The Double Bind (34 page)

Folded behind the photograph was a letter, written in the same hand that had addressed the envelope.

My Dearest Daisy,

I can only begin to imagine what you are feeling, but you have to understand that her death wasn’t your fault. She ran in front of the car! No one could have stopped in time. No one.

Remember: Should anyone ever ask, you must tell them that I was driving. I can take care of myself. And I can take care of us. This horrible unpleasantness will pass and we will be fine. We will be together.

I watched your house last night and I waited. I waited all night. I stayed awake by imagining our future together. It is a future where you won’t be bullied, where you won’t have to wonder where your husband has gone. We don’t have to stay here, you know. We can settle in Louisville, if you’d like. Or Boston. Or Paris. Or London. It makes no difference to me. So long as we’re together, we can be happy anywhere.

Can’t you see it? I can. I see us: You and me and Pammy and a son. Yes, a little brother for your sweet girl. And we will name him Robert, after your father. That will be our family. A boy and a girl and the most loving and loved mother in the world. That will be us. I will be the husband you deserve and the father our children deserve.

That’s precisely what I saw last night as I stood sentinel outside your house.

We will be okay, you know. We will.

I will be home all day today. Just let me know when I should come get you.

Love,
Jay

She knew she should fill the hole back in, but she was hot and tired and she felt dizzy when she stood up. Besides, it was nearing seven-thirty: In the distance, she had been hearing the sound of irons and woods striking golf balls from the first hole for close to half an hour, and at least five or six vehicles had arrived in the parking lot since she had started to dig. And so, with the box with the small envelope under one arm and the shovel and the trowel under the other, she started back toward her car with its apple cores and empty cans of Red Bull littering the passenger seat.

A
S
G
ATSBY’S OLD HOUSE
and its once-sprawling sage lawns, now an antiseptic prairie of fairways and putting greens, receded in the Honda’s rearview mirror, Laurel began her long journey back to Vermont. Seven more hours. She drove briefly along the Sound, the last of the blue fog having lifted off the water, before veering toward the long strips of expendable plastic and neon that linked West Egg with the expressway. Then she was on the highway itself, rolling past the ambitionless office parks built upon the ash heaps and the remnants of a world’s fair. Past the Unisphere and the skeletal remains of the once great pavilions: the visible detritus of that era’s unachieved aspirations. Didn’t she see daily the castoffs and casualties sprung loose by an ever-spinning globe? Her eyes were small slits, her head heavy with visions and dreams. There was the vindication she anticipated when she shared what she had found to keep her awake—Bobbie’s vindication, not merely hers—but there was also her dawning awareness that her past was a part of her future. Always. It was, for better or worse, inescapable.

She arrived at her apartment mid-afternoon, and when she staggered through the front door encumbered by the cherry box and the portfolio case with Bobbie’s photographs, for a moment she thought she was feverish.

There before her was a small crowd comprised of some of the most important people in her life. Sitting on the couch was her roommate, gazing at her with a look of sodden despair, and her mother—summoned, apparently, back from Italy—in a tight black sweater today instead of a tight black T. And Whit, in the chair by the computer, looking uncharacteristically haggard and gaunt. She saw Katherine in the seat by the balcony, a cell phone pressed up against her ear. She didn’t see David, and for an instant she wondered where he was, but the moment was brief because her attention was diverted by another man—not David—who was pacing between the living room and the kitchen. Initially, it was hard for her to place him. She knew him from somewhere—at least she thought she did.

Then, abruptly, it came to her. She hadn’t recognized him right away, despite the hours and hours they had spent together since she was nearly killed on a dirt road in Vermont, because she always saw him in the context of his office where they usually met.

It was her psychiatrist. Dr. Pierce.

P
ATIENT
29873

Assessment: Bipolar 1 disorder, current episode manic, severe, with psychotic features; PTSD.

This deserves some comment. The unusual presentation was discussed with Dr. R——. That discussion is reviewed here.

PTSD seems fairly clear, in spite of the psychotic symptoms, given severe trauma, intense distress when viewing the bicycle photographs, and numbing symptoms, i.e., avoiding the site in Underhill, memory gaps, feelings of estrangement. This diagnosis is important in terms of functional impairment and prognosis, whatever else is going on.

The psychosis part is more difficult. There is no language/behavior disorganization, in spite of the patient’s wordplay. Mood symptoms, including moderate ongoing irritability, sleep loss prior to admission, and unusual persistent activity, i.e., disappearing from her family and friends, the frenzied travel and searching before admission, her current writing, seem most compatible with a bipolar 1 disorder, which could certainly be associated with psychoses. (Valproate appearing to lower the activity level and mood to a fairly moderate state, in any case.) Main difficulty is that it is unusual to have delusions persist when the mood symptoms are more or less resolved.

One example in the DSM for psychosis not otherwise specified is “persistent non-bizarre delusions with periods of overlapping mood episodes that have been present for a substantial part of the delusional disturbance,” and this fits. Since there is only one manic episode—not “periods” plural—it makes sense to go with a mood diagnosis for now.

The construction of the delusions is intriguing. She has written an entire book chronicling those weeks in September, which she considers a true story, but including characters she has made up completely or derived from an 80-year-old novel: Pamela Buchanan; T. J. Leckbruge, an anagram created from the name of an optometrist on the fictional billboard. Shem Wolfe—apparently Meyer Wolfsheim. Then there is Jay Gatsby.

She also has fabricated or revised conversations with her aunt, her mother, and a neighbor from Long Island.

And perhaps to justify her boyfriend distancing himself from her, she seems to have made up two little girls and given them to him. She insists these two fictitious children are the reason her boyfriend has, apparently, broken up with her. (Am exploring how much of the girls are drawn from her own childhood memories and her relationship with her older sister.)

Re—how encapsulated the delusions are. Although persisting in spite of minimal mood symptoms now, they do not appear to extend much beyond the Gatsby idea. They extend to the homeless man for whom she provided services, who is, of course, deceased. But the case is not closed from her point of view, because the homeless man was indeed the father of one of her assailants. Consequently, I would not yet stop the antipsychotic risperidone.

Am adding to the list of visitors her housemate Whit Nelson. Like her friend Talia, he seems to have a moderating effect on her behavior—and clearly he cares for her.

What is really unusual is the patient’s capacity to have false beliefs, yet to maintain a remarkable empathy for the people in her “memoir” who do not share them—all the while walling off from herself her painful memories of how brutal the attack was. Her characters’ observations toward the end of her story, what she herself has written, imply a dawning realization of how violent the attack was. Nevertheless, at this time she still insists that she escaped years ago with a broken collarbone and a broken finger. She claims to have no conscious recollection at all that she was mutilated and left for dead in the woods…

From the notes of Kenneth Pierce,
attending psychiatrist,
Vermont State Hospital, Waterbury, Vermont

A
CKNOWLEDGMENTS

I
WANT TO THANK
R
ITA
M
ARKLEY,
executive director of Burlington, Vermont’s Committee on Temporary Shelter, both for sharing these images with me and then for inviting me into her life to see the shelter she manages.

In addition, I could not have written this novel without the wisdom, guidance, and unfailing patience of two advance readers: Johanna Boyce, a psychotherapist with her master’s in social work; and Dr. Richard Munson, a psychiatrist at the Vermont State Hospital in Waterbury, Vermont.

I am grateful as well to the following people for answering my specific questions about mental illness, the homeless, and the law: Sally Ballin, Milia Bell, Tim Coleman, and Lucia Volino, of Burlington’s Committee on Temporary Shelter; Shawn Thompson-Snow, of the Howard Center for Human Services in Chittenden County, Vermont; Brian M. Bilodeau, Susan K. Blair, Thomas McMorrow Martin, and Kory Stone, of the Northwest State Correctional Facility in Swanton, Vermont; Doug Wilson, a psychotherapist with the Vermont Treatment Program for Sexual Abusers at the Northwest State Correctional Facility; Rebecca Holt, of the
Burlington Free Press;
Jill Kirsch Jemison; Dr. Michael Kiernan; Stephen Kiernan; Steve Bennett; attorneys Albert Cicchetti, William Drislane, Joe McNeil, and Tom Wells; and, finally, the Probate Court of Chittenden County, Vermont.

As always, I am indebted to my literary agent, Jane Gelfman; to my editors at Random House—Shaye Areheart, Marty Asher, and Jennifer Jackson; and to my wife, Victoria Blewer, a wonderful reader who manages to balance candor with kindness.

I thank you all.

Finally, I want to acknowledge my appreciation for three books. Two are nonfiction stories about mental illness that were both informative and inspirational: Greg Bottoms’s
Angelhead: My Brother’s Descent into Madness
, and Nathaniel Lachenmeyer’s
The Outsider: A Journey into My Father’s Struggle with Madness.

The third, of course, is F. Scott Fitzgerald’s
The Great Gatsby.
There are myriad reasons why—along with millions of readers spanning four generations—I have read and reread this novel. Why, as a novelist, I have revered it. There is the poignancy of Gatsby’s great dream, Fitzgerald’s luminescent prose, and the writer’s profound insight into the American character. There is that wrenchingly beautiful ending.

For the purposes of
The Double Bind,
however, there was something more. Few novels have had the intellectual influence on our literary culture as
The Great Gatsby,
and fewer still have been as widely read. Second,
The Great Gatsby
is a book, in part, about broken people, their lies and distortions: the lies we live consciously, and those we convince ourselves are mere embellishments upon a basic reality. That is, perhaps, among the principal issues the characters confront in
The Double Bind,
too, and why
The Great Gatsby
presents itself as such a unique and pervasive influence on the fictional Laurel Estabrook.

Consequently, I want to express both my admiration for
The Great Gatsby
and my gratitude that it is a part of the canon.

P
UBLISHER’S NOTE
:
The author is donating a portion of his royalties to Burlington’s Committee on Temporary Shelter.

A
BOUT THE
A
UTHOR

C
HRIS
B
OHJALIAN
is the author of ten novels, including
Before You Know Kindness, The Buffalo Soldier,
and
Trans-Sister Radio.
His novel
Midwives
was a Publisher’s Weekly “Best Book” and a selection of Oprah’s Book Club. His work has been translated into eighteen languages and published in twenty-one countries. In 2002, he won the New England Book Award for fiction. He lives in Vermont with his wife and daughter.

Visit him at
www.chrisbohjalian.com
.

To see more of photographer Bob Campbell’s work, visit
www.chrisbohjalian.com/doublebind/campbell
.