Loud in the House of Myself (18 page)

“I’m sorry. It’s mandatory that you spend at least twenty-four hours in psych after a suicide attempt.”

The amount of hell I could raise about this was limited by the presence of my mother. “Fine,” I said, “but only twenty-four hours. After that I’ll sign myself out against medical advice if I have to.”

“If your family agrees to take responsibility for you, that won’t be necessary.”

“About that Ativan…” I said.

My family spoke to him in the hallway and signed papers on a clipboard while the nurse brought in a syringe and shot me up. Within minutes I was drowsy. She bustled about getting my things together and helping me into a wheelchair to take me to the psych ward. An elevator ride, a trip down a long white hallway, and two sets of metal doors swung shut and locked behind us. The nurse wheeled me down the hall, which was surprisingly empty, and into my room, which looked like my college dorm. The wooden beds were covered with nicks and had words carved into them, though with what they had been carved, I had no idea. Mine said
lucky
.

The nurse helped me into bed. I tried not to think about the reason it had a vinyl mattress. I pulled the sheets up to my chin and screwed my eyes shut. It was the last peaceful sleep I would have for months.

The next day, my parents were given permission to take me back to their hotel. I wanted to go home, but it had apparently been decided that that was a bad idea. I knew better than to push it.

The one time in my life I’ve ever been in a limo was that morning. They had called for a car service in Brooklyn, and when they said there would be four passengers, the car service sent a limousine. So I walked out of the hospital, into the dilapidated, razor-wire-enclosed parking lot, wearing my faded cotton pants and ratty green T-shirt, and stepped right into the limo like I was going to the prom.

“Are you hungry?” my mother asked.

Surprisingly enough, I was. I couldn’t remember having eaten anything during my stay. I wasn’t even sure how long I’d been there. When we got to the hotel, my dad helped me into bed, took off my shoes, handed me the room service menu, and told me to order anything I wanted.

He was walking on eggshells. They all were. The only other time my family had ever ordered room service was at Disney World when I was twelve. Then I had drunk fresh-squeezed orange juice from a crystal goblet. Now I struggled to suck a chocolate milkshake through a straw. I had bitten my tongue so hard I winced with pain, but I tried not to let my family see.

For two days we stayed in the hotel and all I managed to swallow and keep down were chocolate shakes and mozzarella sticks. In fact, that would be all I ate for the next two weeks. Once a day, sugar and grease, then back to a comatose sleep.

I showered, finally, unsupervised. I let it pummel me as I examined my bruises. As the hot mist pulled the flimsy fabric shower curtain in on me, as it enveloped my body like the big white ball in
The Prisoner,
I sweated and tried to cry. I wanted to release my anger and sorrow as I released the hospital from my pores. I wanted the water to beat it out of me. But my heart and soul and brain were locked down, shut off tight. Whatever I felt now was trapped in the oddly shaped spaces between my heartbeats. (They had taken me off Wellbutrin after the overdose and put me on Lexapro, which sped up my heart rate.)

Kendra and I shared a bed. Just as we had when we were little girls spending the night at each other’s houses, only this time everything was different. Two marriages, two children, three hospitalizations, and millions of dollars separated us now. She drove a BMW; I rode the subway. She had three houses; I was a month behind on rent. She was thin and beautiful, and I…well, I was doughy and beaten, black and purple, an obvious casualty of the outside world. She had succeeded. I had failed spectacularly, a fallen meteor giving up and cooling after crashing into the earth. I snuggled against her. She pretended not to wake up.

Eventually I had to go back to my apartment. On the third morning, outpatient treatment secured, we checked out of the hotel, and I held my mother’s hand in a death grip as our cab approached the shabby brownstone. I was so grateful she was taking me seriously, that she hadn’t let me come back to this place without making sure I had immediate therapy scheduled. I had a feeling I knew what was waiting for me, but I figured it would just be a barrage of emails and phone messages, not the goddamn
New York Post
hanging out on the stoop. My upstairs neighbors, who knew what had happened, told me the reporters were harassing the other tenants for information about me every time they walked out the door. They had been there for two days.

There were three of them, and my mother led me past them, my head bowed like a criminal. Once we were inside, my dad called the police, but apparently the reporters were allowed to stand outside the building as long as they didn’t knock on the door.

The answering machine was blinking like mad. Even though I was already in shock, I wanted to get it over with, so I took a deep breath and hit the button. Apparently, attempting suicide on the Internet was of some great interest to the public, at least according to Montel and Maury and the
Post
and every other news outlet with a penchant for schadenfreude. I deleted them all immediately.

The phone rang. It was the
Post
again.

“Get your reporters off my goddamn stoop,” I said.

“All we want is a quote,” said the man on the other end.

“Sometimes people do things they’d like to live down and they want their fucking privacy. You are not getting a quote from me,” I shouted, and hung up.

In the paper the next day was a story. “Sometimes people do things they’d like to live down and they want their…privacy,” said Pershall in an interview with the
Post
. They had also called Glenn and quoted him similarly. The reporters went away.

Parody websites, the kind that exist to make fun of other people, called me everything from crazy to “a tattooed trucker bitch,” to someone who should stop taking up space but was too stupid to kill herself correctly. I went numb, except for the incredible shame, guilt, and horror at having done something melodramatic I could never live down.

I vowed that day that I would never, under any circumstances, attempt suicide again. I had to find something to save myself—specifically, something besides a man. I had to channel the energy I had expended on self-destruction, on crisis after crisis, into something positive. Enough women hated themselves already; the world didn’t need one more.

I would make my skin a place in which I could live.

DENISE IS DRAWING
on me, carving the story of my life into my body. I have become so used to her tools that they live behind my eyes and in my nostrils and my eardrums. The room we work in has a smell, green soap and A+D ointment; the things she does to me require germicides and antiseptic. She is another mad scientist, another strange girl, she whips off her latex gloves long enough to slap a piece of Scotch tape on the hair that keeps falling in her face.

I love her. I gave her my skin.

On September 10, 2001, in the last hours of normalcy in New York City, I got my first big, visible tattoo: across my chest, from armpit to armpit. I went to a convention on Long Island with a friend, and a large man named Baba, from Los Angeles, inked a smiling cat over my sternum. I needed to shout to the world that my heart could be broken but I’d paint over it with vivid colors. I would live, despite all the guys who’d dumped me and the fact that a humiliating picture from the worst day of my life would forever be available on the Internet. The next morning, when the planes hit and I blinked awake and said goodbye to my beloved city as I knew it, my freshly abraded chest was covered with Saran Wrap wet with plasma and Vaseline. It seemed fitting to have a bandage covering my heart.

One night I was with a tattooed sort-of boyfriend who lived in Jersey City, on our way to spend the night at his house, when we ran into his neighbor Denise de la Cerda on the PATH train. She had worked on him, and her pieces were my favorites among his tattoos. He introduced us, and in that instant, indefinable way, we recognized each other as kindred spirits. The next day I went to visit her tattoo shop, decorated with Buddhist altars and Tibetan masks brought back by her Nepalese husband. The photographs of her tattoos hanging on the wall took my breath away. I was entranced by her work, how she used white in a way I’d never seen before, how she crammed so much detail into one tattoo. I asked her to begin painting the story of my life into my skin.

There was a time when I liked to pride myself on my pain tolerance, but as the years have worn on, I have run out of nonpainful bodily real estate. A session is no longer a full piece but a little more work on the one in progress. It’s agonizingly slow, and agonizing in general, but I am healing myself, and what this means for my friends is that while they no longer have to listen to my endless litany of emotional torment, they have to listen to me bitch about my inner-elbow abrasions and pretend not to know me when, in public places, I pause to dab saliva on the blood seeping from the cracking scabs on my ankles. It’s all a trade-off, really. I hope they can see it that way.

Denise has told me that people have actually fallen asleep in her tattoo chair because she’s so light-handed and her machines are so awesome, which makes me feel like the world’s biggest pussy, seeing as how I’ve been known to bite my fist as the Nepali holds me down by the ankle.

“I’m sorry,” I tell her. “Fuck, I’m twitching like a motherfucker.” My vocabulary narrows to approximately twenty words when I’m getting tattooed, and five of them are variants of
fuck
.

But we always laugh. She goes back to inflicting pain and I go back to taking it. With each breath I count to one again. Each inhale, each exhale, time passes in the smallest of pieces, and pieces still smaller of those.

Knowing I can survive this, and that I have found in Denise a friend who so respects and understands my need to modify my body that she has agreed to commit to me for a long time. When Denise agreed to tattoo me from head to toe, a process that would easily take at least a decade, she said to me,
I will not leave you
. She deemed me worthy of patience, collaboration, and hours upon hours of her time.

Denise refers to the pictures she paints on me as “the shit you let me get away with,” but to me these tattoos signify my liftoff. My parents are, unfortunately, very opposed to them, and my mother has cried over them more than once. This kills me, of course, but I have tried to explain that this is something I have to do to reclaim my body, to experience and survive physical pain that approximates the mental.

A tattoo machine (not gun!) is built around a DC coil like the inside of a doorbell. On one end is a hammer, on the other is a metal tube. Tattoo needles are entomology pins or small sewing machine needles soldered in a cluster to the end of a long metal bar with a loop at one end. The loop is attached to the hammer and the bar passed through the tube so that the needles just barely stick out the end of the tube. The needles are dipped into small cups of ink. When the machine is connected to electric current, vibrating needles pull the ink into the tube. By the same token, the hammer drives the needle repeatedly into the dermis, the layer of skin just above the fat. The tattoo artist holds the tube like a pen, the machine resting on the top of her hand. The needles poke holes in the skin, and the ink is deposited into those holes. When a tattoo heals, it scabs over like an abrasion, which means the process of getting the tattoo feels a bit like getting road rash, if the road were made of angry bees.

Obviously, Karen Pershall is never going to approve of my doing this to myself, and I have learned to live with that. Although we love each other and have a better relationship now than we’ve ever had, I remember when, at sixteen, I tried in vain to explain to her why the stories I wrote contained curse words. When, at nineteen, I played Agnes of God and I had to prepare her for the molestation flashback scene; when, at thirty, I admitted to her I had been broadcasting my life on the Internet. Between being an artist and a mental patient, I have forced my mother to accept things no parent wants to know or see. But acceptance doesn’t mean approval, and although my mother will now speak openly with me about my mental illness, she cuts to monosyllables when I mention my tattoos. The conversation goes something like this:

She says it like this:
WaaAAAYYYYYulll
. It’s two syllables. You draw the first one out, it gets longer and louder, and the
l
’s slam it shut. It’s the verbal equivalent of smiling through your teeth and closing the door a little too hard on your way out.

What she doesn’t say is,
When I see you now I think about your baby skin, how you were born on Mother’s Day with jaundice, and how the doctors made me leave the hospital without you. I’m trying not to tell you what you looked like, yellow under those fluorescent lights with patches on your eyes. I’m trying to let you walk away now, trying to see the real you through your colors. I’m trying not to remember how when you were finally pink they let me take you home.

PHILIP THORNTON IS
an old man now. He has white hair and age spots, but his smile is the same, and his glasses are the same: lenses without frames, gold wires that wrap around his ears. I sit on the edge of his leather chair and wonder whether or not to take my entire shirt off when I show him the tattoo.

“I have something for you,” I say.

“Is it a book?” he asks.

“No,” I say. “Remember the last time we talked and I told you I was getting tattooed, and you said, ‘Get a tattoo for me’?”

His head snaps back a little. He looks at me sideways. I turn my back to him, lift up my shirt.

“Oh my god,” he shouts, and then he laughs and laughs. “Wildcat Frenchie.”

Wildcat Frenchie was a burlesque girl in New Orleans in the 1950s. Phil, a student at Tulane, had a crush on her. To illustrate a point in one of our sessions many years ago, he’d told me about her. I delighted in teasing him about it.

Denise’s rendition of her takes up my entire back. She stands on a pedestal. She has a black cat and a crystal ball, and her name is emblazoned six inches high and surrounded by peacock feathers. Over her head is a banner that reads
Harm’s Way.

“Do you remember?” I ask him. “Do you remember when you told me my job was to put myself in harm’s way?”

“Oh, I remember.” He lifts his glasses, wipes his eyes, shakes his head. “You always did take things a little too seriously.”

What finally happened to drive me into dialectical behavioral therapy was one last bad relationship—this time with an author we’ll call Shitnugget—in the spring of 2003. Although I had vowed never to attempt suicide again, Shitnugget drove me pretty close to it. I called my shrink, she sent an ambulance, and I ended up in the Bellevue emergency room. But wait, there’s more: a month later I spent a night in jail for defacing copies of Shitnugget’s book, with its front-page dedication to his penis, at a nearby Barnes & Noble. I ripped the covers off them the day they came out in paperback and hid them in the yoga and pilates section. As I was walking out of the store, a plainclothes security guard grabbed my bag and pulled me into the back room, where three managers, the eldest of whom was at least a decade younger than me, took their time in calling the cops. I was led in handcuffs through the store and taken to Central Booking, where crack-heads threw water on me for being (a) white and (b) in jail for tearing up books.

I found myself once again letting my world shatter around me over a man, and I was mortified. How many times did I have to let it happen before I gave it up once and for all? Therapist after therapist heard how I couldn’t live without the love of whatever schmuck had last crossed my field of vision. When someone, anyone, was mean to me, I still couldn’t take it. I would melt in the floor of the deli sobbing and begging the forgiveness of the woman who called me a bitch when I bumped into her. I was exhausted from the effort of basic survival, and knew I had to stop everything and put all my energy into getting well before I killed myself or someone else.

All this is to say that tattoos alone didn’t heal me, even though they went a long way. Once I started looking like an artist on the outside, I was much more comfortable being one on the inside. It was immediate and honest, and it felt good to have everything out in the open. However, medical and therapeutic intervention was still necessary.

Here is how the psych med story tends to go. After either (a) much convincing or (b) no convincing at all, we crazies march ourselves into the pharmacy one day with a fresh prescription for potential sanity. Once there, we may or may not fork over hundreds of dollars for a month’s supply of pink or orange or yellow pills. If we’re one of the lucky ones with health insurance, they hand over the bottle for little or no money, bestowing upon us a chance at getting better. If we’re among the 46 million uninsured, well, tough shit, we’ll just have to be depressed (or suicidal, or homicidal, as the case may be). Having been uninsured for most of my adult life, I will always remember the day when, at age thirty-five, I first handed my new insurance card across the counter at Walgreen’s and paid three dollars for a thirty-day supply of a drug that normally cost four hundred. I felt privileged, as if I had gained access to some exclusive club, then felt guilty for feeling privileged, then felt an overwhelming sense of relief, like for the first time in my life I could take a breath that went all the way to the bottom of my lungs. I found myself daydreaming about other doctors I could visit: the orthopedist, the audiologist, the gynecologist. Visions of annual pap smears danced in my head.

While we wait for the pills to take effect, we either (a) worry about or (b) look forward to our new personality. Will we recognize ourselves? We hope so, we hope not. In the ideal situation, we will be ourselves, but enhanced—calmer, funnier, the kind of person who could be described as stable. We hope against hope that once the pills help us stop sabotaging our relationships, pushing away and/or stalking our lovers, and throwing things at people, maybe we’ll get boyfriends or girlfriends who stick around. We’ll sleep better, wake without dread, and our smiles will come back. We won’t go on any more impulsive shopping sprees, and we’ll always be able to pay our rent.

Or maybe we don’t dare hope for a good life, because a good life is a foreign concept. We wouldn’t know it if it bit us. Instead, we just hope for tranquillity, and if that comes at the expense of having no personality and taking up permanent residence on the couch, so be it. This was my experience on lithium, and although it made me fat and boring, it allowed me to sleep. One cannot overestimate the importance of sleep to the manic. However, I certainly wouldn’t call lithium a success.

Psychiatrists, who these days tend to prescribe meds but not provide talk therapy, generally require a referral from a therapist, because them’s the rules set forth by the managed care companies. This means we patients have to build trusting relationships with two doctors at once, show up for two sets of appointments, and repeat ourselves a lot. These are the hoops through which we must jump to get the drugs, to have our shot at Better. Because psychiatrists have ten more patients waiting in the lobby and need you to repeat yourself in shorthand, they love to assign scales to things. We are asked to describe our feelings on scales of 1 to 10: Are we depressed? Manic? Happy? Sad? Thinking of hurting ourselves or anyone else? Are things more or less hopeless than last week? Last month? Three minutes ago? We describe ourselves: Today I am a 5 of depression, a 6 of anxiety, a 2 of suicidal. I have often thought we should decide our numbers beforehand, and instead of reading old issues of
Golf Digest
in the waiting room, make labels to wear on our clothes. They can identify us by our numbers like inmates, if only for that day, and we won’t have to say anything at all.

The question is, of course, at what numbers can we consider a drug successful? If I lower my depression score by 3 and raise my happy scale by 2, am I well? Do you have to be a certain universal number to qualify as sane, or is it relative based on how crazy you were to start with? Is my 6 of happiness somebody else’s 8? If you’re a 4 of happy on one drug but a 5 using another with more side effects, is that extra point worth gaining forty pounds (or twitching, or getting a rash, or experiencing involuntary movements of the tongue, or any of those other things they say veryveryfast at the end of drug commercials)?

I think of the whirlwind of side effects I’ve experienced, and it exhausts me. The massive lithium/Depakote/Seroquel weight gain, the shitting of my pants on Wellbutrin, the crippling dizziness that hits after 24.5 hours without Effexor. It should not be that if you take a pill at noon one day and twelve-thirty the next, your brain should come loose and send loud buzzing echoes ricocheting through your skull, but that is in fact what happens. Taking these medications requires vigilance, and if you are careless, there are serious consequences. It only takes one weekend of going out of town and leaving your meds at home to make you never, ever do it again. Once, deprived of Paxil for 48 hours, I spent a gruesome Sunday lying in a fetal position in a hotel room in Austin while my friends partied it up at South by Southwest. My day consisted of attempting to stand up and falling down because I was too dizzy, punctuated by unsuccessful attempts to drink orange juice with the tiniest of swallows, so as to induce only the smallest of brain shivers. A gulp left me clutching my head, pressing my fists into my eyeballs to stop the jolts.

I endured fifteen years of side effects and questionable efficacy before I was given Lamictal, the mood stabilizer that has, along with completing the full eighteen-month, three-day-a-week course of DBT, kept me out of the hospital for four years now. I greatly enjoy living a life not punctuated by suicide attempts, and I’m grateful to GlaxoSmithKline for their help. One thing that pisses me off royally is hearing drug companies denounced as the devil. I don’t like giant corporations (or, in the words of Spalding Gray, “the big indifferent machine”) any more than anyone else, but I
really
don’t like wanting to kill myself. A person who denounces psychopharmaceuticals based on a political agenda is a person who has never lain crumpled in a ball in the closet, sobbing uncontrollably, face covered in Sharpie, throat raw from induced vomiting. Accordingly, that person should be thankful and shut the hell up.

While it is true that a drug which relieves symptoms in one person may exacerbate them in another, and that doctors thus have no way of knowing how a patient will respond to a drug unless they try it, misdiagnosis—and thus mismedication—is all too frequent. I would not have taken twenty-four drugs if I’d been diagnosed borderline in the first place. When I began to request my charts from the many clinics and hospitals where I’ve been treated, I was amazed that for the first ten years I sought help, shrink upon shrink diagnosed me bipolar and borderline, but none of them ever told me about the borderline part, the all-important Axis II. When a person is diagnosed with a mental illness, according to the DSM, she is given both an Axis I and Axis II diagnosis. Axis I comprises all conditions
except
personality disorders and mental retardation. This creates two major complications right off the bat. First, the Axis I disorder is seen as the primary illness in need of treatment, when in fact the personality disorder may be more prominent and troubling, and second, the Axis II diagnosis is much more open to interpretation, and therefore much harder to pin down. According to the DSM, “general diagnostic criteria [for an Axis II disorder] is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture.” Given the difficult task of defining that experience, it is no wonder misdiagnosis is rampant. Even though I’m a hell of a lot better than when I was first diagnosed, I daresay I continue to deviate from the expectations of my culture. But the journey of that deviance, the covering of my body in tattoos, has allowed me to make a tentative peace with my flesh. It has taught me that I am brave and can withstand tremendous pain. Not all deviance is negative; without it, we’d never change the world.

Still, I spent a lot of time wondering if I’d have been less borderline if I’d been raised by liberal artists in New York City. In Prairie Grove, if you don’t bow your head and pray to Jesus, you’re culturally transgressive. In New York, I have yet to hear anyone say grace before every meal, but my parents pray before eating a McDonald’s cheeseburger. So am I only borderline according to Arkansas standards? The answer is
of course not
. I tried moving to Cincinnati, and after that Boston, and after that New York, and my illness followed me everywhere I went. There are very real and pervasive indicators of borderline personality disorder, particularly recurrent difficulty sustaining meaningful relationships. There was no question that this difficulty was central to my life and my sorrow.

This is where teasing out the entanglement of borderline and bipolar becomes crucial. Had an astute clinician had more than seventy-two hours to do this detangling during my first hospitalization, it would have saved me a lot of misdiagnoses, and thus reduced the number of ineffective medications whose side effects I suffered. (I do not think Phil Thornton misdiagnosed me; I think he was correct to treat the primary illness with which I presented: the eating disorder.) But more than that, it might have led to more efficient therapy, and greatly reduced the amount of money I spent on medication that didn’t help, therapy that didn’t help, and repeated hospitalization. It would also have reduced the amount paid by my insurance, on the all-too-fleeting occasions when I had insurance.

The back-asswards way in which this is viewed by insurance companies is as follows: Axis II disorders are long-term and acute. As such, many borderlines, including myself, suffer in silence for years before getting treatment simply because it is more cost-effective to treat only the Axis I disorder. Insurance providers read “long-term” as analogous to “too costly,” and that’s as far as it goes. This is why residential eating disorder treatment, for example, is largely ineffective. Although anorexia and bulimia are Axis I diagnoses, both are highly comorbid with a diagnosis of borderline (particularly bulimia). Because poor impulse control is one of the major difficulties borderlines face, and gorging and purging are nothing if not poor impulse control, it doesn’t take a genius to see that if the personality disorder is not treated, the eating disorder can’t be eradicated in thirty days or less. And we are lucky if even thirty days are covered.

The entire time I was in treatment at Central Clinic in Cincinnati, I was told I was bipolar. The clinicians there were caring but overwhelmed, interns just beginning to see individual patients, and inexperienced in the recognition of personality vs. mood disorders. If someone (say, me) comes in hyperactive and talking a mile a minute one day and suicidally depressed the next, it could be rapid-cycling bipolar disorder, or it could be a borderline reaction to circumstance. If, for example, I am dumped one day, I am desolate and the world seems hopeless, because I’m at the black end of the black-and-white thinking. If, the next day, the guy calls me up and says he’ll still have sex with me, I shoot to the white end; the world is full of love and light. Everything is fine, I don’t need to hurt myself, and I
certainly
don’t need therapy.