The End of Everything Before

There are a few jobs less appealing to me than that of President of the United States, but not many: working the incinerator at the animal shelter, for example, or peddling my ass on the streets.  I hate politics with a passion that really ought to be incompatible with my utter lack of interest.  Moreover, I have more than enough trouble managing my own quiet little life without worrying about, say, tax legislation, or who should be the ambassador to Peru, or what everyone's so upset about in the Middle East.

Strangely enough, however, when I was riding in an ambulance for the first time, staring out the windows in the back doors at places I'd just been, on my way to the hospital, the thought that kept coming to the forefront of my mind was this: Well, there goes any chance I had to become Leader of the Free World.

It had happened the way these things always do: all of a sudden, out of the blue, and inevitably.  It was just about a month earlier, on my eighteenth birthday, that I'd taken my first dose of antidepressants.  I still remember placing my thumb over the scoring in the middle of the little powder-blue pill, pausing for a moment before breaking it in half, lingering for a moment before swallowing one of the halves, a tiny thing, barely perceptible really, compared to the great mouthfuls of big pills that would soon become my daily regimen.  I had become a user of psychotropic drugs, the same day that I had become a legal adult.  It was a sober moment, a drizzle of gravity in a day marked by the triumph of having survived childhood.

I was a savvy consumer, of course.  I started devouring everything I could find online about the medication I was now taking.  Strangely enough, however, I didn't immediately recognize the side effects for what they were.  It was only after several days of persistent insomnia, combined with an ever-mounting restlessness, that I put two and two together and realized that this was something the powder-blue pill was doing to me.  I hadn't had any side effects at all to start with, but after the first four days, I stopped breaking the little pills in half.  When I realized what was going on, I was stunned: how could something so tiny and inanimate have such immense power over me?  I fought for control in the only way I could: through knowledge.  I spent hours online, reading about my new prescription and the conditions it treated.  And little by little, empowered by knowledge, I began to forget that I was a promising student at a prestigious college and lost myself into a new identity as a person with a frazzled and fragmented brain.

It's not as if I could have done homework, anyway, all those awful sleepless nights.  My mind and body felt by turns fuzzy and frenetic, and sometimes both at once.  I didn't want to disturb my roommate, so I either went down to the computer lab to putter around online or just lay miserably in the dark.  A couple of times, I went to the infirmary to spend the night.  The staff there were kind, professional, and friendly; to this day I am grateful for their patience and matter-of-fact cheerfulness.  The infirmary was closed over the Thanksgiving holiday, however, and so for four intense nights I was left to my own devices.  My roommate was gone, so at least I could putter in relative privacy.  I spent hours taking personality quizzes online; I catnapped uselessly in the afternoons, wrapped in the heavy stickiness of uneasy sleep; and at night, when the restlessness possessed me like a fire in my veins, I put on one of my more energetic CDs and danced.  It was a graceless, artless dance, a pure kinetic frenzy.  Habitually sedentary as I was, I found myself quickly exhausted.  I kept dancing.  I brought my heel down hard on a tiny bit of lead that had come from one of my mechanical pencils and jammed it up under the skin, and kept dancing.  I worked myself up into a giddy and discontented euphoria; into the night I danced like burning, and when I woke the next afternoon it was all I could do to stumble down the hallway to the bathroom.  One night I left campus and walked down the road a ways, to CVS.  I didn't know if they were open all night or not, but if they were I was going to buy a big bottle of sleeping pills.  For the insomnia, of course.  I don't know what would have happened if I'd gotten them, because the store was closed.

After the Thanksgiving weekend, I was so far gone that my psychiatrist ordered me confined to the infirmary, allowed out only to go to class.  I usually went; going to class provided a brief oasis of sanity in the midst of what my life had become; a taste of recent routines I had almost forgotten.  It was my only remaining pretense at being a student.  I'd started missing class regularly in mid-November; I'd been struggling for the most part to keep up with the assigned readings, and the prospect of researching and writing a paper quite simply reduced me to tears.  I spent about a week in the infirmary: sometimes trying to write in my journal, sometimes reading a bit; there was a computer there that I was allowed to use, and I spent hours at night reading up on urban legends or playing Snood; amusements in which I took no real relish, but which served as a flimsy barrier between me and the immensity of my chaos and despair.

It was too late, though; the real barrier, the one I'd carefully constructed all those years of increasingly severe depressive episodes, had already crumbled away.  I couldn't pretend anymore.  I couldn't conceal the truth from myself or anyone else.  In daily conversations with my psychiatrist and psychologist, it all came pouring out, all the dark ugly reality, or at any rate more than anyone had ever heard before.  And after several days with no sign of improvement, there came the morning when all the staff came to surround my bed and my psychiatrist told me I was going to be sent to the hospital.  They seemed to appear from all corners at once, before I even knew they were coming, like a flock of birds.  I was later to learn that this happens all the time in the mental health system; if they're doing anything they know you won't like, they don't give you a chance to respond to reason rather than force, no matter how docile and cooperative and sensible they've always known you to be.  It's not just a formality, either; they have steel in their eyes and look right through you without seeing anything more than the trouble you have the potential to be.  I've seen it happen many a time since then, to me or to others, and it never gets any less frightening, the feeling that you've already lost a fight you never meant to put up in the first place.

There wasn't a thing in the world wrong with me physically, but for some reason they wouldn't let me walk out to the ambulance.  They pushed me out on a stretcher.  For weeks now, I had felt myself slipping slowly out of control of my life, and as I lay on the stretcher watching the walls of the infirmary slip past me without saying goodbye, I felt that these people had come to finish the job.

It was then, in the ambulance, as the shadows of sparse-leafed late-autumn trees flicked over the back windows, that I realized a line had been crossed.  I wasn't just a bright college student who had to swallow a pill every day.  I was going to be a mental patient.  For the rest of my life, I'd never be able to shake that part of my history.  I would never be able to look in the mirror and see someone who hadn't been locked up with the crazies.  I remembered an extremely dull book I had read a year or two earlier, about the 1988 presidential election.  The stability of Democratic candidate Michael Dukakis had been called into question when rumors surfaced that he had been treated for depression in the past.  (Dukakis and his personal physician denied the rumors, which there had never been any real evidence to support; later his wife, Kitty, would go on record about her own struggles with alcoholism and depression and become active in mental health education and advocacy.)  It wasn't that, as an aspiring writer and academician, I imagined having many relentless and well-connected enemies in the future who would stop at nothing to bring me down.  It was more that, if I ever did, the ammunition was there, packing a wallop whether anyone ever used it or not.  No matter where I went or what I did in the future,  I would always have the knowledge deep within me that many, if not most, of the people around me would look at me, not with admiration and respect, but with revulsion and pity, if they only knew.

A more immediate and concrete dread was the anticipation of what lay ahead for me at the hospital itself.  In my senior year of high school, I'd taken an evening psychology class offered by a local community college, and the professor told us about his experiences working in a large state mental hospital.  It was some scary stuff that he told us.  I remembered one story in particular about a patient smearing feces on the walls.  Could I really be going to such a place?  Did these professionals whom I had trusted actually think that I belonged there?

The first thing they did in the hospital was take me to a private waiting room.  I'm not sure how long I was there, but it was long enough to read a whole magazine cover-to-cover, including the boring articles I had no interest in reading in the first place.  Then the interviews began, with bored clinicians whose role I didn't quite understand.  One of them inquired about my family mental-health history, and I told them my paternal grandfather had suffered from depression and committed suicide in the early '80s, before I was born.  Eventually he left, and fifteen minutes or half an hour later another came in and greeted me with, "So, I understand you're having some trouble getting over your grandfather's death?"  It was my first taste of just how garbled beyond recognition my life could become in the hands and charts of the mental health system.

I think it was then, during those interviews in that waiting room, that I began to lie.  It was simple honesty that had gotten me into this mess in the first place.  These people didn't want to help me, and I didn't want their help.  I was tired of fighting this uphill battle called life, and what could I possibly have to live for now?  Whatever might once have provided some flimsy hope to cling to was surely ruined now.  This hospital full of frowning professionals wanted to keep me alive, and I wanted to die - and if they weren't with me, as the saying goes, they were against me, and what right did they have to the truth if they were only going to use it against me?  At first I didn't so much lie outright as just soften the truth as much as my conscience would allow.  Once they took me upstairs to the adult psychiatric unit, however, I began to prevaricate in earnest.

They told me it was for legal reasons that they had to transport me in a wheelchair, but in my mind it was a symbolic crippling.  The power of self-determination was out of my hands, even to the extent that I wasn't trusted to walk on my own without - what?  Falling, or running?

I remember the moment they opened the doors to the ward.  I didn't hear any screaming.  I didn't smell anything foul.  There was something almost sinister about how sinister it wasn't.  I remember doors and generic artwork on the walls and a pukey pink everywhere that I later learned was supposed to be soothing.  They wheeled me to the nurses' station, where I was handed over to a woman I would later learn was one of the least warm and personable staff members on the unit.  She showed me to one of the regular rooms, but when I learned I would have a roommate, I went into a panic.  So far I hadn't seen any of the other patients.  I imagined myself alone with someone wild-eyed and delusional, and I wouldn't even step over the threshold.  The nurse simply said "Come on then" and led me back through a door on one side of the nurses' station, to what I would later learn was the ICU section of the unit.  Ironically, had there been any patients there prone to unprovoked violence or the smearing of shit, this was where they would most likely have been . . . but the rooms were private.  The four regular patient rooms were taken, so I would spend my first few days in the seclusion room - a narrow, windowless chamber with no furniture but a metal frame bed with a mattress, where patients who had lost control of themselves were taken to calm down.

It would be nine weeks before I was released.  Over the course of the next week, I would put up a valiant effort to act "normal" and convince them I didn't belong there.  I would have to figure out what on earth to say when a nurse asked, as a routine part of the intake, whether I would rather be restrained face up or face down, if it came to that.  I would be asked to name the presidents in reverse chronological order as far back as I could (I tripped up somewhere around World War I, but my psychiatrist told me I'd made it farther than any patient he'd ever had) and given a list of three items to remember, to see if I could recall them five minutes later (a shiny new penny, a red rubber ball, and a tall oak tree).  In the weeks to come, I would have nurses ask me on a daily basis if I was "feeling anxious," because I was pacing, which is something I've done almost from the time I learned to walk, having discovered early on that it liberates my mind and encourages my creative process.  I would form relationships with some of the staff and other patients that would make an impression on my heart forever.  I would learn how easily figurative language can be taken literally by those who are more used to dealing with psychotics than poets, how easily a timid appeasement smile can be taken as evidence of insincerity on one hand, disconnection from reality on the other, based on what it is that the observer is looking for.  I would read, write, color pictures, get a member of the staff to take me walking in a blizzard, and celebrate the coming of a new millennium.  I would bang my head in frustration and melt ice cubes in my hands just for spite.  I would follow in the newspapers the story of a man who murdered seven coworkers and claimed that his antidepressants made him do it.  I would be tested, diagnosed, doubted, believed, and dismissed, and ultimately I would make the decision, for reasons of my own, to take the medications and give life a try.

For the moment, though . . . my first moment alone on a psychiatric ward . . . all I could do was shut myself up in the seclusion room and curl up on the bed, closing my eyes against the light that came through the reinforced glass window in the door.  It was a place beyond tears.  It was the end of everything before.  Making myself as small as I could, I wrapped myself around the refrain that was pounding in my head, the one that had been with me a thousand different ways since the ride in the ambulance: Nothing is going to be the same ever again.