“Not me, boss.”
“Let’s go down to fifty milligrams three times a day.”
Today, if I was lucky, I’d see a case supervisor monthly and maybe a psychopharmacology nurse every three months. Clinical guidelines would mandate that I be on antipsychotics for at least five years. The medication I was on would be determined by who paid for lunch and what deal was cut between my health insurer and the pharmaceutical industry.
It didn’t seem all that special at the time, but the fact that a doctor and I were left alone to figure out what was best for me was a lifesaving miracle.
My father had been teaching creative writing at Harvard and had seen Dr. Kirk a few times, which is how I got to see him the first time around. My now impeccably dressed in Brooks Brothers clothing father, increasingly recognized and recognizable with his multi-book contract and growing bank account, told me in a letter that he enjoyed the Harvard experience because it gave him a chance to know people who were at home in the world.
Kurt the pained loner seemed to be gone, but was he really winking at me like it wasn’t for real as he went to fancy places with fancy people? Was he really a representative of loners and misfits? Where was I at home? Would I be called upon to rule a small but very nice planet in some faraway galaxy once my apprenticeship on Earth was done?
From the team owner’s box, where I sat with my father, I watched Pelé play soccer and score a goal with a bicycle kick over his head for the New York Cosmos. After the game I went to the locker room and got to see Pelé’s feet. They were the widest, most amazing feet I’ve ever seen. I tried not to stare. I almost went to a cocktail party given by a game-show host. Were my father and I playing out some hysterically funny joke we couldn’t talk about?
The landscaping went well. I got a job substitute teaching at Barnstable High. That went well. I wrote a short article that got published.
I started painting again. The paintings were much lighter, mostly landscapes. I found that I liked watercolors better than oils. People actually liked my watercolors enough to buy them. I loved painting but I never felt like I was talented the way my sisters and my father were. Art came easily to them. They were graceful. My paintings were more peaceful than theirs, but painting for me will always be like trying to get up out of a tar pit while I’m fighting off Africanized killer bees.
Someone, maybe me, asks me what I would have liked to have done if it hadn’t been for the sixties and all that and being mentally ill. I thought back to when I was nine or ten.
I should have been a doctor.
Part of getting better from being crazy included the realization that my life might be a lot longer than I had thought and that I probably wasn’t going to get out of anything by having the world end or Western civilization collapse.
It was too bad I was twenty-five, hadn’t taken the right courses, and had this mental health history. I had a mental health history, the way other people might have a suitcase.
I wondered how I’d do taking math and science courses again. It seemed like my brain was back and working well, maybe even better than it had been for a while. I thought I had stopped doing math and science because they were so German and responsible for so much death and destruction.
I should have been a doctor.
When I started taking premed classes at UMass Boston, I was thrilled to find that I could do math and science again.
My illness became a compass of sorts. I could ask myself whether something was leading me away from or closer to being crazy. There was less of the “six of this, half dozen of that” that had made up so much of life.
Marijuana seemed to have been working hand in glove with the damn illness and trying to do me in, so I stopped that without regret or difficulty. Part of what saved my life was my strong reluctance to part with money. I tried cocaine once and liked how chatty it made me, but I wasn’t about to part with hundreds of dollars just to be chatty.
If you take good care of any disease by eating well, sleeping well, being aware of your health, consciously wanting to be well, not smoking, et cetera, you are doing all the same things you should be doing anyway, but somehow having a disease makes them easier to do. A human without a disease is like a ship without a rudder.
I cleaned up my diet, avoided sugar and caffeine, got regular exercise, and took medication as prescribed and vitamin B12 shots once a month. Being normal with a vengeance was a big step up from being mentally ill, but it wasn’t without its problems. As soon as someone who has been crazy can pass for normal, he is offered a witness relocation program with a new diagnosis and a new childhood if necessary. Everyone needs reassurance that the beast has been contained. If you’re going to go nuts over and over, why bother to get an education, a job, or a date for Saturday night?
I had a number of notes to self about voodoo, ESP, and other forms of belief in things unseen that seemed related to the voices and ideas of reference. These things were harmless for others but not so good for me. I’d had my fill, and then some, of “Wow.”
Having a not entirely reasonable expectation that things will go well turns out to be exactly the sort of delusion that increases your chances for success in this world, be it getting into medical school or whatever. If in fact you are skating on thin ice, the last thing you want to do is slow down and think about it. Once I made it through the process and was actually admitted to medical school, my unreasonable expectation that things would go well became retroactively reasonable.
I bought some Brooks Brothers clothes. I regained the twenty pounds I’d lost and then some. I had a mustache for a while and then ended up clean-shaven. I looked younger than I was. There was a chip on my shoulder the size of Montana, but nobody noticed. Why had such a nice guy like me been so rudely put upon and interrupted?
I had three more articles published. I was running and lifting weights. I had a girlfriend. Someone wanted to publish my book. I enrolled at Harvard Medical School. I was a goddamned panzer division. I’ll never know if a less disciplined, less vigilant, less muscular me would have done as well. I was burning the candle at too many ends and getting away with it.
I should have been a doctor.
Note to self: Being Kurt’s son, being an ex–mental patient, getting into Harvard, having written a book, and being a doctor are all things that in and of themselves do not make a life. If you lean on them too hard, you’ll find that there’s not much there. But if you add up enough things that aren’t in and of themselves enough, it almost starts to add up to something.…
Painted by Kurt over the dining room mantel in Barnstable, circa 1957
(Vonnegut family photo)
Pickup game
(Photo by Barb Vonnegut)
chapter 6
Bow Wow Boogie
The older we get, the better we were.
—United States Marine Corps motto
The Bow Wow Boogie was what we ended up calling our twenty-seven-inning softball marathon that took place the first weekend in August every year for thirty years. Just about everyone on the other team had gone to Harvard, but they wanted to be called the Boston Massacre. One summer in Cambridge they had made themselves into a softball team that was beating teams from the local Boston and Cambridge bars. Their captain had spent his summers in Barnstable and had beaten me for the under-sixteen Barnstable Yacht Club tennis championship, which was as close as I ever got to winning something in organized sports. He brought his team down for a weekend on the Cape and asked Steve, my cousin/brother/orphan, if he could get a team together so they could have someone to practice against. So Steve gathered a bunch of locals, including me. The baseball gods smiled on us and not them that day, and we won. Whenever we wanted to bother them we called them Harvard.
When I went to Harvard Medical School, some of my teammates jokingly asked if I’d have to change sides. I was and am anything but ashamed of getting into and going to Harvard, but I found myself shuffling and explaining unnecessarily that it was the only medical sch
ool that took me, which was true. It confuses people who didn’t go to Harvard when you try to avoid mentioning it or qualify it. And since you don’t have to do it with people who did go there, all the shucking and jiving you do has to be mostly for yourself.
The other day a patient told me that he had gotten into what was a very good college. “It’s not Harvard,” he said.
“Harvard’s not Harvard either,” I answered.
For the first Bow Wow Boogie I was just off Thorazine and there was no thought that Harvard would be a part of my life except as a place my father had once taught. The Harvard guys were on average a few years younger than we were, they were better athletes, they aged better and won more series than we did. They hit better, ran faster, and made fewer errors, but baseball is a funny game and we had our wonderful moments and days that were all the more tasty because they expected to win and got so pissed when they didn’t. We loved when they whined and snarled at one another.
We looked forward to the game all year, and when it was over we looked back on it remembering and talking about key plays, great catches, big hits. Everybody ran hard, threw hard, swung hard, and played hard, every play, every game. There was nothing soft about it. We were storing up things to make us feel good about ourselves for the rest of the year. It was my chance, and one I’m very grateful for, to make up for having gypped myself out of sports when I was younger.
I started out playing second base but switched over to catcher when a rational fear of hard-hit ground balls took hold of me and wouldn’t let go. Catching was hard too. I dreaded having to block the plate and catch the ball when runners churned around third base and headed for home. It cost me the use of my left hand for two months and a minor permanent deformity when two bones in my left hand snapped like pencils. I would have given anything to have held on to the ball, but I dropped it and the run scored. Even when I knew for sure that the hand was broken—it was swollen and misshapen—I splinted it and coached first base and went to the hospital later, after the softball was over.
Toward the end it was like there was a sniper in the woods. Because the signal to lunge left or right and how hard was based on how strong and flexible you used to be and what you used to weigh, things tended to snap on the first step and the unfortunate player gave a yelp, grabbed a knee, and fell down.
It seemed like one year I could throw accurately and the next it was anyone’s guess where the ball would go. I had been walking around with the false idea that if I caught a ball and threw it, I could control where it would go. The Yankees used to have a second baseman like that.
Once, toward the end, we let some of our eighteen- and nineteen-year-old sons play in the Bow Wow Boogie. It was horrible how beautifully they could run and throw.
When I was still young and the ball still went where I thought it would, I drank a lot at the postgame party and woke up at 2 A.M. at a green light and wondered how long and for how many green lights I’d been sitting there. I’d heard that blackouts were a sign of alcoholism but figured what they meant was blackouts when something bad happened. They should have said that rather than make normal people like me worry.
A few years before we quit the annual softball ritual, Vinny, the Harvard shortstop, was found dead in his rooming house, sitting in a chair dressed in a sport coat, next to an unopened six-pack. He died without bothering to fall over. We scattered his ashes at home plate the following August. As a medical student, one of the things I noticed about death was how little else happened. The patient who just died lies there quietly and everyone else stops rushing around trying to do something about it.
Vinny, like several of the Harvard softball players, had been good enough at sports to be recruited by several colleges. He had been the fastest, smartest, best-coordinated kid his small town had produced in a decade or so. His romance and charm lay in how well he did with what might have been and how gracefully he accepted what was. What Vinny was not graceful about or accepting of was making errors. He’d yell and swear and throw his glove and pick it up and throw it again. You could be sure that more errors were on the way. Up until Vinny made that first error, his demeanor and play were effortless, calm, and efficient. We spent considerable time trying to get Vinny to make an error as early in the first game as possible.
Trying to play sports as if you were twenty-something when you are fifty-something causes pain and suffering. Bones that years earlier would have flexed, shatter. Fractures that would have healed perfectly in six weeks take twelve and are never quite right. Tendonitis only gets better quickly if you are young. My cousin Steve needs his shoulders replaced and wonders if he should do both at once or one at a time.
I was expecting a slower decline.
——
I didn’t play much baseball as a child. Part of the reason was I couldn’t see the ball. For years I had gone up to the blackboard to read and copy questions. I didn’t wonder why no one else did that. None of my teachers seemed to think it was unusual. I also had far and away the worst handwriting and spelling in the class. Needing to get up to read the board was just one more thing about me that was a little off. Closer up I could see well enough to read and did well on standardized tests.
I got to be almost fourteen before I was diagnosed as having 20/300 vision. My mother asked why I hadn’t complained about things being blurry.
“Blurry compared to what?”
By the time I could see, Little League was done. In the sixties, aggression and competition were somehow implicated as root causes of war and misery and I was left high and dry as a pretty good athlete who loved trying to win whatever game was at hand. With the Bow Wow Boogie, it was a wonderful blessing to play softball every year with these guys who had been the Little League and high school stars. And if I came across a pickup game where they needed an extra player, I whacked the hell out of the ball and could play even more beautifully than I did in August. I don’t think I ever made an error or hit less than .600 in a pickup game. I have never anywhere run across people in their fifties who insist on playing twenty-seven innings of softball in midday August heat.
I can also make game-ending jump shots when I’m playing basketball playground pickup games with strangers but not if I’m playing with people I know.
At the age of thirty-nine, three months sober, recovering from what will hopefully be my last psychotic break and hospitalization, I threw out a runner at third to preserve the tie in the top of the ninth and then got the game-winning hit in the bottom of the ninth with two outs and two strikes. I felt like complete crap that day and honestly don’t know how I did either thing.
At Vinny’s memorial service someone told me about watching him play football. I imagined a halfback so quick and strong he didn’t really need blockers. And he was gracious and kind to younger kids and kids who weren’t athletes.
What could be more contingent-dependent and improbable than the individual human?
Vinny quit Harvard midway through his second semester when he was accused of plagiarism. Everyone I’ve talked to was quite sure he hadn’t plagiarized, but honor was involved and Vinny preferred quitting school, full scholarship and all, to defending himself. He was a reliable and valued worker, but after Harvard he never did anything, more than barely, briefly, a step above a menial job.
I’ve lived long enough now that if I condense time and look back at people I grew up with who have died, it looks like a minute or so of Antietam. There’s not that much difference between leukemia, heart disease, flying into mountains, and bullets whizzing through the air. Maybe, because so few of my friends have been armed at the time of their death, it’s more like soft-shelled newly hatched sea turtles heading for the water and being eaten by hungry gulls.
Poem for Vinny
Your heart attack will not be what you expect
You will not have crushing chest pain
or pain radiating to your jaw or left arm
You will not have shortness of breath
They will not get
you to the hospital just in time
You will not resolve to take better care of yourself
Quit smoking
Eat better
Take up yoga or kickboxing.
Earnest young man
(Vonnegut family photo)
chapter 7
Medical School
Science is a way of trying not to fool yourself.
—Richard P. Feynman
What we hope to get out of taking care of patients is a glimpse of a transcendent moment.
I believed that I was a bright enough, hardworking, idealistic kid who was good at math and science, who, if it hadn’t been for Vietnam and the sixties and mental illness … if I hadn’t been called upon to save too tough a world at too tender an age … maybe I should have been a doctor.
It was not reasonable for a twenty-eight-year-old with a 1.8 undergraduate math and science grade-point average, recently off heavy meds, to think he might be able to go to medical school, but there’s something about manic depression that, if you’re lucky, gives you a contagious optimism. I believed I should be a doctor, and people who met me back then, especially if they were interviewing me, came to think so too. Sooner or later a medical school had to admit someone six years off the beaten track, with three psychotic breaks and a 1.8 undergraduate math and science GPA. Maybe I’d be the guy.
By the time I actually applied to medical school, I had put together two and a half years of straight A’s at UMass Boston and had published a few articles in Harper’s and The Village Voice. And I was working on a book that I thought was going well. Attitude was creating reality.
When I applied to medical school, no one asked me if I thought I was going to go crazy again. It was a more polite time. The questions I was asked were vague enough that I could have gotten out of talking about mental illness altogether, but how and why I came to be applying to medical school at the advanced age of twenty-eight didn’t make much sense without it. My grades at Swarthmore weren’t very good; my MCAT scores were good, but a ton of applicants had good MCAT scores. My only real distinction and accomplishment was having published a few articles, and they were about mental illness. “Why I Want to Bite R. D. Laing” was a seminal piece of work. Without being mentally ill, I was just another overaged, mediocre applicant. I had to project some strength that would make up for the fact that I’d have six years’ less time to take care of patients than most applicants.
Just Like Someone Without Mental Illness Only More So Page 5
