Death Grip (27 page)

“Oh no, you'd have to be an inpatient so we could supervise you.”

What?

I go stiff, feel ice in my belly at the notion of being locked up on a ward so far from Colorado and my life as a climber, so far from Kasey and from Clyde. I don't like other people dictating my decisions, controlling my fate. I remember this one thing from Mapleton: A “voluntary hold” doesn't mean you can check yourself out whenever you want, but that you've voluntarily checked
in
for X amount of time and that
they
can hold you for at least that duration. And that if during that period you refuse treatment or insist on leaving, they'll toss you in jail. If, like me, you just want help getting off drugs and the doctors decide, no, not good enough, he needs more drugs, declining the meds will see you, at your weakest, most crazed, vulnerable hour, thrown into county lockup.

“I'm not sure,” I croak, “that I am willing to stay on your ward.”

“I want you to consider it, Mr. Samet,” the psychiatrist says. “I really think it's the only option. You are quite obviously in a bad way.” I'll see it later on the evaluation, his professional impression: “[Matt] was obviously psychomotor slowed. He spoke slowly and there was latency to his answers.… He reported being depressed and looked depressed.”

I'm sure that I did.

We are to meet with my father in two hours to discuss the evaluation. I shuffle back across Wolfe Street to my dad's office, running the gauntlet of security guards, sign-in sheets, and doctors and grad students clipping briskly along the hallways. Only the annointed come to Hopkins, and their crisp, erect carriage is designed to let you know this. I sit with my father in his office and relate the doctor's diagnosis. My dad wants me to check myself in, too, wants me to be here close to him to sort out this mess. He walks me through the School of Public Health, shows me a gym on one of the highest floors with a row of treadmills, with grad students sweating away before floor-to-ceiling windows facing grand city views. “See, you can even come over and work out when you're feeling anxious, Matthew,” he says. “We could run together.”

“Dad, I'm not well enough to run on a treadmill,” I say. “It's all I can do to walk the dog.…”

“It can't be that bad,” he says. “Exercise has always helped you.”

I bite my tongue. I love my father dearly, but right now his cluelessness annoys me. I know that he's forcing optimism because he wants to see my pain end as much as I do, but I also know that he has no idea what I'm feeling subjectively, internally. No one does. No one wants to. We have lunch and return to the psychiatrist. My father sits and listens raptly to Dr. Sock Garters's spiel, but this time there's a new flourish:

“There's also some evidence,” says the psychiatrist, “that electroconvulsive therapy helps with benzodiazepine withdrawal, so we might also try five or six rounds of that.” He's almost giddy, like a car salesman who smells blood in the water and sneaks in another few hundred dollars for the factory coating—only ECT costs a thousand dollars a pop and I don't have health insurance. Moreover, it's barbaric: You're strapped to a table with a giant rubber band around your head, sedated and given succinylcholine, a paralyzing agent that prevents your vertebrae from cracking and limbs from snapping during the post-shock seizure, fitted with a tooth guard, and then electricity—up to hundreds of volts—is pumped through your temple, precipitating the “curative” epileptic fit (the believed mechanism of treatment, inducing, as it does, neuronal firing). Sound like fun? ECT stems back to the notion of “convulsive therapy,” first deliberately applied in the 1930s by the Hungarian psychiatrist Ladislav von Meduna, who triggered seizures in his patients with camphor and, later, Metrazol, a cardiac stimulant (an Italian psychiatrist, Ugo Cerletti, began using electricity in 1938);
14
a typical course of ECT will involve multiple sessions—a few a week for up to a month.
15
While ECT fell into disfavor in the 1970s, it has made a resurgence, and estimates point to one hundred thousand Americans a year receiving it. ECT can cause memory problems, particularly with short-term memory and memories accrued during the treatment phase, brain-cell death and hemorrhage, and—as I'd later learn, talking to other patients upon my return to Hopkins—set you up for deep depressive backslides, necessitating more shock therapy ad infinitum. One description of ECT presented in
Unhinged
describes it as “resetting” your brain, like hitting control
+
alt
+
delete on a frozen computer. However, the human brain is not a $300 laptop. ECT only works, as Dr. Peter Breggin points out in
Toxic Psychiatry
, by “disabling the brain … by causing an organic brain syndrome, with memory loss, confusion, and disorientation, and by producing lobotomy effects.”
16
The patient, bombarded by neurotransmitters, feels temporary euphoria masquerading as improvement, but over the long run, argues Breggin, becomes more apathetic and “makes fewer complaints”—a perfect subject for continued, profitable shocking.

I'm almost desperate enough to consider it.

“Electro-shock? Really?”

“Yes,” says the doctor. “It would be your decision, but we have seen some benefit with benzo-withdrawal patients.”

I look over at my father. The pathos is clear in his eyes, bright blue through his bifocals. What father wants to hear that his only child needs shock therapy?

“I'm not sure we want to do that,” my father says, giving an uneasy chuckle. “But, Matthew, I do think that Dr. Garters is right, and that you do need to check yourself in.”

“Yes … no. Well…” I stammer. “It's … ECT's not for me. And I don't really want to be an inpatient here.” In one gushing soliloquy this doctor has mentioned megadoses of Paxil
and
ECT; I'm starting to feel less willing, if indeed I ever was, to trust him. The three of us talk it through some more, both of them working on me until a lump forms in my throat. I know that I'm scared, know that I'm depressed, know that it's not going well back in Boulder, but an interior voice is shouting that I should not do this. Call it intuition, but this is the same voice that told me to “Go left!” on Spearhead. It is the same voice I'll heed a year later when, despite the protestations of many friends and family members, I quit my final medicine.

Finally, I make a concession.

“Okay, I'm willing to try an inpatient stay,” I tell them. “But I want to do it back home, close to my girlfriend and my dog. I'm sorry, but Colorado is where I live. Not here, not Baltimore, not Maryland: Colorado.”

“But Hopkins is one of the best hospitals in America,” my father says.

“Yes,” chimes in the doctor. “Our affective-disorders unit is one of the oldest in the country.”

I say nothing.

My father asks if Johns Hopkins has any satellite clinics or affiliations near Boulder, and the doctor says no. My dad places so much stock in Hopkins, having worked all his life to reach a chair at this storied institution. His and the psychiatrist's East Coast parochialism irks me, this attitude that anything out West is inadequate or hayseed. And besides, it's not their decision.

“I'll do this,” I tell them. “I'll commit myself. But it will have to be back in Boulder.”

Three quarters milligram a day, Klonopin, Boulder, Colorado, September 2005:

The only other time I saw my father cry was after his mother died, in her early seventies, from heart disease caused by cigarettes. Even when his marriage went south, he never shed a tear in my presence. Now we slouch in the lobby of a psychiatric hospital outside Boulder, he, Kasey, and I, all three of us moist-eyed and mute in the face of the reality that I am committing myself. A staff member spots our trio, comes over, starts asking questions. She's African American, middle-aged, matronly, kind in a way that cannot be faked. Whoopi Goldberg would play her in a movie. She asks me why I've come, and I tell her it's to get off benzos.

“It's hard, honey,” she says. “Benzo withdrawal is really, really hard. But you're strong—you can do it. You're a healthy young man and you want your life back. I'm not going to say it's not going to be difficult, but we'll be here to help you. We have good doctors, and they've seen this sort of thing before. They will help you—I promise you that, honey.”

Something in me relaxes.
They're going to fix this.

“Thank you,” I say. “Thank you so … very, very much.” I cry some more, not caring who sees me. That's become the norm lately: sobbing fits, triggered by the merest trifle—a sparrow on a branch, a dead squirrel in the road, a gutter curl of red autumn leaf. And weeping: wordless weeping. Decay, dissolution, self-pity, salty tears.

I hug my father good-bye, kiss Kasey, and let a nurse lead me back to the ward, to the intake room. This intake room is just like all the others—they never have windows. The hospital doesn't want you to see the outside world, to get too torn up over what you're leaving behind. And the lobbies are always nicer, too, more calming and feng shui than the wards themselves. It's a ruse, a trick to placate would-be patients and the family members guiltily dropping them off like dogs at the kennel. Potted plants, terra cotta floors, soft-lit golden lamps, and leather chairs give way to banged-up laminate cabinets with outdated board games and dog-eared puzzles. To TV/VCR combos with flickery low-resolution screens, white linoleum hallways, institutional bench-and-table dining sets, black-plastic toilet seats and leaky shower heads, blurry metal mirrors, and fungible plastic chairs that can be quickly wiped clean and stacked against the walls. To the odor of bleach and the starchy, spoiled-milk-and-baby-food stench of cafeteria fodder. To med stations where nurses call names off a sheet and bark orders at the patients, making them stand there and swallow every last pill. To impersonal, fluorescent-lit group rooms with scuffed tabletops and blackboards covered in fading chalk hieroglyphics—years upon years and layers upon layers of psychobabble nonsense.

The nurse takes my history; I recount my story automatically and then hand her the Hopkins evaluation to relay to the psychiatrist who will take my case. I've been told that he'll either see me this evening or early the next day—in either case within twenty-four hours of admission. This nurse says that she had to come off Valium three decades earlier and that she knows what I'm going through. I'm encouraged when she squeezes my forearm and says that I can do it. She's middle-aged, her hair pulled back in a salt-and-pepper ponytail, brusque but with a kind smile. I'm led to my room, told to strip to my boxers, and patted down by two orderlies, fresh-faced Baby Hueys barely out of high school. They go through my bag, distributing the contents on the bed with surprising daintiness. I have a stuffed animal with me, a green frog, Smeech. My father and Kasey return with new boxer shorts and an electric razor. They've been to Target, they say,
out in the world.
We bid each other another rough, sad good-bye, and then I sit on my bed. It's night now, a sudden and total autumn darkness. I have a roommate who shows up some time after dinner, nods at me, grunts, and lies sidelong in his bed facing the window, looking out into the central courtyard. He's in his mid-thirties with jaundiced skin, a billygoat beard, and the “fuck-off” air of an ex-convict. I'll learn the next day in group that he is months shy of liver failure, that his name is on a transplant list but that alcoholics don't get precedence. I try not to let him hear me crying. Lately, I've been experiencing a torturous transition into sleep, hallucinating that my pillow is a gnashing mouth, swallowing me up like the ghosts in Pac-Man. I clutch the mouth face-to-face, grasping it as I collapse through the mattress and into hell.

The next day it's breakfast before meds, and I sit at a dining table at 7:30
A.M.
trying to choke down a mealy heap of scrambled eggs. Mornings are bad—I wake up in a toxic funk, sleep fog quickly giving way to anxiety shivers before the first Klonopin, my breath accelerating as soon as my eyes shutter open.

“Meds aren't until nine,” says my tablemate when I ask.

I couldn't tell you his name; only that he's come for a med checkup, says he's bipolar, and is a repeat visitor. A friendly guy, indistinct, bland as a manager at Applebee's. He suggests a game of gin rummy, and he and I and a mute, dark-haired woman who can barely make eye contact play a few rounds. I glance up at the clock every five minutes, willing the time to pass. Soon it's 9:00
A.M.
, and I queue up for my pills: Klonopin 0.5mg, Paxil-CR 12.5mg, Trileptal 150mg. I know from experience that the warm, sedated “it's all going to be okay” glow the pills impart will vanish by 11:00
A.M.,
at which point I'll feel even worse. But I ride it out for now. This particular hospital leans heavily on group therapy: Every other hour you pack like sardines into a meeting room and discuss this or that topic while a social worker or nurse steers the conversation. I'm not sure what they're on about in the groups—as the pills wear off, it's harder and harder to concentrate. I snap out of it long enough to listen to a burly young guy at the end of the table recount how, on a bender, he drove his truck through a wall and is now withdrawing from painkillers. After group, I overhear him tell a social worker that he cried and cried the first few days, but that now he feels better. The social worker tells him that it was chemical, a result of narcotic withdrawal causing low dopamine in the brain, and that it will pass quickly.

Lucky him.
Me: I'm constantly on the cusp of fight-or-flight. I squirm atop my bed between groups, jolt up agitated, the cheap, windrowed blue bedspread itchy and tactile along my back. I scan the hallways, looking for exits; I spy a battered exercise bicycle down one hall and take tepid consolation in the fact that perhaps I can jump on that and ride myself into exhaustion if need be. I'm like a wolf in a trap, ready to gnaw off its own leg. The doctor has yet to see me, but I need to see this doctor. This doctor will fix me. That's what doctors do: They heal. They fix people—they've even taken a Hippocratic oath to do so.