Just Like Someone Without Mental Illness Only More So (18 page)

At any given point there are several million people in this country who are psychotic. As a matter of law they are exempt from being judged responsible for their actions while crazy. They are also 99 percent invisible. Most won’t get better enough to be as well as they were before. Many won’t really get better at all, just another part of life to not look at if you don’t want to get depressed. I’ve read studies indicating that 90+ percent of the homeless are mentally ill.

Things do not even out.

Jane at age fifty-five

(Photo by Michael Cullen)

It was the day before Christmas, 1985. I was thirty-eight and seven-twelfths years old. I wanted to come home from the hospital under my own steam. I took a taxi most of the way and walked the last half mile. The third-floor window I had tried to jump through had been repaired, but there was still glass and broken sash in the bushes. I had three Christmas ornaments I had made in art therapy in my pocket. I have them still; regardless of how “good” the music or painting is, the arts have been a lifeline and the heart of the matter for me and Kurt and many other people.

When I was getting ready to leave the hospital I would look at my hands like they were someone else’s. It was the damnedest thing how they shook and trembled. I had always had a mild intention tremor, but I prided myself on doing medical procedures well. I needed at least an approximate sense of where my fingertips were and what they were up to.

The first time I managed to speak up and ask a question at an AA meeting, I asked, “How long does the shaking last?”

“You drank a long time, you’re going to shake a long time,” said a gravel-voiced woman named Hope.

While I was still in the hospital I had to sign something about my disability insurance. “Too bad it doesn’t really insure against disability,” I thought. My father sincerely said it was a good thing I had disability insurance, and I wanted to yell at him. How would anybody be able to tell if a writer and an icon was disabled?

Before, I’d been seeing twenty or thirty patients a day. I thought it was keeping me sane and at the same time proving to the world that I was cured and making me a living. I thought things were fixed and okay forever. Right before all hell broke loose on the commune, I had thought that things were all right and fixed forever.

Jane defied the odds long enough to see several more grandchildren born. When asked, I regretfully told her that stage-four ovarian cancer wasn’t a curable disease. She said that none of us knew the future and that something else might kill her, like getting hit by a truck. When I was in the hospital wrestling the Russian Bear and standing up for free markets, my mother’s cancer came back and no one knew how to tell me.

She was in the hospital being operated on again when they told her that I was in the hospital. I had just finished opening Christmas presents when they told me her cancer was back.

I cried. It was a bad December for the home team. We didn’t deserve to be having things going so badly. Would it have been that hard to stagger my mental illness and my mother’s cancer by a couple of months?

——

I looked out from a home that I somehow owned. There were two cars in the driveway. I had been to medical school and done an internship and residency. For the moment, anyway, I had a valid license to practice medicine in the Commonwealth of Massachusetts. Work wasn’t eager to have me back like tomorrow or the next day, but no one was saying I was done forever. I was related to the person who had done all the hard work that made the house, cars, et cetera, possible, but it was a complicated relationship. I couldn’t imagine what it would be like to see patients again but guessed that maybe I could do it if that was what I was supposed to do.

Maybe I just had to learn to be comfortable with being uncomfortable, with being scared out of my mind, and to let it go past like it wasn’t about me.

The place I felt most welcome and comfortable was AA meetings, even though there was a sticky-sweet optimism there I found insufferable.

“The grace of God won’t take you where the grace of God can’t keep you.”

“You never get more than you can handle.”

“You won’t die from not drinking or not sleeping or being afraid.”

“Ha.”

The people who had died from not drinking or sheer fright were respectfully dead and quiet and unavailable for comment. I was quite sure I was going to be one of them. I had slowly and carefully consumed a lethal dose of alcohol and alcohol equivalents
and would eventually die from either drinking or not drinking. My biggest problem was figuring out how to get word back to these cheerful pabulum peddlers when I died from not drinking. I wanted to have a gravestone carved: “Mark got more than he could handle.”

Had I been any sicker for very much longer back in the seventies, I wouldn’t have recovered enough to think about going to medical school and no medical school would have let me in. I had put together a good chunk of well time—fourteen years—but now there was a substantial chance that if I didn’t get my act together reasonably quickly, I’d be put out on the curb with the rest of the trash.

One month after the hospital, I was depressed and had the zip of a soggy potato chip, so someone ordered an EEG or brain-wave test. It was mostly normal but showed
generalized frontal slowing
. It didn’t seem to worry my doctors much, but it seemed ominous to me. Maybe the threads on my screw were too worn down for me to be able to practice medicine again. I wasn’t arguing. I just wanted to know if generalized slowing was something people got better from or not.

I missed alcohol very much. Those little slivers of Xanax they gave me in the hospital had made me feel so very much better, it made sense that if I could just have one or even half a beer, I would be able to sparkle just a little and maybe complete a thought and be a better father or be able to read a newspaper. I
wanted to be the guy who everyone thought should be a pediatrician again.

My partners took me to grand rounds at MGH, where I thought everyone was looking at me. I appreciated the change of pace and their time but wanted to blurt out, “When can I come back?” knowing it was exactly the wrong thing to say.

My wife said I wasn’t the person she had married and she couldn’t stand having me hanging around the house. I’d spent my whole life believing that by force of will I could do things and make things happen. I just wanted to be a normal guy who was married and went to work and had kids, but it all seemed to be slipping away.

My second son, Eli, was sick a lot. I had brought home respiratory syncytial virus from the hospital when he was a few months old. RSV for most people is just a bad cold, but with babies it can go down into the lungs and, as it did with Eli, set them up to become asthmatic. He was five years old when I came home.

Eli never complained but spent a fair amount of his early childhood sitting on the couch coughing and wheezing. He would get pneumonia two or three times a year, during which he’d throw up everything and run 104-degree fevers. He didn’t grow much. It didn’t help that until he was four his father still smoked.

When I stopped drinking, Eli stopped getting sick. He fattened up a little, grew a sneaker size, and started playing sports. Six months into my experiment of living life without the buffers of drugs and alcohol, it all became too much. My father was impossible, my mother was dying, I had a horrible fight with one of my sisters, my wife didn’t like me even a little, there wasn’t enough money. I begged my psychiatrist for some Ativan. I
didn’t even like Ativan. I certainly couldn’t get addicted to a drug I had so little affection for. Half a milligram later, I felt instantly better and it became clear that Jack Daniel’s had never been anything but a good and true friend. Within a day Eli threw up everything and spiked a fever to 104 with what proved to be his last pneumonia. He’s now taller than me, which I don’t mind, and I’ve been drug- and alcohol-free ever since. About all I was good for during the first months of recovery was wrestling and hanging out with Eli. That had to be enough, and it was.