There will be no reckoning.
The day before the day before Christmas 1985, in the dayroom where the five mean teenagers ruled, I went up to the very overweight curly-haired girl I knew was the Russian Bear and said, “Do you want to dance or what?” and she fled crying. It was pretty much the end of Soviet-style communism. They took me back to my room like nothing big had happened.
It was over. I tried to explain my theory of grammar and psychosis to the people at the hospital, and they listened politely.
If
If you come to weighing ten pounds less than you remember yourself weighing…
If there are a bunch of psych patients hanging around outside a door you can’t open or lock…
If big people come through the door, angry, like maybe you gave them a hard time the last time they came to give you shots without so much as a hello how’s it going or goodbye…
If you think about what it was you were thinking just before all hell broke loose and you get a little nervous…
If you find yourself thinking it again even if you can’t remember exactly what it is…
Then you are a nut, my son.
My hospitalization was all black and gruesome punctuated by daily moments of peace and light when they gave me pathetic little fragments of Xanax around 5 P.M. For twenty minutes or so there would be hope in the world and color and then it would fade and I’d wait for 5 P.M. the next day. Never trust a drug that’s spelled the same backward and forward and has two x’s in its name.
I was not addicted to Xanax. That would have made me a drug addict. I just needed it to breathe. Six years of drinking a little every day with a little Xanax to help me sleep = no trouble. One week of no drinking, no Xanax = big trouble. It’s not easy to go from being one of the seven righteous pillars holding up the planet to being just another mental patient.
My frightened eight-year-old son came out of the fog to visit me in the hospital. I wished very much that he didn’t see me like that. Maybe having kids was pushing things too far.
Big strong man, strong right arm, machete, will of steel, had managed to hack his way deep into the jungle.
“Things will get better, Zachary.” I vowed I would fight through hell itself (might as well, since I was already there) to make this moment go away and not be what my precious son remembered of his father. My mother looked at pictures from her childhood and saw a mother not able to look at or pay attention to her little girl. She was not sure for how long or how many times her mother was hospitalized.
At any given point there are several million people in this country who are psychotic. As a matter of law they are exempt from being judged responsible for their actions while crazy. They are also 99 percent invisible. Most won’t get better enough to be as well as they were before. Many won’t really get better at all, just another part of life to not look at if you don’t want to get depressed. I’ve read studies indicating that 90+ percent of the homeless are mentally ill.
Things do not even out.
Jane at age fifty-five
(Photo by Michael Cullen)
chapter 10
Coming Home
Drinking a little every day, I had come to live in a small space where my feelings were very big and scary.
It was the day before Christmas, 1985. I was thirty-eight and seven-twelfths years old. I wanted to come home from the hospital under my own steam. I took a taxi most of the way and walked the last half mile. The third-floor window I had tried to jump through had been repaired, but there was still glass and broken sash in the bushes. I had three Christmas ornaments I had made in art therapy in my pocket. I have them still; regardless of how “good” the music or painting is, the arts have been a lifeline and the heart of the matter for me and Kurt and many other people.
When I was getting ready to leave the hospital I would look at my hands like they were someone else’s. It was the damnedest thing how they shook and trembled. I had always had a mild intention tremor, but I prided myself on doing medical procedures well. I needed at least an approximate sense of where my fingertips were and what they were up to.
The first time I managed to speak up and ask a question at an AA meeting, I asked, “How long does the shaking last?”
“You drank a long time, you’re going to shake a long time,” said a gravel-voiced woman named Hope.
While I was still in the hospital I had to sign something about my disability insurance. “Too bad it doesn’t really insure against disability,” I thought. My father sincerely said it was a good thing I had disability insurance, and I wanted to yell at him. How would anybody be able to tell if a writer and an icon was disabled?
Before, I’d been seeing twenty or thirty patients a day. I thought it was keeping me sane and at the same time proving to the world that I was cured and making me a living. I thought things were fixed and okay forever. Right before all hell broke loose on the commune, I had thought that things were all right and fixed forever.
Jane defied the odds long enough to see several more grandchildren born. When asked, I regretfully told her that stage-four ovarian cancer wasn’t a curable disease. She said that none of us knew the future and that something else might kill her, like getting hit by a truck. When I was in the hospital wrestling the Russian Bear and standing up for free markets, my mother’s cancer came back and no one knew how to tell me.
She was in the hospital being operated on again when they told her that I was in the hospital. I had just finished opening Christmas presents when they told me her cancer was back.
I cried. It was a bad December for the home team. We didn’t deserve to be having things going so badly. Would it have been that hard to stagger my mental illness and my mother’s cancer by a couple of months?
——
I looked out from a home that I somehow owned. There were two cars in the driveway. I had been to medical school and done an internship and residency. For the moment, anyway, I had a valid license to practice medicine in the Commonwealth of Massachusetts. Work wasn’t eager to have me back like tomorrow or the next day, but no one was saying I was done forever. I was related to the person who had done all the hard work that made the house, cars, et cetera, possible, but it was a complicated relationship. I couldn’t imagine what it would be like to see patients again but guessed that maybe I could do it if that was what I was supposed to do.
Maybe I just had to learn to be comfortable with being uncomfortable, with being scared out of my mind, and to let it go past like it wasn’t about me.
The place I felt most welcome and comfortable was AA meetings, even though there was a sticky-sweet optimism there I found insufferable.
“The grace of God won’t take you where the grace of God can’t keep you.”
“You never get more than you can handle.”
“You won’t die from not drinking or not sleeping or being afraid.”
“Ha.”
The people who had died from not drinking or sheer fright were respectfully dead and quiet and unavailable for comment. I was quite sure I was going to be one of them. I had slowly and carefully consumed a lethal dose of alcohol and alcohol equivalents and would eventually die from either drinking or not drinking. My biggest problem was figuring out how to get word back to these cheerful pabulum peddlers when I died from not drinking. I wanted to have a gravestone carved: “Mark got more than he could handle.”
Happy Joyous and Free, the fine print.
It’s only fair to inform you that if you manage to not drink, your capacity to suffer and endure is going to be increased by several orders of magnitude and you are going to need it.
Had I been any sicker for very much longer back in the seventies, I wouldn’t have recovered enough to think about going to medical school and no medical school would have let me in. I had put together a good chunk of well time—fourteen years—but now there was a substantial chance that if I didn’t get my act together reasonably quickly, I’d be put out on the curb with the rest of the trash.
/> One month after the hospital, I was depressed and had the zip of a soggy potato chip, so someone ordered an EEG or brain-wave test. It was mostly normal but showed generalized frontal slowing. It didn’t seem to worry my doctors much, but it seemed ominous to me. Maybe the threads on my screw were too worn down for me to be able to practice medicine again. I wasn’t arguing. I just wanted to know if generalized slowing was something people got better from or not.
I missed alcohol very much. Those little slivers of Xanax they gave me in the hospital had made me feel so very much better, it made sense that if I could just have one or even half a beer, I would be able to sparkle just a little and maybe complete a thought and be a better father or be able to read a newspaper. I wanted to be the guy who everyone thought should be a pediatrician again.
My partners took me to grand rounds at MGH, where I thought everyone was looking at me. I appreciated the change of pace and their time but wanted to blurt out, “When can I come back?” knowing it was exactly the wrong thing to say.
My wife said I wasn’t the person she had married and she couldn’t stand having me hanging around the house. I’d spent my whole life believing that by force of will I could do things and make things happen. I just wanted to be a normal guy who was married and went to work and had kids, but it all seemed to be slipping away.
My second son, Eli, was sick a lot. I had brought home respiratory syncytial virus from the hospital when he was a few months old. RSV for most people is just a bad cold, but with babies it can go down into the lungs and, as it did with Eli, set them up to become asthmatic. He was five years old when I came home.
Eli never complained but spent a fair amount of his early childhood sitting on the couch coughing and wheezing. He would get pneumonia two or three times a year, during which he’d throw up everything and run 104-degree fevers. He didn’t grow much. It didn’t help that until he was four his father still smoked.
When I stopped drinking, Eli stopped getting sick. He fattened up a little, grew a sneaker size, and started playing sports. Six months into my experiment of living life without the buffers of drugs and alcohol, it all became too much. My father was impossible, my mother was dying, I had a horrible fight with one of my sisters, my wife didn’t like me even a little, there wasn’t enough money. I begged my psychiatrist for some Ativan. I didn’t even like Ativan. I certainly couldn’t get addicted to a drug I had so little affection for. Half a milligram later, I felt instantly better and it became clear that Jack Daniel’s had never been anything but a good and true friend. Within a day Eli threw up everything and spiked a fever to 104 with what proved to be his last pneumonia. He’s now taller than me, which I don’t mind, and I’ve been drug- and alcohol-free ever since. About all I was good for during the first months of recovery was wrestling and hanging out with Eli. That had to be enough, and it was.
Somewhere in there I started painting after ten years off, at first with oils and then back to watercolors. I did it in the basement so as to not wreck anything. I bought a Yamaha digital piano and started working on jazz standards. I started writing a novel about a depressed pediatric senior resident who gets run over by the angry father of a baby who gets mistreated in the ER. When I wanted to take music-theory courses at the New England Conservatory, my wife became exasperated; surely there was something I could be doing to get back to work faster. Why wasn’t I taking a medical course of some sort?
“You’re a doctor,” she said.
Was I a drug addict or an alcoholic or just plain crazy? There were all those questions on the medical license renewal application to deal with. The chief of pediatrics at MGH knew I had been hospitalized. He liked me, so I more or less followed his lead when he described the problem as a drug problem that I had gotten into by taking drugs as prescribed for my sleeping problem. To me it seemed a little bit more complicated than that, but if I was going to have a shot at continuing to practice medicine, I had to give people a simple, easy package to swallow.
Because I hadn’t screwed up medically or acted out in a professional setting, I didn’t have to report to the Board of Registration of Medicine. In AA meetings I was an alcoholic who also used drugs, but mostly as prescribed. Purists said that if you were a drug addict who also drank, you were supposed to go to different meetings.
An earnest, bright-eyed young man at an AA meeting told me that to stay sober most people couldn’t keep doing whatever it was they had been doing for a living before they got sober but that perhaps I could work in a bookstore until I figured it out. I had to face the possibility that I could lose my profession, but it seemed like a terrible waste of all those premed courses and then medical school and then internship and residency. What was I going to do to pay the bills when the disability insurance ran out?
Two months after being hospitalized, I met with my partners and my psychiatrist to try to figure out when, if ever, it was going to be okay for me to come back to work. It was a tentative, very soft-spoken, slow-moving tea party. I tried to be dull without being too dull. Everyone was doing the best they could.
I was on lithium, which had been restarted during my hospitalization. Lithium is a mood stabilizer, yet my mood seemed anything but stable. I wanted to be stable and could have been stable by using the mood stabilizer that came in cases of twenty-four returnable bottles and tasted really good in chilled mugs or the more concentrated stuff in the bottle with Jack Daniel’s written on it. I could have been a lot more like Clint Eastwood and less like me and probably more popular.
It would have been almost logical to ditch the notion that alcohol was part of my problem. Alcohol had, in fact, been mostly a comfort that had brought me safely through many bad times. Ninety-nine times out of a hundred I felt at least a little better with every drink. Except for maybe the seizure when I stopped, alcohol and I had gotten along very well, and maybe the real issue was Xanax.
With four psychotic breaks to my credit and a solid four-straight-generation family history of hyper-religiosity, voices, delusions, et cetera, I more than met diagnostic criteria for bipolar disease, formerly known as manic depression, which was why I was taking lithium. Why did I want to crud things up by bringing alcohol into the picture? If you’re an alcoholic, you don’t have to take lithium. You just don’t drink. If you’re bipolar and take your lithium, you can probably drink a little. It seemed unlikely, over the top, gilding the lily, and almost bragging to say that I could be an alcoholic and a drug addict and bipolar. Where’s Ockham’s razor* when you need it?
But there was something about the intensity of the vision that alcohol was not my friend. I would have rather eaten putrid flesh off the bone than had another drink. Just because I could drink and be okay with it didn’t mean I had to drink.
The next Christmas I took a big bite of coffee cake that was loaded with bourbon and spit it out against the wall.
“Walnuts,” I said to the startled bystanders. “I can’t stand walnuts.”
At a certain blessed point you are able to just not drink without thinking about it all the time.
I wasn’t sleeping. There were times when I went several days with no sleep at all.
My mother was slowly relentlessly crushed from the inside and eaten up by her cancer. Together we wrecked two Christmases in a row.
“Uncle, uncle, uncle, damn it. Didn’t anyone hear me call uncle?”
I was acutely aware of a gritty stiffness twisted into every muscle of my body, as if I was on a spit being roasted over a slow fire. It came and went without there being anything I could do about it. I was painfully aware that I couldn’t drink, which is what anyone in his right mind would have done. God bless the moments when I felt all right.
After I’d been hanging out at home for a few months, a doctor who admired The Eden Express and ran a small psych hospital in Florida offered to pay an honorarium and for my whole family to fly down to Disney World if I would come talk to their staff and patients. I enjoyed being a professional and trying to give them their
money’s worth. I didn’t tell them I had been crazy again and was just a few months out of the hospital.
I ate steamed blue crabs off of newspaper-covered picnic tables and liked that a lot. Maybe this was what Tigger does best.
Shortly after that, my partners let me come back part-time and then full-time. It was a huge relief to be doing something I knew how to do and could get paid for. Maybe in some sense I was and still am addicted to taking care of other people’s problems. Faced with sick children and worried parents again, I felt useful.
There was nothing to do for my mother except to be with her as much as possible while she was dying. When she looked around the Cape house, which she had treated more like a friend and co-conspirator, she was radiant and proud and whole. She had come from very little and created a great deal for many, many people. At the end, she toned down the “Aunt Jane” and acknowledged what my sisters and I had been through. She talked without rancor about Kurt and she said she was glad I didn’t drink anymore. Her initial response had been “Oh no, you’re not an alcoholic. You’re a nice boy.”
During the Bow Wow Boogie that year, three months clean and sober, in the ninth inning of the final game, I threw out a runner trying to go to third on a dribbler out in front of home to preserve the tie. Then I drove in the winning run with a single in the bottom of the ninth. It was no more or less likely than the Red Sox that same year going on their incredible run to get into the World Series and then blowing it with the soft grounder that went through Buckner’s legs. Baseball was something to count on in this crazy world.
With mental illness the trick is to not take your feelings so seriously; you’re zooming in and zooming away from things that go from being too important to being not important at all. So I was watching my thoughts in a detached way. I could zoom in or out to see how they looked without trying to change them. If I was lucky, I might find things that could be part of how I try to tell the truth.
Just Like Someone Without Mental Illness Only More So Page 10
