by David Sheff
Over the next twenty-four hours, Nic's mood ranges from agitated to comatose. In addition to the monkey, his plans include backpacking to Mexico, joining the Peace Corps, and farming in South America, but each time he ultimately comes around to a grim resignation that he will return to rehab. Then he again says that he doesn't need it, he is sober, fuck you, and then he says he needs drugs and cannot survive without them. "Life sucks, which is why I get high."
I am unsure if another four weeks of rehab makes sense, but I know it's worth trying. This time I manage to get him into St. Helena Hospital, improbably located in the Napa Valley wine country.
Many families drain every penny, mortgaging their homes and bankrupting their college funds and retirement accounts, trying successive drug-rehab programs as well as boot camps, wilderness camps, and every variety of therapist. His mother's insurance and mine pay most of the costs of these programs. Without this coverage, I'm not sure what we would do. For twenty-eight days, they cost nearly twenty thousand dollars.
The following morning, Nic, Karen, and I drive past endless yellow fields and green ones—mustard flower, geometric vineyards—on our way to the hospital.
Above the Napa Valley, off the Silverado Trail, I turn the car onto Sanatorium Road, which leads to the hospital. Nic looks at the sign, shakes his head, and wryly remarks, "Great. Therapy camp. Here we go again."
I park the car and see Nic looking over his shoulder. He is thinking of making a run for it.
"Don't you dare."
"I'm scared, all right? Jesus!" he says. "This is going to be a nightmare."
"Compared to getting beaten up and almost killed?"
"Yeah."
We enter the main building and follow the signs to the substance-abuse program. We take an elevator to the second floor and from there walk down a corridor. In contrast with Ohlhoff Recovery, this is a sterile hospital—gray carpeting, fluorescent light, endless hallways, nurses in white, orderlies in blue. We sit on a pair of upholstered chairs near a busy nurses' station, filling out forms. We don't talk.
Then a nurse with a Harpo Marx hairdo and large pink glasses comes for Nic. She explains that he will be interviewed and undergo a physical examination before he is admitted. To me, she says, "It will take about an hour. He'll meet you here."
Karen and I go downstairs to the hospital gift shop and from the meager selection buy him a few toiletries. When we return, Nic says that it's time for him to go to his room. We walk with him a little way down the corridor. He holds on to my arm. He feels almost weightless, as if he could lift from earth.
We all awkwardly hug. "Good luck," I say. "Take care of yourself."
"Thanks, Papa. Thanks, KB."
"I love you," Karen says.
"I love you, too."
He looks at me and says, "Everything." Tears flow.
The program at St. Helena is similar to the one at Count Ohlhoff's, though it includes more exercise, with yoga and swimming in the hospital's kidney-shaped pool, plus consultations with staff physicians and a psychiatrist. It emphasizes education, with lectures and films about the brain chemistry of addiction, and daily AA and NA meetings, plus an expanded two-day-a-week family program. At this point, I am not sanguine about rehab, but I allow myself a sliver of hope. As in the Springsteen song, "At the end of every hard-earned day people find some reason to believe." Mine is a mix of this hope and, once again, tenuous relief because I know where he is.
At home I sleep, though unsoundly. In my nightmares, Nic is on drugs. I rage at him. I plead with him. I weep for him. High, he does not care. High, he stares back blankly and coldly.
Other people visit the wine country for its cabernet and pinot noir, mud baths and good food. Karen and I make pilgrimages for family weekends at the hospital. Before our first St. Helena session, a counselor tells me that an addict's prognosis is far better when his or her family participates. "We worry most about ones without families," she says. "Nic is one of the lucky ones."
"You will find Nicolas greatly changed," she remarks as we walk down a white hallway. "But he's feeling pretty depressed. They all do when they're detoxing, and meth is the worst."
Family sessions at the hospital are structured differently than at Count Ohlhoff's. We first gather in a large room with lines of chairs facing a lectern and TV monitors. The hospital offers four education forums on alternating Sundays. Our first is on the disease model of addiction. This is an alien concept for me. What other diseases include, as a symptom, the willing participation of the victim? Each time Nic does speed, he makes a choice. (Doesn't he?) Smokers may bring on their lung cancer, but otherwise cancer patients are not responsible for their condition. Drug addicts are. (Aren't they?)
The lecturer explains that addiction is genetic, at least the predisposition to addiction. That is, Nic's genes are partly to blame, the potent mix of his ancestry: my dark-complexioned forebears, Russian Jews, mixed with his mother's fair Southern Methodists. Vicki's father died of alcoholism, so we didn't have to look far in the family tree, though no one really knows exactly how the predisposition is passed down. Roughly 10 percent of people have it, the speaker says. If they do, drugs or alcohol "activates" the disease. "A switch is turned on," she says. Once it's activated it cannot be deactivated. Pandora's box cannot be closed.
A man interrupts. "You're letting people off the hook," he says. "No one forced my son to go to his drug dealer, to score, to cook up meth, to inject heroin, to rob us, to rob a liquor store and his grandparents."
"No," she answers. "No one did. He did it himself. But nonetheless he has an illness. It's a tricky illness. Yes, people do have choices about what to do about it. It's the same with an illness like diabetes. A diabetic can choose to monitor his insulin levels and take his medication; an addict can choose to treat his disease through recovery. In both cases, if they don't treat their illnesses, they worsen and the person can die."
"But," the same man interjects, "a diabetic does not steal, cheat, lie. A diabetic doesn't choose to shoot up heroin."
"There's evidence that people who become addicted, once they begin using, have a type of compulsion that cannot be easily stopped or controlled," she says. "It's almost like breathing. It's not a matter of willpower. They cannot just stop on their own or they would. No one wants to be an addict. The drug takes a person over. The drug, not a person's rational mind, is in control. We teach addicts how to deal with their illness through ongoing recovery work. It's the only way. People who say they can control it don't understand the nature of the disease, because the disease is in control."
No, I think.
Nic is in control.
No, Nic is out of control.
After the presentation, there are questions and answers. Then we meet in another room. We sit in a circle of chairs. Another circle. We are becoming used to these surreal circular gatherings of parents and children and significant others of addicts. We take turns introducing ourselves, sharing abridged versions of our stories. They are all different—different drugs, different lies, different betrayals—but the same, dreadful and heartbreaking, all laced with intense worry and sadness and palpable desperation.
We are dismissed for lunch, to dine with our family member in the program. Nic wanders shakily down a hallway toward us. He is pallid, moving slowly, as if each step causes searing pain. He seems genuinely happy to see us. He gives us warm hugs, holding on to each of us for a long time. His cheek presses against mine.
We choose sandwiches wrapped in plastic and pour coffee into plastic mugs and carry them on trays to an empty bench outside on the balcony. After taking a bite of his sandwich and then pushing it away, Nic explains his lassitude. He has been given sedatives to aid in the come-down process. He says that the medication is distributed twice each day by "Nurse Ratched"—he impersonates Louise Fletcher in One Flew Over the Cuckoo's Nest. "If Mr. McMurphy doesn't want to take his medication orally," he says, with a drawl accompanied by a menacing look, "I'm sure we can arrange that h
e can have it some other way."
He chortles, but it's a weak performance; he is too sedated to put much verve into it.
After lunch, he shows us his room, with twin single beds and nightstands and a small round table with two chairs. It looks comfortable, like a modest hotel room. Indicating the bed by one wall, he tells us about his roommate. "He's a great guy," Nic says. "He was a chef. A drunk. He's married with a baby. Look..."
He picks up a photograph in a bamboo frame on the bedside table. An angelic baby girl, around two years old, and her mother, a beauty with a churned-up sea of yellow curls and a light-filled smile. "She told him this is his last chance," Nic says. "If he doesn't stay sober, she'll leave him."
On Nic's bedside table is the Alcoholics Anonymous Big Book and a stack of recovery literature. There is a small closet and a dresser into which he stashed the small pile of his folded clothes we brought along.
Next he guides us onto the balcony, which looks out over vineyards.
"I'm so sorry about everything," he blurts.
I look at Karen. We do not know what to say.
13
Another weekend in wine country. The morning lecture is on the "addicted family"—that is, us.
"I probably don't have to tell you that this is a disease that affects families, too," the speaker, a program counselor, begins. "They don't sleep, they don't eat, they become ill. They blame themselves. They feel rage, overwhelming worry, shame. Many people keep their suffering to themselves. If your child had cancer, the support from your friends and family would flood in. Because of the stigma of addiction, people often keep it quiet. Their friends and family may try to be supportive, but they may also communicate a subtle or unsubtle judgment."
Apparently the family dynamics are predictable, illustrated in a mobile that hangs from a ceiling on one side of the lectern. Pointing to the mobile, the speaker explains all of our roles with disturbing accuracy.
Hanging in the center is a paper-doll figure, which represents the addict. Smaller dolls float around the central figure. The figures dangling off to the side represent the kids and Karen, on the periphery, helpless, but inextricably tied to the moods and whims and drug-taking of the central figure. Another figure hangs somewhat precariously between them—me. I am an enabler, propping Nic up; making excuses for him; bending over backward to care for him; trying to protect Karen and Jasper and Daisy from him, and yet also trying to keep them all connected to one another.
"It's not your fault," says the speaker. "That's the first thing to understand. There are addicts who were abused and addicts who from all accounts had ideal childhoods. Yet still many family members blame themselves. Another thing they do is try to solve it. They hide liquor bottles and medication and search for drugs in their loved one's clothes and bedrooms, and they drive the addict to AA or NA meetings. They try to control where the addict goes and what they do and who they hang out with. It's understandable, but it's futile. You cannot control an addict."
Later, the speaker says, "An addict can take over the family—take all of a parent's attention, even at the expense of other children and of one's spouse. Family members' moods become dependent on how the addict is doing. People become obsessed. It's understandable, but it's harmful. They become controlling in ways that they never were before, because they are so afraid. People lose their identity because nothing matters except their addicted spouse or child or parent or whoever it is. There is no joy left in their life."
When we meet Nic for lunch, he has some color back in his face and some life back in his eyes. He is freer in his movements, no longer constricted by pain. Nonetheless, he hunches over and seems dejected.
We talk while sitting in chairs on the balcony of his room. "I don't think this is going to work for me any better than last time," he says. "All the talk about God..."
He is quiet.
"All the God talk. I can't get past it."
I respond, "They say 'higher power,' not God. There's a difference."
" 'Higher power' is another way of saying God. You have to believe, and I don't. You can't get over this unless you believe."
Nic explains his conundrum. "I have no problem with the first step of the twelve steps," he says. "Well, sometimes I do, but I guess it's obvious that I am powerless over drugs and alcohol and my life has become unmanageable. But after that, it's bullshit."
He reads steps two and three from a bookmark.
" 'Two: Came to believe that a Power greater than ourselves could restore us to sanity. Three: Made a decision to turn our will and our lives over to the care of God as we understood Him.' "
I point out, "There's a lot of room in 'as we understood Him.' "
"I don't understand Him to be anything."
For some people, this—his atheism, a gift from his parents, at least me—is enough to explain Nic's problem. I don't believe that any single factor could have changed his fate, but who knows? If a belief in God or a religious upbringing precludes addiction, though, how does one explain all of the people with religious backgrounds and beliefs who have become addicted? The devout are not spared.
Without being solicitous or disingenuous, I try to offer a way that he can conceive of a higher power. Though I raised him without religion, his upbringing was not devoid of a set of moral values. I tried to instill the idea that morality is right for its own sake. The Dalai Lama, writing in the New York Times, recently explained this in a way that reflects my thinking: "key ethical principles we all share as human beings, such as compassion, tolerance, a sense of caring, consideration of others, and the responsible use of knowledge and power—principles that transcend the barriers between religious believers and non-believers, and followers of this religion or that religion." To me, those principles are a higher power, one accessible to each of us. My father once explained his concept of God: the "still small voice" inside us—our consciences. I don't call it God, but I too believe in our consciences. When we listen to that voice, we do the right thing. When we don't, we fail to. In my life I haven't paid close enough attention to it—I didn't know how—but I try to now. When I listen to it and act on it, I am more compassionate, less self-obsessed, and more loving. That, I tell Nic, is my higher power.
He is unimpressed. "Rationalizations," he says, "more bullshit. It's a big lie."
Counselors at Ohlhoff, people he has met at meetings, and now the staff at St. Helena have tried to convince him that one's higher power can be anything one imagines it to be—a source of guidance that comes from outside of oneself when it's dangerous to rely on the warped, drug-influenced guidance that comes from one's own brain, the addict brain. "For some, it takes a leap of faith," a counselor told Nic. "You have to trust that there is something bigger than us out there—something that can show us the path that will save our lives. The first step is honesty: my life is out of control. So what are your choices? Continue or submit to a higher power. You have to risk it—to be courageous enough to take a leap of faith and trust that there is something bigger than us that can help."
We once again eat on the deck outside the cafeteria, where Nic introduces us to two friends he has made here. We feel as if we already know them because by now we have been in group sessions with their wives. James is an amiable businessman, handsome, with red hair and freckles and the reassuring manner of one of Jimmy Stewart's wholesome characters. He is a Vicodin addict. The drug was prescribed after back surgery. Before checking himself into St. Helena, he was swallowing as many as forty pills a day. Nic's other friend is his roommate, the chef, Stephen, who has apprenticed in some of the Bay Area's most renowned kitchens. According to Nic, the sandy-haired, athletic man with sloping blue eyes abused a variety of drugs, but his primary addiction is alcohol, which has nearly destroyed his marriage and has nearly killed him at least twice. In his early thirties, he has already undergone surgery on his liver and pancreas due to alcohol poisoning. It is shocking to hear his age. He looks fifty.
We sit at long tables with them
and their wives, both of whom seem kind-hearted, loving, and exceedingly tired. Nic, James, and Stephen share the same sense of humor and something else: the type of intimacy and affection that normally builds over months or years but is hastened in rehab, where people's souls are exposed. Indeed, afterward, Nic tells us how much it means to have connected with James and Stephen. "Late at night, when everyone else is asleep, we sneak into the hospital kitchen," he says.
"Is that allowed?" asks Karen.
"No one cares," Nic says, speaking quietly. "The other night Stephen made an artichoke soufflé and leek soup. Last night we had chicken cordon bleu. I was sous chef."
We talk to Nic about the morning's and last week's lectures, and I ask if he agrees that addiction is a disease—and he has it. He shrugs. "I go back and forth."
"If a switch was thrown, when did it happen?" I ask. "At Berkeley?"
"God, no," he says. "Earlier. Much."
"How much earlier? When you got drunk in Lake Tahoe? When you first smoked pot?"
After a minute, he says, "Maybe Paris."
I nod, remembering the ulcer, and ask, "What happened in Paris?"
He admits that his language classes at the university couldn't compete with the city's other draws, including an abundance of easily accessible alcohol; French waiters thought nothing of serving wine to a sixteen-year-old. As a result, Nic spent much of his time there emulating his drunken heroes—but he forgot the writing and painting part. "One night," he says, "I was so drunk that I crawled into a boat tied to the shore of the Seine and passed out. I slept there, woke up the next day."
"You could have been murdered."
His eyes take me in. "I know," he says darkly. "When I flew home, I snuck some bottles of wine in my suitcase, but they only lasted a few days. I was fucked. In Paris, I'd been going out to bars and clubs every night, drinking a fucking shitload, but when I got home, I was sixteen, a high school student, living with you guys." He looks down. "It was too bizarre. I couldn't get alcohol, so I started smoking pot every day. It wasn't the same, but it was easier to get."
