Voluntary Madness: My Year Lost and Found in the Loony Bin (22 page)

And so I was back to depression and Catholicism. Gluttony, like sloth, was one of the seven deadly sins, I recalled, and then it seemed clear. Despair was a mortal sin in the catechism, because despair was a gluttony of sadness and a form of spiritual sloth. An overindulgence of an appetite or propensity. The people in St. Luke’s, and I was just as guilty of this, consumed their depression, rolled in it like pigs. We were all so eager to decline responsibility for everything, to recline in the arms of a disease and quit, to take our failures, our gloomy, angry view of the world and make it into a fortress against that world. A defense.

That is what quitting is. It is not a passive state. It is, to return to John Nash’s analogy, a very active resistance, a work stoppage, a throwing down of the spade in the face of adversity. Despair, in this sense, is not a giving up, but rather a taking up, a forceful “No” that says “I will not participate.”

This, in theology, is the rebellion of the fallen angel who says,
Non serviam
. I will not serve. This is the soul that sets up a rival good to God’s and makes negation his creed, the soul who will not struggle, the king of pain, the emperor of resentment gorging himself on sour grapes.

Depression is hell. Indeed. But perhaps a participatory one, I thought. After all, the fallen angels didn’t really fall. Like every high-rise successful suicide, they jumped.

Again it was the ugly train of thought at work. Convincing, to me at least. But right or wrong? I didn’t know.

And so what? What did it matter? The better question was: What now? What was I going to do with my own gluttony of sadness, my own spiritual sloth, the nihilism with the candy coat that I was gobbling as greedily as Josephine devoured her trail mix, or Chloe her Skittles?

I was either going to have to convert some of this shoestring theology into action, or I was going to have to stop grinding the ringer. Either these thoughts led somewhere or they didn’t. And if they didn’t, I was better off medicating myself back to some sort of functional retardation than I was sitting with the Don Quixote of nuns over a bowl of brown bananas finding cosmic truth in the last words of Lucifer.

I was becoming annoyed with myself. And this was a good sign. An impatience with thought. A dialing down of the navel gazing, and the first mild rejection of all my Cracker Jack college education running at the mouth. The first rays of perspective breaking through.

After I made my first trip out on an hour pass, I found that one hour wasn’t quite enough time to exercise and walk into town to get a little something to eat, so I requested two hours, figuring that it would be turned down. But Magic Doc stepped up and gave me a two-hour pass every day from then on.

My run in the park across the street hadn’t gone all that well on the first day, partly because it was a very small park, and running laps around it made me feel like a hamster, plus doing so in my white socks and brown loafers, the only shoes I had brought (because they don’t have laces) made the young mothers in the playground pull their children closer.

There was a YMCA just up the road, and I could get a day pass for $12. For the rest of my stay I spent the first hour on pass working out on the StairMaster. Then I walked the ten minutes into town—I had to time this perfectly so as to be back on the dot of 5:06 or 5:08 or whatever minute was exactly two hours after the time I left.

In town I stopped at a brewhouse for a real meal of grilled salmon, sautéed veggies, and two beers. I only ate at the brewhouse because it was on the near side of the freight tracks, and I knew from experience that a train could take ten minutes to pass, blocking my return to the hospital when every minute counted.

The beer tasted like God’s brew, especially since I was not supposed to have it, so cold and smooth first thing after a workout, a quenching buzz rushing to my brain, pumped express by an elevated pulse. There was a little joy in my loins, with the sweat and the blood and the delirious high of temporary freedom, which was at least as potent as any drug, the power of sitting at a barstool of my own accord, almost like a person.

Yet I felt like a criminal, sitting there incognito, the loon on the lam. Or did everybody know? Did the waiters all have jokes about this? A game? Spot the tuner on furlough? Shoes with no laces must have been a dead giveaway. I was grateful again for no wristband, but I couldn’t help feeling marked nonetheless, like yet another kind of queer, like the dyke whose sartorial misstep or too rugged swagger gives her away as a weird sister, a genetic mistake faking it poorly.

“I mean really,” says the normal, “who does she think she’s fooling?”

Are the mad so easily recognizable? Or are they only craftily off-kilter? Their screws not loose but loosened, like the hinge on a practical joke or the dousing bucket cleverly balanced over the door. What role does the madman play? And does he play it straight?

I was sipping my beer thinking all of this. Again. Did they know? Did I want them to know? Did I know? Did my being who I was serve a purpose for them? Did I play this role, rather than simply live it? Was it my job, like being the village idiot? Did they need me to be this way so that they could safely be that way? What was normal, after all, without contrast, without aberration? The extremes define the center. Not that I flattered myself that I was on the extremes. More just somewhere nondescript on the tapering of the curve.

As I paid and finished, I sent a few quick text messages on my phone (which I would have to surrender at the nurse’s station when I got back). I did this just to let a few friends and family know that I was not in a Turkish prison having the bottoms of my feet pounded by a fat man with a length of pipe. On the contrary, I said, all was well. This was an enlightened penitentiary, where they (or at least my doc) understood the benefits of exercise and fresh air and private vices.

They had rules, like any locked facility, but I didn’t have the sense that they expended much energy on the details. If I had been fifteen minutes or even a half hour late getting back, for example, I doubt if anyone would have noticed, much less said or done anything. I didn’t test this, though, because my freedom meant too much to me. Likewise, I don’t know what they would have done if they had smelled beer on my breath. But since I wasn’t there for addiction, I wasn’t on any medication, contraindicated or otherwise, and I wasn’t getting drunk, it might not have mattered. At most, they would have revoked my passes. But no one smelled my breath. The security guard downstairs put me through the metal detector and checked my bag every time I reentered the building, but he didn’t pat me down or make me empty my pockets, so smuggling wouldn’t have been hard. Still, what was I going to smuggle in that town? Library books?

For obvious reasons, the addicts only went on passes accompanied by family or friends, and the involuntary MI people, especially the less cooperative ones, didn’t go on passes at all, for equally obvious reasons. But several of my vanilla fellow depressives, like Josephine and Teary Molly, did take advantage of the breaks and leave the grounds for an hour or two of an afternoon.

I was going to meet with Magic Doc when I got back and this put a little pace in my walk as I crossed the minigrid of sparsely populated downtown streets and passed through empty lots overhung by billboards advertising hotlines for the pregnant and the drug addicted.

As I turned a corner, I was surprised to see someone I knew.

Fridge was lurking in front of a shop with a friend. I said a booming hello, but he was less than enthusiastic, not eager to acknowledge a fellow St. Luke’s alum, especially in front of a friend who hadn’t been there. Unlike prison, there’s no pride in doing time in the bin.

I passed on, skirting the skateboard park where bored ruffians of Bard’s approximate age and type were caroming off curbs and railings, honing a legal outlet for their rage.

Finally, I was back through the doors, through the metal detector, up in the cattle-car elevator, and back in the sanctum sanitorium.

As I was walking down the hall to the ward I heard a nurse announce over the loudspeaker:

“Please take a moment of quiet reflection this evening. The thought for the day is: The essence of prayer is seeing everything through its life-filled dimension.”

I just had the chance to shower and change before doc time.

 

As soon as I sat down, Magic Doc delivered some bad news. Or what would have been bad news to a normal patient, but which turned out to be of interest in my case.

“I have to apologize to you,” he said. “It seems your insurance company is not going to cover any more of your stay here.”

“Really?” I said. It wasn’t clear to me why this was, or why it was his fault. “I don’t understand.”

“Well, they gave two reasons. One is that you’re not taking medication. The other is that you’ve been going on two-hour passes every day.”

“They think I don’t need to be here?”

“Right.”

“Because I’m getting fresh air and exercise?”

“Well, their reasoning is that if you’re well enough to leave the hospital for two hours a day, then you’re well enough to be at home. I don’t agree at all, but that’s the way a lot of insurance companies see it. I didn’t realize that you had out-of-state insurance. If I had, I wouldn’t have given you the pass and risked this cancellation. Around here, most local insurance providers won’t stop coverage because somebody is going on a pass, so it’s usually fine. But a lot of carriers in other states will. Obviously, yours is one.”

“It’s amazing. I do something that will actually speed my recovery, and they penalize me for it,” I said, shaking my head. Then I added, “You know, that reminds me, not that I haven’t been immensely grateful for the passes, for all kinds of reasons, because I have been, but I’ve been meaning to ask you this anyway. Why don’t you have a gym right here in the hospital, or an outdoor track or something? That way people could work out and not have to leave for two hours to get it all in.”

“I agree,” he said. “I’ve tried. I lobbied for a lap pool and all kinds of things, but the liability insurance costs are just too high to have exercise facilities here. It’s just easier to give you a pass so that you can go across the street to the Y.”

“Ridiculous.”

“I know. I know.”

“And the meds are the same story?”

“It was probably both things, the pass and the lack of meds, but again, attitudes on meds are different in this state. That’s, in fact, why I came here. I’m not from here, and, as you can imagine, I wouldn’t have chosen this town for lifestyle reasons, but it happens to be one of the few places in the country where the insurance companies don’t make it impossible to practice real psychiatry.”

“You mean psychiatry without meds?”

“Yes, or at least the option not to use them.”

“What happened with that back in your home state?”

“I was practicing child psychiatry, but I didn’t want to prescribe Ritalin to kids. First thing I did when I got a new patient was take them off the drugs. I wanted to see who the person was.”

“So you think the drugs really got in the way of therapy?” I asked.

“Oh yeah. And the kids end up taking much more than they should. What often happens is that the mothers give the kids the pill in the morning and it works great. But then when it wears off, the kids are worse than before, so they give them another pill in the afternoon, even though they’re not supposed to.”

I thought of Bard, and asked, “And do you think that this ends up predisposing them to taking street drugs like meth as they get older?”

“Sure. They’re craving that high.”

I thought of myself going off the Prozac and feeling worse than I’d ever felt before taking it. I wondered if I was hooked in much the same way, needing the drug just to feel normal. I told Magic Doc that I thought a lot of psychiatrists were prescribing too much medication to a lot of people and either not understanding or not disclosing the dangers of dependency.

He agreed.

“A lot of psychiatrists these days are not really practicing anymore. They’re not listening. They’re just prescribing meds. I don’t know why most MDs even go into psychiatry.”

“No shit. Most of them have got the emotional intelligence of sandstone. And I won’t even get into the way too cozy relationship between doctors and pharmaceutical companies.”

“Yeah, I had that out with the drug reps at one point. They wanted to sell me on Lexapro when it first came out. Lexapro is just half a Celexa molecule. The patent was running out on Celexa, so they needed a new drug that essentially did the same thing. They realized that they could get the same effect with half the molecule, so they created a ‘new drug’ by cutting an old drug in half. I told them that I’d prescribe Lexapro if they admitted that they’d released it when they did and in the way that they did because the patent was running out on Celexa. But of course I got no answer.”

This jibed with critiques I had read in which it was asserted that when drugs go off patent and the pharmaceutical companies market their patented replacements, only then does the public learn about the original drugs’ downsides or unknowns. It is either that or, as happened with Zyprexa, lawyers and the media got hold of suppressed information and blew the whistle.

I brought up Zyprexa, and mentioned how heavily I’d seen it being advertized in places like Meriwether. I told him about the pens and the clipboards that the nurses carried around.

“Yeah, I’ve seen that, too,” he said. “I used to walk around the offices throwing away all that stuff—calendars, pens, clipboards. I used to say that if they want to pay us to advertise for them, fine. Otherwise the stuff was going in the garbage.”