Notes from Inside III

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The second thing you notice on the psych ward is the alteration in the passage of time. This is hardly my insight -- Thomas Mann explored the strange slipping of time in an institution to perfection in The Magic Mountain (which I definitely will need to read again in light of recent circumstances). The hours drag on, and every time you check the clock you find that only half the minutes you thought had passed actually did. Your life breaks down into hour-long increments, punctuated by mealtimes and medication. Breakfast is served at 7:30, and you wake up and stagger groggily toward the common room. You grab your tray from the metal box on wheels and try to find a seat near the people you know are somewhat sane. You fill your menu out at breakfast for the next day, and while the food isn't as bad as you might have expected, it's hardly fantastic. You learn quickly that you can add items and change quantities, so that my tray each morning comes laden with three covered plastic cups of extraordinarily weak coffee.

It's pretty much a given that there will be an incident at breakfast. It's more or less inevitable, mealtime being the only times during the day when the entire population is gathered in one space. This morning, it was Stephanie, she of the suspected wet brain, who set off this sweet elderly African-American woman who rightfully had had enough of poorly-coded racism. See, one of the schizophrenics had an outburst yesterday in which she repeatedly yelled "nigger" at the staff, which is about 70% African-American. I believe she also called them "gorillas," at least before the sedation hit in. In any case, Cassandra -- the elderly woman -- was really on edge wrt overt racism, and so when Stephanie started ranting about "the blacks" and how you can't trust them, a deeply-buried rage in Cassandra roared to life, and she threw her fully-laden breakfast tray at Stephanie, and when she missed, she picked up the tray and tried again. Naturally, both parties were separated and ushered in to different rooms, yet the incident was fairly typical of the increased pressure and tension that accompany a full house. More typically Carolyn (about whom more later) will start on a rant and at some point her scattershot will touch someone's exposed nerve, and then shit goes down. You learn to tune most of this out.

Carolyn is pretty much the queen crazy, bipolar with psychosis and delusions. She's by far the least-liked person on the ward, and this holds true for patients and staff. Carolyn is 38, and has spent most of her adult life in and out of psych wards, mental hospitals, and group homes. In many cases, such a life trajectory owes in large part to poverty and the appalling fraying of the American social safety net. Individuals who express mental illness at a young age often are victims of inadequate living situations, abusive parents, parents who abuse drugs and alcohol, neglect, and left to the mercy of Departments of Mental Health that are woefully underfunded, inadequately staffed, and a part of no politician's stump speech. The mentally ill remain largely invisible in America.

Carolyn, on the other hand, comes from a well-off family of Russian-Jewish immigrants. Her father is a well-respected psychiatrist (ironically enough) in New Jersey, and she was raised in suburban comfort, educated at good schools, has a college degree. Not that her relative luck in the family lottery makes her case any more tragic than the hundreds of thousands of less fortunate individuals who fall into the black hole of the mental health system, but it does add an interesting wrinkle. From what I could gather, Carolyn grew up in suburban New Jersey before moving to Boston in her late adolescence. She graduated from Lesley University with a degree in human services, and apparently that's when things began to fall apart.

Before getting into her story -- or at least what of it I could piece together -- it's really important to explain the sort of psychosocial milieu in which Carolyn spends her days, and will in all likelihood spend the remainder of her days. It's important to preface all of this with the fact that Carolyn is an extremely kind person, and has an extremely kind heart; the circumstances of her illness conspire to mask that kindness and to isolate her when she craves human contact. It requires, first of all, a staggering amount of patience to hold a conversation with her. She sits forward in her chair when she speaks and gesticulates wildly, all while emitting a garbled logorrheic stream of consciousness. It doesn't take more than a minute or so to realize the obvious paranoid and delusional ideation underpinning most of what she says. She'll tell you that she's putting together an operation, and that the nurses and counselors are bad people who need to be taken down. She's going to send in the black belts and they'll bleed so, but the FBI and CIA are watching her every move, and have put her in here to prevent her from carrying out her global mission. When I came back here for my second stint, she was certain that I was FBI because I was back. They've assaulted her with chemical weapons, so she won't take her medication, because the nurses work for Dick Cheney, who is the real president and who has been offended highly by her protestation against his regime in Harvard Square, and by her calling George Bush "George Tush." Similarly the chemical weapons have invaded her group home, and her face and lips burned and the skin on her feet rotted. She has access to special software, which, if you choose not to be on her team, will monitor your every move and can immolate you instantaneously should you act unethically. She's in love with a man named Dan Crowley, who, as far as I can tell, doesn't exist, but apparently is the most gorgeous man in the world as well as a legendary musician who can change his face to look like anyone. He's secretly written every hit pop song of the last 20 years, and is the shadowy figure behind the entire operation. But she also refers to pretty much every male under 40 (yours truly included) as "gorgeous" and makes vaguely sexual overtures that become quickly uncomfortable. She wouldn't believe that I'm gay because "someone so gorgeous just couldn't be. It's not fair" (lawlz). She suffers from tremendous delusions of grandeur. She believes herself to be a virtuoso piano player and composer, but when she sits down at the piano, the sound that results is best described as aleatory. She believes that she is a gifted designer, even though her "designs" amount to random blotches of paint on t-shirts under a thick coat of glitter. The other day her room had to be steam cleaned because she had managed to cover half the floor in paint and glitter. Similiarly she thinks of herself as a fashionista and model, though her style amounts to one of her paint-splattered t-shirts over zebra print leggings with flip flops, and her body type is best described as spherical. If she gets agitated, she'll tell you that you're headed to an internment camp where you'll eat carcasses until your carcass is eaten, and that they'll test new chemical weapons on you and zap you. But there are flying cars and flying houses ready for you if you play, and it's all about playing. She at times mouths bits and pieces of Christianity, but one doubts that faith plays much of a role in her life, or that she has the cognitive equipment to understand faith. Which is not to say that she's dumb, because that's very much not the case -- she has an impressive vocabulary and a wide body of knowledge. I imagine she was once a very intelligent person with a bright future.

And that's part of what makes Carolyn's story so tragic in an almost Shakespearean way -- there's a great deal there beneath the surface that her illness, the drugs used to treat it, and other drugs more recreational in nature have so mangled and garbled that only this manically paranoid word salad remains. From what I could gather, her illness began to present in her adolescence. She received treatment, which was apparently inadequate, and was medicated through her early 20s and college. I guess her condition seemed to worsen in her mid-20s, because she was incapable of providing any semblance of chronology for the last decade or so. She's used crystal meth on and off. She's been a prostitute and has slept in Harvard Square for weeks at a time. She's been in and out of psych wards like this one, has amassed over $30,000 in credit card debt, and lived in section VIII housing on disability payments, because her illness precluded the possibility of working. She has worked, however -- in a kitchen remodeling store, in a shoe store, as a waitress. One gets the sense that her Dan Crowley was a boyfriend sometime in her early-mid-20s, maybe the first time she fell in love. Maybe it was a brief and tumultuous affair, maybe the one stable long-term relationship she's had, but the impression is that his memory has winnowed its way so deeply into her psyche as to color many aspects of her psychoses. Her group home situation is terrifying to her -- the housemaster is cruel and uncaring, several of her other housemates sociopathic. Her parents have cut her off entirely. They won't return her calls or help her financially, and she can't get her own apartment. If she can't recover here and return to her group home, she'll be headed to one of the state mental hospitals to be institutionalized. During our conversation, she repeated over and over that she just wants to have a life, she wants to fall in love, she wants a life like anyone else.