Voluntary Madness: My Year Lost and Found in the Loony Bin (16 page)

This and raisin bran was most of what I ended up eating while at St. Luke’s. Lunches and dinners were egregious, catered unwholesomely by the same company that served a local college. Often entrées were some form of semicongealed mash casserole consisting of hamburger, corn pone, peas, and potatoes. It was either that or macaroni and ham and viscous, ersatz cheese all served with an ice-cream scooper. Starch was the staple. At times even the vegetables were adulterated by it. One side dish of glazed carrots had soggy bits of bread mixed in.

But snacks! Snacks. God, how civilized. How good.

Of course there were always people for whom too much idle time in the octagon and too much access to the kitchen weren’t a particularly healthy combination, people like the 350-plus-pound, six-foot, four-inch mulatto whom I unoriginally nicknamed Fridge, not just because of the famous football player of the same moniker, but because this guy spent way too much time gazing into, and dwarfing, that particular appliance.

He was twenty-one years old and seemingly still afflicted with the near demonic munchies of the growing boy. The siren song of the sandwich was so strong in him that the whole ward eventually took to joking about the fridge itself being haunted.

“It’s calling to you, man.”

And he was indeed a comical figure standing there huge as a door himself, gripping the handles of both fridge and freezer, swinging them rhythmically as he rocked back and forth on his size twenty feet.

Fridge was MI. Some undifferentiated mood disorder that made him prone to attacks of rage. He was the one who had been “very upset” while I was waiting downstairs. He got upset fairly frequently, and when he did, he often kicked open the magnetic doors that were supposed to keep us all locked in. There were three sets of them. He never got past the second. Not that he would ever have made a run for it. I doubt if he could have run: his size alone hobbled him. But he also had an understandable tendency to trip over his own feet.

Fridge had been in St. Luke’s about ten times before, ostensibly to have his meds adjusted. He seemed to have some problem taking them when at home, or at least doing so consistently. He lived with his grandmother and was subsisting on welfare or disability or both. He said he was the victim of fetal alcohol syndrome, and that at least a good portion of his emotional difficulties were attributable to that.

When he wasn’t in a rage Fridge was a lapdog, friendly and sweet, always amenable to teasing. He did remarkably well for a large man confined in a small space.

As I sat there in the kitchen munching my bright green buttered broccoli, he was standing with a sandwich in one hand, head in the fridge looking for more. He said a chewing hello. I nodded and smiled.

Soon there was a parade of others coming into the kitchen, like Fridge, for a snack and a gander at me, the new meat.

There was Clay, a fifty-one-year-old father of four. He wandered in sighing, wearing scrubs and socks. St. Luke’s distributed scrubs to patients instead of pajamas, if they wanted them, though this was mostly just for the ICU, where people were more likely to have shown up without a change of clothes.

After a long look at me, Clay said quizzically,

“What are you doing here? You look great.”

“Appearances can be deceiving,” I said.

“I don’t know,” he countered. “You look like you work here.”

He wandered over to a chair and fell into it, grunting painfully.

He was paying what for him was attention, but he was not altogether there. His eyes were at half-mast, and he was swaying ever so slightly on his feet, as if he were standing on a boat. He was one of the addicts. Chemical dependency. CD. He was detoxing hard from a spree.

He had lost his job a few months back, just before Christmas. Then on Christmas day he’d had a terrible fight with his wife and stormed out of the house. He’d spent the next three months in what he called “the rubber room,” which meant that he’d holed up in a cheap motel on the edge of town, a place infamous for being a drug den, and had gone on a protracted 24/7 bender, drinking beer and shooting coke all day and night, bouncing off the walls until they had to scrape him off the floor, near dead, with a needle stuck in his arm.

You can have a mighty good evening on a couple of grams of coke. When they found him, Clay had done an ounce. An ounce is 28 grams.

They took him to the emergency room. Then, once stabilized, they transferred him to St. Luke’s. Now they were giving him 10 milligrams of Klonopin a day (1 milligram will make a novice woozy), plus trazodone (an antidepressant that everyone at St. Luke’s said made them feel like a wet noodle), Ativan (another benzodiazepine, or “benzo,” like Klonopin), and the famous sleep aid, Ambien. All this just so that he could cope, and pass out for a while at night.

Coming to see me in the kitchen was a feat at that hour, around seven. He’d had his evening meds, which is why he had the sea legs. Usually at that time, he was sitting on the couch in the octagon, his knees bouncing like they had a jolt in them, his face flushed, his eyes darting, his whole nervous system in overdrive.

I would see him in this condition fairly often over the next few days, but just as often he would be on the opposite pole. He tended to alternate between these two states. The one when he was on the edge of a panic attack, the coke making its hair-trigger way through his system, or the silly semistuporous one he got into about half an hour after he’d had his meds. Then, like now, he just smiled a lot, stated the obvious, and cheated very poorly at cards.

Clay, like Bunny, was still wearing a wristband. Seeing it, and having the same squeamish reaction to it that I had had with Bunny in the lobby, I was thankful that St. Luke’s didn’t use wristbands. To patients they are indicative of anonymity and neglect, and the doctors who owned St. Luke’s seemed keyed into that, or so I imagined, understanding on some level that being tagged is a gross insult to your dignity. It makes you feel like property, or a corpse, a body not a person, the implication of the tag—maybe the need for it—being that if you passed out in the hall, they’d know who the hell you were.

By the time the introductions with Fridge and Clay were over, Bunny had made her way into the unit as well. I looked over and saw her slumped in a lounger in the octagon.

She was as wrecked as Clay, but alcohol was her drug. As she told me later, she was only recently out of prison, where she had done a six-month sentence on her third drunk-driving conviction. Depending on the state, the legal limit for blood alcohol content (BAC) is either 0.08 or 0.1 percent. When Bunny was admitted to the hospital, her BAC (or so she said) was 0.59, a poisonous, quite possibly fatal amount.

Though obviously an alcoholic, Bunny was, by her own admission, primarily depressed and self-medicating. Her mother had died a few months back, and that was most of what had precipitated her recent binge.

She was a bright woman and had spent her life in this dinky prairie town going mostly nowhere. There was nowhere to go but out and away, very far away. But she never had, and so, like so many of the other addicts and depressives I met at St. Luke’s, she sank, and then did drugs and drank to pass the time, or obliterate it.

That part of the world would depress anyone—anyone with imagination or ambition. It was easy to see how it would happen, how slowly, over the course of years and many dull days, the landscape would destroy you.

The people were a mirror of that landscape. Flat, simple, but existentially in pain. They spoke plainly but liltingly, their vowels all attached to an
e
, as if transcribed from the Greek—
ae, oe, ie.
They were eager to help, and easy. Not southern sluggish, but in no particular hurry or busy snit either.

They were real, and rudeness was rare, but they would not let you into their hearts. They would not even let themselves. They were kind on the surface, but, as on the farms so plentiful in the region, the soil underneath was black. Not the black of cruelty, but of despair. The thing that nearly everyone around me was in the hospital for.

And the prognosis was not good. Not good at all. Because even if these people landed in St. Luke’s or places like it, there would be no lasting remedy for the disease—the disease of their lives. Even if you cleaned a person up and dusted him off and stanched the flow of immediate tears with a rub on the back and a pat on the head, there would still be the same world out there to confront when the treatment was over.

There were still the hours to fill and the lack of opportunities or hope. These people would still go home to an empty apartment or a family fight, all the same stressors still in place, and they would have no means of lessening them, because their will, if they had amassed any in their time away, was still weak and always a quick casualty. No match for the horror of lost chances.

That’s why they all landed back in here. They came in zonked. Got sober. Went home, and the minute they put their keys down on the counter, took their first real breath, and the smell of all they were running from got way up in their nostrils, they reached for the same solution, and did it all over again.

That’s why, when Clay was on the phone talking to his mother or his cousin, he said, “Yeah, that guy who kicks in the doors is here again. Remember him? And that lady with the red hair, too.”

He was talking about April, another depressive alcoholic repeat who may have set some kind of record for rebounds. This time around she had been in St. Luke’s half a dozen times in as many months. She was fifty-eight years old and divorced, living off the settlement and boozing her way through it, drinking 1.75-liter bottles of liquor in two days with no food. Now she was on a boatload of tranquilizers too. Five milligrams of Klonopin a day, trazodone, and Lunesta for sleep.

Living alone with no occupation was the killer for her, and the reason why she relapsed so fast, usually within hours of release. It usually took her a few weeks to work her way into such a state of acute malnutrition that she had to come back to the hospital, but she always did it. A terrible, common cycle.

Of course, not everybody was a repeat. Chloe was a first-timer. I met her, too, that first night.

She was a nineteen-year-old student at the local college who had come in for suicidal ideation. She was yet another one of those hapless people—there always seemed to be one, usually a woman—who, in an unguarded moment, confessed to feeling suicidal or inclined to self-harm and got shuttled off to the psych ward.

The door had locked behind her before she had gotten her bearings enough to know that she couldn’t just walk out, and she was stuck here at the mercy of a total stranger’s judgment about her own internal life.

I found this bitterly amusing, and so indicative of the state of psychiatry today. They admit a person to the hospital based solely on what she tells them about how she’s feeling. They diagnose her on that basis, too. Yet once she’s in the hospital her word is no longer good enough. She has been magically diagnosed, and that diagnosis supersedes her testimony. Suddenly the doctor knows better, even though he knows only what you have told him.

Does the word match the disease? Does the disease exist at all? The doc is dealing in shadows. Yet we all speak with such conviction, as if diseases were made entirely of ideas, floating in judgment between doctor and patient, and then somehow locked down, the person locked in and trapped by the doors and the diagnosis.

When I first saw her that night, Chloe was talking on the pay phone, crying. The trap had done its work. She was frightened and feeling worse, looking around at all the rest of us downhearts and drowsers and thinking, “What the hell have I done?”

She was a tall, broad-shouldered, athletic girl with medium-length dirty blond hair, which she often wore in a ponytail. She was wearing jeans and a jean jacket over a T-shirt, the jeans and the jacket both fitted and faded to the same ice blue.

She moved and held herself upright and square-shouldered, with the command of someone whose body is an instrument, efficient and well trained. Her face was covered with shiny pink pimples, which she picked unself-consciously, often until they bled. This, combined with an air of insouciance that somehow coexisted with her depression and self-loathing, had the effect of making her seem even younger than she was, and more exuberant, as if her youth could not help bursting through all the worldly woes that had gotten her here.

She was filled with determination and energy. Nothing like the other depressives I met at St. Luke’s. But then this was part of her problem. It was what drove her to self-harm and a suicide attempt.

She told me that when she was a child her father used to give her a sheet of paper every morning and tell her to use it to make out a schedule, dividing the day into fifteen-minute increments. She was then required to write down exactly what she had done during each of those fifteen-minute periods, everything from brushing her teeth to saying her prayers. At the end of the day her father would read over her schedule and tell her whether or not she had had a good day.

Her life was a drive. One long drive to be good enough, to achieve, to use time, not to fail. She was a good athlete, she said, basketball and soccer, and a good student, though not a natural one. She had been on antidepressants for two years, and had been cutting herself for longer than that, just trying to find some relief from the expectation.

“I don’t feel that I will be loved if I’m not the best at everything,” she said.

Nonetheless, she had her head screwed on pretty straight. She had enough perspective to say that her father meant well, as no doubt he did, even as he hammered her into shape. He wanted her to succeed, wanted to teach her to order her world, a skill that she knew had served her well in many respects, even as it had drummed home the message that love was to be earned, not freely given. She knew that medication was not a hale holy panacea, and that she would have to build her emotional well-being out of effort and vigilance as much as the almighty chemical fillip.