David's Inferno (14 page)

Maybe the only reliable diagnosis is the treatment. Maybe we should give up trying to label all the different flavors of mental weirdness. Doesn't the fact that there are so many diagnoses suggest that it's an effort in futility? Especially since a whole lot of them are
NOS
(Not Otherwise Specified). C'mon. That's clearly a cop-out.

Why not, instead, diagnose people based on whatever ever-changing formulation of prescription drugs, alternative remedies
and therapies, random symptoms, psychological/spiritual practices, everyday functioning, and self-medication that's getting them through the day? (Or failing to do so.)

There are as many variations on depression, obsession, agitation, mania, attention deficit and combinations thereof as there are patients. But I'm currently the only guy I know who's a fairly highly functioning, Lamictal-Cymbalta-Klonopin taking, alternative-medicine-trusting, wood-splitting, road-biking, single-malt drinking, melancholic, hypomanic writer in remission.

 … Who, during the 1980s and 1990s was an extremely unpredictable, cigarette-smoking, whiskey-drinking, racquetball playing, business-owning, vitamin-taking, garden-variety (and vegetable-gardening), self-medicating depressive with hypomanic spells.

 … Who, after surviving his first big-time breakdown in 1999, became a fairly high-functioning Celexa, Wellbutrin, acupuncture-ing, freelance writing, squash-playing, moderate major (or major moderate) depressive in remission.

 … Who, one fateful day in 2005 became, for the next two years, a barely functioning, try-just-about-anything, desperately self-medicating, exercising-like-crazy, anxiety-ridden and occasionally screaming major depressive with a touch of hypomania.

To provide a “precise” diagnosis of anyone, you'd have to add details about their gender, weight, genetics, hours of sleep, diet, the number of close friends … the list is endless.

The disease is that personal.

The treatment is that elusive.

When I told a friend I'd had a nervous break
down
, he suggested, with a slightly maniacal if transcendent grin, that maybe I'd actually had a break
up
. With a single preposition, he changed the entire way I understood my experience.

Things break
down
—bicycles, laptops, nuclear power plants, etc. You want them to work the way they did before. Even if it means buying a few new, identical parts.

Relationships break
up
—teenage romances, marriages, negotiations, etc. In those cases you usually
don't
want things to work the way they did before. You want to use the opportunity to try something new.

Mental illness rides the line between them.

During what I called my break
down
, I thought I wanted my mind to work the way it did before. During remissions, I'd say: “I think I'm back.”

At the same time, my relationship with and perspective on myself and the world had completely broken
up
and there
was
no going back—any more than there had been after I got stoned for the first time, lost my virginity, got married, watched our daughter being born, or buried my father.

Our brains are
things
. Physical objects in which cells divide, cerebral spinal fluid flows, and neurons exchange molecules. When those parts break
down
, we want to get them working
physically
the way they did before. Or, better yet, like they did when we were younger!

But each of us—the whole package—is an ever-changing, seemingly limitless, network of complex
relationships
between the physical and the distinctly (albeit mysteriously) ineffable.

And so, while in many ways I yearned desperately for a brain that I could relate to as I did before—a brain that didn't keep sending fight-flight signals to my adrenals; that had internal circuitry which tickled some pleasure points once in a while; a brain where millions of tiny synaptic electrical signals created the occasional wave of calm; a brain that could convince itself that this too would pass—I also sincerely hoped and believed the experience would be transformative … one way or another.

Perhaps even a break
through
.

B
ACK IN
H
ELL
, D
ANTE ACTED LIKE A TOURIST
. H
EY, IT
wasn't his fault he was down there. It was part of a research project. Beatrice wanted him to learn as much as he could about the structure of the universe. And, as part of his final presentation, he was able to make sure all his enemies got what they deserved. Talk about poetic justice!

But now Dante's entering Purgatory. Which is an entirely different scene. He's been on the road—circling round and round Florence—long enough to begin realizing that those damn clerics and politicians don't have a monopoly on sin … 
he's
no angel either (yet).

As he walks through the Gates of Purgatory, a
real
angel carves seven Ps on his forehead—representing the seven deadly sins. Every time he successfully works his way around and up another terrace of Purgatory Mountain, one of those Ps is brushed away.

But it takes work. He walks along the First Terrace bent over with the prideful (as well he should), all of whom carry massive weights on their back. On the Third Terrace, he walks with the wrathful through black smoke.

The key scene takes place when it's time for Dante to cleanse himself of the final deadly sin: lust. To do so, he has to walk through flames. He hesitates. Virgil pushes and prods. Dante resists. Virgil tells him not to worry … nobody dies here, so to speak. It's only when Virgil promises Dante that Beatrice is on the other side, does he manage to screw up the courage to do it.

Isn't it kind of ironic that he needs lust to transform lust?

By now, even Dante must be thinking that the whole sin thing is getting kind of old. Throughout history, it's been such a moving and often self-serving target. In order to make sure they're
in the right, people's definitions have ranged from outer rules so strict that there's little margin for error to inner disciplines that are supposed to cultivate qualities of wisdom and judgment in and of themselves. Doesn't make much difference: regardless of beliefs or philosophy, people find ways to justify the most outrageous behaviors.

While the seven deadly sins can definitely get you into a lot of trouble, they aren't really deadly. Even more heretically, they're not even sins
per se
. They're the other side of the story. Pride is part and parcel of courage. Envy, aspiration. Wrath, energy. Sloth, contemplativeness. Greed, hunger. Gluttony, completion. And lust? Lust? Lust is passion.

There's a famous Zen story about some monks going to their Master to complain about one of their fellow monks—a real screw-up. The guy coughs, sneezes, and makes even less-pleasant bodily sounds during meditation. When it's his turn to serve dinner, he trips and spills hot soup on the Master's lap.

One day they're all out working in the woods and this guy fells a tree so close to the group that a branch whacks the Master on the side of his head and knocks him out. That's the last straw.

“We gotta get rid of this guy,” the monks say to the Master, who's finally come back to (enlightened) consciousness. He's lying in a hospital bed, sipping chai tea through a bendable straw, his head held rigidly in place by one of those contraptions that holds your head rigidly in place.

The Master hears them out and thinks (or no-thinks) about it deeply for a while. So deeply and for so long that they think he's fallen asleep, is resting in
satori
, or both. Finally the Master speaks: “Okay. We'll send him away.”

The monks are surprised, but very relieved. At last, they can get back to the serious business of stillness—without worrying about what that crazy monk is going to do next. But, as they begin to file out, the Master calls them back into the hospital room. Even with bandages covering half his head, the monks can tell the Master is still pondering the issue. They wait expectantly. The Master sighs.
They wait expectantly. The Master looks up at them quizzically—as if he's been working on a koan of his very own:

“But who will we replace him with?” he asks.

Without lust—okay, passion—how would we get anywhere?

Of course, without love, how would we survive the flames?

T
HERE
'
S A LEGEND
among road bikers in Vermont that back in the 1700s when they first cut roads in the Green Mountains, they'd eyeball the height and start working their way up—at, say, a 6%–8% incline. But, they inevitably miscalculated a little, so toward the top, rather than bother with another full switchback, they'd take one more hard turn and head straight up at a 12%+ pitch.

More than one good biker has rounded that last corner only to realize he's got no more gears on his bike or strength in his quads.

The other bane of a climber's existence is the false top. Glimpses of treetops on surrounding hills make you think you can tell how much elevation remains, only to find out that, thanks to some unseen dips, you still have several steep climbs to go. (Or, as they say, the problem with downhills in Vermont is that they're mostly up.)