The Flock

by Joan Frances Casey

  I thought that he might be able to get through to Joan Frances in a way that I could not. Dr. Tate was a new person, whom Joan Frances had chosen to see; she interpreted any help taken from me as disloyalty to her mother.

  I suggested that Renee and Jo might be very helpful—Renee because of her broad understanding of the group, and Jo because she had by now read everything published on the disorder. I stressed that the group wanted to help Joan Frances through this crisis and that they would all provide what help they could.

  —

  DR. TATE WAS NOT available for another five days, and I worked to keep Joan Frances as comfortable as possible, but a crisis was brewing.

  Bethany sat me down one evening. “Renee,” she said, “I have to tell you that Joan Frances is driving me crazy. She won’t leave me alone.”

  “Sorry about that,” I said to Bethany. “Joan Frances isn’t much fun for anyone right now. I’ll try to keep her out of your way.” I didn’t need to alienate my roommate on top of everything else.

  Jo learned about Joan Frances’s upcoming appointment with a psychiatrist from my notes on the group calendar. At first Jo objected: a strange psychiatrist’s office was the last place she wanted to find herself. But she talked to Lynn and wrote in her journal about the differences between her own new feelings of self-worth and Joan Frances’s perceived worthlessness. Jo wrote:

  I’ve started thinking about how close I’ve come to committing suicide. The first time I can remember feeling suicidal, I was ten years old. I sat on my bedroom window ledge, wondering if it would hurt very much if I jumped. With my new sense of well-being, I know that I’ll never feel suicidal again. But I think that now I understand how suicides happen.

  The possibility of death came closer each time I felt suicidal. The most difficult part of any suicide is the actual decision to die. Once that struggle is completed, once that decision is made, the act that brings about death is anticlimactic.

  A lot of people probably misunderstand what it’s like to feel suicidal. They think that repeated threats mean that the suicide is less likely to happen. I think that the reverse is true.

  If making the decision to die is the most difficult part of suicide, then that decision-making becomes easier with practice. The decision is tremendously hard the first time, a struggle the second and third. But then there comes a time when the thought that death would be better is almost simultaneous with the fixing on a method. Reaching for pills, a razor blade, the window becomes reflexive.

  Most suicides are probably the result of years of practice, so that the thought and action become blended into one. I suspect that the final act happens quickly, with little fear.

  Now I’m grateful that Lynn always took my suicidal feelings seriously. I wonder how many suicides are successful because the potential helper thinks that the suicidal person is calling “wolf,” when in fact every threat pulls the victim closer to the actual event.

  I was uneasy about letting a doctor so near to the Harvard community know that I was multiple, but I felt bolstered by the talk Lynn had had with Dr. Tate.

  The personalities agreed that this was to be, as much as possible, Joan Frances’s appointment. She was the one in crisis.

  Joan Frances spent forty-five minutes telling Dr. Tate about her wonderful mother and how much she wanted to please Nancy. She explained that she had come to the doctor because she felt terribly depressed and despaired of ever being what her mother wanted.

  When Dr. Tate said that he had had a call from Lynn Wilson, Joan Frances cringed. “Lynn is all wrong,” she said. “I’m not a multiple. My mother says so. She should know.” Joan Frances told the doctor that, if she couldn’t figure out how to be the daughter her mother wanted, she might as well die.

  I pushed Joan Frances aside a few minutes before the end of the session. I introduced myself to Dr. Tate and told him that I was available and willing to do what I could to help.

  “Joan Frances really needs someone to talk to right now,” I said. “She doesn’t think life is worth living if she can’t please her mother. Everyone inside, Joan Frances included, hopes that talking with you will make her feel less dependent on her mother’s approval.” Dr. Tate didn’t comment on my analysis, but said that he wanted to see me again in two weeks.

  —

  THE WEEKS BETWEEN THE appointments were hard on the Flock. Joan Frances’s depression was dragging everyone down. I felt continually on guard, watching so that Joan Frances did nothing physically harmful.

  I took the time at the beginning of the next appointment with Dr. Tate, hoping that I could give the doctor enough information so that he could really start helping Joan Frances.

  “Joan Frances has got to talk this through,” I said to Dr. Tate, and then set out to answer his many questions about the Flock’s past. When, after an abbreviated history and explanation of the etiology of the disorder, Dr. Tate focused on how poorly I had handled my relationships with Keith and Steve, I sensed I was wasting precious time. The problem right now was Joan Frances’s depression, not how I handled relationships with men. I slipped inside and pushed Joan Frances out.

  “What can I do to help you?” Dr. Tate was asking as Joan Frances became aware of her surroundings. She brushed aside the confusion of how she had gotten to Dr. Tate’s office and answered, “I want to become a better person; I want to stop feeling that death is the only answer.”

  Dr. Tate cut her off. “Can you put me in touch with Renee?” he asked. Joan Frances looked at the doctor helplessly, but answered firmly, “I am not a multiple.”

  “Nevertheless,” the psychiatrist persisted, “can you put me in touch with Renee?”

  Tears ran down Joan Frances’s face. “Please, can’t you help me?” she asked, and then felt overwhelmed. How did she make people think she was multiple when she wasn’t? Why wouldn’t this doctor help her? Why didn’t the doctor care how bad she was feeling?

  Then Dr. Tate found himself with a personality he hadn’t met.

  Jo looked around, taking in the doctor’s office. She quickly figured out where she must be and smiled hesitantly at the psychiatrist. “Lynn said that I don’t have to cover things up for you,” Jo said. “You are Dr. Tate, aren’t you?”

  “Yes,” he said, “and who are you?”

  Jo identified herself.

  “Can you put me in touch with Renee?” the doctor asked.

  “No, I can’t,” Jo explained slowly, ready to help the doctor understand. “I’m largely amnestic and I seem not to have the ability to control which personality is out, but I do have a lot of theoretical knowledge about MPD.” Jo told Dr. Tate how grateful she was that Joan Frances finally had someone to talk to.

  “Your time is up,” Dr. Tate said.

  “Am I to see you again?” Jo asked. “Definitely,” responded the doctor. “How about March 1?” Jo shifted uneasily; she never knew her schedule without looking to see what the other personalities had penciled in. I took over and agreed on the date and time for our next appointment.

  “You know, Renee, talking about your relationships with men made you uncomfortable,” Dr. Tate observed.

  “Well, yes, I suppose that’s true,” I replied politely.

  “And that’s why you lost time!” he ended triumphantly.

  “What should I do about Joan Frances’s depression?” I asked.

  “We’ll talk about that next time,” the doctor promised.

  I left Dr. Tate’s office very worried. The doctor didn’t seem to understand that Joan Frances was in crisis and getting worse. March 1 was yet another two weeks away, and I was struggling day by day to keep Joan Frances from acting on her self-destructive impulse.

  —

  TWO DAYS LATER, I called Dr. Tate. “I’m really worried about Joan Frances,” I said. “I don’t think she can wait another couple of weeks.”

  “What do you want me to do?” Dr. Tate asked. I thought that was obvious. “I would like you to see Joan Frances before March 1,”
I said.

  The doctor said that wasn’t possible; he was all booked up. “I understand that you’re busy,” I said, “and I’m open to other suggestions. I’ve got to find a way to help Joan Frances feel better about herself. I just don’t think I can get through two more weeks of monitoring her actions and keeping the rest of us going. When I tell you how serious Joan Frances’s need is, I don’t feel you are hearing me.”

  Dr. Tate replied that it was difficult to do an evaluation-intake on a multiple.

  Yes, I could appreciate that, but…Suddenly I knew there was nothing left to say. I’d have to find a way to struggle through on my own.

  That night, I removed a razor blade from Joan Frances’s hand and tried to keep busy enough to remain the personality in control. The next day, Saturday, I worked in the library from opening to closing—anything to avoid the dorm room, where Joan Frances might surface. By Sunday night, I was exhausted and Joan Frances had found another razor blade.

  She scratched her wrist and watched drops of blood form on the cut and run down her arm. “I’m worthless, an utter waste,” she said. “My mother can’t stand me no matter what I do.” She ran the blade across her skin again. “Even that Dr. Tate didn’t care how bad I felt. All he wanted to do was tell me that I had multiple personalities.” This time, she stabbed at her wrist with the blade’s sharp point. “Why doesn’t anyone care how I feel?” The blood and tears welled up simultaneously. “I’m not worth it, that’s why.”

  I pushed Joan Frances aside, wiped the blood from my wrist, and tried to control my trembling hands. I felt so alone. There was no sense in calling Lynn. She couldn’t do anything from such a distance, and Joan Frances wouldn’t talk to Lynn anyway. But I knew she needed to talk with someone.

  I called Harvard Health Service and told the nurse on call that I had a friend who was feeling suicidal. I hoped they would have a hotline number my friend could call. “Tell your friend to come into the emergency room,” the nurse said. “She can talk to a nurse, the internist, or we even have a psychiatrist on call. There are professionals here who can help.”

  I thanked the nurse and tried to maintain control by doing some reading for a course. At 11:00 p.m., I found Joan Frances again scratching her wrist. I had to get out of the dorm room.

  I walked through the night, fighting to stay in control and trying to decide how best to handle the situation. I didn’t want to die; Jo didn’t want to die; not even Joan Frances really wanted to die. But her depression and need were overwhelming the system.

  No other personality could reach Joan Frances to let her know that we were there and caring for her. We could only try to control her actions.

  “This is really absurd,” I thought. The situation seemed incredibly simple to me—Joan Frances felt bad because she couldn’t please her mother and she wanted to talk to somebody about that. Being a multiple had little to do with her immediate crisis.

  Even now Joan Frances was reaching out. The scratches on my wrist were far from life-threatening. She was punishing herself, not trying to die. She was asking, as loudly as she could, if there weren’t someone willing to pay attention to her and her pain. “I’m trying, sweetie,” I murmured.

  After I noticed the avidity with which Joan Frances was watching the cars speeding by her, I steered her toward the emergency-room entrance at the health service. Rather than have to explain we were multiple—Joan Frances was the problem, not multiple selves—I allowed Joan Frances fully into consciousness as I pushed the body through the emergency-room door.

  Joan Frances blinked uncertainly in the bright lights and at her own disorientation. She hadn’t made the decision to come here. Or had she? A nurse looked at her and led her quickly into a back room. “What’s wrong with you?” the nurse asked. “Have you been drinking? What drugs have you taken?”

  Joan Frances bridled at the questions. She didn’t drink except for an occasional glass of wine with her mother, and she would never use illegal drugs. But that all seemed like too much effort to say. The nurse wouldn’t understand any more than anyone else had. Finally, Joan Frances told the nurse that she had cut herself and pushed up her sleeve to expose her bleeding wrist.

  “I don’t really want to die,” Joan Frances began. “I just feel so bad and nobody will listen….”

  The nurse cut her off. “Do you know Dr. Tate?” she asked.

  “Yes,” Joan Frances said, startled to hear the doctor’s name.

  “Dr. Tate is the psychiatrist on call tonight,” the nurse said, and left the room.

  I was as startled as Joan Frances by this new bit of information, and inwardly mused that coming in may not have been such a great idea. I had no idea that he moonlighted with the service. If Dr. Tate had not heard Joan Frances’s need during our office visits, I didn’t hold out much hope that he’d understand now. But I reminded myself that Dr. Tate didn’t have to get involved in this. The emergency room was filled with nurses. There was an internist on duty. Any of them could spend a little time talking with Joan Frances and helping her feel less depressed.

  The internist came into the examining room and handed the phone to Joan Frances. Dr. Tate was on the other end.

  Dr. Tate angrily demanded to know why Joan Frances had cut her wrist. “What happened tonight to make you do this? Did you know I was the psychiatrist on call tonight?”

  “No,” Joan Frances replied. There was no special reason she had acted this way tonight. The depression was just getting worse, and no one was listening.

  “I can’t decide if you belong upstairs in the infirmary or if I should put you on a psychiatric ward,” Dr. Tate said.

  Joan Frances hung up the phone, shrugged into her jacket, and walked out of the examining room toward the entrance hall. The doctor and nurse stood in front of her, blocking her way to the exit.

  Trapped. The scene bent, twisted. The image of walls, walls everywhere, trapping and releasing, shook me from my own shock. Josie, I realized, was very close to surfacing. “No, Josie, not now,” I pleaded silently. “Let us handle it. Stay inside.”

  Joan Frances calmly told the doctor and nurse that she was fine now and just wanted to go back to the dorm.

  I was furious. I knew Lynn had told Dr. Tate how terrified we all were of commitment. All we wanted now, as we had wanted for the past month, was for someone to talk with Joan Frances and help her through her depression. Despite Joan Frances’s panic at Dr. Tate’s threat, she was acting far less hysterical than many of us were feeling. For now, we let Joan Frances stay in control.

  The internist led her back to the examining room and sat down near her. “I’ve called Dr. Tate,” he said, “and he’s coming in to talk with you.”

  “I don’t want to talk with anyone,” Joan Frances responded shakily. “I want to go back to my dorm.”

  The internist soothed her: “There’s nothing for you to fear. No one can make you remain here against your will,” he said. “I wish you would stay, because I know that you’ll feel better after you’ve had a chance to talk with Dr. Tate about what’s troubling you. Give him a chance. Why don’t you wait here for him to come in?”

  The desire to run vibrated throughout the Flock, but I stifled the urge. “Look, gang,” I said internally, “what if we tried to leave and someone physically prevented us? You know that would bring Josie, and we’d be sure to get locked up.”

  And I had a ray of hope that the internist meant what he said. Maybe Dr. Tate finally did understand that Joan Frances needed to talk. I calmed the personalities poised for flight and held back the others so as not to interfere with Joan Frances. I wanted her ready and willing to interact with the psychiatrist.

  Dr. Tate arrived, demanding to know specifically what had happened tonight to make Joan Frances feel so bad. Joan Frances had no new answers; she had felt like this since her return from Virginia.

  “What do you want me to do?” the doctor asked.

  Joan Frances shook her head in bewilderment. She had told this d
octor what she wanted so often that it seemed silly to repeat the litany. “I don’t want you to do anything,” Joan Frances finally said. “I just want to go back to the dorm.”

  “No,” Dr. Tate said firmly, “I’m having you admitted to a locked ward.” Joan Frances lost awareness in a rush.

  Jo found herself in the small examining room. No windows. No clue as to whether it was day or night. “There’s a sliding wall instead of a door in front of me,” Jo observed silently, “and Dr. Tate is sitting in front of that exit.” Jo looked at her watch, checking for the time, knowing that her gesture was clumsy, obvious, but she didn’t care. Her hands were clammy. She felt very frightened, but didn’t know why. Maybe if she could figure out where she was and what was going on…

  “Well, ask,” Dr. Tate said.

  Jo relaxed instantly. Dr. Tate’s reaction was so much like the way Lynn responded when Jo appeared suddenly, feeling anxious and confused.

  “Where am I?” Jo asked.

  “The emergency room at Harvard Health Service,” Dr. Tate said.

  “Why?”

  “Look at your wrist,” the psychiatrist said.

  Jo again looked at her watch, confused by the doctor’s direction.

  “No,” Dr. Tate said with a trace of irritation, “look at your other wrist.”

  Jo looked, inspected the cuts long enough to realize that they were not dangerous, and said, “Oh, this has happened before. Joan Frances’s work, I’d guess.”

  Dr. Tate looked a little startled by Jo’s blasé attitude.

  “Oh, I know this is a problem,” Jo said. “It’s something to be taken seriously. But Lynn calls this a gesture, not a suicidal act. She says that these scratches are the way that a really troubled personality broadcasts her need. If Joan Frances had been serious about killing herself, she would have taken an overdose.”

  “Who are you?” Dr. Tate asked.

  Now it was Jo’s turn to look startled. She knew she had talked to the psychiatrist during one of the Flock’s two visits to his office. Didn’t Dr. Tate remember?