A Mind Unraveled

by Kurt Eichenwald

  An older doctor arrived. I heard the words “infectious disease.” I glanced at the curtain drawn around the stretcher. This new doctor hadn’t closed it completely.

  They really should close the curtain. Why did they have a curtain if they weren’t going to close it? I saw people walk by. I couldn’t stop wondering about the curtain.

  The doctor spoke my name in this odd tone that was both abrupt and kind. I looked back at him.

  “No,” I said. I knew his question even though I was certain I hadn’t heard it.

  I didn’t have to discuss it today, he told me. I could wait until one of my follow-ups, but until then I should avoid sexual activity. The rape placed me in a risk category, and I should gain as much information as I could about all sexually transmitted diseases, including AIDS.

  “No,” I replied. I didn’t want to know. AIDS meant death. People were already afraid of epilepsy; epilepsy and AIDS? I was at a breaking point. Emotional overload.

  Nothing. I felt nothing.

  He nodded, reminding me to discuss these matters with my doctor. He wrote a prescription for antibiotics to prevent an infection from the rectal injuries. Two doctors urged me to stay overnight for observation. I refused and signed a document saying I was rejecting their advice.

  I left the hospital, hailed a cab, and headed home. It was dark. Had it been the previous night when I had the seizure? The night before? I didn’t know. I went inside, walked upstairs to my room, and flicked on the light. Bloodstained sheets still covered the bed. I grabbed a pillow and lay on the floor, staring at the ceiling. I noticed chips in the paint and wondered how they got there. I fell asleep studying those spots, trying to see if they formed identifiable shapes like clouds do.

  * * *

  —

  The next morning, I telephoned Rick Smith to let him know I would not be coming to work. I had been his assistant for several months, but we were no longer at the Times. He was taking time off to write a book about Washington and had asked me to stay on as his researcher. By then, Smith knew about my seizures and treated them as unimportant events with no bearing on my work.

  Smith told me he had called the previous day when I failed to show up to the American Enterprise Institute, a think tank where we had set up shop. I apologized, explaining that I had been in the hospital because of a seizure. I then assured him that I would be well enough to return the next day.

  After hanging up, I collected everything stained with blood—sheets, mattress pad, towel, jeans, underwear. I lived with a group of strangers who were all at work, so I carried the horrifying pile downstairs. In the kitchen, I stuffed it into a bag. Then I threw it in an outside garbage can. I never considered washing it. I wanted it all out of my life, forever.

  I still felt nothing—no fear, no anger, no rage, no desire for revenge. I knew enough to recognize this emotional shutdown was destructive. I searched for the phone directory and called several psychiatrists until I located one in Northwest Washington willing to see me that week.

  In our sessions, I reviewed my history, my fear of seizures, my experience being kicked out of school, my assault in Chicago. I often cried unexpectedly, sometimes over nothing. But I was unable to mention my rape to any counselor for years to come.

  * * *

  —

  The pain in my shoulder was intense. At some point after the rape, I fell down the stairs outside of my bedroom and banged myself up. I suspected I had broken a bone and decided to get an X ray once I was more coherent. About an hour later, I hailed a cab and asked to go to the nearest hospital. Any doctor, I figured, could find a fracture. The cabby dropped me off at Capitol Hill Hospital.

  I remember little that followed, but my father later told me what happened. Someone checked my blood sugar levels with a test strip. The person wrote down the results incorrectly, stating they came from a complete glucose test—involving drawing blood—rather than the finger stick that was performed. Mistake piled on mistake, and soon a doctor diagnosed pancreatic cancer. I may have gone into convulsions in the emergency room, and my planned short visit turned into a major hospitalization.

  No one checked the MedicAlert medallion that hung around my neck, which disclosed my epilepsy and instructed medical teams to check my wallet for a card with my anticonvulsant schedule and emergency contact information. As a result, the hospital stopped providing my medication. For days, each time I went into convulsions, the staff infused IV Valium to stop the seizure. At one point, I opened my eyes and saw Neil Fisher, a friend from Swarthmore who worked in town, standing by me. I didn’t know how he had ended up there, but I recognized I was in danger.

  “Call my parents, and tell them to get here right now!” I begged him. “Tell them this is an emergency!”

  Later that day, I was admitted to the intensive care unit.

  * * *

  —

  I woke with someone stuffing pills into my mouth. I pushed up my tongue to block them from going down my throat, then spat them on the floor. I recognized the red bands around the white capsules; it was Dilantin, three times my normal dose.

  A short, dark-haired man stood beside me.

  “Get the fuck away!” I growled.

  “You need your medicine,” he said.

  Right. In my sleep. At triple the dose.

  “Get away from me, or I’ll scream!”

  I watched him leave the enclosed area and saw my parents in a main room. My father was confronting a doctor. They were too far away for me to hear the words, but I could tell Dad—who had plenty of experience brutalizing unprepared interns and residents—was ripping apart the other physician.

  As staff members rushed about, producing records for my father, my mother saw I was awake and came to my bedside.

  “Are you all right?” she asked.

  I nodded. “Feel like I’ve been hit by a truck,” I said. My tongue moved as if coated in molasses. “What happened?”

  She told me I had been in the hospital for days and that the doctors had made one terrible gaffe after another. The medical team learned of my epilepsy only when my parents arrived. At first, the doctors insisted they had given me my medication, which set my father off: How the hell would they have known to provide me with my prescribed anticonvulsants if they didn’t understand I had epilepsy? He called the doctor a liar to his face.

  My father came in with my chart. He grabbed my arm. “Don’t worry about how you feel; it’s not because of something wrong with you. You’re in intensive care. The doctors made a mistake with a blood sugar test and decided—but you don’t!—they incorrectly decided you had pancreatic cancer.”

  “From one blood sugar test?” That was ridiculous.

  My father shook his head. “Don’t get me started.”

  “Why do I feel so awful?”

  “They’ve been giving you IV Valium every time you had a seizure, and they’ve used too much. It settles in muscles and fatty tissue. Don’t try to get out of bed. You’ll fall.”

  Another man arrived who looked familiar. It was a former teacher from my high school who now worked as a Washington lawyer. He had picked up my parents at the airport and driven them to the hospital.

  Soon after, Smith showed up. Assuming he would be panicked by my disappearance, my mother had notified him I was at the hospital in intensive care. When he saw me, his usual expression of calm assurance drained away, replaced by a look of shock.

  The area around my bed was packed, with everyone listening to my father explain the gross incompetence of the physicians. At some point, a doctor burst in, angry about the number of visitors surrounding my ICU bed.

  “Who are all you people?” the doctor barked.

  My mother stepped forward, gesturing to each individual as she made the introductions. “I’m his mother, this is his father, this is his lawyer, and this is Hedrick Smith of The New Y
ork Times.”

  The four of them stared at the doctor in silence.

  “Oh,” he said. Then he scurried away.

  * * *

  —

  Within the hour, I was transported to Georgetown University Hospital to recuperate from the damage caused at Capitol Hill Hospital. The doctors diagnosed a Valium overdose but also found that my anticonvulsant levels had dropped below the therapeutic level. When sufficient time had passed, a doctor told me they were going to infuse Dilantin. I asked what that meant.

  “We’re giving you a load of Dilantin directly into the bloodstream,” he explained.

  “You know I have a lot of Valium in me?”

  I heard a voice. “They know.” It was my father, who was beside my mother on the other side of the room. “They’ve been monitoring it, and it’s okay now.”

  It’s okay? Already? “How long have I been here?”

  “Since yesterday,” my father said. “You’ve been sleeping.”

  I remembered: My shoulder. It didn’t hurt anymore.

  “What happened to my shoulder?”

  My mother spoke. “That was a dream. Nothing happened to your shoulder.”

  “No, it was real. That’s why I went to the hospital. I fell down the stairs and hurt my shoulder. What did the X ray show?”

  “That’s why you were there?” my father asked. “We assumed you had been found on the street.”

  “So what did the X ray show?”

  My father seethed. “They didn’t take an X ray. They didn’t do anything about your shoulder.”

  The doctor beside me asked how my shoulder felt now.

  “It’s fine,” I said. “Guess I would have been safer if I had just stayed home.”

  * * *

  —

  Time detached from reality. There were moments of consciousness, then not. Hours, perhaps days, passed without my taking notice.

  My next memory is of sitting up in my bed. A middle-aged doctor knocked on my door and asked for permission to speak with me. He walked in with a group of fresh-faced young people in lab coats, then introduced himself.

  “These are medical students,” he explained. “I’m visiting patients with them and was hoping you’d be willing to talk to them about why you’re here today.”

  Damn straight I’ll talk to them.

  I chose my words carefully. “I’m here because a doctor at another hospital failed to take a proper medical history. The doctor—not a disease, not some chronic medical condition—injured me so badly I had to be brought here.”

  I gave an account not just of the latest near-fatal mistakes but also of the times over the years when doctors failed to ask questions, conduct follow-up, or listen. By shortchanging the importance of a patient’s past, doctors could cause incalculable damage, I said.

  I studied the students’ faces. Do they understand?

  “So someday, when you have a patient in front of you, remember me. Remember how bad I look right now,” I said. “Remember this happened because a doctor didn’t take a proper history. All the labs and machinery are useless if you don’t talk to patients extensively.

  “You need to ask about their health and about their medications. You need to look them up in the Physicians’ Desk Reference to know if they’re taking the right amounts or are on drugs that conflict. Don’t let gadgets and drugs be your first thought. Ask questions. Write down the answers. Figure out why those answers are important and what they show.”

  I ended my lecture, and a few students tentatively asked questions. Then the doctor told them to head to the hallway.

  “Thank you,” he said to me. “I wish I had recorded that.”

  * * *

  —

  Six months. In six months, I would be off my parents’ insurance. I thought back to Plissner’s offer at CBS and cursed myself for turning it down. That job had insurance; it might not have been the right industry, but people like me didn’t have the luxury of being choosy. My medication, my hospitalizations—group coverage was suddenly more important than my aspirations. After my success at CBS, I had grown arrogant and figured I would also climb the ladder quickly at the Times.

  I told Smith I could no longer work on the book, that I needed a job with insurance right away. He introduced me to a senior editor at National Journal, who offered me a position at the Washington political magazine. I grabbed it—I had no choice. I hated the work, which mostly involved retyping press releases about people changing jobs in the city. I saw no future for myself there. I felt cheated, but at least I had insurance.

  Or did I? After a few weeks on the job, I discovered the group policy contained a preexisting-condition clause. I had no choice. I resigned from National Journal so I could go back on my parents’ insurance for the few weeks that remained until my birthday, when the company would kick me off the policy. Desperate, I told Smith about my predicament. I said I would take anything that offered immediate insurance with no preexisting-condition clause.

  He telephoned the Times in New York and learned that they had some openings for what they called “copy kids.” That was a full-time job, and the insurance benefits kicked in immediately. A senior editor agreed to meet with me, and my parents paid for a plane ticket so I could see him the next day.

  * * *

  —

  I sat anxiously while the editor in charge of hiring clerks and copy kids studied my résumé.

  “You’re overqualified,” he finally announced. “And why have you been jumping from job to job? What happened at CBS?”

  “Nothing,” I replied. “In fact, I was offered a promotion but turned it down. I can give you my old boss’s contact information if you want to check.”

  “What was the promotion?”

  “Assistant to the executive political director.”

  His expression was unreadable. “You turned that down? You would rather be here running wire copy?”

  “No,” I said. “I would rather have a chance at working for a newspaper. That’s all I’ve ever wanted. As a copy boy, I have a chance to become a reporter through the writing program.”

  “Very few people are hired out of the writing program,” he replied. “And it will take years.”

  “I know. I don’t care. It’s a chance.”

  “You could become a reporter right away by applying to small newspapers. Why not do that?”

  Lie. Just lie. “Because I want to work at The New York Times, and I have a better chance of getting hired by starting here if people can see how I work.”

  He studied my résumé again.

  “I promise you,” I said. “If you hire me, you won’t regret it. I’ll work harder than anyone you’ve hired before.”

  He looked hard at me, sizing me up. “Okay. You can start in two weeks. But I think you’re going to regret this decision.”

  He escorted me across the newsroom to a woman sitting at an isolated corner desk. “Marie,” he said to her, “this is Kurt Eichenwald. We’re hiring him as a copy boy.”

  * * *

  —

  I missed the deadline: For two weeks, I was uninsured. I turned twenty-five in June 1986, and on that day, the one that had terrified me for so long, my parents’ policy no longer covered me. My start date at the Times hadn’t arrived and the insurance at National Journal was still useless. I considered just staying in my house to avoid possible hospitalization, but instead decided to take a gamble and use that time for my move back to New York.

  I shouldn’t have taken the chance. Before my first day at the Times, I went into convulsions somewhere in Manhattan. An ambulance brought me to St. Luke’s-Roosevelt Hospital Center in midtown, where emergency room doctors apparently checked my MedicAlert necklace, read that I had epilepsy, and left me to sleep it off. I received a bill for thousands of dollars a few weeks later, costs
incurred for nothing.

  Distraught, I telephoned my parents. My salary at the Times wasn’t enough to pay the hospital and afford my living costs in New York. Ignoring the bill—hell, even delaying payment—would destroy my credit rating. Would I never be able to buy a house because of my epilepsy and this ridiculous insurance system? Why was I forced to jump from job to job in search of coverage? What if I had wanted to work at National Journal but couldn't because of insurance? My panic escalated as I badgered my parents with questions before they could answer.

  “I never told my new bosses about my seizures,” I rambled in a tone of escalating dread. “I don’t know if Rick Smith told them. What’s going to happen when I tell them? And if I don’t, what’ll they do if I have a seizure in the newsroom? And what if I got pushed out of my job again? How would I afford my medicine? I can’t pay this bill! How can anyone with epilepsy survive without insurance? Are we just supposed to go away and die somewhere?”

  My parents, who were both on the line, urged me to calm down.

  “Kurt, we’ll pay the bill,” my father said. “You’re not alone. We’re here to help.”

  My mother interrupted. “I promise, Kurt, I promise, you will have all of our financial and emotional support. No strings attached.”

  I wiped my eyes and took several deep breaths. “Thank you,” I said softly. “Thank you so much.”

  A second passed, then I teared up again. “What about everybody else?” I asked. “What about other people with epilepsy who don’t have someone to pay the bill for them? Do they all just die?”

  My parents mentioned free clinics and other options, but eventually acknowledged that any uninsured person with epilepsy was at risk, and there were almost certainly others who stayed in jobs they hated simply for the insurance.

  “So if I—so if any of us—ever lose our jobs, we could die?” I asked in disbelief. “What kind of world do we live in?”