Madness (10 page)

I sit here in the hospital room painted the shade of pink that is supposed to make people calm. I examine, enchanted, my feet in their blue hospital footies, while someone speaks in soft tones to me and says I am psychotic, but it's going to be all right. I put on my hat, unperturbed, and ask for some crayons.

"For all is well in our little tiny town," I sing, my hands a blur as I deal out the millionth game of solitaire of the night. I stand up in my chair, sit down in my chair, hop out of my chair, do a little Snoopy dance, my hospital gowns flapping about me like wings—I've grown inordinately fond of these gowns and am wearing several at once, "for dramatic effect"—and I sing the Snoopy song, stand on my chair again, imitating Snoopy as vulture, plop down. "I never did like
Peanuts
much," I remark to the catatonic man who sits across from me, "but when I was little my parents took me to see the
Peanuts
musical, and I liked that, but I thought it was kind of ridiculous that all the kids were played by grownups." I look at the man, who is just off an unfortunate suicide attempt, and, feeling bad for him, I climb onto the table and deal him a game of solitaire too, very pleased with myself for doing so upside down. I spit tobacco juice in a little cup, this nice man having loaned me some chewing tobacco since I am not allowed to smoke. "I don't mind that stuff," I say, my lower lip full of chew. "Here," I say, climbing off the table and coming around to the back of his chair, "old chum," I say, banging him on the back, "you play like this. You pretend that all the face cards are aces, and so when you get a face card you put it
here,
and then you go through the deck looking for all the
twos
or
fours,
which you use as wild cards, and when you
do
get an ace, or a joker, we're playing with two jokers, see, then when you, like I said,
do
get an ace, you turn the face cards upside down on it and call it a
double ace,
and after that you flip the cards upward, like regular solitaire"—I am leaning over him, my hands flying over the table like a blackjack dealer's, my arms on either side of his head, and I'm stacking the deck and shuffling the deck and stacking it and shuffling, and flipping up the cards—"and you start going for a flush or a full house." I fan out my hand, the result, apparently, of the above machinations, say, "See?" and pound him on the back. "It's very grand!" I cry, and go skipping down the hall, am shushed (nicely) by the very nice night staff as I skip by, skipping backward back to the desk; "You're
very
nice," I say, "I like you
very
much," and I skip on, skip straight on till morning.

Dr. Lentz has explained to me that I'm having the good kind of mania, a euphoric mania. Everything is beautiful, simply gorgeous, I am talking a blue streak and what I'm saying is nearly incomprehensible, seeing as I'm dashing through a thicket of random thoughts so quickly no one can follow (it's called flight of ideas). I am grandiose, delusional, I'm flinging my body about; I am, to the casual observer, clearly possessed.

It would seem I'm a textbook case. Every symptom of mania I could have, I have, in force: the extreme, minute-to-minute mood swings, rapid speech, the grandiosity, the impulsivity, the delusions, the feeling of complete invincibility, and the absolute conviction that certain untrue things are true. I can hear my thoughts
zipping and whistling through my head, and see them snap and sizzle in streaking red lines on a complex grid that was designed by God and given to me personally; I am a millionaire high-society lady and should be treated with the utmost respect due to my superior station; my car can fly. These and various other ideas flash through my head, passing as quickly as they arrive. What causes them? I'm guilty of every precipitating factor you can think of—no sleep, gallons of booze, not enough effort to stick with my medication, a complete inability to grasp the seriousness of my diagnosis—and, it turns out, I have a disorder that has gone untreated for too long. But from my perspective, a manic break is a fine, fine thing, and I can't for the life of me imagine why everyone is so upset.

The staff of this hospital, at least, is experienced and trained (and did I mention that I like them very much?), so my batshit state is nothing new to them. I'm on Unit 47, where they put patients who aren't capable of being responsible for themselves—the suicidal, the very manic or profoundly depressed, the schizophrenic during a severe episode of delusion, and the variously psychotic. They dose me with a powerful antipsychotic, probably Zyprexa. It's a stopgap to get me down off the ceiling while, over the next few days, Dr. Lentz works on figuring out what kinds of meds and how much of them I'll need long term. I don't mind taking it, not at all—these people are lovely, absolutely lovely, and so nice! I'll do whatever they say.

Dr. Lentz makes his rounds in the morning. He sits on a chair in the center of the room and I sit on the edge of the bed, bouncing up and down. I come in and out of the conversation. I stop bouncing and fall back on my bed. I sit up again. I fall back, sit up, and keep finding him still there, sitting on his chair. I leap to my feet and start striding in purposeful circles around him, studying him from all angles, walking in and out of the stream of light coming through the window.

And still, here sits Dr. Lentz. Amazing. He has not moved. He
is a compact, square sort of man, and his pants are hemmed too short and show his socks when he crosses his legs, and his hair is gray and dense like a thick-haired poodle's shorn short, and he wears dated glasses and has an almost beatific look of kindness on his face. He is completely calm as I whip around the room in a frenzy, babbling, questioning, wanting to know what the hell is going on. Elated as I am, I am also mightily disoriented, and Lentz's calm manner —
Marya, it really is going to be all right. Would you like to sit down? No? Well, perhaps you could hold still for a moment while we talk. That's better. Now, I know the mania is lots of fun, but here you are in the hospital, and you don't care for that. So perhaps you should try taking your medication
all
the time? Just to see how it works? Here's what I'm going to give you
—is comforting, and gives me some sort of compass with which to navigate the truly weird waters I'm in.

I do understand that I am locked in, but I am feeling particularly magnanimous about it. Maybe I'll stay. Every time I can get myself to hold still, as I am practically levitating, I again tell everyone—Lentz, the staff, the other patients, all my visitors—how very much I like them, and how much I appreciate their concern, and that I am sure we will get this whole thing sorted out soon. Then I expound on my theories, of which I have not a few, and they are elaborate, extremely logical theories evidencing the sheer scope and connectivity of my thoughts, which, I explain, exist as a complex web in my head, in 3-D, that turns on an axis, thus showing more clearly the precise connections between, and activity of, my thoughts.

Psych wards these days are a far cry from
One Flew Over the Cuckoo's Nest.
The staff has assured me that there will be no lobotomies. They don't seem to mind me; they explain everything, no matter how many times I ask, and forget, and ask again. They make every effort to treat people as if they are completely sane. You are sane until proven crazy. And when you are proven crazy, they know you'll come around again.

The outside world—"real" people—might treat me as if I'm a lost cause, hopeless, but the staff treats me as if I'm still human, still conscious, and that makes an enormous difference. I'm not completely removed from the world that you and I agree is real. My perspective is off, certainly, but I'm not totally gone. I'm not off the planet. I know what the world would think if they came onto the unit, what they would think if they saw me. The staff simply refuses to make those sorts of judgments.

Eventually I slow down to a frantic, cheerful agitation, in which state I spend several days—no sleep, extreme motor activity, rapid, continuous speech, but no hallucinations or delusions. I am no longer a millionaire, and I have no private jet; regrettable, but so it goes. Now, instead, I'm terrified, my chest churning with unspecified, wretched fears. Any thought that whips through my somewhat slowed but still speeding mind is cause for panic. I race up and down the hall trying to outrun the terrors, reciting under my breath,
It will all be all right, I will be all right, it won't all fall apart
—I pop out of my room twenty times a night, come padding down the hall in my hospital footies, hopping up and down with my latest question for the staff—What if my husband keeps me here? What if I stay in here so long I can't go on book tour? What if the doctor doesn't like me, what if he can't help me, what if morning never comes?

Marya, sit down. Well, all right. I'm going to give you something for the anxiety. It should help. No, it won't turn you into a zombie. It'll just take the edge off. It's called Klonopin.

The sunlight streams through the window in my room in a single ray. Dr. Lentz's face is half hidden by shadow, and periodically I forget who he is.

Marya, I need you to hold still and listen to me.
He puts both laced-loafer-shod feet on the floor and leans forward.
You need to start taking this seriously. From what you've told me, you're not doing the first thing to manage your mental illness. That's going to
get you in trouble. Look around you. This is what you can expect to see, more and more often, if you don't work with me to treat it.

I leap out of my chair, irritated, agitated, dimly aware that what he's saying is important but not wanting to hear it. I fold my hands behind my back and start loping in circles around the room. Dr. Lentz is in the center and his head swings around to follow me as I go.

He clarifies my diagnosis—the manic break changed it from bipolar II to bipolar I, and he adds the term
rapid cycle. The way you cycle up and down all day, and the way the moods come close together? That's what rapid cycle means.

He watches me lie face-down on the bed.

I honestly can't believe you weren't diagnosed sooner. That's one of the reasons your illness has gotten as bad as it is. But that's just the way it is. You're really going to have to work with me. You need to completely change the way you're living. You need to stay on your meds. It's going to take a while for us to get the right combination, and you need to do your part to control this.

Like what? Do what?

Don't drink, for starters. It will just neutralize the positive effects of the meds, and with the specific meds you're on, it can cause serious liver damage, seizures, and some other very unpleasant side effects. Sleep. Every night, seven to eight hours. Stay away from caffeine. Avoid situations that make you agitated. Marya, there's a lot you can do to make this better for yourself. You need to educate yourself about the illness and what you can do.

I leap off the bed and gallop around the room. I may be nuts, but I can take this in. Holy shit. If I go by his definition, if the symptoms he's talking about mean I'm having an episode, then how long have I been having them? I think of the suicide attempt three years ago. It must have been going on for at least that long. Does that mean that everything that's happened since then wasn't, somehow, real? Is my entire life going to be defined by being crazy?

No, no, Marya. Not at all. You're a writer, right? All the things you've written in that time, they're real. And the people in your life are real, and your memories are real. It's all real. It's just that it was all probably a little painful. Wasn't it? A little hard to get through the day?

I press my head with my fists, as it seems the thing to do if I am not going to cry. Far away, out in the hall, I can hear people shouting and talking, the calm voices of the staff saying,
Maybe you could get dressed? How about you come into the day room and eat some breakfast? Come back here! Harry, you need to come with me. Sue, slow down, please. Stop shouting. It doesn't help the rest of the patients,
and I hear the rapid chatter of some patients, and the slow, slurred speech of others. The voices come near my door, a body flashes or shuffles past, and then the voices fade away. I see the sound in waves, and put my hand out before me, tracing the waves in the air.

So the point is that now we can treat it, and make it a little less hard.

Always? Will it always be less hard, then? Will I stop acting crazy for good?

He smiles gently at me.
No.

Then what?

Things will still be hard. You've had this a long time. It probably won't ever be easy. But we can make it livable.

Livable? I think. That's it?

But I have to admit, livable is better than nothing. Depending on what it entails.

Dr. Lentz tells me that once I've had a major manic break, I'm likely to have one again, and the more I have, the more I will have. He tells me the bipolar has already progressed quite a ways.
No, it's not going to go away. No, there's no cure. Yes, you'll always have to take the meds. Yes, always. Yes.

Now I am crying. What will happen to me? I ask.

He raises his eyebrows and shrugs.
That depends,
he says.
It's
up to you. You can treat the illness, and you can arrest the progression, and your outcome will be better. It's possible, though unlikely, that you'll never have another complete break. You'll have fewer of them, though, if you are vigilant with your medication, and if you start living in a much healthier manner than you are right now—you've got to stop trying to do everything, you've got to learn how to rest. You've got to get some balance in your life.

I roll my eyes. Balance. They've been telling me that for years. It doesn't mean anything, and even if it did, I'm not capable of it.

That may be true.

I look sharply at him. Well, what if I'm not? What if I can't balance?

Then you'll get sicker.
He closes my file and stands up.
I think it could be more a matter of you don't want to balance,
he says.