One Friday in April

by One Friday in April (retail) (epub)

  On my last day at the Institute, the community gathered to say goodbye, a hospital tradition. Right before one of us left, the patients and the doctors and nurses gathered in the common room. I was grateful for them, for the hospital, a wondrous place. I felt gratitude, and something that seemed brand new in my life, a sense of calm, even happiness. I wished John well with his ECT, and told Helen that I saw her improving. I promised Dawn that I would stay in touch, which I did, for a while, after she got home. I shook my doctor’s hand, and hugged Nurse D and the other nurses, and then I packed my clothes into my black canvas bag, and Nurse D gave me my prescriptions, my phone, and my keys. She opened the door, the gate, the portal, and I went out. The door closed, and I heard the key in the lock. I walked to the elevators, rode up a floor, and crossed the skywalk to Columbia Presbyterian, where, back in May, I’d spent the weekend in the psych emergency room, guarded by cops. There were cars on the street outside. I got in one and said hello to the driver. I rolled down the window and felt the fresh air. We drove down Riverside Drive, and then cut over to the West Side Highway. It was about four o’clock in the afternoon. To the right was the Hudson, shining in the light, and to the left were the buildings of Harlem, and then the glass and steel skyscrapers of midtown. We passed Chelsea and the Village. At Canal Street, we turned left off the highway and headed east through Chinatown to the Manhattan Bridge. We crossed the bridge and drove up Flatbush Avenue, and then turned right, and then left onto my street.

  The car stopped in front of my building. I’d taken myself to the hospital in the spring, and now it was almost the end of summer. I got out of the car and stood on the sidewalk. People were out, and I could hear children playing. Had you seen me walking up the stoop, opening the front door, you might have thought that I was coming home from a job in the city or an errand in the neighborhood. I’d been gone so long, though it seemed only hours or a day.

  We might recall about a period of tedium or distress that it seemed to last an eternity. Dying in psychosis, in isolation from others, takes place in a kind of eternity, though not in the same way as, say, waiting on the platform for a train running late; that eternity is a hyperbolic figure of speech. The eternity of suicide is more like the eternity that we find in myth and theology, a true forever. Our lives begin and end, friendships flourish and fail, and cultures and societies rise and fall, but, for the patient sick with suicide, history might not seem to exist. Suicide is absolute, as is death. Ambivalence, our ability to hold many ideas and beliefs at once, is absent in the psychosis. Up on the roof, I let go of the fire escape railing and felt myself falling. Then, quickly, I caught hold. As kids, we played a game called chicken. Lying down on the road on a dark night, waiting still as the car zooms toward you, and then leaping away at the last moment, at the instant when the driver sees you lying like a corpse in the headlights, is playing chicken.

  Peter and I played chicken. Peter was my friend after my family left Charlottesville for the countryside west of town. We lived at the foot of Afton Mountain, in a farmhouse that we rented. A creek ran in front of the house, and my father grew a garden out back. The garden had rows of corn and tomatoes and cucumbers and squash. I was in charge of lettuce. We had pickle barrels in the kitchen. Terry and I went to Greenwood Elementary for her fifth and my sixth grades, and then I went to Henley Junior High for seventh. Peter’s father taught biology at the university, and his family hiked and camped. We camped too, but comfortably, in the Shenandoah National Park campgrounds, where my parents sat in lawn chairs and drank. I had a fantasy of hiking on the Appalachian Trail, which follows the Appalachian chain from Georgia to Maine. The trail passed a mile or two from our farm. When could we go? I begged my father. Could Peter come? My father agreed to the trip, and we drove over the mountain to the hardware store in Waynesboro. We got backpacks, rain ponchos, freeze-dried soups and stews, and stiff, heavy boots. We planned a three-day journey, starting near the intersection of Route 250 and the Skyline Drive, which follows the mountaintops from Virginia to North Carolina. When the day came, we got up early and packed my father’s black Volkswagen Beetle. We picked up Peter, drove up the mountain, and parked at a scenic overlook. There was the trail access. We got our gear and went in a line, Peter in front. My feet blistered after two hours of slipping up and down rocks and inclines, and we stopped, and I pulled off my boots and rubbed my feet. I felt embarrassed, and Peter was impatient. It was still early in the morning. This wasn’t how Peter’s family took a hike. They walked twenty miles in a day. We made it a couple, and then came to a place where the trail crossed the Skyline Drive again. My father told Peter and me to wait while he hitchhiked back to the Volkswagen. There was something at home that he’d forgotten to do, he said.

  Peter and I sat on the side of the road, watching cars go by. Twenty minutes later, my father picked us up, and we drove down the mountain to the farm, where he opened the mail, made a phone call, put food and ice from the refrigerator in a cooler chest, and put the chest in the car. When I told my therapist, D, this story, he suggested that my father needed a drink. Maybe that’s right. We drove back up the mountain, but didn’t do much hiking. Instead, we traveled in the car. We parked on the drive, and then walked to trail cabins, open, wood-framed shelters where we slept on wooden bunks and gazed up at a roof. I heard years later that Peter was dead. He crashed his car into a tree, driving home late one night from a party.

  I wasn’t playing chicken on the fire escape. I might or might not catch the railing before falling, might or might not fall. I did not imagine bounding from the roof in a swan dive onto the concrete, any more than I’d considered jumping from one of my apartment windows. Suicide did not seem like a choice to me, but an eternal state, like the eternity of death.

  I was not aware of time, that Friday on the roof, only of screeching sounds and the helicopter overhead and my blistered hands and the cold. The sun was bright, and then the sky in the west was orange; the day got dark, and the temperature dropped, but was time speeding or slowing? We talk about the weight of the world. After ECT, the feeling in my body of immense weight went away; I felt a kind of physical lightness. I no longer required Ativan. I’d believed that I was fatal to others, and that I would be destroyed by my losses. After shocks and convulsions, after months of waiting to get well, I regained my sense of time passing. These days, I think of ECT as clean power, good electricity added to a wet, saline medium in which electrical signaling has become chaotic and mistimed.

  I slept ten or eleven hours a night. I was no longer afraid to be alone in my apartment. I liked it. During the days, I went on walkabouts, exploratory expeditions up and down and across Brooklyn and Manhattan. It was summertime, and then fall, and people were out. I was not in isolation. I had solitude and contemplation, not rumination, and the world seemed to be filled with light. I told a friend that I could see the light glowing behind the leaves of the trees. Honking car horns didn’t bother me. I cut my hair, and shopped for clothes that fit. My medications caused my vision to blur, and, though I wasn’t reading, or not much, I began wearing reading glasses. I already had my regular pair, and so you might have seen me wearing two, one pair to look through, and the other, perched on my head, to switch to. My friend Jane had a brother who wore his glasses this way. He was schizophrenic, and lived most of his life in a private institution outside Washington, DC. Sometimes he escaped and walked around the town. Everyone knew the crazy guy with the glasses. I think that I would have liked him.

  One morning in the hospital, near the end of my stay, a nurse came to my room. It was dark out, too early to be up. The nurse told me that I had a phone call. She took me down the dormitory hall. She told me that it was against the rules to wake patients for calls, but that the phone had rung and rung. It was Christa. I’d met Christa at around the same time that Regan and I remet, in the summer of 2005. She was an artist and a writer. She lived in another state. She was married, and had a sister named Cara.

  Christa was crying into
the phone. She told me that Cara had died. Cara had been at their mother’s house. She’d shot heroin cut with fentanyl. Christa and Cara’s mother found her. I stayed on the phone with Christa until the sun came up. Later that week, she drove down from New England and came to the hospital. She’d been taking anti-anxiety medication. She told me that she didn’t know how she would keep living.

  Immediately after leaving the hospital, I went into Dr. T’s care. Once a week, I rode the subway from Brooklyn to the Upper West Side, got out at 86th Street and Central Park West, and slogged uptown. There was a food cart parked along the way, serving coffee and donuts. Typically, I bought coffee on the way to the office, and a donut on my way home. I was hungry for carbohydrates and sugar, and I was gaining more weight. My face had become round, and I had to push myself up from chairs. It didn’t seem to matter how much I hiked around the city. I needed pants three sizes larger than any I’d worn before, and my shirts felt like wrappers.

  I went to department stores to look at nice clothes. I wanted to feel good. I wanted to look good. I wanted to be part of things. I ate dinner by myself at a local bar, and searched for books in secondhand bookstores, books that I might want to read one day, or that might be useful to me when I began writing again. But I had no clear idea what that meant—writing again. It didn’t matter. Someday I would, I supposed, write, the way I once had.

  I sat out on benches and watched people walk by. After some time went by, and I felt more confident, I made plans and met people for dinner. I rode the subway. I felt good, but the time of suicide was close, recent, and several times I had the feeling that I was falling back, as it were, slipping. I felt that I was losing my balance. My heart raced, and the crushing feeling returned. Dr. T told me that this could happen, that I might get tremors, aftershocks, as it were, but that they would go away.

  Regan and I saw each other, though less over the months. I stayed in my apartment, and Regan stayed in hers. Regan had taken care of me, and hoped, I think, that my wellness would lead to good changes in me, and therefore between us. But I didn’t know what I was supposed to do or be. During the months following ECT, I felt calm and at peace, but also that I was vulnerable. I couldn’t, at that time, describe my homecoming, but now I can say, speaking poetically, that I felt naked. My face in the bathroom mirror was my face, no longer disfigured. My apartment was the same apartment, on the same block. The houses were the same as before, and so were the trees outside the living room window. I saw people walking their dogs or pushing children in strollers or coming home from work. I slept in my own bed, and made coffee in the morning. I didn’t make many plans. And I didn’t cook much at first, though eventually I did. I was capable. I could use utensils. In the hospital, I’d been certain that my life had been defined by errors and mistakes, but now I was not so sure. I felt that I’d been through something, jumped a gorge, as it were, died and come back. I might have told you that I’d had a breakdown. But that word seems misleading to me now. What, after all, is breaking? Are we made of parts that break?

  That fall and winter and spring, I kept Regan at a distance, and made excuses. She lived only ten minutes away. I became afraid to go see her. I did not feel as I had at any time before, not a year or two earlier, or five or ten, or when I was younger, back at school. I’d lost my mother. My mother was gone. I couldn’t imagine life or a future, but I was free of symptoms, free of suicide. I was no longer psychotic. Reconnecting with people, or making new connections, seemed important, but I wasn’t in a hurry. I slept for months, it seems now. I slept and slept, through the fall and winter and into spring. I hadn’t been able to sleep at all, and now sleep came on hard; it was imperturbable, and I woke feeling safe, not startled, not panicked. I changed the sheets, vacuumed the floors, washed the dishes, and kept the bathroom clean. I trimmed my beard and tucked in my shirt.

  Most of what we say about suicide has nothing to do with suicide. Breakdown is not an accurate word for suicide, any more than it would be for tuberculosis or cancer. Depression is another misleading term, as are madness, lunacy, hysteria, the blues, despair, and so on—all words that speak to appearances, or to the affect and the disorganized behavior of the patient. But the patient dying of suicide need not seem mad or lunatic or despairing. We most likely do not necessarily appear to be “out of our minds.”

  The terms that we use to describe illness can either inform or impede our understanding. We can speak and write in language that expresses tactility and touch, not theory and abstraction. We can figure forth meaning in appearances, or we can question appearances. To say, for instance, that suicides are naturally impulsive people is to miss the hours, months, and years of anxiety and physical deterioration, the fear and the seeming resignation with which we go to our deaths. Or we might think the catatonic torpid, and not understand the anguish, the feeling of the body somehow vibrating, the paralysis. The man on the bridge may spend hours perched at the railing, peering down, afraid to look. The woman in the waves does not splash her way into the sea, but more likely walks slowly, until she is submerged. We think of gun suicides as violent, rather than merciful. Better to say that suicides are sick and at risk, rather than needy, disturbed, or crazy. Suicide is not a storm or a conflagration, a deluge or an inferno.

  Each era sees the world in terms of its own technologies. Friends and lovers are on the same frequency, accident victims go into shock, the successful enjoy power, and frustration might cause you to blow a fuse. Our current imagery for suicide is not possible without computers and an electrical grid. We imagine our brains and bodies as wired, and when we are tired we might say that we are off-line, or powered down, or that we need a reboot. Are we on the same wavelength? Freud, who posits an unruly id, a willful ego, and a controlling superego as a system, and who writes about pressures, drives, and releases, invokes the coal furnaces, steam engines, and valves and stoppers of the Industrial Revolution. Paracelsus, the sixteenth-century itinerant Swiss doctor who discovered and named miners’ disease, black lung, writes about illness in alchemical terms. Paracelsus might speak of the moon and the stars, and then prescribe mineral and vegetable tinctures and compounds. We still use pharmaceutical compounds, which we call psychiatric medications. Hippocrates, writing around 450–400 BC, centuries before dissection and the study of anatomy and pathology became medical practice, describes delirium and convulsions in naturalistic terms. About epilepsy, then popularly taken as a form of divine possession, he writes, “This so-called ‘sacred disease,’ is due to the same causes as all other diseases, to the things we see come and go, the cold and the sun too, the changing and inconstant winds.” Hippocrates looks to nature, to the body, to what we can see, hear, touch, and feel, the things in the world that we can concretely describe.

  All our diseases are terrifying until they are known and named. A good example is consumption, which we could call a historical disease. Consumption was marked by coughing, weakness, night sweats, pallor, fevers, weight loss, difficulty breathing, bloody sputum, and the visible collapse of the patient’s chest, a kind of drying and shrinking of the body, as if the patient were being consumed, eaten away from within. Hippocrates knew the disease as phthisis—the wasting disease—and over the centuries it has had other names, among them the “white death,” an allusion to the pale, wasted look of the sufferer. In the sixteenth century, doctors suggested that contagion might be the route for infection, rather than God, heredity, alchemical misalignments, or problems with the patient’s traits and dispositions. You could be seen as the consumptive type, prone to tragic, early death. In the late eighteenth and early nineteenth centuries, consumptive emaciation became associated with beauty. Emily and Anne Brontë both died of consumption. Chopin and Chekhov were consumptives. In the nineteenth century, the removal of the sick to mountain retreats became the main treatment in Europe and America. Patients rested in bed or reclined in chairs set out in the fresh air. Then, in 1882, a Berlin physician named Robert Koch isolated a bacillus, Mycobacterium tuber
culosis, as the cause, and the name “consumption” has since fallen from use. The disease is no longer a romance; it has lost its mystique. We refer to tuberculosis now, and treat it with antibiotics.

  In the late summer of 2008, David Foster Wallace died. He hanged himself. I found out at my fiftieth birthday party. Christa threw the party at my friend Jon’s apartment on the Upper East Side. Many of the people who’d visited me at the Psychiatric Institute were there, other writers, people I worked with. I thanked them for helping me survive. Then, after most everyone had left, Jon told me about David. I felt that I’d lost a comrade in survival. He’d died on September 12, my mother’s birthday. Jon asked me if I would be all right.

  Wallace was a famous writer—or we should say that he is one. He was, and is, regarded as a literary genius. His death was celebrated in magazines, and a movie about his life appeared. He’d written novels and stories that are built from his own experience of suicide, and after his death, that writing took on the dual qualities of prophecy and evidence, as if David’s death established his authenticity and value, his worth to us. The death by suicide of the public figure is invariably controversial, and we interpret it widely. In David’s case, as is true with many artists who die this way, the news was shocking—and then not. We speak of the pain of the creative process, of loneliness, invention, and the fear of the blank page. What torment drives the artist? What makes a writer? What is genius? Might fame be linked with suicide? But these are old questions.

  If you’ve said that you are well when you’re in danger, then you may know the feeling that you are, as it were, hoarding death. Maybe we aren’t lying when we deny our condition and the danger—not exactly. Our smiles are forced and our voices are flat. We tell others not to worry. But are we simply powerless to say otherwise? People remark, about a drunk’s abusive style, “That’s the booze talking,” and though booze doesn’t talk, we take the meaning. Our claims of wellness, our promises that we will never succumb, are a little like the booze talking.