Against Medical Advice

by James Patterson; Hal Friedman

  We need the fire for more than warmth. It melts our drinking water, which freezes every night, and is also used for all our cooking. If we can’t make a fire, we can’t eat the cornmeal, soy, and millet they’ve given us in small bags.

  Today it takes me so long to get my boots on that there isn’t time to try to make my own fire. When I get enough ice off my boots to get into them, I realize that one of my gloves is missing, and I spend another precious few minutes looking for it. Finally, one of the counselors gives me another glove but says it will be the last. This is the third time I’ve lost a glove — in two days.

  I walk out into the woods to go to the bathroom, then come back and start to clean up my area.

  By the time I get to the common kettle, the rest of the guys are already finished eating and about to put out the fire. Nobody makes fun of me, but nobody offers to help either. That’s okay.

  I get some water, but there’s no breakfast for me this morning because I haven’t contributed to the effort. Back at my sleeping bag, I stuff some raw cornmeal into my mouth, then spit it out when it makes me gag.

  The lead counselor gathers us together and checks each person’s gear. By now everyone else is carrying their possessions in a backpack they’ve made themselves, shaping it with branches and holding it together with strips of rawhide. The backpack is crucial to survival because there’s no other way to carry the supplies that keep us going.

  It takes most people a day or two to make a backpack. I’ve been working on mine since I got here, and it’s still not holding together enough to carry much. Until I make it better, I’m hand-carrying some of my stuff, which partly explains why I keep losing certain items over and over, like my gloves.

  As the sun comes up from behind a nearby mountain, everyone assembles with their gear. One of the counselors tells us about the day’s activity plan.

  “We’re going on a little hike today, nothing too hard,” he announces. “Just a few miles, straight up the mountain.”

  He conveniently forgets to add, in knee-deep snow.

  Chapter 58

  DAY 12

  Since that first time we climbed up the mountain, we’ve made a big trip every single day. Now we’re going to stay in base camp for a while, so we’re digging ditches that will serve as latrines and will ensure that we don’t contaminate the area around us.

  The only tools we have are the jagged stones we’ve been able to pry out of the frozen ground. Using them to dig is backbreaking work, and it takes several hours to show very little in the way of results.

  We are also completing a clearing in the woods for a future campsite for another group. We’ve found a patch of land rising above the snow that doesn’t have much growing on it, and we have to figure out how to cut down what’s left.

  One of the tics I’ve feared the most has suddenly returned — the need to twist my ribs back until something hurts inside of me. I’ve been doing it all day and have either torn something in my chest again or pulled a muscle.

  I’m having trouble breathing, but I don’t want to use that as an excuse to stop working. I’m part of the group now, and they’ve accepted me, so I want to do my share.

  I’ve also had to make my rope belt tighter again; my pants have dropped to my ankles a few times because I’ve lost so much weight. I still miss at least one meal a day because I’m usually too frozen or tired to prepare it, and I’m burning calories from working and trying to stay warm in the freezing climate. I’m even burning calories because of my tics.

  Despite the extreme cold, the bottoms of my layered shirts get soaking wet from sweat. It’s no wonder I can feel myself getting thinner. I imagine what I would look like in a mirror. But of course there are no mirrors.

  For some reason the skin on the back of my hands is turning black. I don’t know if I’m just dirty or if that is an early sign of frostbite. I’ve lost so many gloves that they’ve stopped giving them to me sometimes. They think that this will make me learn to keep track of them better, but I’m just too disorganized. Or maybe too forgetful. It usually takes a lot of mistakes, and suffering a lot of consequences, before I learn any lesson.

  Chapter 59

  DAY 16

  We’re halfway up the mountain. Today, we’ve been walking for six hours with only short rests for water and a break for lunch that took longer than planned. I finally get to eat some cooked soy and cornmeal, which tastes like the best steak I’ve ever had. I still haven’t finished making my backpack strong enough, and carrying some of my supplies in my arms has been almost impossible, especially in the rougher terrain.

  Part of the trip is over bare rocks swept clean by a strong wind, and part is in waist-deep snow. My famous hopping tic is severe today, and when I hop in the deep snow, I often fall and there’s no one to pick me up. But at least the snow softens the blow.

  “We’re way behind schedule,” one of the counselors tells us halfway through the day. “If we get any slower, we won’t reach our camp and you won’t like where you have to sleep tonight. You won’t like it at all!”

  This is not the greatest threat in the world. We already don’t like where we sleep.

  But lying out in the open is dangerous at this higher altitude, where it’s much colder. Before dark we have to get to a level place much higher up that will serve as our campsite for the night and that will be safe from the big snowstorm that’s supposed to be coming.

  Another serious problem arises around four o’clock. The water we’re carrying has frozen solid, and because we’re so far behind, there’s no time to stop and thaw it out. A few mouthfuls of snow every now and then keep us from getting dehydrated.

  When we get to the campsite it’s almost dark, and by the time I’ve laid out my sleeping bag and set up my tarp, my hands are too frozen to work on a fire. As hungry as I am, I’m too tired to eat. I take my boots off and crawl into my sleeping bag, missing a second meal in one day.

  I have to sleep within view of two counselors who are watching from about fifty yards away. I pray they don’t ask me to get out of my sleeping bag, and they don’t. But in the morning they tell me that if I don’t get my act together and finish the hike, I’ll be in the wilderness for a long time.

  Or be kicked out.

  With all that I’m going through, I’m once again astonished to find myself thinking that this is the worst that can happen.

  Chapter 60

  DAY 20

  Miraculously, I’m at the top of the mountain as the sun is setting. I’m the last to arrive, but I got here.

  The backpack, which took me more than two weeks to assemble, isn’t anything to brag about, but it actually holds together pretty well, and all my supplies have made it with me. Tonight I will sleep in this frigid air with a smile on my face and food in my stomach.

  The beauty of the place is amazing, especially the light and the quiet peacefulness. I feel like I’m at the top of that tree again, the one I climbed back at my house years ago. Maybe that’s the way I have to find the answer — I need to be on my own like this, and to push hard in order to relax and be myself. Now I can spend hours looking at the patterns of the nighttime shadows in the snow, the way the white-coated treetops are lit up by the sun and the moon.

  As tired as I am, being here is exhilarating.

  I am living life on a very basic level. Its calming effect is stronger than any medicine I’ve ever taken.

  I haven’t wanted a drink . . . or my medicines . . . since the very first night. The air is so pure here that the idea of putting cigarette smoke into my lungs seems outrageously dumb and disgusting.

  The worst of my wrenching body movements have also lessened, either because I’ve been so distracted or because the exertion has tired me out. I deal only with the rituals of survival and the simple jobs that make it possible. I’m making it. I think of nothing else.

  In some ways, my past life seems like it was a hundred years ago and happened to a different person. When I do think of my friends, I feel s
orry for the smallness of their average days and wish they could experience what I have. I’ve been able to put aside threatening intrusive thoughts, like the idea that something has happened to my parents. I’m going on faith that it is just my mind trying to trap me in a bad loop again.

  As I’ve grown stronger, I’ve become thinner and thinner. My clothes are practically falling off me and the rope is tight around my waist to keep my pants on.

  My depression is lifting, too. I’m learning that I’m able to endure terrible hardship. This is an amazing feeling of power that I know will help me fight whatever comes at me after I leave. I’ve always believed I had inner strength, but I never thought it would be tested in such a profound and crucial way.

  There is no doubt that this has been the worst thing I’ve ever had to do, the worst place my parents could possibly have sent me to.

  And the best thing that has ever happened to me.

  Chapter 61

  DAY 23

  The pickup truck arrives at base camp just after noon.

  I will be its only passenger.

  I shake hands with each of the other kids and the counselors who have assembled to say good-bye, my brothers in the wilderness. There is a mutual respect and an unspoken jealousy felt by the other campers. Some of them will stay for a few more weeks. The one who has already been here for four months still has no idea when he’s leaving.

  But I’m going home.

  Before getting into the truck, I turn for a last look up at the snow-covered mountain that I climbed when my body kept trying to stop me. I’ve suffered more here physically than I ever thought possible.

  I’m leaving the mountain a different person than I was when I arrived. I’ve lost sixty pounds and am free of my addictions. I am stronger inside and out and have gotten past fears that none of the medicines I’ve taken could conquer.

  My tics haven’t left, but now they are more like nuisances, not overwhelming problems.

  Mainly, I feel as if I can do anything I set my mind to.

  The trip down the mountain takes a half hour on trails barely wide enough for our vehicle. Eventually the snowpack gets thin, and there are patches of dirt and bleached-out grass here and there.

  Soon after that, we get to a rough country dirt road that leads back to the main street and the modest two-story house that serves as the camp’s headquarters.

  There are a bunch of new teenagers on the front lawn, boys and girls about my age fixing up sleeping bags for their trip to the mountain. They look fresh and rosy cheeked and seem like nice kids, but I know they’re here because they’ve got problems. I wonder if they understand what lies ahead. I wonder if they’ll be able to make it.

  As I pass them, they stare at the kid with blackened hands who is back from weeks of cold and deprivation but is walking tall.

  I turn from them to go into the house, and I see my father standing outside, waiting for me. He sees me and waves. “Hey,” he calls. In the end, no matter what, he’s always there. My mind is flooded with a thousand thoughts, but mostly I am proud. A big grin spreads over my face as I reach out for him.

  He holds me and grabs my shoulder tightly. “You did it.”

  When we hug, I can feel his body shaking with emotion, almost as much as mine.

  Leap of Faith

  Chapter 62

  I SIT ACROSS THE TABLE from an absolutely beautiful teenage girl who breaks my heart every time I look at her. I’m at the adolescent OCD ward of the world-famous Wellington Neurological Center, a thousand miles from where my father picked me up at the bottom of the mountain.

  Six of us patients are in the cafeteria to eat lunch, but what Noelle is doing is like nothing I’ve ever seen in my life. It kills me just to watch.

  Noelle is a teenager from somewhere in Canada. She has long black silken hair and flashing eyes with dark circles under them that must be there because she doesn’t sleep much. Her parents have sent her all over the world for different kinds of treatments, and none of them has helped. She’s been at the clinic for a long time, and from what I can see, she shows no signs of getting out.

  I try not to stare as she picks up a small portion of food from her plate, then stops the movement of her fork after lifting it only a few inches. She holds the fork there for as long as it takes her to complete some unknown counting ritual or some need for symmetry.

  After about twenty seconds, she gathers herself for another move. A second lurch of her right arm brings the fork higher, but she stops it before it gets to her mouth. Something else must be completed in her mind before she can go any farther.

  Finally, when she is able to get the food into her mouth, she chews and swallows in a certain regulated way. It’s exhausting just to watch her. And so damn sad that I can barely stand it.

  Noelle has multiple obsessive-compulsive rituals so complex that it can take her more than a minute to eat a single bite of food. Getting through a simple meal takes forever, and she usually doesn’t finish because time runs out.

  By now the rest of us have gotten used to eating with her, but today’s lunch is so protracted that we’ll miss our therapy sessions if we don’t leave. So finally the aide who has come with us gently urges her to stop.

  Noelle does what she’s told with a gracious smile, and slowly she lowers the fork to her plate. My heart breaks for her again. She must be incredibly embarrassed by what she has to do, but she doesn’t show it. I’ll never get used to watching her go through so much hell just to feed herself.

  Despite her sickness, Noelle is amazingly smart, maybe genius level. I’ve been told that she can speak four languages, but she’s so deeply afflicted with her ritual disorders that her intelligence isn’t any help to her right now. These days she usually just sits there, her eyes wide open in a dazed, sometimes frightened look, and seems almost paralyzed. She might say a few words, but very slowly and as if she’s gasping them.

  Most of the time she has a gentle way about her and an angelic smile. But yesterday that changed abruptly.

  A few of us were in the common room using headphones to relax with tapes we’d made. All of a sudden we could hear a horrible screaming, which was getting louder as it got closer. Noelle was running down the hall. At first I thought she was running away from someone, but she was heading right for us. Her screaming seemed to be coming straight from her soul, as if all the pain in her entire life could no longer be contained and burst loose in pure fury. She was so out of control I’m not even sure she knew what she was doing, and if it hadn’t been for one of the strong nurses who caught hold of her at the last minute, I swear she would have gone after us. It reminded me of my own rage attacks.

  The saddest thing about Noelle is so painful that I try not to think about it too much. Sometimes I hear her screaming in the middle of the night. I lie there thinking it’s that she realizes, in the endless darkness of her mind, she’s alone and lost in a place where no one can reach her, and she is so unbelievably frightened to be who she is.

  Chapter 63

  FOR THE FIRST TIME in my life, I’m being consistently sensitive to other people and not mostly concerned with myself.

  About a week into my stay at the ward, a tall, quiet guy named William appears in the common area without a shirt on. The fact that he’s partly dressed is a huge breakthrough. For many years before he came here, William hadn’t been able to wear any clothing. Just having fabric touch his skin gave him an unbearable feeling. I don’t know how he got through life to this point, but they’ve been working with him here, with some obvious success.

  Even though the rest of us are in our teens, William appears to be in his thirties and is easily the oldest patient around. He’s really intelligent, and his long wild hair makes him look like a mad scientist or some kind of wizard. It seems that most of the people I meet with Tourette’s or OCD are unusually smart. Maybe that’s just nature’s way of compensating, but sometimes I think it’s not such a good thing to be so smart and think so much about everything. To be
inside your mind so much. Maybe it’s too easy to get trapped there — like some of us do.

  Except on rare occasions, William keeps to himself and stays in his room, which is why I’m surprised to see him in the common area. His obsessions and compulsions are very different from Noelle’s, but, like her, he has an awful lot of them. Two of his problems are in direct conflict with each other. He has an extreme phobia of germs. His food has to come from sealed containers, and no one can touch it or be around him when he eats, which is why he never eats with the group. At the same time, another fear makes him deathly afraid to take showers.

  William also has a fear of shaving, so his beard is long and scraggly. And he’s afraid to lie down on a bed or sit in a chair, so I don’t know how he sleeps. Every time I see him, he’s standing. He’s been standing for so long that his ankles and legs have become terribly swollen.

  Germs aren’t the only small things that terrify him. One time when he ventured out of his room, he ended up near a girl who was working on an arts-and-crafts project, and she accidentally spilled a bag of glitter. William went totally crazy when he saw it, and he went running off down the hall. I don’t know what would have happened if some glitter had actually gotten on him. It’s so hard to understand how someone as smart as William can be so irrational about something as harmless as glitter, but that’s OCD for you.

  “Hey, man,” I say as he passes by. He keeps his distance, not because he’s antisocial but because he’s afraid of any kind of physical contact. He can’t touch or be near anyone, even his doctors, so you don’t shake hands with William. I can’t imagine he’s ever high-fived anybody in his entire life. Someone coming up to hug him would probably be his living hell. I wonder how that must have made his parents feel . . . or William himself . . . having to live a life without any physical affection, ever.