Habit. Ritual. The beauty of repetition. The music and I have a thing that goes together. There’s a secret to this even if I’m not entirely in on it. I’m chasing it. The 11s are in play. I’m placating them with every burn. Meanwhile, pain and I, we have a date. I am beautiful, clear, and uncomplicated inside the pain. If it didn’t matter, if nobody were around to see or know, would I cover the right side of my body from ear to toe with marks, never stopping? I think I would.
As I draw near the next though the one finished a moment before still radiates heat, every location feels like the right and only choice—as with choosing a cigarette from a pack, it takes time to decide where to hit next. The spot, once chosen, isn’t ever let off or forgotten. I connect the dots, thinking about where I will go all day—or I fight off the plan for days, the chosen spot begging to be had, hard as I try to ignore the inevitable.
I stayed on the inside of my right arm to begin; it was easier to hide the Band-Aids. The right–left split exists within the economy of my own internal logic, in which the devaluation of the right side’s alienated flesh begs burning while the sanctity of the left side’s innocence is never subject to damage. It’s enough.
All I lack is remorse. I’ve never hated myself after creating a new hole in my skin—quite the opposite. I revel in my work. Admire it. Observe the progress of the developing scar as it morphs into what will be a permanent feature of my body. I suppose the failure to recognize that it matters that I do this—or not—is no small part of the pathology. Caring would entail balancing the damage I’ve been doing to my appearance with the immensity of the pleasure the act gives me. Maybe it’s all those tasty opioids flooding my brain in response to the pain? No, my failure to stop, my ultimate inability to cease, exceeds the physical.
I’m actually scared by the power of the compulsion. I have an inkling of how a serial killer feels, the pressure to do the deed building until there’s no stopping it because the momentum of inevitability beats down the part of the mind that doesn’t want to repeat the offense.
“The pressure builds until I burn myself. It’s ‘a forgiveness,’ ‘a numbness.’ Sometimes I can do it and it doesn’t hurt and I can do it and do it,” I told Dr. Kohl.
CHAPTER 11
Hide Better!
It was the vacation that did it. Isn’t that always the way? August. In the weeks before Labor Day psychiatrists and other professionals who set their own schedules take their precious families to breathe the cool air, eat buttery lobster, and stain their teeth with wild blueberries in company with the rocky ocean pleasures of Kennebunkport, Camden, Mount Desert, Bar Harbor, Blue Harbor, Monhegan, or the sandy expanses of Goose Rocks. If not this, they remove for weeks to the fashionable pleasures of glittering Martha’s Vineyard, Nantucket, Hyannis, Newport, Narragansett, Montauk, East Hampton, or Southampton. August: the dreaded annual shrink drought.
That year it wasn’t August; it was July. Dr. Kohl, against precedent, went on vacation a month earlier than every other shrink in the Western Hemisphere.
“It feels like it cheats me out of any degree of sanity,” I told him two sessions before he left. “It has to be funny to me. What will I do?”
“Kill yourself?” he asked.
“I am considering it carefully, or doing something else first. If you were staying it would be manageable. I kept burning myself this morning. It’s like a chink in my brain, a slamming door. Something gives in. It didn’t work today. I’ve created this incredible dependence and now it’s almost killing me when it’s going away … I am kind of daring you.”
“You’re going to kill yourself?”
“If I try I don’t want to die….” All the talk was bringing the fear closer. “You’re daring me! I know you’re going. Why is this different?”
“Who said it was?” he asked.
“Now I’m pissed.”
“We all know what you can do to yourself. I am going to leave. I am going to Alaska no matter what.” It sounded as if he was reassuring himself more than he was assuring me.
While he’s with his family in Alaska he leaves me in the care of his colleague.
The notes she took when Dr. Kohl briefed her before leaving for vacation on July 8 were not optimistic. She hadn’t even met me but, according to Dr. Kohl, she might be confronted with handling a psychiatric emergency. Her notes from Dr. Kohl’s debriefing read:
Parents abandoned. Now feeling this in relation Dr. Kohl vacation. Wealthy. Self burning R arm. Limits set with A.K. Not expecting competence—key. Can she stay alive: this would be key. May need to hospitalize.
I can’t say he didn’t prepare her. She was a blank to me other than the curious fact of her gender. I was nervous about meeting her.
We spent our session talking about what it meant for me to come to her office and how being there reminded me of Dr. Kohl. This made “missing him harder,” I confessed.
“I have a tendency not to let anyone have a concept of my needs. But,” I added, “you know my needs, so …” I didn’t have to start from zero or pretend to be something I wasn’t. Not only would this have been a waste of time; I didn’t have the energy.
She bullet-pointed the basics of what I told her about burning and vomiting. “Seems to occur when I’m feeling ‘usual’ not at times of dissociation. Both seem like fuck-yous, but most common when feel most isolated,” she wrote.
“The pain clicks me into another mode,” I said.
“WAITING for Dr. Kohl to return,” she wrote.
The next day she asked to see the burns. Nobody but Dr. Kohl had ever seen them. Scattered jumbo Band-Aids bunched in patches with generic nonstick pads covered the damage. I peeled them away to expose the flesh. Afterward, she drew a mini-illustration of my arm in her notes with a dotted line indicating the burned area.
“Looked at arm,” she wrote. “Burns appear quite serious and now complicated by infection. Large area of scar, desquamated, red, swollen, with pus in places. Made arrangements for evaluation at Lakewood Health Center, Dr. Ahlers.”
True, the loosely clustered matrix of mostly overlapping burns was the tiniest bit infected. But it would clear up soon enough. I was pleased because she took me seriously.
I suspect there are few cases a doctor likes less than a patient with a self-inflicted wound. In my experience, it fundamentally pisses doctors off. They work all day to heal and then some nut arrives on their examination table having hurt his or her body on purpose.
The doctor I saw that day, Dr. Gordon Ahlers, acted as if I’d set out to purposefully steal time and expertise from his other, more deserving patients. Cigarette burns are characteristic of child abuse. Maybe the hostility I perceived was associated with the treatment of the real burn victims, who make up roughly 10 percent of child abuse cases. The children are usually no more than ten years old but most of them are under the age of two. Doctors are trained to identify non-accidental burns caused by hot objects and to distinguish them from hot-liquid burns. The evidence of liquid is in the “sparing” or spots where the position of the body naturally protects the skin. Hot-object injuries, once identified as such, must be assessed as accidental or intentional. Minor burns from a hot object can, of course, occur if a child accidentally touches a hot iron, pot, sheet pan, or oven rack. Doctors are trained to recognize such accidental burns by their shallow irregularity. Most suspicious are perfectly circular blisters or scars on a child’s back or buttocks. Such confined damage to the skin can’t be caused by accidentally walking into a lit cigarette.
Silent for the most part, after a few minutes Dr. Ahlers shook his head and looked away.
He asked if I’d burned myself with cigarettes.
I wanted to say, “Yes, genius,” but I kept my silence. He was about to debride the extensive open wound. I nodded, barely. He and his nurse then proceeded to wash the wound and brush away the dead and infected tissue on my inner forearm.
If treating self-inflicted injuries once makes a doctor angry, watching them expa
nd enrages him. I covered a good bit of ground in the ten days that Dr. Kohl was on vacation. The repetition of the debriding when Dr. Kohl sent me back for more after he returned from vacation was more awful than the first round.
But before Dr. Kohl returned I had another appointment to fill while he enjoyed the beauty of Denali or trout fishing on the Kenai River with his wife and sons.
“It’s a relief not to have to cover the burns,” I told her at my next appointment. My new “cast” fully concealed the damage but it was difficult to miss. I asked about the picture of a child on her desk. She told me it was her daughter. We discussed mothers, because mine had called to tell me she was in Connecticut at her mother’s house for five days and would I like to come down for the weekend? It was of so little significance to see me that she’d already arrived on the East Coast from California when she called to invite me.
I expressed my hesitation about going to see her.
“You need to stop having expectations that all of sudden they’ll be perfect parents,” she said.
Actually, far from expecting perfection, I expected almost nothing and readied myself to freeze my emotions. My mother didn’t know I was in therapy; really, she doesn’t know anything about my life. Asking questions is not a thing she does much of.
“I’m in a quandary,” I told her. “I’d like to fill the weekend but it horrifies me to lie to them [my mother and grandmother], but having them accept the lie is all the more distancing.” At this she made sympathetic noises and gestures.
“If I go I’ll just end up taking care of her,” I said.
I did go and when my mother noticed, despite my long sleeves, evidence of the thick gauze that encased my arm from just above my elbow to my wrist—or my grandmother noticed and asked—I lied.
“Poison ivy,” I said. I spent the weekend concealing my unhappiness in the interest of everyone’s comfort.
Driving home, I couldn’t stop thinking how the feminine clothing, hair, and well-tended nails of Dr. Kohl’s colleague contrasted with my mother’s short-cropped hair, bitten cuticles, and personality—not to mention confidence—requiring the lubrication of liquor to operate at all. This substitute shrink took charge of my well-being by sending me to Dr. Ahlers. My mother never told me to do anything, advised, listened, or expressed much sympathy. I’m not sure she knows how. I suspect she exists deep inside her own anxiety, continually working to quell her own emptiness and fear.
I say this because I observed as a child how my mother dreaded being alone in the house, day or night. Maybe that was why she spent so much time trail-riding on her bay quarter horse Stonecrop when she wasn’t clocking in hours at the Jerome Bar, my sister and I asleep on the sticky floor under the table blanketed by cigarette smoke and the mixed perfume of booze and beer. Resigned, we curled our little bodies around one another, entwined in the table’s metal pedestal like French lapdogs.
My mom liked her guns as much as our neighbor Hunter S. Thompson loved being famous for his. I doubt he slept with one under his pillow as my mom did. Guns have always scared me; a loaded gun in the house invites destruction.
When I was growing up, we had a locked gun cabinet for half a dozen hunting rifles, but a gun in there did my mother no good if her imaginary bogeyman sashayed his way into her bedroom at night, so she kept her guns close. The serial killer Ted Bundy was making news in the Northwest—I knew I’d find a loaded pistol in the glove compartment of her truck and another in the drawer of her bedside table amid shiny green packets of slender, sugar-dusted wafers of Wrigley’s Spearmint Gum, its bullets rattling up against the ceramic Carmex canister. The heavy cold metal barrel exuded the unmistakable scent of a freshly minted coin as my sister gingerly lifted it out to show off to a friend.
One of my mother’s imperfectly spelled but chatty postcards, sent from France while my aunt Sid stayed with us, mailed to “N. and C. LeFavour, P.O. Box 104, Aspen, CO 81611 U.S.A.” on September 18, 1973, from Hostellerie La Demi-Lune, Proprietor Madame Vve. Teuschel, Sundhouse, Bas-Rhin, France, read:
Hello! Cree, Nicole and Sid, First day of pedaling very sore fanny. This is a favorite spot and Madam recognized us. We went 25 miles today. Last night had a very piggy meal in Strassbourg. Thrush Paté, Trout ala Creme, Quail, Cheese, Desert, Rasberry Liqueur. Sunday tomorrow + a 3 Star. A friend from Aspen met us in Strassbourg and another very nice fellow joined the biking for a bit. We miss our bunnies.
xxxooo Mama + Papa.
Then, written up the side of the postcard:
Sid, take down pistol (loaded) from top of dresser.
Hide Better.
This was mailed two days before my eighth birthday. I wonder where my aunt hid it.
∗ ∗ ∗
While my mother never went so far as to make sure I brushed my teeth, Dr. Kohl’s colleague didn’t stop tending me by sending me to the doctor. She finished her three-session record with a note to herself: “Self burning needs direct address with Dr. Kohl. Will discuss with him Wed. July 24 (wished for earlier time).”
I sported that soft white gauze cast, courtesy of Dr. Ahlers, some form of which would remain with me for months, along with a prescription for the broad-spectrum oral antibiotic Keflex. The 3rd-degree burns I’ve been making take about six weeks to heal; infection slows the healing process. All I had to do was wait for Dr. Kohl’s return.
With the exception of the weekend I spent at my grandmother’s house in Connecticut, I burned myself daily while Dr. Kohl was on vacation. By turning the talionic impulse inside out, I punished Dr. Kohl for activating my desire for him; leaving for Alaska only underlined his priorities as far as I was concerned. A shrink might call this self-punishment introjection. Never mind “an eye for an eye”; I prefer the full Code of Hammurabi articulated in this translation of Exodus 21: 23–25: “Life for life, eye for eye, tooth for tooth, hand for hand, foot for foot, burn for burn, wound for wound, stripe for stripe.”
CHAPTER 12
Appetite for Destruction
I was nervous when I arrived at the post-vacation appointment with Dr. Kohl on July 24. He was about to see my professionally bandaged arm. I’d betrayed him by showing others the burns; they were our secret. But I didn’t notice any surprise or discomfort. Rather, he told me he had spoken with Dr. Ahlers about the burns and infection.
The denouement of that heady day was, after more than a year of sitting so frequently, so intimately together in that room, I felt his skin on my skin.
“Changed her dressings for her,” he wrote at the bottom of the page. Did he. Patiently he helped me unwrap the bandages while I pulled at the gauze with brusque, nonchalant efficiency to cover my excitement. He cleaned and sterilized the wounds, and laid down the Tefla nonstick pads, overlapping them to cover the open wounds on the inside of my arm that extended by then from mid-biceps to halfway down my forearm. He then took a roll of gauze to secure it all in place, just as Dr. Ahlers and his nurse had done. As I said, it had all the trappings of a cast without the plaster. I don’t remember where the gauze, antiseptic, tape, and pads came from. In my memory they just appeared.
I don’t remember that detail, because the nimble feel of his fingers overwhelmed me; for so long he’d been over there, eyes on paper, pen in hand forming letters out of strokes of black ink to note, graph, number, and line me up. The wreckage of open wounds on my arm lured him in so close I could touch the wrinkles around his eyes, put my finger on his lip, run my hand over his nearly invisible stubble. I didn’t dare do any of this. As he bandaged me I sat up straight and pretended not to notice the collapsed distance while his proximity dried my mouth and tightened my clenched left fist.
“Visibly shaking as I bandaged her,” he wrote.
Dr. Kohl changed after he returned from paradise to three dozen or so new 2nd- and 3rd-degree cigarette burns. Perhaps the “direct address of the situation” with his colleague altered his engagement ever so subtly.
The limit he had set before leaving for vacation, that I mus
t stop burning by August 31, became an ultimatum. I would cease to be his patient or be hospitalized if it happened again after that date. The idea of being hospitalized if I didn’t stop burning myself scared the shit out of me. It also intrigued me.
“The burning is an angry message,” he said to me. And then he wrote, “Time to fight.”
“I’m scared,” I told him at the next appointment.
“About?”
“Talking about all this stuff. I don’t understand it.”
“The burning relieves pressure to work on things,” he said.
In answer to this I said, “Yesterday I burned and vomited and slept really well.”
At the end of the session he wrote a note to himself: “I can’t fight with her over life or death.”
On Monday, August 5, I told him, “I threw up and burned myself again on Sunday.” We talked about Aspen, childhood, parents, and being alone. Nothing new. I left my session and went to work at Community Action, where I spent the morning on the ramp at the back of the Commodity Credit Corporation’s truck parked in front of a Grange Hall, handing down giant blocks of surplus government cheese from the Temporary Emergency Food Assistance Program.
Distracted, thinking about and smelling the earthy, sour cheese, I wondered what the people who came for their portion did with it. The cheese was expendable because the government paid farmers to keep the milk off the market. Rather than dumping the milk they decided to use it to help solve the problem of hunger and poverty in America. Brilliant!
As I passed out the cheese, block upon block, I felt my mind churning over the course of the morning, forming a litany of dishes that ran restless and slightly unhinged up and down my brain: Macaroni and Cheese. Cheese Pizza. Cheese Sandwich. Cheese Cubes. Cheese Balls. Cheese Log. Cheese and Olive Loaf. Cheese and Crackers. Cheese Crackers. Cheese Dip. Ham and Cheese Sandwich. Cheese Panini. Cheese Fries. Cheese Casserole. Cheese Grits. Cheese Danish. Cheese Sticks. Cheese Fondue. Cheese Soufflé. Cheese Lasagna. Cheese Melt. Cheese Nachos. Cheese Dog. Chili-Cheese Dog. Cheeseburger. Cheesesteak. Cheese Quesadilla. Cheese Taco. Egg, Bacon, and Cheese Sandwich. Cheese Soup. Cheese Cauliflower. Cheese Toast. Cheese Scone. Cheese Biscuit. Apple and Cheese Pie. Cheese Quiche. Cheese Puffs. Cheesecake? The sickening cheese and the stupidity of the system created greater and greater friction in my brain. I badly needed a shower.
Lights On, Rats Out Page 7
