"I need stronger words to describe this experience. In my mind, the whole episode occurs in colors. Rage vibrates through me in orange. Despair weights down my body in grey, and self-hatred screams in a blinding white light. Rock bottom is complete darkness. But even the colors can't communicate this experience. Right now, I feel totally frustrated with my inability to convey the horror of it to you."
Quizzically, he shifted his head.
"Let me try explaining another way. A Molotov cocktail is made by putting gasoline, kerosene, and a wick into a glass bottle. Toss worthlessness and self-loathing into my glass brain and then dump in huge quantities of horrible self-image. Now, spice the mixture with rage--detonation. I'm oblivious to the rage until it infuses my thoughts coloring them a violent shade of orange--the shade of acid reflux rising from your stomach to your throat.
"A match lights the wick of a Molotov cocktail. My head requires no external heat source. It combusts spontaneously the minute all the horrible emotions and thoughts are blended."
Dr. Graham removed his reading glasses. "Why do you believe you're doing a poor job of explaining this experience?"
"An episode is beyond overwhelming. No word in the English language can accurately describe the pain. The pain is so strong, death's arms appear as warm as a mother's hug."
He sat silently for a brief moment. "Maggie, I don't see any evidence that Zoloft is helping you."
"Like I told you last week, the Zoloft takes away my desire to kill myself. Scary Maggie still wants me to be dead. Now, instead of suicide, the focus is more on death by a freak accident or an extremely painful disease. And the episodes don't happen as often. Zoloft seems to soften them a bit. Most days, I feel pretty good. I used to feel 'regular depressed' every day."
Dr. Graham adjusted his reading glasses and then continued with his questioning. "Is there a difference between 'regular depressed' and depressed during an episode?"
"The two have nothing in common. They are totally different. Depressed is just sad and grey. Episodes are mental explosions."
"Conversely, Maggie," he asked, "do you ever have periods where you don't need a lot of sleep, or you feel completely energized?"
"Sometimes, but the energy doesn't last long."
"I'd like to pick up on this energy topic in our next session. Is Monday at eleven o'clock good for you?"
"Sure, that will be fine."
He wrote the appointment time on a card as I typed it into the calendar on my cell phone.
***
I arrived home from Dr. Graham's office frustrated, wanting to unravel the mystery, but I dreaded confronting Mildred. I filled my coffee cup, grabbed a pen and paper, and dialed.
She answered the phone in a pleasant tone, which changed when she recognized my voice. I did the dutiful niece thing and asked about her health. The kidneys were functioning fine this week. Her gall bladder bothered her a bit, but definitely not enough to have it removed. She conveyed, at great length, her disappointment with the cream the doctor prescribed for the eczema on her legs. For a woman who loved medical illness, you would think she would have invested a little effort into the family's mental illness. I inquired about Uncle Max's health. According to her, he was fine. Call Aunt Mildred as Uncle Max lay semi-sedated on a cold hospital gurney, with men in white coats wheeling him into brain surgery, and she would still insist he was fine. Other people's health and well-being generated no empathy in her. Actually, on numerous occasions, she declared listening to sick, old people describe their aches and pains was annoying.
I let her prattle for about twenty minutes before cutting and asking my big question. "Aunt Mildred, what hospital did Ella live in for all of those years?"
During the silence, I envisioned her skinny, saggy face scrunching into what I referred to as her shut up face. I didn't speak, but let her break the silence.
"Are you coming for Christmas dinner this year?"
"Aunt Mildred, do not change the subject. What was the name of the hospital in New Castle?"
"I can't remember," she replied.
"Bullshit. You know it. You said you and my grandma visited her twice a month for years and years. Most hospitals post their name over the main door. What was it called?"
"Glenn Hill," she snarled. "Are you happy now?"
"Yes, I am, Aunt Mildred--thank you. Does the place still exist?" I asked.
This question pushed her over the edge. Her breathing sounded angry. "How in the hell should I know? I stopped caring about that place after Ella died. It could burn to the ground and good riddance. Nasty, evil place."
Sincerely confused by her words, I pushed forward. "I don't understand, Aunt Mildred, if it was so awful, why didn't you and Grandma move Ella to a nicer place?"
"Who would take her? You never knew how she would act from one day to the next. Some days she smiled and talked to us. The next time we went back, the nurse described how Ella cried in bed for days and refused to eat anything. Once, when your grandma and I walked into her room, she started screaming and throwing things at us. Regular hospitals didn't want people like her, and we weren't rich. We paid money for her to live there."
The level of intrigue in this story kept rising. "Who was the 'we' that paid the money, Aunt Mildred?"
"All of us." The anger permeated her voice and words. Your grandma, Aunt Rose, me, and occasionally, my brother would send money."
"Aunt Mildred, you don't have a brother," I replied.
"Not anymore, but I did," spewed from her mouth. "He was a drunk who moved away. When things got tight, and we didn't have enough money to make the monthly payment, Aunt Rose called him. He liked her. Then, he would send some money to the hospital."
Now I was getting angry. "So, Aunt Mildred, are there any other relatives I should know about? Why have you hidden all these people from us?"
"I didn't hide anything, Maggie. My brother was a despicable man who drank and chased women. I bet his kids are as bad as he was."
I inhaled. "These children would be my father's first cousins. Did my dad know about them?"
Again, silence on the other end of the phone, I knew she was wrestling with a choice, hang up on me or not. I waited, and she responded to the question.
"How in the hell should I know what my sister told her sons? Grace always got a Christmas card from my brother."
"Did he have a name, Aunt Mildred?"
"George, his name was George, and he's dead. I don't want to talk about him either." She spat the words out as if they were poison in her mouth.
"Fine, let's go back to Ella." I leaned forward, reaching for the tepid coffee sitting in front of me and briefly wished for a stack of pancakes. "So tell me, why didn't the sisters bring her home and try to care for her? You said on some days she would smile and talk to you. Maybe if she lived outside of the hospital, she would have had more days like that. Maybe, Ella just got angry because she had to live there."
The line went silent except for strained breathing. Then a sound, somewhere between a groan and a throat being cleared, smacked my eardrum. Immediately after, Aunt Mildred spoke to me in a tone of voice I never heard before. "She was nuts. There, I said it. I hope you're happy. Yes, one member of our family had mental illness."
I knew the truth before I dialed the phone, but Mildred's words rammed into my heart. They erased the small amount of doubt I carried. Mental illness existed in our family. Quickly, I gathered my composure. I glanced out the kitchen window. The morning fog hung in the air. "Any other hidden relatives I should know about, Aunt Mildred?"
"No."
Her anger level escalated off the chart. Mildred's temper always ran hot, but this exceeded any outburst I ever witnessed. I could feel the heat of her body radiating through the phone. A small, maybe not so small, part of me was enjoying her agony. I pushed a little more.
"So George was an alcoholic. Interesting, do you know, Aunt Mildred, before scientists invented all of these drugs, people with mental illness self-medicated to
get relief? Sometimes, they drank alcohol to ease the pain. Maybe George suffered from a mental illness, too."
"Maggie Louise Hovis, I've had enough of this conversation. Please do not call me again to discuss this subject. Ella and George are dead, and we will leave it at that."
"Where are they buried?"
She hung up the phone. I laughed.
I set my phone on the table, walked to the cabinet, and removed a box of cereal and a bowl. After grabbing the milk carton, I set my future breakfast on the table, but before starting to eat, I retrieved my laptop from my desk.
While the computer booted up, I poured the milk into my fruit loops. Finally, a search box appeared on the screen, and I typed the words: Glen Hill, New Castle PA. I got three hits on Google. After reading the first one, I closed the computer and leaned back.
Glenn Hill closed its doors in 1988. One year after Ella passed away. The administration transferred the remaining patients to other institutions in Western Pennsylvania. No information regarding the storage of medical records was mentioned. A real sense of loss swept over me, and it went deeper than the informational dead end. I could accept never learning her diagnosis, but the guilt I felt over the family leaving this woman in an institution overwhelmed me.
Based on Mildred's description, Ella might have been bipolar. But everyone in the family knew Aunt Mildred rewrote history to suit her needs. So there may have been more to Ella's condition which Mildred conveniently edited. I doubted that, during her visits, she ever spoke to a doctor regarding Ella's condition. My grandma would have talked to the doctors. She and Mildred were such opposites. My grandma volunteered at the local hospital every week. She told us kids about the sick people and asked us to pray for them. Maybe she volunteered out of guilt over her sister. Another family secret sealed in a grave. I put my bowl in the sink and walked to the bedroom. My first class of the day began in a half hour. I had to get moving.
Mundane tasks, homework, laundry, grocery shopping, and cleaning consumed the first part of the week. The second part of the week was spent holed up in the library researching for a big Evidence class project. By Friday night, totally brain-fried, I curled up on my sofa with a novel, which I vowed to complete before the semester ended. After a few pages, I struggled to focus because infuriating thoughts of my family kept interrupting my concentration. I put down the book and turned on the TV. A supermarket commercial pushing traditional Thanksgiving fare, reminded me of the upcoming holiday. Thanksgiving, the biggest family day of the year, was only two weeks away and reminders were everywhere.
For the last twenty years, Mildred and Max hosted Thanksgiving dinner at their house. The guest list remained the same each year, my family and Steph's family. Every other year, Aunt Rose flew in for the holiday. Even though my dad was gone, Aunt Mildred still included my mom and Ed. My mom, an only child, had no family left in Ellwood. Her parents moved to a swank retirement community in Boca Raton. Each November, they mailed me a plane ticket for my birthday. Every December twenty-sixth, I boarded the first flight to Fort Lauderdale and enjoyed two weeks of sunshine while being spoiled by two of my favorite people. Last year, I spent the holiday break with Sam and his family. My plane ticket was still sitting in my dresser drawer.
Uncle Roy, Aunt Dori, and Steph were coming in for the weekend. My mom always housed my aunt and uncle. For the last few years, Steph camped at my place. No one expected Justin. We assumed he would remain legally stoned in LA. I made a mental note to e-mail him all the information I gathered about George, Ella, and mental illness.
The opening credits of a movie rolled on my TV screen. It starred some interesting actors. I set the remote control on the coffee table and walked into the kitchen for a late dinner of potato chips and iced tea. As I poured the granulated mix into my super-sized cup, I thought about my favorite part of Thanksgiving dinner--Ed. At family functions, Ed assumed the role of jester and provided much-needed comic relief. Thinking about potential dinner conversation topics, I smiled and predicted this year Ed would need the skills of Jay Leno to keep the family sidetracked. The entire dinner was fraught with fight potential. Snickering out loud, I thought, someone better know how to do the Heimlich maneuver. We wouldn't want Mildred to choke on a turkey bone.
CHAPTER 12
Pills, Light, and T-Shirt Vendors
Dr. Graham always spoke first at our sessions, and today was no different. I sat down at the end of the sofa, my usual spot, and crossed my legs.
"As I said at the end of our last session, Maggie, I want to discuss your energized periods. Let's begin by talking about your body. Physically, how do you feel during these periods?"
Answering this question required no thought at all. "Amazing."
"'Amazing' is a rather vague description, Maggie," he retorted.
"Awesome," I said. He peered at me over the top of his wire frame glasses--chastisement. I got the point. "I could run a marathon without breathing hard. My body revs like NASCAR, I love it. When I'm energized, nothing can stop me. I want to conquer the world."
As usual, he scribbled on his notepad, and I waited for the next question. Glancing around the room, I thought it looked different, but I couldn't figure out why.
"And mentally, how do you feel?" he asked.
"Like a genius. School work becomes clearer and the whole world becomes interconnected. I see relationships between things most people could never imagine. My creativity shifts into overdrive. I've written some of my very best papers while hyper. If I woke up with that energy level every day, I would be number one in my class."
He twisted his head. "Excuse me," he said. "I worked out yesterday and now I'm a bit stiff."
I smiled.
"Maggie, do you sleep during these periods?" he asked.
"As I said before, sleep shuts off my brain. Most days, I prefer being asleep because being awake is hard work. When I'm energized, it's opposite. I want to stay awake and busy.
"How are your thoughts when you're energized?"
"My mind races, but the thoughts are positive. They motivate me to attack my 'to do' list--clean, exercise, cook, write papers, get ahead on classwork. The best part is I do everything ten times better on those days. Life flows easier and clearer. Sam referred to them as Beautiful Maggie days. If I woke up in that condition every day, I wouldn't be in this room talking to you," I explained. "Switching back to your question about sleep for a moment, I think I avoid going to bed when I'm energized because I know it will disappear by the time I wake up."
He wrote a few more notes. I scanned the room, still unable to figure out why it felt so different.
"How often do you these days occur?" he asked.
His voice interrupted my analysis of the notebooks piled high on his desk. Each, I imagined, contained the words of other patients. People who sat on this sofa, dreaming of a drug, or therapy that would give them the ability to control their own emotions and thoughts--normalcy.
"Not often enough. I don't keep track, but let's just say if I marked the days on the calendar, it would take a long, long time for the pen to run out of ink."
"Do these high-energy days occur before you have an episode or afterward?"
I thought about this question for a few seconds. Good days were like sunshine in Pittsburgh, rare but glorious. "I've never noticed a pattern, partially because, like I said before, they don't happen very often. So whether the energy hits before or after an episode, I don't know, but I do consider my good days a blessing. And today would be an excellent time for one. Two of my professors dumped a ton of homework on us this week, and my apartment is a mess," I replied, worried my answer sounded flippant.
Dr. Graham didn't flinch, so I assumed my answer was acceptable.
"You do realize, Maggie, that you're describing hypomania?" he asked.
"Yeah," I replied and shrugged. How could I not understand? The information on the internet left no room for misinterpretation. These days were the other side of the illness, so technically spea
king, even my good days were bad.
Dr. Graham nestled back into his recliner and removed his glasses. As he picked up his coffee cup, I shifted my eyes to the window--new curtains, that's what was different. "Hey, Dr. Graham, I like the new curtains."
He set the coffee cup down. "Thanks," he mumbled. "Linda picked them out."
How cute, he's embarrassed about the curtains. For a shrink and non-talker, he was an okay guy.
"Maggie, I believe Karen hit the target with her hunch. It's impossible to be one hundred percent sure because a precise method of diagnosing is still decades away, but your symptoms do fit on the bipolar spectrum. Because you have never been hospitalized, and your lows are more significant than the manic side, I feel confident in calling it Bipolar 2."
Being diagnosed as bipolar followed by any number would be distressing to most people--not me. His words triggered relief, which flooded my body and tears oozed from the corners of my eyes--joy. My episodes had a name. Dr. Graham didn't realize it, but his words were a gift--an acknowledgement--my lack of emotional control was not my fault. For a brief moment, he watched me smile, then returned to his frantic note taking.
"Great, it has a name. Can you fix it? Is there a drug that will help?" I said, unable to contain my excitement for another heartbeat.
"Actually, there are quite a few drugs, but every person reacts differently to them. One, which relieves the same symptoms exhibited in another patient, may do nothing for you. In fact, it's possible that a drug could make you worse. Because much of the brain's chemistry remains a mystery, trial and error remains the most effective method of ascertaining a good fit for a patient. At this point, I'm hesitant to take you off the Zoloft, because it does seem to be having some positive effect. Another drug, used in combination with Zoloft, has been shown to provide relief for people with your symptoms. This drug will be a good place for us begin."
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