Every day was the same. Process/goals group ended at eleven, with me and the rest of the crew having stated our purpose for the day ahead and condition of the night before. Then there was an hour before lunch during which most of us watched talk shows on TV, or doodled with the array of colored pencils that were piled in an old tin on the table in the octagon, or worked on a jigsaw puzzle that was spread accommodatingly on this same table. At noon we were lining up for the chow cart. They scooped the daily grub onto our outstretched paper plates and handed out plastic utensils. (Other than at meals, plastic flatware could only be had by special request.)
At one o’clock, sometimes there was social work group. There we met with a social worker and bellyached about our prospects, or fidgeted about what we were going to do when we got out.
If it wasn’t social work group it was medication group, where we bellyached to a nurse about how stoned we were or weren’t, what kind of nightmares the meds were giving us, how shaky or sweaty or constipated we were, and so on, and she made notes to give to our docs.
Some days there was no group at one, in which case we all ensconced ourselves in front of the TV, or resumed work on the pastoral scene with skipping girl that we’d so assiduously been coloring. Or, as in Gerald’s case, we got back to counting the pile in the carpet.
At two it was either occupational therapy or activity therapy: OT or AT. In OT we headed into the art room and got all crafty-creative with beads and glue guns. For an hour, we made pieces of jewelry or wind chimes, or, in my case, a mosaic tile trivet, while listening to soft rock on the radio—“WDSM, the station everyone in the bin can agree on.”
In AT, we either played a game like Scattergories or Cranium, or we headed down to the activities room in the basement, where there was a foosball table, a Ping-Pong table, an array of Nerf balls, a plastic Fisher-Price basketball hoop, and semifoam, semiplastic bowling ball and pins. There was also an Exercycle and a treadmill, though not the kind you could break much of a sweat on, or a limb, which was the point. Everything in the room was sue-proof, or as near as they can make it.
OT or AT finished at three, and the rest of the day was ours, not that there was much you could do with it, unless you had a pass. I used my hour pass at this time, from just after three to just after four.
The days went slowly, and as much as I found solace in my room, and in the company of the addicts, I found that working so often in groups with emotionally destroyed people only worsened my depression. The addicts were following their own program, based on a twelve-step model, and we never mixed in group therapy, so I was left to founder with my own kind.
Looking around the circle in therapy meetings, I often found myself going back to my ugly round of thoughts.
These are the palest, most rumpled, useless, yet somehow proudly despondent sacks of meal I have ever had the misfortune to call myself one of. The entitlement in all of us is appalling. My, me, mine. I’m unhappy. Fix it. Happiness is my right as an American. Not its pursuit, but its persistence, like an arc over my life, cradle to grave, a sheltering bough, for spacious skies and fruited plains, the bounty of my country. America the beautiful. And happy. Except that the next verse of that song says, “Mend thine every flaw.” Meaning make a fucking effort, you sloth.
Sloth. A deadly sin. I’ll have to talk to Sister Pete about that. But sin is so unfashionable now anyway. Who needs it when you have the great exoneration of disease? Hell, that’s better than nihilism. That is nihilism. Nihilism with a candy coat.
What’s easier than, Everything is permitted? I’ll tell you what. Everything is a disease. That’s what.
I was not really making sense or being fair. I was pissed off, rage being just another form of negativity to indulge at these crumpled people’s expense, and my own. Yet, how could they expect the group therapy model to work for depressives the way it appeared to work for the addicts? They shared their stories, as so many other addicts did in twelve-step groups, and seemed to gain insight and relief from their fellow patients’ articulated pain and reciprocated understanding. I knew this, in part, because of things I overheard in the dayroom, or things they told me directly when I asked them. But I also knew it because, despite the usual separations, I did manage to sit in on one of the addicts’ sessions, an open AA meeting that met once a week in the basement of the clinic.
There, among the resident addicts, as well as another forty or so outpatient former clients, people joked and laughed. They spoke seriously, too, of course, about their more sordid escapades and histories, and about the destruction they had brought to their own as well as others’ lives. But even the hard ideas helped cement the bond of public confession and shared mistakes. There was a sense of forward motion and positivity even in the darkest stories. People were there to lance their boils and walk away relieved. They were not, as my fellow depressives and I seemed always to be, intent on stewing in their distemper.
Maybe it was just this particular crop of depressives—they were no one’s dream team, to be sure, and neither was I—but I wasn’t getting anything except more negativity and a heightened sense of alienation out of listening to Trevor talk about his devil dogs and watching Gerald become one with the wallpaper.
It wasn’t that I couldn’t see, in theory, how talking to other depressives might help me get some perspective on my own death spiral. It certainly had in the past, when I had spoken to depressive friends. But that had only been true when the depressives I had been talking to hadn’t themselves been depressed.
Those conversations had helped me only because the person in question had recovered. They weren’t in the hole anymore, which meant that (a) the hole hadn’t swallowed them up, and so, by extension, it wasn’t necessarily going to swallow me up either, and (b) they were standing aboveground and had some perspective on where they’d been and where I currently was. They could throw me a rope.
But these people on the ward were just as firmly in the hole as I was, so what rescue could they offer? To make things worse, it wasn’t even the same hole. We were all in our own separate holes, so we couldn’t even play blind patty-cake. The best we could do was overhear and cross-talk each other’s pitiful wailing and griping. We were just blobs in sweatpants in dire need of dandruff shampoo. All those groups were just wasted time, as far as I was concerned. I got much more out of my individual therapy with my psychologist.
Not that that was transformative either. It was fine. It probably helped in the way that traditional psychotherapy is supposed to help, or at least in the way it has helped me in the past: by getting me to organize my thoughts through verbalizing them. But in the end it was just your basic three times a week for fifty minutes.
My stalwart therapist was very sympathetic, obviously thoughtful and caring. A practiced and expert listener. She always tilted her head to one side and slightly down, and tucked her long hair behind her ear. Her watery blue eyes looked up at me and blinked slowly at all the right times. She compressed her lips sorrowfully when I cried, or, as was more often the case, when I tried not to cry and failed, and licked the snot off my upper lip. When I choked on a word, she always waited for me to go on. She never spoke before I’d finished. She understood. She responded. She tried. She had all the right tools of the profession, except maybe that spark of the dark arts that therapists always have in the movies, and that I had always looked for in real-life therapists but never found. It was probably just as well that I hadn’t, since the most appealing movie shrinks usually turned out to be serial killers anyway.
I don’t mean in any way to denigrate her. I am grateful to her. She did well by me, such as doing well can be with bread and butter. She was the companion piece to my room. Another clear benefit of St. Luke’s that I had not enjoyed elsewhere. A place to rest and confer with myself, a wall to bounce my riffs against, a small but true light to steer by. It wasn’t her fault that I needed Hannibal Lecter as my therapist. Or thought I did.
But whatever the misfires of the treatment, the staff treated us with what I came to see as St. Luke’s trademark kindness and concern, and sometimes staff members even made surprising and creative extra efforts to reach us.
On one occasion, for example, a psych tech named Mitch did something far more inventive and healing than I would have expected from anyone in a hospital setting. Just before wrap-up group one evening, he hid a remote-controlled fart machine under Teary Molly’s chair. When it was her turn to blubber and whinge about her day, he hit her with a loud one. She looked puzzled. Didn’t get it. The group, presuming she had lost control of her sphincter in her distress, decided to ignore it. But then very quickly he sent another. The machine was well designed, offering an inspired array of sounds from plappy to squeezed, and every permutation in between. This one was a percussive blurt, like a low note from a flügelhorn, followed by a long slow deflating wheeze. At this Sam could no longer keep a straight face. He dissolved in silent laughter. I, being me, took the helm on this one.
“Jesus, honey, do I need to move?”
Mitch sent another. A classic whoopee-cushion bubbler.
“Okay,” I said, “you have my respect. Peace.”
Now the whole circle was roaring.
Mitch had done the impossible. He had tickled the walking dead. Like the employment of Sister Pete, this struck me as an awe-inspiring act of kindness on Mitch’s part, and I was impressed anew with the quality of person St. Luke’s managed to employ. Not only had the nostrum of laughter as best medicine managed to survive the pharmaceutical age, but it came sliding into that circle of pathetics on the whim of a young man who had no degrees or pedigrees, just some old wives’ wisdom about what was good for a soul in pain.
Sister Pete was holding a black Grave Digger Monster Truck, a stuffed toy that a kid on the children’s ward had given her to mend. She was planning to sew up one of the wheels whose seam was ripped and return it tomorrow. But for now, sitting with me in my night-lighted blue-walled room after supper, she was holding the thing like a baby, fascinated as usual.
I, too, was interested in this artifact. Where else but on a children’s mental ward would you find a stuffed truck? No hard edges allowed, even in toys, which could be and no doubt were thrown. The children’s ward was above us, and I had already heard loud pounding coming through the ceiling in the octagon on the addicts’ side, where I had been spending most of my social time.
“What the hell is that?” I had asked Fenske, who was watching the Lakers game with me on TV.
“Another kid flipping out,” he said casually, as I wondered whether that strangely soft thumping was someone’s head drumming the floor.
Aside from the monster truck, Sister Pete was also carrying something she called “the hem of Christ’s garment.” She carried this wherever she went, but this was the first time I had seen it, a conspicuously laundered-looking relic that she housed in a Ziploc bag. I couldn’t quite tell whether she thought the tidy white swatch was two thousand years old, but still suitable for dry-cleaning or she just liked having something talismanic to place on people’s heads while she stood over them and said her blessings.
She said she pressed the hem against the tabernacle for hours, praying feverishly to imbue it with, or replenish, its healing power, which I can imagine was sorely drained after a night on the ward. As I’m sure she was.
It must have taken a lot of energy to pump so much spirit into three wards full of people, especially when a third of them were kids. I actually wondered what she ate to make herself so round, when she claimed to eat a fairly healthy diet. There must have been some doughnuts and potato chips in there somewhere.
She said she ate her food mostly raw. Veggies for sure. Potatoes too. If she ate animal protein, it was usually at some public event, like the Lenten Friday fish fry at the community center, where clergy ate for free. She was living on a tiny budget, I’m sure, and so she was duly frugal. She could rattle off the price of celery at three different markets. Usually, when I was talking with her in the kitchen of an evening—say, about depression and the sin of despair—she would investigate the fruit bowls for brown bananas.
“They just throw them away,” she’d say, slinging them like pistols into the hip pockets of her habit.
I was talking about despair with Pete because it was the theologian’s version of depression, and I had been thinking about what they taught us in catechism as a child. Why is despair a sin—a mortal sin? I used to ask this of my teachers, it seeming unfair to damn a person for feeling bad.
But as I watched so many of the patients at St. Luke’s, myself most of all, indulging in depression as a form of bratty rebellion, and as I had fought with myself about volition, about how much of depression is a willful resignation rather than an actual absence of will, I had begun to understand why despair could be characterized as vice. It occurred to me first because so many of the patients around me were fat. Clinically obese, actually.
I thought again of the favored diabetes analogy. “Would you begrudge a diabetic his insulin?” they say. “So, then, why begrudge a depressive his Prozac?”
But I began to think of the link between diabetes and obesity, one exacerbating the other, one biological, the other behavioral, and I began to see how fault and will could come into it. I thought of how eager we are, a society in which corpulence is an epidemic, to absolve ourselves of our own bad eating habits, how eager we are to locate obesity in the genes or blame it on a virus. Take this pill and be thin, says Big Pharma (how rich will the first company be that can really say that?) and we’ll make billions telling you what you want to hear. Obesity is not your fault.