Just Like Someone Without Mental Illness Only More So (15 page)

When the cardiologist praised me to the parents and said that their little girl hadn’t been hurt by her rough start and was going to grow up 100 percent normal I felt sick and couldn’t get out of that room fast enough.

I was just doing my job. It had been a lucky guess. I hadn’t actually diagnosed the specific cardiac defect their daughter had
.

The day after I finished my residency, my mother had an operation that was supposed to be for a uterine fibroid that turned out to be stage-four ovarian cancer. I hadn’t admitted to myself the possibility of something being seriously wrong till I got the phone call.

Enthusiasm

(Vonnegut family photo)

I loved the rhythm and rank of being a primary-care pediatrician. I started paying down the money I had had to borrow to get through medical school and residency. I’d tried to cut down a few times but still smoked two packs of cigarettes a day. I’d take care of a couple of patients, go out to my car to have a cigarette, and come back and see a few more patients.

I was dealing mostly with self-limited viral illnesses in otherwise well babies and children, but life and death wasn’t the point. I didn’t feel
less than
neurosurgeons, oncologists, or cardiologists. Someone had to be looking through the haystack to find treatable diseases in salvageable patients. Leukemia or brain tumors would always be trying to sneak through, and I was ready to catch them. Maybe I was the catcher in the rye.

I didn’t want to be rich or famous. I didn’t want to write again. I wanted nothing more than to keep doing pediatrics forever.

——

For a year or so before I went crazy for the last time, an odd feeling of panic would take hold of me almost every night driving home from work. I’d feel sick to my stomach, my heart would race, and I’d have chest pain. I’d imagine getting into accidents or getting dragged out of my car and beaten. I went to a cardiologist, got on a treadmill, and passed my stress test. He reassured me that my heart was fine and joked that it was nice seeing me but that he had to go take care of sick people.

He asked me about alcohol and drugs, and I told him I drank a few beers after work, had half a bottle or less of wine with dinner, maybe a shot of bourbon after dinner, and Xanax as prescribed for insomnia. He said nothing, so it must have been okay. Apparently what I had used to be called “soldier’s heart” because so many soldiers complained of the same thing during World War I. I was a good soldier. Crushing chest pain and nausea were just part of being me.

My wife and I were two cordial, barely connected children of divorce who mostly wanted no drama. The harder I tried to be a good husband, the worse it seemed to get. She was married to a doctor—what more could she want?

My sisters and I were on good terms. I was glad they were married to decent men and having children. We all knew Jane had cancer that wasn’t going to go away, but she was doing remarkably well.

Man Recovers from Mental Illness, Goes to Medical School, and Becomes a Doctor
. It was a perfectly good story with a perfectly good ending.

For about ten years running, Kurt had hosted a family fishing trip out of Montauk, near his place on Long Island. It was usually the weekend after Labor Day. It was usually an all-guy thing, though sometimes my father enjoyed inviting Betty Friedan along. We were all fighting our own battles, looking for some time off, and willing to show up for Kurt and see what happened. Bluefish are, pound for pound, the most vicious of God’s creatures, and we caught a lot of them.

Bernie, Kurt’s older and only brother, usually came with two or three of his five sons and sometimes a grandchild. Sometimes my sons came with me, but not on the 1985 trip. Kurt and Bernie would tell the same stories and jokes. I knew most of the punch lines, as did Bernie’s sons.

Bernie was Kurt’s only real peer at that point in his life. Eight years Kurt’s senior, he was a scientist who did things that hadn’t been done before, like seeding clouds to make it rain. My favorite experiment of his was the release of several tons of chicken feathers into thunderclouds to see where the air currents were going. Kurt and Bernie’s sister, Allie, the mother of the four cousins who came to live with us, had been a gifted painter and sculptor who said, “Just because you’re talented doesn’t mean you have to do something about it.”

One of my favorite stories about Bernie and Kurt involved a trip they took to see their father, Kurt senior, when he was dying. On the way to Indianapolis, the car they were driving ran out of gas, so they were going to hitchhike to a gas station. Kurt propped the hood up to let people know there was mechanical trouble and asked Bernie if there was anything else they should do.

“We could let the air out of the tires,” suggested Bernie.

——

On the 1985 fishing trip, Bernie brought twenty glass-and-gel plates he had used to record the path electricity took through gel under different conditions. The branching patterns were intricate and beautiful. Bernie’s provocative question to Kurt was whether or not they were art. Kurt thought they weren’t art, because the objects weren’t made by an artist who could have a conversation with himself or anyone else about what he had done. For it to be art there had to be an artist who could learn from it and do something different or the same the next time.

Maybe Bernie, by noticing these things and dragging them to Long Island for us to see, was the artist? You can’t create or destroy matter or energy, but you can take blank paper and write a novel or canvas and make a painting or wood and make furniture. An artist is someone who isn’t put off by how terrible his first tries are, who finds himself talking back and notices that he changes and grows when he makes art.

That trip was the beginning of the end of what I had assumed was a lifetime no-cut contract with alcohol. I can’t remember why, but I drank much more than I usually did, and nothing happened. I drank beer steadily through the morning and then had two glasses of bourbon. No click, no feeling a little looser, nothing.

We caught a bunch of bluefish. The mate filleted them and I grilled them over charcoal with garlic salt and everyone said they tasted great just like always, but I couldn’t get away from the feeling that another shoe was going to drop.

What if you pick up the early signs too late?

Back home, I was playing the piano better than ever. I’d be playing the piano and singing and start crying after a beer or
two. Unless we had a business lunch on Friday, I never drank at work or before getting home, somewhere around 6
P.M.
I sometimes kept beer in the office refrigerator on Fridays if I was going to be going to the Cape, but that was okay because of the traffic. If I had had a drinking problem, I would have hidden it, but I didn’t so I didn’t.

The thing that keeps the gambler gambling is the illusion that he has control, special knowledge that will make him come out on top. If the gambler comes to believe that he is up against a random number generator and that what he once thought of as special knowledge is worthless, he stops gambling. What keeps the drinker drinking is the certainty that she can stop whenever she wants. It never would have occurred to me that stopping the pathetic little bit of drinking I did would have mattered.

I kept in touch with MGH by serving as the ward attending once a year and teaching in the ER one night a week along with admitting my patients there. It was a way of giving back. They paid me about sixteen dollars an hour.

Four years after I’d finished my residency at MGH, right after Thanksgiving, a twelve-year-old girl came in having had a seizure that had stopped by the time she arrived. We examined her, drew labs, reassured her parents, called her pediatrician, and had the resident doing pediatric neurology come down to see her. He started her on medication, decided she didn’t have to be admitted, and set up a time to see her in the pedi-neuro clinic two days later.

Off the top of my head I gave the medical students a ten-minute lecture on the differential diagnosis, work-up, and treatment of pediatric seizures. I was a hardworking, integral part of a wonderful hospital and a wonderful medical school and a
wonderful city, full of people all doing the best they could. I was headed off into the sunset with two hours of movie left.

My final drink was the stale last half of a two-dollar bottle of red wine I’d hoped might taste more like a ten-dollar bottle, guzzled and gulped through chopped cork fragments left behind by a paring knife when the corkscrew failed to get the job done. I had rules that guaranteed I would never get into trouble with drinking. If I broke a rule, I had to stop drinking for a week to prove there was no problem. Finding myself drinking the bottle I had recorked after dinner violated both the half-bottle-of-wine-per-night rule and the no-alcohol-after-Xanax rule as well as the not-being-pathetic-and-desperate rule. All the trouble that followed that night could have been avoided if I had just taken an extra milligram of Xanax and stayed in bed where I belonged or if I hadn’t had so many stupid rules.

When I stopped drinking the next day, I threw in the Xanax as a generous gesture. The first twelve hours went well. “If you do something every day, you won’t be able to figure out what it’s doing to you unless you stop doing it,” I kept repeating. I was an almost-forty-year-old, home-owning, married father of two boys who was on the faculty of Harvard Medical School and who coached soccer.

Time started stretching in unpredictable ways. Maybe orange juice would help. My first appointment that morning after slugging down a quart of orange juice was a mother who wanted to talk to me about her son’s alcoholism. Once your moorings come a little loose, that sort of thing happens and happens and happens until you just can’t pick yourself up off
the floor anymore. Snowflakes hit with the force of Mack trucks. The floor and ground got a little springy, sort of like I was walking on a trampoline.