“All done.”
Couldn’t the doctors see, in my blood work, signs of my real disease? There was nothing wrong with my thinking. Surely I wasn’t psychotic. Surely I wasn’t hallucinating. I thought I had a vascular disease. Why else would my extremities tingle and ache? Or I had a muscular disorder, some sort of dystrophy. Why else was I so clumsy and stiff? Did I have a rare disease affecting the bones of my face? Why else would I see, as I did, or thought I did one day, my misshapen skull in the bathroom mirror? It was fleeting, a moment of death imagined. I stood before the mirror, and saw my hair, ears, beard, and my chin and mouth, my cloudy eyes. But my cheekbones and jaw looked warped and disfigured. My cheeks jutted out, and I thought I saw, for a moment, my eye sockets in place of my eyes.
I ran from my room, down the hall, not able to keep straight, careening, furious, scared. Was it morning? Was it nighttime? And when was it that I stormed the nurses’ station? It was a day near the end of my medication trial, a day in July. Why hadn’t I already been taken by ambulance to the right hospital? Why was I being held against my will? Why would no one listen to me? Why would no one help me? I was pleading. I was begging. I don’t remember if I was shouting. Who would hear me? Who would believe me?
Dr. A was standing behind the desk. He stepped back. Immediately the area filled with personnel. Nurses and residents and social workers appeared and formed a line; they made a kind of semicircle. They were ready to tackle and restrain me. “Stop right there,” my doctor said to me, and I stopped. Were the other patients watching? Would I be put in a straitjacket? Dr. A held his hands out, palms facing me, as if he were pushing something away. Then he turned his hands palm down. “Take it easy,” he said. No one moved. The doctor gently lowered, and then raised, and then lowered his hands. I stepped back. I looked down at the floor. Had he really thought that I’d become violent? He dropped his hands, and I went into the common room and lay on the sofa. I felt misunderstood, and I was ashamed.
A few days later, Dr. A brought me into the dining room. It was midday. The tables had been pushed to the walls. My team of doctors and the nurses and residents in psychiatry sat in a line, like a jury. There were the social workers, the ones who’d encouraged me to join in activities that I rejected. I didn’t want to play games with patients who got excited and noisy, or eat the donuts that the nurses brought. I didn’t want to sit in the leisure activity workshop and hear about pleasures that I would never feel, relaxing on porches or going on vacations or having picnics. I couldn’t bear the weekly cooking class that was held in the little kitchen down the hall from the dining room. Must I fumble with pans? I couldn’t safely boil water. I’d once been a good home cook. I had cooked in my own kitchen. I had chopped vegetables with the Sabatier knife that my father had held to my mother. I had cooked with girlfriends, and read literature, and gone to movies, and acted in plays, and graduated from schools, and run errands, and sat with my mother while she shook from delirium tremens, and driven with my grandfather, her father, through the North Carolina mountains, where he and my grandmother retired. My grandfather and I used to go for milk from a farm in Old Fort that had one cow. He was in his eighties, and I was in my thirties. He took Lasix for his congested heart, and frequently stopped the car to urinate in the bushes beside the road. On one of our drives, he asked if I’d been to the Carl Sandburg house, outside Hendersonville, and I said, “No, I haven’t,” and so we drove across the mountain to see the poet’s house and the land around it, the woods and the barn and the pens that hold the descendants of the goats that Sandburg kept. Lying in bed, the night after my grandfather died of a heart attack, in 1995, I had the feeling that he’d driven to Brooklyn in his Buick and was waiting for me to come downstairs to the sidewalk and get in. I didn’t go to the window to look. The next day I flew to North Carolina to scatter his ashes. I’d been in therapy, by then, for twelve years, since my mother had got sober, when I lived on the Upper East Side, not long after I came to New York. My apartment then was across from a fire station. My roommate was an actor named Scott. My bedroom was through the kitchen. The bedroom had a sleeping loft with a ladder, and was painted white—white ceiling, white walls, and white floor. I put my desk under the loft, and wrote stories on a Smith Corona typewriter. When I hit the return key, the recoil force of the electric carriage jarred the typewriter, and with each new line of writing, the typewriter inched farther sideways across the desk. Day and night, I could hear the fire trucks across the street, their sirens.
In 1983, a friend, Susan, whose mother had died of suicide, referred me to my first therapist. His name was D, and he had come to New York from the Midwest, where he’d been a Congregationalist minister. D told me that he’d become a therapist because he had felt unable to help his parishioners, only offer homilies and consolations. He worked out with weights, and had a bowl haircut. His office was in a brownstone, three blocks uptown from my apartment, on the second floor in the back. D said that if I drank I would become an alcoholic like my parents. I went to Al-Anon. Al-Anon is for people whose lives have been affected by alcoholics, family members, for instance. The meetings stem from Alcoholics Anonymous, which got its start in 1935, at a house in Akron, Ohio, where two men who believed themselves incurable alcoholics sat through a day and a night, keeping each other company, telling their stories. One was a doctor named Bob, the other a stockbroker named Bill. Bill and Doctor Bob realized that if they could stay sober for a day, a single day, then maybe they could do it again, and from that came the main lesson of AA, that sobriety can only be undertaken with others, one day at a time. Alcoholics Anonymous helped produce the concept of alcoholism as a disease, not a sin or a sign of weakness, and this understanding has led to better health care and reduced stigma. Stigma, the stigmata, refers to Christ’s martyrdom, His blood, the wounds made by the nails driven through His hands and feet when He is crucified by the Romans; and on His head, the marks left by the crown of thorns that Christ wore as He died. Christ dies for our sins. He dies to save us. I read and reread the Twelve Steps of AA, which follow from our acceptance of some higher power in our lives, God, as we understood Him. At night, I called my mother, and we talked about the program. At that time, I was beginning as a writer. The short stories that I wrote then were about her, mainly, but one was about a man I met one night on the street, not long before I started therapy with D.
I was on my way home from a party where I’d had a lot to drink. The man was waving a flashlight, looking to open the sidewalk grate to get at the fuse box in the basement. The street was dark, and there were no people. The power had gone out in the man’s building. But the sidewalk grate was locked, and he asked me to help him upstairs to his room. His name was Waldo. He was German, had gray hair, and looked sick. His building was a neglected rooming house a block east of Park Avenue. Waldo’s flashlight lit the way up the stairs. The light was dim, and I heard noises coming from behind doors on the hallway. Waldo’s room was on the second floor; it had a table, two chairs, and a single bed. The bathroom was down the hall, but Waldo had a sink. The room’s one window was partly covered by a torn shade hanging from its spindle. Waldo lit a candle. A little refrigerator held cans of beer with their lids popped open. Waldo told me that he didn’t like fizzy American beer; he liked the beer that he’d drunk in Germany when he was young. Snapshots were pinned on the wall, and a medal hung from a nail. It was Waldo’s Iron Cross, his EK2, he said. He told me that he’d been one of the boy recruits conscripted by Himmler to fill out the Nazi ranks at the end of World War II. EK2 medals were given to soldiers who fought on the Eastern Front. I watched him in the candlelight. He told me that he’d finished the war in a prison camp, and that in America he’d been a baker. He showed me pictures of his trip with his wife to Florida in the sixties, and then raised his shirt, displaying gunshot wounds. He asked me to get him a pistol. He had no one, he told me. He was alone. He said that he wanted to shoot himself. Would I help him? Could I bring him a gun? I told him that I didn�
�t have a gun, and couldn’t get one, and then I got up to go. He tried to stop me. He grabbed my arm, but I pulled away. “Get me a gun, get me a gun,” he pleaded. I ran down the stairs and up the street. I saw him after that, a few times, looking out from behind his shade. I hurried past.
Back when I was a teenager, I liked to visit my father’s mother and his alcoholic brother, my uncle, Eldridge, also known as Bob, and sometimes Sam. This was in the mid-1970s, after my family left Virginia for Miami. I rode the bus across the Everglades and up the coast to Sarasota, where Eldridge and his mother, my other grandmother, shared a house on a man-made lake. The house was west of town, about a twenty-minute drive from my mother’s parents’ house. The land out there was scrubby and dry. Eldridge kept a stack of Playboys and a gun collection. He ate in the middle of the night, watching Johnny Carson. My grandmother was frail, and had white hair. Her name was Eliza. She and Eldridge lived together until she died, in the mid-1980s. A few years later, at fifty-one, he died from alcohol poisoning. When I was a teenager, I thought that my uncle was a free spirit. One night when I was fifteen, he threw me onto the foldout sofa on the enclosed porch, the Florida room. I thought that he was wrestling. He climbed on top of me, pinning me down on the mattress. I was on my stomach, and he lay across my back. I smelled his English Leather cologne and the beer on his breath. Was he playing? It didn’t feel like playing. What was happening? What would he do? He didn’t move. I felt his weight on me. Did he have an erection? I said, “Get off,” and then, again, “Get off.” He rolled over and lay beside me. How long had we lain like that? Why did my uncle put his weight on me like that? I felt terrified; I felt that I was in danger, and that I must run away, and that I would never be able to see him again. It happened in a moment. And I understand now why our grandmother, when Terry and I were little, when we were four, five, six, took us into her bed to sleep. She was protecting us from our grandfather. His name was Robert Antrim. He was a retired farmer, taciturn and unsmiling. He wandered around the house wearing Old Spice and his underwear. He died when I was twelve. The morning after that night in Sarasota, the night my uncle got on top of me, I fled to Miami, and a month later left home for school in Virginia. I returned to Florida less and less over the years, except to care for my mother.
I was twenty-three, twenty-four, and twenty-five. I went to therapy with D, and then, three years after he left the city, in 1988, I began again, with a man named R. R had come from England to study at the William Alanson White Institute, on the Upper West Side. He and I met twice a week in an attic room. I rode the 86th Street bus across Central Park. Sometimes, when coming into the room, I might say hello and ask R how he’d been, and he might then ask me what it would mean to me to know. We tangled over whether I needed to talk about my father. The William Alanson White Institute practices interpersonal relations, which examines the family and society—the patient’s story of growing up and living in the world—in relation to trauma, broken bonds, and compromised lives. Harry Stack Sullivan, the White Institute’s first director, introduced the term “problems of living,” economically expressing the idea that anxiety originates in crises and failures in relationships, in violations of trust. Problems of living include crises and concerns of daily life—divorce, the death of a family member, bankruptcy—problems that are not necessarily associated with suicide, but that are, just the same, frequently causative. Sullivan’s name was unfortunately taken by a sex cult, the Sullivanians, who lived at that time in a brownstone twenty blocks north and west of the White Institute, between Broadway and Riverside Drive. I recall walking past their building one afternoon in the late 1980s. At that time, when I was around thirty, I was reading sociology and child psychiatry. I read John Bowlby, whose work on separation and loss forms attachment theory, which predicts social competency and the ability to thrive as functions of nurturing early attachments, of bonding; and Erik Erikson, whose work suggests that the violation of the child’s trust leads to a life of increasingly perilous failures of trust; and D. W. Winnicott, the British pediatrician whose writings stress the importance of parental love, the ongoing connection between mother and child. All these authors describe the crucial role of touch, and of the family setting as a place of safety and security.
After leaving therapy with R, in 1991, I began with M. I moved to Brooklyn, to the apartment from which I ran to the roof. M grew up in Staten Island. She had her office in an Art Deco apartment building on York Avenue in Manhattan, near the East River. I commuted from Brooklyn to Manhattan to see her, sometimes once a week, sometimes twice. Our therapy lasted fifteen years. During those years, I published a novel that begins and ends with a man who is alone and looking out a window, and whose wife transforms into a prehistoric fish; and then a novel about a host of brothers who have lost their father, and who rampage through their immense, ancient library; and then one about a psychoanalyst who, when a colleague lifts him in a bear hug, levitates to the ceiling of a pancake house. M followed Heinz Kohut, a German immigrant who practiced what he called self psychology, which emphasizes the integrity and wholeness of the self, whatever that is.
After writing three novels and the memoir of my life with my mother, I began filling Klonopin prescriptions from the Brooklyn psychiatrist, the doctor who scribbled the graph showing depression on one side of a line, anxiety on the other. I had survived, or thought that I’d survived, my parents’ drinking and shouting, our constant moving, the losses of places and friends, my uncle lying on my back, annihilation after annihilation. I’d played in the yard, and smashed tennis balls against walls for hours, and built model airplanes, and listened to my records at night in my room. I’d slept at night with cats for company, and ridden my bike, and struggled in school, and, later in life, gone to bars, and then quit going to bars, and smoked cigarettes and pot, and fallen in love, and argued and made up, and refused to speak to my father, and suffered my mother. None of this had stopped my dying. Writing had not stopped my dying. The Twelve Steps had not stopped my dying. Therapy alone hadn’t stopped it, and my old friends couldn’t, nor could Regan. No one could.
Dr. A waited in the patients’ dining room. Nurse D was there. The activity leaders were there. It was midsummer, and I’d not been outside for weeks. I’d had no fresh air. My medication trial was ending. My book had come out, and I’d seen my face disfigured in the bathroom mirror. I had charged the nurses’ station. Now my doctors, my team, sat in a circle, holding notebooks and pens. The tables where patients ate meals had been pushed against the walls. In the center of the dining room was a chair. One person in the room I did not recognize, a woman wearing a Chanel suit. Her hair was cut short. She spoke directly and deliberately, and immediately I was terrified of her.
“You are sick,” she said.
I cried and cried.
“You are psychotic.”
I sobbed, “No, no.”
“We can get you better.”
Tears ran down my face, onto my clothes.
“We can get you well,” she said.
Her name was Dr. P, and she was an ECT specialist at the Institute. ECT, electroconvulsive therapy, once known as shock therapy, produces convulsions that affect dopamine and other neurotransmitters. During the procedure, the patient is anesthetized, and paralytic drugs are administered to quiet convulsions in the body. The focus of treatment is the brain. Without paralytics, the patient will twitch and flail on the operating table. ECT is a powerful measure against suicide, and yet it has traditionally been used as a treatment of last resort. Early images of patients undergoing shock therapy inform our fears. I was terrified of ECT. I imagined the electric chair; and I knew, or thought I knew, what shock would do to me. It would destroy my ability to write, or even to think clearly. It would take away my memories and my personality. I would be unable to function, and live confined to hospital wards.
“We want to perform ECT. It is an excellent treatment. There is nothing to be afraid of. ECT will not harm you. It will help you. We need y
ou to agree. We need your consent.”
Who could save me? I wandered around the ward, crying. I asked one of the residents if she would ever do ECT herself, and she told me that if she were as sick as I was, she would.
Later that day, or maybe it was the next day, the patients’ phone rang. It was for me. It was the writer David Foster Wallace. I’d met David, but didn’t know him. I’d read his writing; his frantically paced stories about manic, destructive characters; his funny and digressive, intimate nonfiction pieces; and the novel Infinite Jest. Suicide features as a concern in much of Wallace’s work. He told me, that day on the phone, that our mutual friend Jon had shared the news about my situation. Did I mind hearing from him?
“No, I don’t mind,” I said, and he asked how I was feeling.
“Not so good.”
“How long have you been there?”
“Two months.”
He said, “I’m calling to tell you that if your doctors recommend ECT, then I want you to do it.”
He asked me, “Have they offered it?”
“Yes,” I said.
David told me that he’d had ECT in the Midwest, twenty years before, during the eighties. He said that ECT could save my life, that it is a safe and robust treatment, that the doctors knew what they were doing, and that I should not be afraid that I would lose my memory or competency; I was in good hands. “I want you to try ECT,” he told me. He said it again and again, because he knew that I was ruminating, and that I would not be able to believe him for long, just a few minutes.
One Friday in April Page 5