But even the sight of my familiar possessions didn't reassure me. Everything about this place frightened me. This wasn't just a new hospital unit. I had seen plenty of those. No, this was the end of the road. This was the place I was going to learn to live— or die.
Months earlier, when I had awakened from my suicidal slumber on that first night in the hospital, I had begged to be allowed to go back to sleep. I wanted to sleep forever, I told everyone. Let me sleep or let me out, I ranted. I wanted to finish the job. 1 wanted to die.
Once the intensity of my suicidal urges had passed, however, the staff offered me a different choice. I could be discharged immediately as I wished. Or I could sign myself into an extended care unit. There I could plan on a stay of at least a year, maybe longer. There, the doctors would make every possible attempt to find a medication that would help me. At the same time, though, I would have to learn to help myself. I would have to undergo intensive therapy. I would have to begin to acknowledge that I had an illness. I would have to begin to learn to control my illness on my own. No more in-and-out. No more revolving door. Go or stay, the choice was mine.
Everyone waited expectantly. I was well known at the hospital. Many of the staff had been around me during my first and second stays. They knew how vigorously I had fought each time to leave. No one could believe it when this time I chose to stay.
What no one realized—not even me—was that the hospital's ultimatum had spoken to a tiny gleam of insight that had begun glimmering in me. Even while I had been fighting my hardest, little cracks had begun appearing in the steely armor of my denial. Toward the end of my last stay at New York Hospital, their threats to discharge me had panicked me into realizing that I might need help. Those months living in the halfway house, spending lonely afternoons in a pastry shop watching the rest of the world live their lives, had convinced me that I was different from other people. The three-times-a-week lessons Dr. Rockland had given me for years were at last having an effect. Perhaps he was right, I admitted grudgingly. Perhaps I did have an illness. And if I did have an illness, perhaps they were right. Perhaps I did belong in a hospital.
I considered the first option. Down the road, I saw a discharge to a halfway house, another few months of misery and despair, another suicide attempt, another hospitalization—in other words the wretched half life of a chronic mental patient. I knew I couldn't take that. 1 realized what really lay down that road: death. Not the amorphous welcoming, relieving death of my sick fantasies, but real death. I had failed again this time but sooner or later I was going to succeed. This last attempt had come too close.
So when the doctors handed me the choice to go or to stay, something snapped inside me. This time, instead of trying to die, why not try to live? The last time I had been in the hospital I had fought their programs. This time why not go along with them? The last time, I had allied myself with the Voices. This time, why not fight them?
My decision seemed like a good idea at the time I made it. In fact, having made a decision gave me hope. If I had an illness, maybe it could be cured. If I was sick, maybe I could be made well. Maybe they could pull these Voices right out of my skull. Maybe I could have a real life. I agreed to transfer to the long-term unit.
Yes, back at that time it had all made sense. Now that I was here however everything seemed different.
It was clear that this wasn't going to be easy. This was going to be war, a war against the Voices. And the Voices weren't going to give up without a fight. They were going to struggle against me—and anyone else who tried to conquer them.
The Voices were yelling so loud I could barely hear over them when, later on that afternoon, I had my first meeting with Dr. Doller.
Dr. Jane Doller. Jane Doller, M.D. I had first met her on my old unit, during the months I was waiting to be transferred here to 3 South. She often came through to visit another patient on the unit where I was staying. Once I found out her name, I instantly became part of her fan club. For some reason, I got such a kick out of the pun in her name that I looked forward to her visits just so I could greet her.
“Hello, Dr. Doller!” I called out. “Hi, Dr. Doller!” I just loved saying that name. Dr. Doller. Dr. Doller. Each time, she returned the acknowledgment with a nod of her head, or a quiet hello.
I knew she was a psychiatrist. But she didn't look like a psychiatrist. She didn't look like any kind of doctor I had ever seen before. She wasn't angular and crisp like so many of the young professionals I had met. Instead, she looked like the Pillsbury Dough Girl, all pudgy and squeezable. She was always rushing and busy whenever I saw her, but somehow her manner was different from that of the other doctors. She wasn't brisk and businesslike like so many of the others. She was soft. Her face was soft. Her hair was a soft brown. Her manner was soft, and almost retiring. Her voice was soft. Her words were soft. Everything about her seemed soft. I liked her immediately, without knowing why.
Still, except for the several-times-a-week hello, Dr. Doller and I had nothing else to do with each other until I transferred over to 3 South. So when she came to my room, and gently steered me to a bank of chairs in the hall of the unit, I was nervous and apprehensive. I had just found out that she was not just any psychiatrist. She was one of this unit's bosses. She was staff psychiatrist of 3 South, and she was going to be the administrator of my case. I was impressed immediately.
The Voices chattered and wailed and screamed as Dr. Doller asked me questions about my experiences. It amazed me that she was not writing everything else down as psychiatrists usually did. She was just listening, her head tipped slightly to the side, a quizzical look on her face.
I knew that as my administrator she would be the person in charge of my overall treatment, from prescribing my medications to assigning my privileges and my status. What she wanted to know, though, was who should be my therapist. The therapist would be the person who would work with me closely, one on one as Dr. Rockland had, to try to find out what was going on in my head. The choice of therapist was hers; she was trying to find out what I wanted before she made her decision.
I tried to concentrate over the din of the Voices. I would like a woman this time, I said. Over all my years in and out of the hospital, I had mostly worked with men. There had been a few women, but only for very brief periods. In Futura House, I had felt so comfortable with Deanna. It made me realize I related better to women, and wanted to give it a try. It amazed me how well I was able to verbalize my wants and my needs.
Dr. Doller listened to me very carefully, occasionally asking me a few questions in her soft, gentle manner. She agreed, she said. She thought it would be a good idea to assign me a woman as my therapist.
Meanwhile, I was fighting to stay in focus, to stay with her, and not to accept the invitations from my Voices to follow them into their world. It was taking all my energy to keep the two worlds apart, to keep the Voices away from her, to answer her from the other, objective, real-world part of my brain, to keep my answers to her relating as closely as possible to her questions.
And then it spilled over. I couldn't keep the two worlds apart. My Voices spilled over into my own voice.
“Come to hell with me, Dr. Doller,” I shouted, my voice echoing the chant in my own ear.
I was horrified. I had slipped. The Voices were going to punish me. Dr. Doller was going to punish me. Ever since I had first heard those Voices so many years ago, my sole aim had been to keep them hidden. I occasionally had let Dr. Rockland peep at the Voices’ world. But when I did so, it was with fear. In the hospital, I resisted speaking of them as best I could, especially with doctors. I never stopped fearing that to let a psychiatrist know that I was hearing Voices was to write myself a one-way ticket to a state hospital, or to death.
I watched Dr. Doller's face for the shock and disgust I was sure she would show.
But nothing changed. She kept right on talking and listening to me with the same tranquil demeanor, the same caring, curious look on her face. I had had man
y doctors listening to me before. But somehow with Dr. Doller it was different. It seemed to me that she peered right inside of me and sensed what I was feeling. As we parted, the Voices were still howling, yelling in my ear that Dr. Doller was a witch and that she was trying to kill me. But something deep down inside me—the real, well side of me— told me that the Voices were lying. Deep down inside me I knew that this was a woman I could trust.
Three South was a completely different kind of unit from any I had been on before. For one thing, patients couldn't just come and go from 3 South. They had to be interviewed, and they had to be accepted. The patients’ families had to be interviewed too to see how involved they would be in the patients’ treatments.
I found the interviewing process incredibly stressful. One day I came back to my unit in despair after one meeting. I was sure I was going to be rejected. I had been so nervous that I had lashed out at the interviewer.
“They aren't going to want me,” I told the mental health worker when I returned to my old unit. “I just told the guy interviewing me that he was the one who should be on antipsy-chotics, not me.”
When, to my surprise, 3 South accepted me, I still had a long wait to be admitted. There was very little turnover on the unit, and it was eight long months after I was admitted before a bed finally became available.
While I waited, I watched more of my life slide by. I spent my twenty-eighth birthday in the hospital. While I sat lifeless in the hospital, I watched the lives of my brothers move on. While I was in the hospital this'time Steven had graduated from college and Mark and Sally had gotten married. I knew I had agreed to accept long-term treatment, but when I faced the reality, I retreated into rage. What did they mean by long-term if eight months waiting for a bed was short? They were eating my life. My life was being swallowed up by endless days in the hospital.
Once on 3 South, everything moved at even more of a snail's pace.
On the other units, the emphasis had seemed to be on getting better and getting out. I had always felt pressured to show progress. Here it was exactly the opposite. Everyone kept impressing on me the importance of going slowly, of not expecting too much of myself.
In the past, I had felt that my problem—when I even accepted that I had a problem—was like a circuit breaker that had flipped off. All we needed to do was flip the right switch, find the right pill, adjust the thoughts in my head, and Presto! the problem would be solved.
On 3 South, though, the message was different. It wasn't about flipping switches. It was about understanding your own illness, and learning to live with it. Everything was geared toward learning to recognize the warning signs before you flipped out, and to get help fast.
We were all supposed to be responsible for our own treatment. On 3 South you couldn't get away—as you could on other units— with breaking the rules and staying in bed when you felt like it. Nor could you lie around on the hall chairs. Everyone had to be out and about, engaged in some activity or socializing.
On other units, group meetings were always supposed to be mandatory, but you could dodge them if you said you weren't feeling well. Here, cutting meetings cost you passes and privileges. It was your responsibility to remember when you were to go to activities, prepare for them and wait at the door if you needed an escort.
What's more, we were all supposed to get involved in not only our own treatment, but in the treatment of other patients as well. On other units decisions about changes in status, or about passes, were made by the doctors, nurses and social workers. On other units, for example, to get a pass we just signed our name to a list on the bulletin board, and the decision was announced at the next community meeting. On 3 South, however, it was other patients who, along with the doctors and nurses, debated their fellow patients’ fates.
Before I moved to 3 South, I found this idea appealing. But that was before I arrived and found out who I would be working with. The other patients were all so sick. They were so much sicker than I was!
There we sat in our group meetings, three times a week, nine of us, in a circle in the living room. The doctors and social workers and nurses and mental health workers looked alert and in charge. And the rest of us? It varied by how we felt. Many of us had the diagnosis of schizophrenia. During the meeting on any given day, some might be actively hallucinating. Some might be feeling relatively clear and cogent. Some might be nodding off from the effects of a new medication.
At first I just sat in the group and cried. I didn't want to have anything to do with the other patients. I didn't want to talk about them and I didn't want them talking about me. But the staff wouldn't let me off the hook. If I wanted a pass to go home and see my parents, I had to present my request to the group just as everyone else did.
“I'd like to request a pass this weekend,” I mumbled, looking at the floor, arms clenched in front of me.
The social worker spoke up. “I'm meeting with Lori's parents tomorrow evening, and we are going to discuss this issue. We've been afraid that you would run away, Lori.”
I flared. “My parents aren't me. What do they have to do with it? ”
“We're going to hear from everyone, Lori,” said Dr. Doller, who was leading the group. “Then we'll get back to you.”
One patient spoke up. “I think Lori should get the pass. You go nuts here being locked up for so long.”
“I agree,” chimed in another.
Dr. Doller turned to another patient, who was sleeping in her chair. “Claire? Claire? Claire, if you can't stay awake, maybe you should stand up.”
Margo, one of the nurses, spoke on my behalf: “Lori seems to be trying very hard to avoid impulsive behavior. I think she should get the pass.”
“Lori, how do you feel about what everyone is saying about you? ”
Silence.
“Lori? ”
“I don't want to talk about it.”
“Are you having some feelings about us talking about you, Lori?” asked Dr. Doller.
“I'm having a drug reaction. My throat is all tight and I can't talk.”
“Lori, you're a part of this group, and you're expected to participate in it.” Dr. Doller's voice was slightly chiding.
My paranoia flared. “You're all ganging up on me. You're all picking on me.” And the Voices screamed on: “Maggots. Maggots. They hate you. They hate you. To die! To die! To die! ”
Whenever something like this happened, the feelings started to engulf me. The Voices began to flood me with their fury. I didn't want to be here. I didn't want to be anywhere. I wanted out. I wanted to stop the Voices. I wanted to stop everything around me. I wanted to lash out. I'd refuse my medicine. I'd kick the walls. I'd punch the screens. I'd tip over a table and lamp.
The funny thing was though, with this behavior, while people rushed to stop me, no one seemed angry. No one seemed upset. In fact, everyone seemed genuinely interested in trying to figure out how I felt, and what had pushed me toward snapping.
“When you start feeling yourself go out of control, you have to come talk to one of us right way,” Margo told me. “You've got to come get help before you're overwhelmed.”
Within a few days of ray arrival on the unit, Dr. Fischer had come to escort me to her office downstairs on the first floor for our first therapy session. True to her word, Dr. Doller had assigned a woman to be my therapist. It was all just as I had wished, except for one thing. Dr. Diane Fischer, my new therapist, was trying to kill me.
I knew it the moment I saw her. The Voices only confirmed it. Something about this doctor terrified me. All the way down two flights of stairs to the main floor to her office, the Voices warned me against her. All my senses went on alert, as I struggled to stay in control, to watch her, to protect myself against whatever she was trying to do to me. I didn't believe what the Voices told me about Dr. Doller; I did believe everything they said about Dr. Fischer. Everything they said was one hundred percent true. She was going to kill me because she found me so repulsive. I was a fat, disgusti
ng, ugly tub of lard, and I deserved to die. I was frightened. I couldn't take my eyes off her.
By the time we reached her office, the Voices had changed their tune. I was the one to do the killing, they screamed at me. I had to kill Dr. Fischer. I had to do it quickly, before she killed me, they said. If I didn't kill her quickly, they would. I felt my panic mount as the Voices’ commands became more insistent.
“Kill her! Kill her! Put your hands around her neck and choke her!” These were more than orders, more than commands. I felt I could not resist them.
I sat bolt upright on a chair in her office, trying hard to answer the routine questions she was asking me, and to warn her that her life was in danger. My body shook all over. I had to warn her in a way that the Voices couldn't hear, or they would kill both of us. I couldn't speak. I couldn't concentrate. There was no way of talking to her without the Voices jumping between us. The orders were growing more and more insistent.
“Kill her! Kill her now!” they commanded.
I couldn't stand it. I leaped from my chair and bolted from the room. I ran all the way back to the unit where I collapsed, panting with fear, in the safety of my room.
After that I refused to go to her office again. I refused to meet anywhere alone with her. I was afraid of what she would do to me. More than that, I was afraid of what I would do to her. I was afraid of succumbing to the Voices’ charges. I was afraid of becoming a murderer.
Why did this happen? Why was I so afraid of Dr. Fischer? I had had many therapists before throughout my hospitalization. I had often been tense and nervous on meeting a new therapist, or anxious and depressed when one I was used to left me. But no one had affected me the way Dr. Fischer did. Dr. Fischer was special.
The Quiet Room Page 20
