In a college dorm, in a prison, in a marriage
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“Do you feel you’re a danger to yourself or others?” Dr. Lyman G. Glandy, head psychiatrist at Fairview Psychiatric Hospital, wants to know. He’s interviewing me for the first time since my arrival here three days ago. We’re in my room, a small, Spartan, dimly lit chamber with all the charm of a prison cell.
It’s a good question. A few weeks before the drug overdose that got me here, I woke up one early morning in my car outside my favorite bar with a bow and several arrows in my lap and no idea what I was doing with them.
I’m a blackout drunk. Of course I’m a danger to myself and others. But I’m not about to admit this to Dr. Glandy. I’ve seen One Flew over the Cuckoo’s Nest. This is a locked ward, and they’ve taken away my shaving equipment. Sure, this is 1983, not the 1950s, but I’m probably going to be here as long as Glandy wants to keep me. Best to say as little as possible. The harder a man tries to convince someone in authority he’s sane, the loonier he’s going to appear.
“What do you think brought you here?” Glandy asks in his annoying monotone after I finally mumble “no” to his question about being a danger. He keeps glancing at his notebook, giving me the impression that he’s reading from a list of questions. He knows as well as I do what brought me here: an overdose of Xanax that I can’t say for sure was an accident.
“Overdose,” I say. “Accidental overdose,” I add with too much emphasis.
Glandy’s large, lumpy head and bland features put me in mind of a potato. I know what he’s thinking: This guy tried to off himself as sure as we’re sitting here, and I’d better give him a nice long rest.
All my adult life I’ve lived in fear of being locked up and at the mercy of cruel and stupid people — “cruel and stupid” being defined as anyone who tries to keep me away from drugs.
“Well, let me ask you this,” Glandy says, his washed-out brown eyes doing nothing to lessen the potato impression: “How does one take a whole bottle of pills by accident?”
I can tell he thinks he’s got me. Would it do more harm than good to try to explain that I’ve been eating Xanax like candy for years now? And I mean that literally, just popping them into my mouth by the handful and chewing them like so many Good & Plenty. With all the booze I was drinking that day, I could have lost track. It could have been an accident. On the other hand, why, if it was an accident, did I wake up on the bathroom floor feeling even more ashamed than usual?
Of course the first thing I did after getting off the floor was reach for my Xanax. No matter that I’d just taken enough to kill most people. Finding the bottle empty, and with no prospect of getting any more until my regular psychiatric appointment days later, I had what I thought was a brilliant idea: I’d call the fire department. Isn’t that what people generally do when they’ve overdosed? It’s not that I was worried about dying. Since I hadn’t died yet, I figured I probably wasn’t going to. But running out of Xanax — that was a five-alarm emergency. I needed my meds, and for that I needed a doctor. Where better to find one than in a hospital? Naturally I wasn’t thinking clearly, as the last thing any half-sane physician was going to do was give me more pills.
After I made the call, I guess I passed out again. All I remember is being carried out of my apartment on a stretcher.
They must have gotten my girlfriend Rhonda’s work number from my wallet. She came barging through the doors to the emergency room — where I was busy puking up what was left of the Xanax into a metal basin — and wailed, “Oh, my poor baby!” I was more embarrassed that people would realize this loud, melodramatic woman was my girlfriend than I was about my overdose. “I’m with you right down the line, baby,” she said, sobbing, “right down the line.”
I’d like to leave Rhonda. I really would. I often can’t stand being in the same room with her. But I just can’t do it. At times, seeing me waver, she’ll use her tall, skinny body like a weapon, running her purple fingernails up and down her snow-white legs and fondling her tiny breasts while telling me all about the women she’s slept with, how pretty they were and what she did with them. Helpless and half sick with desire and self-hate and the suffocating odor of too much Shalimar perfume, I’ll bury my head in her crotch.
But her real power lies in the drugs she’s always bringing home like treats from the bakery: Fiorinal and Darvon for her migraines; Percodan for her chronic jaw pain; Seconal for her insomnia; and, wonder of wonders, tincture of opium for her autoimmune disorder. I slurp down Rhonda’s drugs until I’m a burbling idiot, then sometimes lie on the couch for entire weekends while hallucinating little animals hanging from the ceiling. If I’m lucky, I eventually descend into astonishingly vivid opium dreams, spectacular epics that have all the depth and narrative complexity of Russian novels. Where do they come from, these magnificent dreams? In between trying to figure out a way to leave her, I thank God every day for making Rhonda so unhealthy.
Dr. Glandy asks me to list all the “illicit substances” I take on a regular basis. I answer truthfully, figuring he already knows anyway from the urine sample I’ve given. The list is long, and Glandy writes as quickly as he can, trying to keep up, his tongue showing between his teeth — as if, when put together, the information might add up to something important.
“And how do these drugs make you feel?” Glandy asks when I’m finished.
“Feel?” I repeat. “How do you think they make me feel?”
“I’m sure I don’t know.” Glandy sniffs. “Why don’t you tell me.”
“They make me feel . . .” Even as I start the sentence, I don’t know how I’m going to finish it. It’s like asking how air makes me feel. Without drugs I cannot live. If I ever doubted it, three hellish, Xanax-deprived days at Fairview have settled the issue once and for all. Despite the medication they’re giving me to ease my withdrawal symptoms, I seem to be getting worse by the hour. Every few minutes I get an adrenaline shock in my chest so powerful it makes me wince. My hands are shaking, and my balance is off. I can’t take more than a few steps without worrying that I’m about to fall over.
“Terrible,” I say, assuming that’s what he wants to hear. “The drugs make me feel terrible.”
For the first time Glandy gives me a cold little smile of approval.
We addicts tend to believe we’re smarter than everyone else, but of course we’re not. Dedicated to the ruinous proposition that feeling good for a little while is more important than our health, our families, our liberty, and our very lives, drug addicts are the stupidest people in existence.
And yet, toss a suffering addict like me into the most impossible situation imaginable — say, the locked ward of a mental hospital — and if there’s any conceivable way to obtain his drug of choice, he just might find it.
Marshaling what I have left in the way of resources, I admit to Dr. Glandy that I have a drug problem. I see that now. I tell him that I’m grateful, but I’m also prone to anxiety attacks for which I legitimately need Xanax. I honestly don’t see how I could even get to an Alcoholics Anonymous meeting without it.
I realize this is like asking for more bullets right after I’ve tried to shoot myself in the head, but I want to hear what he has to say. Besides, like every active addict, I’m adept at believing my own bullshit. I do suffer from anxiety. But I also shamelessly abuse the medication for it, taking far more than I’m supposed to, mixing it with other drugs, including alcohol, and even going so far as to crush the pills and snort them for an added jolt. On top of all that, my tolerance is so great by now that I need to take many times the usual dosage to get a noticeable effect.
Glandy looks at me with what I take to be incredulous contempt, as if I were some sort of talking insect. But just when I’m certain he’s going to laugh in my face, he says something that fills me with wild hope: “It’s far too early to talk about such things. Let’s see where we are in a couple of weeks.”
In my dark and oppressive room at Fairview, my heretofore long-snoozing neurotransmitters, at last freed from the soporific effects of Xanax, are donning party hats and dancing mad jigs. It’s a state of hyperawareness unlike any I’ve ever experienced before. The slightest noise — someone coughing, Glandy’s pen scratching in his notebook — is physically painful. I think too fast. I talk too fast. I have the feeling I’m not controlling my eyes properly. Physical movements like brushing my teeth or reaching for a comb feel abrupt and jerky, as if my limbs were attached to a puppeteer’s strings. Sleep, of course, is impossible.
Dr. Glandy stops by every morning. I can’t decide if his obtuseness is genuine or some sort of perverse gambit to infuriate me. He keeps insisting that I’m angry, which I guess I am. (Just what was I doing with that archery equipment?) But his relentless hammering away on the subject serves only to turn any anger I started with into a boiling rage.
“So,” Glandy says at one point, his lips parting in a creepy, vaguely sexual way, “do you want to hit me now?”
When Rhonda comes to visit, I’ve never seen her looking so good. She’s even washed her hair. I grab her around her waist, suddenly convinced that I love her with all my heart. The life we had together, as sordid as it was, now seems like a paradise. How could I have been so blind?
“I’m dying in here, Rhonda,” I say. “I just can’t stand being locked up. Maybe you could find a lawyer to help spring me.”
“Do you even have the money for a lawyer?” she asks.
“Well, I was hoping maybe you could lend it to me,” I say.
She grows strangely distant and tells me that money’s tight. But since I signed myself in, she explains, I can leave anytime. All I have to do is sign myself out “against medical advice.” They could go to court to hold me, but they never do that. (Rhonda’s no dummy. Although she works as a janitor, she’s got a BA in philosophy.)
It’s true. I did sign myself in. I was still so high on pills, I’d have signed anything. But I didn’t realize I could just turn around and sign myself back out.
For the first time I see that Rhonda’s customary purple nail polish has been replaced by hot pink. “What’s going on, Rhonda?” I ask weakly.
She looks at the floor for a long time. “I’ve met someone,” she says. “I’m sorry to tell you about it in here. You know: with you being locked up and in crisis and all.”
So much for all that Oh, my sweet baby and I’m with you right down the line.
“Met someone? How could you have met someone? I’ve been gone a week.”
“I know, I know,” she says. “It seems longer, though.”
There’s something about being locked up in a mental hospital that induces a man to take stock. One thing’s entirely clear: the way some are born to music or art or mathematics, I was born to addiction. It’s in my DNA, as fixed a part of who I am as my frizzy brown hair and short, fat fingers. By the time I was nine years old, I was already dreaming about one day taking drugs, trying to imagine how they’d feel, and wondering whether they could ease the loneliness and anxiety I couldn’t recall ever being without. I’m not sure how, at such a young age, I made the connection between taking drugs and the relief of psychic pain, but I did. I loved reading about drugs and drug addicts and watching movies about them. These were often just propaganda intended to scare kids away, but I wasn’t fooled. The scarier they tried to make drugs sound, the more I wanted them. Obviously anything that could cause a man to endure so much trouble must be pretty damn good.
Interestingly enough, the way I imagined that drugs would feel — I mean the narcotics that have been my lifelong passion — was mostly accurate. The first time I snorted Demerol (a strong painkiller a friend had stolen from his dying grandmother), it was a kind of vindication. “I knew it,” I said to my friend. “I just knew it would be this good.” But it was more than that. I’d not only known that it would be this good; I’d known that it would be this good in pretty much just this way. My first thought was: Please, God, make this last.
The temporary nature of a high is the addict’s essential torment, the existential quandary he can’t outrun. I’ve never had a high, no matter how intense, that I haven’t at least partly ruined by checking my watch: I feel great at this moment, but for how much longer?
How long now?
At our next session Dr. Glandy informs me that if I want to get out of the locked ward, I’m going to have to earn it by mixing with the other patients. “You can’t hide in your room forever,” he says.
I consider asking him whether what Rhonda told me is true: that I can just sign myself out. But it’s beginning to dawn on me that the last thing I want right now is to be released. I can’t even begin to imagine facing life outside without Xanax, and it looks like I don’t even have a place to live. It’s Rhonda’s name on the lease.
I tentatively appeal to Dr. Glandy for a little Xanax, just to get me through this. To my horror I start to weep. All my instincts tell me that if I’m to have any hope of getting this man to fork over the goods, I’m going to have to speak to him from a position of calm, reasoned strength. But I can’t help myself. As much as I dislike Glandy, and as much as I loathe having to beg, I’m desperate.
Of course he turns me down, but then adds, “If you insist, I can always give you something else to calm you down, but, believe me, you won’t like it.”
Maybe it’s my fragile mental state, but his tone seems even more icy than usual. “What do you mean, if I ‘insist’?” I ask, scrutinizing his stony face to discern whether he’s making some sort of veiled threat.
And yet, despite my fears about cruel doctors and nurses, I somehow can’t picture Glandy having me tied down and injecting me with a powerful antipsychotic like Thorazine. I’m not crazy — at least, not that kind of crazy. Perhaps even more to the point, I’ve never been able to bring myself to accept the possibility that something really bad could ever happen to me as a result of my drug use. True, my current address is the locked ward of a mental hospital. And, true, I did take nearly a hundred Xanax — an act that, if not explicitly suicidal, was certainly desperate. But to my drug addict’s way of thinking, all of this somehow seems not that serious.
Even the torments of Xanax withdrawal don’t carry any message beyond the realization that there’s just about nothing I wouldn’t do to make them go away. Sure, if you asked, I’d tell you I’ve no one to blame but myself. I’d even mean it. After years of running away, making bad decisions, and postponing the slightest discomfort till another, more convenient, day, what did I expect? A wife and kids and a house in the suburbs? I’m thirty years old and can’t point to a single thing I’ve ever done that I can be proud of. But it seems obvious to me that this is the result of poor character, not addiction.
Above all else perhaps, we active drug addicts tend to be inveterate optimists. The very act of ingesting on a daily basis large quantities of inherently dangerous substances whose purity often cannot be ascertained is, by its nature, wildly optimistic. And no matter how bad life might be at any given moment, we’re always thinking it will soon get better. We don’t know, of course, just what miracle will intervene to make this happen, but we believe in our hearts that it will.
After Glandy leaves, I decide I don’t have much of a choice but to do as he asks and get out of my room more. Besides, I’m sick of lying on my bed and staring up at the ceiling. I’ve finished the couple of novels I somehow thought to bring with me, and all I’ve got left is the Alcoholics Anonymous (aa) book Rhonda left on my bedside table when I wasn’t looking. Who does she think she is? She’s almost as much of an addict as I am.
So I slowly open the door and venture into the day room, blinking against the harsh fluorescent lights like a man emerging from a cave. I’m dizzy and disoriented, and the air seems strangely thin, as if I’ve been transported to an alien planet.
A psychiatric hospital isn’t really a hospital at all but a temporary sanctuary, a place to rest and perhaps heal, out of reach, if desired, of troublesome family and angry employers and maybe even, to some extent, the law. We’re all grievously wounded, and because we know and accept this, we treat one another for the most part with kindness. It doesn’t matter who we were on the outside or what we might have done to get here.
My fellow patients include Mike, a man with sad, red-veined eyes who drank and gambled away a plumbing-supply business he’d inherited from his father-in-law; Neal, a state trooper who embezzled money to fund his cocaine habit (he says his attempt to hang himself was just a “trick” to help him stay out of jail); and Sarah, an attractive married woman who suffers from bipolar disorder and occasional delusions, although you’d never know it from her friendly, open manner. There’s also a heroin addict named Carl, a tall, confident, chain-smoking black man of perhaps fifty who mostly keeps to himself. Sarah tells me he’s a poet and actor.
Having once had vague dreams of becoming a writer, I find myself watching Carl closely. I admire his poise, and I like that he had the good sense to get addicted to a respectable drug like heroin. (That I’ve been brought low by tranquilizers, of all things, feels pathetic.) If anything, Carl almost seems a little too cool. For someone withdrawing from heroin, he looks awfully comfortable. Feet up, smoking endless Newports with obvious enjoyment, he’s always got a book in hand: Dostoyevsky, Kurt Vonnegut, the Bible. He also has a rather florid way of speaking, tossing out fifty-cent words in this nickel-and-dime environment and using his sonorous voice to good, if unnecessary, effect.
But I can’t hold any of that against him. He’s obviously a smart and talented guy with a lot going for him. Watching Carl, I decide my big mistake has been in using drugs as a way to get through life rather than for pleasure. Someone who can’t function without his medication is by definition “sick,” something I desperately do not want to be.
Sure, Carl got hooked too. But it’s clear that, once he kicks the habit, he has the capacity to live a good and productive life. For me sobriety means nothing but a bleak, wretched, marginal existence. Of course, now that I think about it, that’s not much different from the life I’ve been leading on drugs.
My conversations with Dr. Glandy revolve around my release date and what I keep calling the “utter impossibility” of my living without Xanax. Glandy wants me to spend a couple of weeks in the unlocked part of the hospital, where I’d have daily group therapy and go to AA meetings. I keep insisting that I want to go home, but since I’ve apparently no home to go to, this is mostly a pose to salvage my dignity. I’ve been berating myself for letting Glandy see me cry, and I vow never again to look that weak in front of him. It’s OK to tell him that I can’t live without Xanax; that’s just my addict’s pitch, a case of a man doing what he needs to do. But it’s definitely not OK to let him in on my shameful secret: that I’m an inadequate human being with no more ability to live a responsible adult life than a seven-year-old.
One day Carl, Sarah, and I are sitting around a table in the day room, eating our lunch of chipped beef on soggy toast from cafeteria trays. I’ve become aware lately that if I’m asked personal questions, I have a tendency to start perspiring. I tell myself not to worry about it, but it keeps happening.
“So, Alan,” Sarah says, fixing me with her beautiful brown eyes, “tell us how you’re doing. I’ve noticed you don’t say much.”
I see Carl watching me intently, too, clearly curious how I’m going to answer. The pressure of the two sets of eyes is too much, and my face flushes with heat while beads of moisture pop out on my forehead. The fear that Sarah and Carl will notice this only makes me sweat more until the perspiration is streaming down my face. I can barely mumble a reply.
I ask Dr. Glandy about my sweating during our next session. I’ve mentioned it before in passing, but now I’m really starting to grow concerned. And yet, if there’s one thing I should have learned by now, it’s that Glandy is not the reassuring type. “All I can really suggest,” he says, “is that you try to relax, as this sort of thing can become permanent if you let it.”
That’s just great, I think, mentally cataloging my many miseries: At times I’m experiencing almost unbearable anxiety, rolling waves of panic at least several orders of magnitude greater than the anxiety that caused me to seek out Xanax in the first place. The world is looking so glaringly bright that if I don’t maintain a perpetual squint, my eyes begin to water. The adrenaline shocks continue unabated. I’ve still got the same nasty headache I’ve had since I got here. If anything, it’s getting worse. And now I’ve suddenly become a person who sweats when answering simple questions. It’s as if Fairview were a kind of reverse Lourdes, a place one goes to experience great miracles of torment and ill health.
When Glandy informs me that I have to either move to the unlocked part of the hospital or go home, I call Rhonda.
She answers on the first ring, as if she were waiting for my call — or somebody’s call, anyway. “I’m glad you called, baby,” she says.
So we’re back to “baby.” It’s a good sign, though that favorite word of hers makes me uneasy. It always has.
She tells me to forget all that about her having met someone. She was confused and scared. “Come home to me,” she says. “I love you, baby.”
As much as I need this woman, I just can’t seem to get out the requisite “I love you too.”
“Don’t you love me, baby?” I can hear her beginning to sniffle.
If she’d just stop calling me “baby” for a few seconds, I might be able to tell her that I do. Something inside me resents the level of intimacy the endearment implies. But then, what have she and I been for the last two years if not intimate? I clearly think I’m better than she is, but on what basis? She cleans the apartment, buys the groceries, cooks the food, and brings home the drugs. What do I contribute? A couple of bucks now and then from my crummy job as a security guard. Rhonda has her share of problems, but she’s an intelligent, loving woman. OK, so she’s not particularly loyal. Why should she be? I’ve given her nothing. I think about the time Rhonda’s autoimmune illness suddenly worsened. While she sat up all night moaning in agony, I never even once got out of bed to comfort her. Two days later she had surgery, and all I could think about was all the great drugs I’d be getting.
“Jesus, Rhonda,” I say, “you know I love you.” As I speak the words, I realize I mean them. At the same time I also realize that I can’t go back to her. Not right away, anyway. I tell her that I’m going to stay for another couple of weeks. There’s group therapy and AA meetings. Maybe they can help me. After that, we’ll talk.
“Oh, my darling,” Rhonda says, weeping hard now, “I’m so proud. When you’re ready to come back to me, I’ll be here for you.”
I hang up feeling guilty and ashamed, but Rhonda’s told me what I wanted to hear: she will take me back if I need her.
I’m packing my few belongings into an old duffel bag for my move to the unlocked part of the hospital when I notice Carl standing in the doorway to my room. “All set for the big day, my young friend?” he asks. Carl is moving out of the locked ward today as well. As always, he’s immaculately put together, his hair perfectly coiffed.
“Not really,” I answer.
Carl assures me that if he can clean up, anyone can. It’s just a question of hitting bottom. I must look skeptical, because he asks, in a tone that implies I’d have to be insane to think otherwise, “You do think you’ve hit bottom, don’t you?”
I tell him I’m not sure what “hitting bottom” really means.
“For what it’s worth, I can tell you what I think it means,” Carl says. “I think it’s a kind of grace. A kind of painful, agonizing grace.”
He must have gotten this line from one of his books. Nobody talks like that. And anyway, Carl looks about as agonized as someone on a Caribbean cruise.
“Look, man,” Carl tells me, “if you need a place to stay when we get out of here, why don’t you live with me and my wife for a while. We can go to meetings together. It’s a quiet place, and no one will bother you.”
I try to imagine what it might be like to stay with Carl, to go to meetings with him, maybe meet his artist friends. I might even try a little writing. I bet he could help me with that. With Carl and his wife I might have a chance. With Rhonda I’ll be right back where I started. For an instant I feel a surge of hope.
But who am I kidding? I’d like to stay with Carl. I would. But I’m too afraid, too full of self-hate, and, in some twisted, self-defeating way, too proud.
Before I can think of a respectable-sounding excuse, Carl’s eyes drop to Rhonda’s book, still lying next to my bed where she left it. “Hey, the AA ‘Big Book.’ I’m reading it too. What do you think?”
“It’s OK. Some helpful pointers,” I mumble, hoping he’ll leave it at that, since I haven’t read a single word.
Carl says it’s just superb, in his opinion. Timeless literature in its way. Lays out the whole AA philosophy beautifully. “Incidentally,” he adds, as if he’s letting me in on some excellent news, “I hear they have a regular meeting right here on the premises.” I half expect Carl to start rubbing his hands together, he seems so happy at the prospect. “Now why don’t we take a walk to the nurses’ station. Maybe we can get someone to unlock that door for us.”
Even though I find Carl’s enthusiasm grating, I don’t want to be left alone, so I stumble after him. As we head out the door, I hesitate. Maybe I feel guilty for having lied to Carl, or maybe I feel like a louse for not appreciating Rhonda’s attempts to help. All I know is something makes me go back to get the book.
The nurses’ station is on the other side of the ward, and I follow Carl there, down a long, winding corridor that seems to go on forever.
As a nurse in a busy emergency room, I’ve seen a number of patients come through our doors and declare themselves mentally unstable. My colleagues and I are trained to ask the appropriate questions — Do you feel hopeless? Have you thought about hurting yourself? — and escort them to a locked room and have security search them for potential weapons. We make sure their vitals are within normal limits and ask the mental-health team to evaluate them.
But we roll our eyes as we do all of this. We’d much rather take care of the man with out-of-control blood pressure or the woman with abdominal pain, because their problems are easier to see and diagnose and treat. Mental illness doesn’t show up on an X-ray. It’s easy to think that mental-health patients are just trying to irritate us.
Alan Craig’s essay “Agonizing Grace” [October 2011] reminds me that while people with psychiatric issues can be manipulative, selfish, uncompromising, and altogether unpleasant, they are suffering, and as a nurse it is my job to try to help them. Craig offers me insight into the thought processes of an addict. While his account is at times disconcerting and even aggravating, I appreciate his honesty and understand better now what I can do to help.