The Edge of Every Day

by Marin Sardy

  And there beside that temple, utterly out of context, I may have found the real purpose of my selective amnesia, of Will’s nostalgia. Perhaps the true value of both, I felt, lay in their power to simplify. Where Will erased his loss, I made mine entire. We had known that something was lost, but what remained? A shell of a marriage, a foreigner who was my mother. The nostalgia, the gaps—they created completeness where it was not. After all, something always lingers of what is destroyed. And in that long aftermath, faced with all that has not disappeared, we are forced to confront the persistent presence of what remains.

  Walking through Central Park that afternoon to get home, I still heard the looping music in my head as we traversed the lawns. We stopped near the northern edge of Onassis Reservoir, where an opening in the bushes gave us a wide view of midtown. Will pointed out the office building where he had worked ten years before. Leaning on the railing, looking over the water at the skyline, he commented on the way, in the months after 9/11, he and his first wife were briefly freed from their battles. It was similar, he said, to the way the whole country seemed for a short while united. He noted that America now seemed almost nostalgic for that awful day.

  Ultima Thule

  How does one conceive of another’s homelessness? It was a vast unknown, an empty region on the map. Even now, when it is long over, it remains tempting to simply color it in with a pale blue wash, draw in a few low peaks, and tell myself that was all it contained. Maybe label it: Ultima Thule.

  * * *

  —

  There were questions, always, unvoiced. What did Tom notice? How did it feel? The blocky buildings of downtown. The light of low sun. The earthy, salty rot smell coming off the mudflats at low tide. The ravens picking at trash bins, cawing low.

  * * *

  —

  His way of seeing things. Anchorage, always overcast. He once told me he described it to people in Boulder by saying that you could lie down on your back in the park and look up, and the sky would be so high and white above you that you couldn’t tell if it was covered by a layer of clouds or if that was just how the light was.

  * * *

  —

  Homelessness as felt by way of psychosis. Some things more acute. Others barely noticed. But which, when, to what degree.

  * * *

  —

  The onset of psychosis is framed by a set of deep changes—radical shifts in how the mind relates to both the world and the self. It goes far beyond losing contact with reality, is more than delusions and hallucinations. It generates not only these bizarre highlights but also the subtler, more pervasive disturbances that make it possible to believe them.

  * * *

  —

  The positive moods that can arise from schizophrenic delusions are distinct in that they tend to seem somehow drained of blood. The ecstasy that Tom sometimes felt was not an infectious cheer, not exuberant glee. It was more akin to a spiritual exultation, a transporting rapture. I am susceptible to others’ good moods, easily catching the contagion of laughter, but I could never connect with Tom’s psychotic bliss. It was somehow inaccessible, not a joy occurring between people but one reliant on being apart from people.

  * * *

  —

  The delusional mind state of schizophrenia, argues psychologist Louis Sass, is so profoundly different from ordinary states of mind that it involves alterations in experience itself—that is to say, the experience of having experiences. It is a solipsistic mode, paradoxical, in which consciousness itself is transformed, collapsing the distinctions between one’s surroundings and oneself. In this state, a person may feel godlike or enslaved, all-controlling or entirely controlled, both at once. He constitutes existence and yet is surveilled by it.

  * * *

  —

  The drizzle, more like fog than rain. Pavement—its contours, its opacity, its gray. The birches’ powdery trunks. The alders bent over one another. Water seeping through his clothes. The pall of the sky.

  * * *

  —

  After Tom died, I read parts of his journals from the years leading up to the onset of his illness. I couldn’t get through them—his near-frantic distress about the way his life was going, how long he had struggled before full-blown psychosis set in. I could feel from the page his aching depression, a stinging kind of loneliness. Nothing he tried seemed to work out, except working out, which he did obsessively. He wanted to study but was failing at school. He wanted to attract girls but couldn’t connect with them. And he didn’t know why. He felt deeply that something was wrong, but he couldn’t figure out what it was. No wonder, then, that when psychosis came in with all its colors it felt like salvation.

  * * *

  —

  There had been a lover, back some time before. We didn’t know until long after, when Dad took a wilderness first aid course and she, the instructor, approached him. She had seen the last name on the roster and asked if he was related to Tom. They talked a little while. She said, “He broke my heart.” I later found among Tom’s journals a note from her with a beautiful drawing of some mountains. Her language was precise, lovely. Why he broke it off, why he never mentioned her—

  * * *

  —

  Among other things, one’s perception of time is heavily altered in psychosis. Time loses its continuity, becomes episodic, fragmented, gaping. Much is forgotten, or remembered only as a mood, an atmosphere. Sass noted that people with schizophrenia often speak of “the immobility of time, of the loss of past and future,” of difficulty recalling events in the correct order. Events are not processed, integrated, linked to one another in succession, but rather become, as other researchers noted, like “a series of stills.” One man with psychosis described it as “the infinite present.”

  * * *

  —

  Recently my mother asked me where I went to college. If I had ever lived in Europe. She sounded apologetic, a little embarrassed.

  * * *

  —

  I once met an oral historian who spoke of a “narrative crisis” occurring in people with mental illness, the result of drastic disruptions in the trajectories of their lives and in their recollections of events—a sense of loss of agency, loss of control over not only their lives but also their life stories. Loss of the capacity to shape a life into a story.

  * * *

  —

  By the time Tom was homeless, I had left Alaska for good, chasing down a vague but persistent notion of myself as a writer, following it from Bozeman to graduate school in New Hampshire, then to Santa Fe, where I found work at a magazine (and Will), before moving on to New York and finally Tucson. I only rarely got back to Anchorage, and never for long. In Tom’s eight years on the street, I would see him only four times on two visits home—twice for an hour or so and twice for just a few minutes.

  * * *

  —

  One of those times, I spotted him while riding in a friend’s car down on our neighborhood’s end of Northern Lights Boulevard, the main artery through our part of town, in the residential section that was lined with landscaping of grass and birch trees. We pulled over and I jumped out, but my friend’s presence disconcerted him and after only a few exchanges he said he had to go.

  * * *

  —

  Experience can be defined, as anthropologist Robert Desjarlais has suggested, as a reflective process of interpretation and assimilation of our encounters through time. If this is so, does psychosis create a vacuum of experience? What did Tom make of our encounters? Did he absorb them, consider them, remember them?

  * * *

  —

  Riding away, I fretted in silence, wondering where he was walking to. Maybe he would head all the way out past Mom’s old duplex to where a high barbed-wire-topped fence divided the houses from the boggy woods surrounding the airport. Maybe he would cut over into Ea
rthquake Park and go out toward the seaside bluffs on the Coastal Trail, as we all had long ago, on bikes or Rollerblades or running shoes. Maybe he would follow the shore and its wide, wild mudflats out to the overlook at Point Woronzof, where Cook Inlet rolled into Knik Arm and on a clear day you could see all the way to Denali.

  * * *

  —

  Where does experience go if it can’t proceed forward? For the homeless mentally ill, Desjarlais proposed, it tends to dissolve into an ongoing succession of shocks and surprises—distractions interspersed among months or years of an unmoored kind of stasis.

  * * *

  —

  I have a memory that keeps surfacing. In high school, on overcast nights in winter, the clouds and the snow would trap in the orange light of the streetlamps, making the sky glow a dense pinkish orange-brown. Evenings, desperate to get out of Dad’s house, I would sometimes take the Wagoneer and drive west on Northern Lights near where I would see Tom walking so many years later—out beyond the airport, past the runways, to where the city lights ended and the clouds faded to a deep blue-black, turned invisible. I would look up as I drove, watching for the moment I got out from under that toxic sky. Then I would park at a pullout and turn off the car lights and just sit alone in the darkness, listening to the radio.

  * * *

  —

  Was he beset? Was he thrown wide? Was psychosis a land of many promises? Did he know he was a prisoner there?

  A Tree Falling

  Tom’s slide into homelessness occurred in small, successive stages. In a way, I was never sure quite how it happened, though some of it is clear enough in retrospect. He had no job and did not get one. He ran out of money and was churning through our mother’s savings until Adrienne rescued the last of it by getting his name removed from the account. He had to sell his car, and eventually that money ran out too. In other words, he was a functioning adult until he was not. But we never knew exactly when or how he lost his apartment, when or how he came to crash on friends’ couches, when or how he began having run-ins with the cops. Nor did we mark the beginning of his habit of walking incessantly, roaming the streets and bike paths of west Anchorage as he would for the rest of his life. It was only much later that we learned he had been spending whole days driving around town, marking up a city map with notes and arrows, pursuing a delusion about women he believed had been kidnapped. Tom was a tree falling in the forest, and for a long time none of us were sure he had made a sound.

  His first arrest, in 2004, was for trespassing. He had been loitering at Ben Boeke, an ice arena near downtown, and when the management asked him to leave, he refused. He told none of us, however, so no one posted bail and he was sent to a minimum-security facility, Cordova Center, to await charges. Within days, he stepped outside to take out the trash and bolted. But a few weeks later he was arrested again. So followed a criminal charge: escape. The authorities by then understood that Tom was dealing with mental illness, and he was given the option of proceeding through the state’s Coordinated Resources Project (CRP) court, a mental-health-based alternative to the standard criminal court. But he declined the option and so spent a month in jail.

  Finally things got worse enough that it seemed they might start to get better. That December he somehow made his way fifty miles north to Wasilla, where, at a Blockbuster video store, he began to feel that he was “about to hear the sound of a woman scream.” I know this because he later described it to a doctor at Alaska Psychiatric Institute, the state-run hospital in Anchorage. It seems he was embroiled in his delusion, trying to rescue someone, sensing and following her almost-sounds. I know, too, that the sensation was upsetting—so much so that he changed it, in his mind, to the cry of an eagle. Then he started running, heading back toward Anchorage. Thirty miles south he found himself in Eagle River, cold and confused and unsure of how he had gotten there. He went into a Carrs grocery store to warm up and, afraid he would get kicked out, decided to pretend he worked there. The police picked him up after customers complained that he was following them around the store and talking to himself. He was perceived, the API report states, as “agitated and threatening.”

  He was taken first to Providence Hospital’s psychiatric ER, where they ran some tests and stabilized him on olanzapine, an antipsychotic and sedative. When tests for alcohol and street drugs came up negative, he was transferred to API. There he told the psychiatrist he controlled a TV channel that was being broadcast into space, that he needed neither sleep nor food due to internal energy that kept building itself up, that he spent his waking hours creating businesses in his mind, and that he was hearing voices. “The patient,” the doctor wrote, “indicates his break was very sudden, one day thinking clearly, and the next in a ‘dream.’ ”

  Tom surely knew, then, that his brain wasn’t functioning right. This must have been why he cooperated with the treatment offered during his thirty-day stay at API. It is unnerving now to consider how long ago he first grasped the kind of trouble he was in, and even more so to imagine his reaction to the news of his diagnosis: “schizophrenia, undifferentiated type.” How it must have surprised him, felt like a blow. The power of the name of the thing.

  * * *

  —

  With Tom’s new trespassing charge still pending, Dad convinced him to allow the case to proceed through the CRP court. At Tom’s sentencing, the state mandated that he complete one year of outpatient treatment for his schizophrenia in lieu of punishment—twice-weekly group therapy, regular meetings with a psychiatrist, and a daily dose of risperidone, a common antipsychotic medication. Tom went to live with Dad, and for the next year and a half, Dad assiduously took care of him, cooking his meals, making sure he got to his appointments, renting movies for them to watch together, and each morning handing him his antipsychotic pill. But Tom wasn’t convinced that he had schizophrenia. And although he had chosen this path, he seemed surprised by the medication mandate and felt that he had been forced, or tricked, into treatment. The idea made him flatly furious, so much so that he wrote letters to George W. Bush and Dick Cheney expressing his outrage and asking for release.

  The word anosognosia began to pepper our conversations—the medical term for lack of insight. Impairment or absence of insight affects about half of people with schizophrenia, rendering sufferers unaware that they are ill. Research suggests that this occurs because the illness damages specific structures and networks in the brain that are responsible for such recognition. We weren’t sure how much anosognosia was to blame for Tom’s resistance and how much to attribute to denial or simple anger at being forced into something, but I hoped it was mostly the latter, because I wasn’t sure there was anything we could do if it was the former.

  There were reasons to think Tom would ultimately agree to stay on the risperidone. He had never been a troublemaker, was not a combative or contrarian type. He had a solid and gentle personality, and I had rarely seen him be impulsive or aggressive or extreme. On the contrary, in our family he had usually played the part of the peacekeeper. But he could also be stubborn, and I knew he must be terrified of schizophrenia, as we all were, and that he surely felt humiliated about what had happened. I worried, too, about the distinct mental rigidity I had often seen in Mom—what the twentieth-century psychiatrist Karl Jaspers described as a “specific schizophrenic incorrigibility.” It is a hard quality to convey in words. In my experience, most people can’t believe a human is capable of such intransigence for no apparent reason until they see it for themselves.

  Dad soon discovered that although Tom took his risperidone each morning when prompted, he often cheeked his pills—pretended to swallow them while stashing them in the side of his mouth—and then spat them out and hid them in the potted plants or the folds of his knit cap. Dad would find them when he cleaned. But he couldn’t get Tom to stop. All he could do was keep pressing him to take the pills and to bring up any concerns with the psychiatrist, hopin
g that staying on the medication would eventually clear Tom’s mind enough that he could recognize its necessity.

  * * *

  —

  If you Google “how to convince someone with schizophrenia to get treatment,” you soon discover a vast network of distraught families grappling for answers. The first suggestions you’ll find, from places like the National Institutes of Health and WebMD, usually involve trying to break through resistance by being supportive and allaying fears. Experts counsel family members to avoid sounding threatening, focus on concern for the sufferer’s safety, and keep the discussion among people he trusts and feels close to. It requires partnering with the sufferer as well as influencing him without being controlling or intolerant. What isn’t said is that there is instinct and talent and skill involved in being convincing under these circumstances, and not everyone is good at it.