man who wasn’t yet my husband lay sleeping next to me. I watched him until I could no longer wait, and then I woke him and said, Harris was committed again but he’s been missing for three days and I’m afraid he’s dead.
I wasn’t afraid until I said it.
* * *
On the day the body was identified, everyone who knew about the death gathered in one house. Someone phoned to tell me the address. I didn’t know who lived there, but I went. I asked the woman who answered the door, What was your connection to Harris? and she answered, Love.
The floor was thick with green trimmings. Everyone was crying or had just cried or was about to cry, but Jonathan the software programmer, Harris’s colleague from long ago, cried unceasingly. Who was this inconsolable Jonathan?
It was July. The kitchen smelled of old milk. Somewhere in the old house was a table where a perfect Manhattan stood in a tumbler collecting sweat.
Back in the room of growth and death, flowers and rot, we cried, then stopped crying, then started again. People baked cake after cake. I washed every dish I saw, pacing myself so I never had to stop.
The oven floated a hot smell around us, a sweet miasma.
The scene goes on. Someone brings more flour, more butter, more milk, more flowers, while Jonathan cries. The leafy mat underneath us rises as the cakes rise. An enormous garden throbs outside the back door of the house. We bring the cakes to the people there. We are the people there. We bring stems and long leaves to the people in the kitchen, and we add them to the vases and the floor.
We tread slowly on the grass, tread slowly on the green, far beyond, far beyond, far beyond.
* * *
Harris might have become manic on the ward, convinced the doctors were trying to kill him.
He might have jumped a subway turnstile.
He might have walked, in pouring rain, to the Bronx.
He might have thought he was saving himself from something.
He wandered for ten hours before getting in front of a bright light in Riverdale.
The Guardians Page 3