Wasted: An Alcoholic Therapist's Fight for Recovery in a Tragically Flawed Treatment System (14 page)

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I LIE ON THIS
new couch of willingness as withdrawal pounces. It’s the worst this time. I say that every time, but this time it really is. I wretch. My teeth chatter uncontrollably. It’s impossible to get warm. The fear of another seizure grips me. The rain pounds on the porch plastic. I’m immobilized in pain for six days, punctuated by visits from the men
as they pop out to smoke.

“You really fucked up, Mike,” says Dangerous Doug as he sinks into an ancient chair on the porch and inhales deeply.

“Your head’s got a contract out on your ass, Mike,” Josh says again.

“Sobriety comes before everything, Mike.” Guy stubs out his butt in the thick 1950s glass ashtray.

“Turn your will and your life over to God,” Monk nods.

“We’ve all done it, Mike.” Tom “Guns” reminds me. “You’re gonna be okay.”

After I’ve spent eight days on the couch, Eli calls me into his office. He stares straight ahead, avoiding eye contact. That means he’s not angry. He smirks sanctimoniously.

“I told you you’d relapse, guy. You’re an alcoholic. You’re selfish and self-seeking. Have you surrendered yet, guy?” Eli taps
his fingers on his desk. “If you don’t, you’ll die. Move in with Brad.” Eli is right. I am selfish and self-seeking, and he could have turfed me. I suspect a decade of dealing with guys like me have worn off any softness Eli might have had.

Once again, I’ve made the cut. I’ve graduated from the couch of willingness.

Brad is a biker and a collector for unpaid drug debts. His weapon
of choice is a metal baseball bat, very effective for smashing kneecaps and breaking forearms. He’s within fingertip reach in the tiny room. I cannot sleep.

Not because Biker Brad snores. No, Brad’s dead-sleep utterance is much more interesting than snoring. At the transition from inhale to exhale, when his inflated lungs shift to expel air, his voice box makes a sharp, loud ping, like
a
WWII
German submarine sonar searching for depth charges in the still night of the deep, dark English Channel. My very own
Das Boot
.

Each ping echoes through the halls of the former old folks’ home. It stops at random. Ah, there, it’s stopped. But no, it starts again, and again I jerk alert. Night after night.

I want to kill Brad.

I want him to kill me.

I want
to kill me.

I claw at the head of the stinky, stained mattress, hanging on to life and wishing for death.

The room is dark and claustrophobic. But not dark enough. My eyes refuse to stay closed. They burn and sting. My jaw aches continuously from anxious teeth-grinding. Normally, this far along in withdrawal, I’m through feeling hyper-anxious and hyper-vigilant. This time is different
and frightening.

I cannot sleep. If I do, I’ll suffocate.

The struggle for breath and the compulsion to scream rise in my throat. This mental war rages the entire first night and continues for fourteen successive nights. When I slip into blessed unconsciousness, utter panic takes over. I envision being in front of a firing squad, waiting for the order to fire. I jolt awake, bathed
in sweat, fearfully scanning the room.

Sleep-deprivation psychosis slithers in, and I sink deeper into delusional paranoia. My raw, damaged brain jangles.

The guys in the house hate me.

They’re laughing at me.

They want me to die.

They think I’m crazy.

Another We Surrender client, Ted, suffers from drug-induced psychosis. He’s here because the courts
sent him to rehab as part of his sentence.

“You’re an undercover cop, aren’t you, Inspector Pond?” Ted corners me in the hall. “You’re a narc and you’re out to bust me.”

We feed into each other’s delusions. I believe Ted will kill me in my sleep.

But that’s no problem. I don’t sleep.

Am I an undercover cop?

Clinical Notes—Mental Status Exam:

Appearance
and Behaviour: Patient is an underweight and undernourished fifty-five-year-old male. He is unkempt with scraggly hair and beard. His hygiene is very poor and has strong foul halitosis. His gait a slow shuffle with his head down and avoids any eye contact. He has facial tics and picks at open sores on his scalp. His lips are covered in herpes and he chews them till they bleed. Impulsive.

Speech: Very low, mumbled and mostly incoherent.

Mood and Affect: Reports severe depression and hopelessness. Fearful and anxious with an exaggerated startle response. Tense and agitated.

Sleep: Suffers from severe insomnia and frightening nightmares.

Appetite: Poor.

Thought Content and Process: Obsessive thinking and paranoia. Suicidal intent but denies plan
at this time. Short-term memory and concentration poor.

Perception: Delusions of persecution and influence. Auditory hallucinations.

Orientation: Person and place but not time.

Insight and Judgment: Impaired.

DSM-5
Diagnosis: Alcohol Use Disorder—Severe; Major Depressive Episode; Generalized Anxiety Disorder; Sleep Deprivation–Induced Psychosis.

Global Assessment
of Functioning (GAF) score: 20/100.

Plan: Requires inpatient medical and psychiatric treatment. Folie à Deux.

Folie à deux, or shared psychosis, is a psychiatric syndrome in which symptoms of a delusional belief are transmitted from one individual to another. Ted’s delusions have become mine. In the middle of the night, I rummage around and search for my hidden badge and gun.

I pace the hallways, wring my hands, pick my scalp raw, chew my cold-sore-infested lip and mutter to someone or something not there. Head down, I avoid all contact. Random guttural groans escape me Tourette-like. From a clinical perspective, these utterances are supposed to diminish the anxiety. It doesn’t work.

In a rare flash of insight, I know I’m not just having a bad withdrawal.
The years of alcoholism have taken their toll. Abused for so long, my brain’s neurotransmitters no longer know how to fire properly. I’m mentally ill, suffering from a mood disorder and probably psychosis. This is all too common among addicts. Sixty per cent of those suffering from addictions also have a mental illness. Now I’m one of them. Perhaps this is what happened to some of the black-circled
guys on Eli’s photo collage?

I am clearly in a mental health emergency. I should be in a hospital. But there is no one here to take me. In fact, I’m just like a lot of other guys here now, addicted and mentally ill.

Death becomes a viable option. Tonight, Biker Brad with the submarine ping is away on a pass. I cannot stand being inside my head any longer. I get up and scan the
room.

Our beds stand exactly thirty-eight inches apart. I know—I measured it one day with the tape measure out of Brad’s toolbox. My side of the room has a small wooden dresser at the foot of the bed. The dresser holds a limited selection of donated clothes. My duffle bag and briefcase are stowed under the bed. Brad’s stuff infiltrates my side of the room. Work boots, power tools, tool
belt, chainsaw, motorcycle parts, a yellow gas tank from a Harley Fat Boy. On Brad’s side, the one closet holds leathers, Daytons and an uncountable array of blue jeans.

I open and shut all the drawers in the ancient dresser. I can’t find what I need. I open the closet door. A quick scan of Brad’s clothes, and I find it.

I pull the belt from his navy blue terry bathrobe and clove-hitch
one end to the wooden bar in the tiny closet. I slipknot the other around my neck. I stand on a toolbox on the closet floor and cinch the belt snug.

To be or not to be? The inner debate is brief. My addled brain no longer possesses the cognitive ability to marshal any argument, pro or con.

I drop, almost to my knees suspended, and my airway cuts off; now, at the threshold of unconsciousness,
my legs bicycle. The higher functioning part of my brain wants me dead, but the reptilian amygdala fights for survival. Flight-or-fight kicks in.

I reach my right arm up hook it over the bar and hang by my elbow. My left hand frantically tears at the cinched slipknot. It finally eases open and air hisses in to my body. I loosen the clove hitch and fling the belt off my neck. I collapse
on the floor.

For days the telltale bruise on my throat displays another sign of my insanity. My neck is stiff and sore. If I hold my head bent slightly sideways, the pain eases.

“Did you try to off yourself, Pond?” taunts Gary in the dining room. “You crazy fuck. Don’t let Eli see that. That’s all we need is another shitty corpse to cut down.”

Every night, my vocal tics
worsen. The noise wakes Biker Brad and he yells at me in the night.

“You’re crazy, Pond. Shut the fuck up. I’m trying to sleep and you’re thrashing around like a fuckin’ lunatic. They’re gonna lock you up in the psycho ward.” He holds his filthy pillow over his head to shut me out.

I lay there silent and yell back in my head. I
am
a fuckin’ lunatic, you psychopathic prick.

Brad moves to the only empty bed left—the couch of willingness. He needs his sleep, he mutters as he storms out of the room.

Everyone avoids me. Even the house management avoids me. I’m a pain in their asses. And maybe they’re scared. Another casualty; another tragedy; another failure; another black circle on Eli’s collage. I keep my gaze down. Every time I look up, I’m stunned that
I’m here. I can’t bear to look at the humanity around me.

I don’t eat. I can’t read. I won’t leave my room except to attend the mandatory
AA
meetings, and when I do, I sit there mute. I’m afraid to speak because everything comes out crazy.

I hear Josh waddle my way. He stands in my doorway, one hand on his hip, the other stretched over his head, resting on the door frame.

“Your work called, Pond.” Josh looks at me with distaste. “It’s been two weeks. You better call them. Your whore called, too. Don’t you dare call her! I told you a job and a woman would take you out. Sobriety has to come before everything.”

This is standard recovery-house language—women’s value expressed as only sexual, in the crudest possible language. Dana is not a whore or a cumbucket—that’s
the worst one. She is my last connection to my previous life. But I no longer have any fight left in me to tell Josh off.

I drag my feet to the office and dial work.

“Hello, Odette. It’s Mike Pond. I’m sorry I haven’t been to work. I have been very sick.”

“We haven’t heard from you, Mike. I have talked to
HR
and management. You have to meet with the occupational health
nurse. She’ll assess you and decide what treatment to recommend.”

“I haven’t been fired?” I am incredulous.

“I don’t know. I’ve never dealt with anything like this before. You are on a leave without pay at this point. You barely started your three months’ probation. Mike—do you have a drinking problem?” Odette asks bluntly.

“No,” I lie.

“Have you seen a doctor?”
Odette sounds suspicious. “You have to get a doctor’s note.”

“No, I haven’t. I will. Thank you, Odette.”

Josh nods self-righteously as I hang up. He recites by rote from the Alcoholics Anonymous Big Book (page 58):

“Rarely have we seen a person fail who has thoroughly followed our path. Those who do not recover are people who cannot or will not completely give themselves
to this simple program, usually men and women who are constitutionally incapable of being honest with themselves. There are such unfortunates. They are not at fault; they seem to have been born that way. They are naturally incapable of grasping and developing a manner of living which demands rigorous honesty. Their chances are less than average.”

JOSH CHAUFFEURS ME
to the walk-in medical
centre on 152nd Street. A sign shows up in several strategic places throughout the clinic: “We do not write prescriptions for narcotics or other controlled medications.” Drug abuse runs rampant in this quaint little seashore town, home to millionaires and retired police officers.

Dr. Holic steps into the examination room. He’s a kind-hearted man who speaks with a slight Czech accent. I
saw him once before, when I first arrived at We Surrender. A lot of the men see him. Back then he gave me a physical exam, wrote a prescription for my thyroid medication and scratched a brief note for social assistance saying I couldn’t work because I was in treatment for severe alcoholism.

“What can I do for you today, Mr. Pond? Your lab results from a few months ago look fine.” Dr. Holic
flips through my chart.

“I need a medical note from you for my employer, saying I’m sick.”

“What’s wrong with you?” He looks up from the chart.

“I told them I have an infection.”

“What kind of an infection? Take off your shirt and sit up here.” He gestures to the exam bed and I hop up. Dr. Holic places his stethoscope on my chest. He shakes his head. He’s seen a
lot of drunks and alcoholics.

“Did you start drinking again?” he asks.

Long pause.

“If I don’t get a note saying I’m really sick, I won’t get my job back. I barely started my probationary period.” I stare at the floor.

“Mr. Pond, you are sick. Very sick. You have a disease. It’s called alcoholism. I will write you a note and it will say exactly that. You have an
illness and you require treatment. You need a medical leave.”

“They’ll fire me.”

“I will agree to monitor you medically.” He scribbles a note.

“Thank you, Dr. Holic. But I think I’m done.”

“Mr. Pond, you just have to get well. That’s the only thing that matters right now.” He tears off the note and hands it to me. It says I need a medical leave because I am an alcoholic.

I return to the house. Josh hands me an envelope. It’s been opened. Bastards read my mail. The letterhead reads Fraser Health Human Resources.

I must complete a medical assessment by a qualified addictions specialist at my own personal cost. The College of Registered Psychiatric Nurses and the College of Registered Social Workers concur with my employer. I must have the assessment
before the hospital will even consider my return to work. But I know these assessments are expensive—around fifteen hundred dollars, as I recall. I stare at the collage of black-circled men, convinced it’s just a matter of time until I’m up there with them.