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Authors: Karen Hill

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The months inched by. Although she had more or less settled in, the back of her mind was suffused with questions: Should she have left? Should she go back? She still hadn't heard from Issam. Ruby became restless as the bustling breath of autumn filled the air. The baby was late, and Ruby's laboured breathing slowed her down at every step. Finally she decided to take in an afternoon of comedy, mainly old flicks, including her father's favourite, Buster Keaton, in the hopes that a belly laugh would deliver relief.

It worked. Early the next morning her baby was kicking and pushing, head bobbing and feet dancing, as it prepared to burst into the world. Ruby was set up for a home birth and duly called Jessie to join their parents and the midwife to celebrate the coming birth. The contractions were occurring steadily but
she moved about freely. For a while she kept her father company in the kitchen while he prepared soup and cornbread. But she returned to the basement, too distracted for conversation. By the time the midwife arrived, and Jessie shortly after, her water had broken. The pain of the contractions had increased tenfold. For the next eight hours, Ruby heaved and sighed and cried and grunted and howled, at times wildly cursing her choice of a natural birth. Her mother and her sister helped her as she moved from bathtub to bed and back again. The warm water lifted her spirits and calmed her. In between she paced and squatted, with the midwife holding her up by her arms. In the meantime Ruby's mother recounted the stories of her own pregnancies. When she had been expecting Jessie, their father had been late coming home from work. Her water had broken and she was down on her knees from the pain. He came in to find her on the floor and rushed her into the car. Traffic was heavy; when they finally got to the hospital, Jessie popped out while her mother was still lying on the stretcher, waiting to be transferred to a room. Ruby had been much easier.

Jessie laughed. “See, I had to fight harder to get into this world. That's why I'm made of steel.”

“No comment,” Ruby replied.

Sweating and exhausted, Ruby finally asked to lie down. The midwife stood at the foot of the bed, Jessie rubbed her shoulders and her mom held her hand. She pushed and strained, gasping for breath. This scene repeated itself for ten minutes before a little head covered in flowing ebony curls and milky white drizzle was rounding out of her. The baby
was the colour of café au lait, with almond-shaped eyes, high cheekbones and a little pug nose. She was the picture of her father; Ruby wondered where he was right at that moment.

Gently hugging and rocking her baby girl, Ruby held her to her swollen breast and touched the baby's barely open eyes. “You, my child, you will be my star and my moonbeam, guiding me through any darkness that may come, filling the night air with joy and light.” She kissed her baby's forehead, whispered “Nyota,” then closed her eyes.

Jessie came into the bedroom with a towel for the baby. “You're something awesome, Sis,” she said softly.

Ruby called Issam to let him know he'd had a baby girl. She didn't comment on how hurt she was that he hadn't called. He was ecstatic and offered a name for the baby, Soraya. Ruby explained that she had already named the little one but would gladly use Soraya for her middle name. Then she said, “I miss you.”

“I miss you, too. I think about you all the time. Take care of yourself and Nyota Soraya Edwards. I will write you with my address in Sudan. Maybe one day you will come visit me.”

Ruby knew it was time to put her plan into action. Now that the baby was a few months old, she could leave her with her mother for a few hours without worry. Nobody was home, so she sat down to write up a few questions to ask Melvin Burns about Black history in Toronto and then picked up the phone to dial his number.

What would he say? She hung up the phone. Would he know why she was calling? If he were guilty, then yes. She tried again, but this time her hand was shaking so badly that she couldn't dial the numbers. She paced around the kitchen, making up possible conversations in her head.
You'll just have to do it
, she thought. She took a number of deep breaths and tried again.

The voice at the other end of the line sounded soft but firm. When he realized who he was talking to, he sounded momentarily happy and asked her how she and the family were doing. But when she asked if she could meet up with him, he left the question hanging in the air. Then he began blustering in a pitiful voice, “I don't usually have visitors over.”

“I won't bother you long. Just a few questions to help me with a paper I'm doing.”

“I don't think I can do that.”

“Sure you can. You're a fountain of knowledge, Mr. Burns. That's why I chose you to interview.”

“How much time do you need?”

“Not much.”

“Well, maybe I could spare half an hour next Tuesday afternoon. You can come by then. But only for half an hour, you hear?”

“Great, Mr. Burns. Is one o'clock good?”

“Yup, that's fine.”

“Okay, see you then.”

Ruby hung up the phone and realized that she was shaking all over. She picked up Nyota and went to the living room
to sit down and put her feet up. She snuggled and then fed the baby, loving the feel of her mouth gurgling at her breast. She had done it. Now she was halfway there.

The following Tuesday Ruby left Nyota with her mother. She took the bus and then the subway downtown and hopped a streetcar on St. Clair and rode it west. She only had a few blocks to walk. As she made her way towards Melvyn Burns's house, she felt the slow burn of panic arise within her. Her body started to quiver. She still hadn't figured out what she was going to say. She continued forward but felt blackness and confusion coming on. The urge to vomit overtook her, and she leaned over the curb and retched into the gutter. She stumbled a few feet farther along and then sank down onto the curb. His house was only a block away. After five minutes Ruby steeled herself to carry on. She came upon the house, a little stone bungalow with a blue porch. There was a lovely garden full of irises and peonies to her left. The door was wooden, with a large brass knocker. She rapped three times. After some time had passed she lifted the knocker again and the door creaked open. A pretty young woman, about her own age, opened the door.

“You must be Ruby. Come in. I'm Susanna, Melvin's daughter.” She ushered Ruby towards the living room. Ruby had blanched and was uncertain of her steps. Then she stuck her shaking hands in her pockets and summoned the courage to speak.

“I vaguely remember playing with you and your sisters a few times way back when.”

“Yes, I do too,” said Susanna, smiling wanly. “My father isn't well. He has liver cancer and hasn't much longer to live. You won't be able to spend too much time with him.”

“I see,” said Ruby.

“You should know, I've only been here a few weeks. I hadn't seen him for twenty-five years until this week. We left him when I was five,” she said, her voice now hushed. Ruby stood rooted to the floor, straining to understand what she was hearing. “I've been in therapy for ten years because of him. My sisters, my mother . . .” She was practically stammering. “They couldn't do it, they wouldn't come. They can't stand the thought of being near him. But I wanted to look him in the eye after all these years . . . and then say goodbye. I don't know why, I feel compelled.” She paused, her hands trembling ever so slightly. “Go on in. But don't expect much in the way of niceties. It's the door on the right,” she said, pointing down the hallway.

Ruby's mouth went dry and she broke into a sweat. She wanted to march right back out the front door and keep going straight without ever looking back. But she was here now, she had come this far. She would have to go through with it. Her body felt limp, but she turned down the hallway and pushed open the door.

A slight, balding man, with ashen skin and sunken eyes, was propped up on a large, bright white pillow. He looked a decade older than he actually was. Fumbling, Ruby forgot everything she had planned to say and stood in the doorway, wringing her hands. She was struck by the pathetic sight of this
enemy she felt she had come to know so well in her delusions.

“Hello, Ruby. I'm surprised to see you here. You look lovely, my dear.”

Ruby could feel his eyes coursing over her body, as if trying to recognize something he once knew. She felt violated and shuddered, still at a loss for words. Slowly, as if drawn by a magnet, she brought her gaze to meet his. She saw flinty bits of haughtiness and fire in his eyes.

“You are an awful man,” she finally sputtered. “How many children did you hurt?”

“I knew you were going to say that. Your father was so successful. I had to bring him down a notch by taking something that was his. And you were so precious. But then, he never knew, did he? You were a good girl, you stayed quiet like I told you to. You must have buried it deep inside.”

“You should be ashamed. You had no right.”

Ruby watched astounded as she saw him wrestle with a kind of sadness. His face metamorphosed as the sorrow trickled through and dampened the light in his eyes.

“How true. That I am, that I am. Nobody said that being nice would get you anywhere. In the end I am paying for my sins.”

“Not soon enough. How unfair that you should go unpunished while others suffer because of you.”

Burns's face collapsed now, any arrogance gone. His voice broke as he tried to spit out the words. “I'm so sorry. Please tell me you forgive me. Look, you have your whole life ahead of you still. I am dying now.”

Ruby looked down at the floor, chewing her lip, and then back into his face. “That would be very hard. You have crawled into my head, taken up space with your nasty words that I remember so well. You caused so much fear and pain. I can't think of forgiveness right now. I just needed to finally know.”

She took one last look at the pathetic sight of this dying man crumpled on the bed. “I feel sorry for you and especially for your family, too.” She left the room and closed the door behind her.

Susanna was standing right outside the room. “Did you get what you were looking for?”

Ruby looked at her morosely and nodded. “More or less.”

“Listen, Ruby. I have a card here for you. It might be of use someday when you're ready.” She turned into the living room, rummaged through a desk drawer and then handed the card to Ruby. It read “Abuse Counselling for Women” and listed the names of several psychotherapists.

“It helped me a lot, and it would probably help you, too. Give them a call sometime.”

Ruby smiled her thanks and felt her eyes begin to well up. She struggled with her words. “I have to go, but thank you so much.”

Walking down the driveway, Ruby felt relieved and agitated at the same time. It took her a few moments to regain her composure. When she did, she continued down to the street and walked towards the streetcar stop. She found a seat at the back. She watched the vistas passing by her as she gazed out the window, heart still throbbing. Tears rolled down her
cheeks as she sat thinking, turning the card Susanna had given her over and over in her shaky hand. So it was true. She felt ill and her mouth was still dry as a bone. There was nothing left to do but grieve and get help. She wondered if she would be free of the delusions and dreams that had stalked her so. She hadn't told her parents about Melvin Burns and tried to imagine their surprise, their hurt for her. She would have to tell them soon now. She sat shaken and dishevelled, leaning against the window.

An hour later, Ruby walked up the driveway to her parents' home. The front door was open and the September sun was streaming into the hallway. Her mother stepped out of the kitchen with Nyota in her arms and came to greet her at the door. Ruby scooped her daughter out of her mother's embrace. She squeezed her tight and sat down in the living room. She lifted her top and prepared to let her baby suckle at her swollen breasts. She rippled her fingers through Nyota's hair and gently rubbed her skull, then she tweaked her little nose. She thought of all the stories she would tell her when she was older. She smiled. She was home. She was safe.

On Being Crazy
B
Y
K
AREN
H
ILL

I
TOLD MY EIGHTEEN-YEAR-OLD DAUGHTER THAT I
was sure they were going to kill me. She insisted that I call her hourly that night from the psych ward, to reassure her that I was all right. It was December 2008, and she was away at her first year of university. She cajoled me through my fears and supported me with her love. Only that was supposed to be my job. How did the tables get turned like this?

They're pretending to be busy but they're watching me. I know that they even have cameras in the washrooms and the showers out on the floor, perverts!! Uh-huh! Today they're all wearing colours for the different guys I'm enamoured with, to show their support for one or the other. Purple, red, black, white. The guys, they're always yacking at me and arguing but I can barely hear them. What do
they expect; they're all talking at once. Then they get mad 'cause I can't seem to respond to each one individually. I want us all to live together under one roof. Crazy me. The head doctors are constantly trying to hypnotize me with their eyes again. Drain the information out of me. Can't fight against it; they always win.

In my family, the incidence of mental health problems runs high. My mother and her twin sister are both bipolar. On my father's side, one of my aunts was bipolar and two of my cousins are schizophrenic. While some people dispute the idea that mental illness can be hereditary—and I, too, believe in the importance of social and environmental causes—you can nonetheless see that the odds were pretty high that someone else in my immediate family might get hit over the head with it, too. The only mitigating factor was that, having witnessed my mom in periods of illness, we already knew something about it and were well aware of the signs.

In 1979 I graduated from university and took off to Europe. Six months later I was twenty-one and living in Berlin. I was too busy living my adventure to worry about mental illness. I worked under the table cleaning houses, travelling whenever I could. After two years I married the young German man I was living with and got my work permit. I landed an excellent job at the Max Planck Institute for Human Development. In the summer of 1984 the institute asked me to attend a conference in West Germany on my own as a member of the
Betriebsrat
, a kind of internal watchdog for the institute,
with something like a union role. This conference brought together
Betriebsraten
members from across Germany, and it was an honour to be asked to represent my workplace.

My German was very good by then. But when I was wrangled into presenting complicated findings from the week's working meetings, I felt like the lamb led to slaughter. The pressure was intense, and I found myself not sleeping, walking the halls, then tossing and turning in bed and then up pacing again. Underlying all this was an increasingly unhappy relationship with my husband. I was a wreck by the end of the week, not able to think straight, totally at a loss. I made a mishmash of presenting the group's findings in front of a crowd of two hundred and then collapsed in a sobbing, ranting mess. Someone drove me the three-hour drive back to Berlin because I wasn't fit to get on a plane. From there on in I just got worse. A week later I was going to the doctor's office to get injections of an antipsychotic drug, Haldol, and about three weeks later I was an inmate at the Schlosspark hospital.

This first experience of psychosis with delusions and hallucinations was a surreal nightmare. Emotionally I was petrified—and soon physically petrified as well, as the side effects of the medications slowed my reflexes and made me feel as if my body was slowly turning to stone. I met with the staff psychiatrist regularly. He was never arrogant or condescending, nor was he intrusive or threatening. Our meetings were always one-on-one, and we usually met in his office, unlike at the hospitals in Toronto, where there is
almost always a small group of doctors peering at you while you're sitting uncomfortably on your bed. Other meetings at hospitals here in Toronto sometimes took place in small conference rooms, and again there was always more than one doctor present and I always felt intimidated. When I told my psychiatrist in Berlin that I didn't want to go to group therapy, instead of badgering me, he immediately suggested I join a music program instead, and that worked wonders for me.

My brother Larry came to stay in Berlin for a few weeks as soon as he could get there. He saw me at my worst, before I was hospitalized. In November 1984 my parents came over, and I remember our many walks on grey autumn afternoons through the palace grounds behind the hospital. In December, after two months and countless visits from friends, I was released. By February 1985 I was in a deep depression, and my brother Dan came to visit and took me swimming almost every day. By the end of his stay several weeks later, I was finally coming to, shaking off the vise of blackness that had me in its grip.

One of the most important pieces about this story is that the German doctors deliberately chose not to diagnose me with anything, despite knowing of my family history of mental illness. Instead, immediately upon my release they embarked upon a plan to have me weaned off the antipsychotics over the course of a year and a half. When I was completely off those drugs I wasn't on any other mood stabilizers or other medication. For the following thirteen years I was drug-free and incident-free.

I know they're following my every move, my every thought. I can tell. I know better. I have to get out of here. Don't want to sleep. The staff will get me in my sleep. That's why they always push the extra Ativan—to knock me out. To study me and then do away with me. The windows in my room look out onto tall buildings full of people studying me and controlling me. I'll give those nurses a little wave. To let them know that I know . . .

The choir is singing in my head—constantly singing at the back of my head, bluesy gospel-like singing, call and response. I know it's been put there by friends to help me, to soothe me. Also to guide me to action. I hate that it's there all the time. When it's not the choir, it's an Aboriginal drum circle sent to comfort me and let me know that people are thinking of me. But I can't stand the constancy. It doesn't let up. I don't want anyone to guide me. The worst thing is that sometimes the bad guys—doctors, scientists—try to imitate the sound of the choir or the drums. But I can usually tell the difference in a few minutes. Everybody's inside my head pulling me every which way all the time.

In 1985 I left my German husband and within a year was involved with a young visual artist from Sudan. In 1988 I became pregnant and decided to move back to Canada the following year. My partner stayed behind in Berlin until 1996, when he was able to follow me to Toronto. (He returned to Sudan in 2002 and remained there.)

In 1997, I was rehired as an ESL lead instructor with the Toronto District School Board after a temporary layoff of nine
months. During the layoff I had found a less interesting but still demanding job, and I was trying to ghostwrite a biography of someone at the same time. With the switch back to my regular work it was all too much. I soon became manic and then delusional.

This time I went to Women's College Hospital. There they diagnosed me as being bipolar and as having seasonal affective disorder, and I was put on lithium. I remember my brother Dan bringing me music and a Walkman, and I would constantly walk the halls listening to
The Best Hits of Van Morrison
, and later in my room to Babyface. Nobody seemed bothered by my constant rounds of the halls, and I remember that the nurses seemed friendly.

The following year stress led me into sickness once again. The Mike Harris government had decided to close or amalgamate many hospitals or hospital departments, and the psych ward at Women's College Hospital was closed. Instead I had a horrible seven-week stay at the Clarke Institute, precursor to today's CAMH, or Centre for Addiction and Mental Health. The doctors at the Clarke couldn't figure me out. Despite the lithium, I continued to struggle with psychosis. I felt like I was left pretty much on my own. Soon, I started acting up on the ward, pacing constantly in front of the nursing station, yelling that my brother Dan had told the CBC about me and they were following my plight and the doctors had better take care of me. At the same time, I believed that O. J. Simpson was coming to Toronto to see me for a match of the wits where I was going to tell him off. It was just after his trial,
and while I believed that he had rightly been acquitted given the missteps of the LAPD, I inwardly felt he was nonetheless guilty. I was a mess and not getting much attention from any doctors.

My family complained formally, with a written letter, about inappropriate care. The doctors finally put me on a different mood stabilizer, Epival, plus the antipsychotic olanzapine. Still I believed that the outside world was paying attention to my situation, and I continued to march back and forth every day in front of the nursing station. Finally I tried to bust out past a security guard posted at the door to the ward, and because of this, staff insisted I be put on a Form 1, committing me to the institution for seventy-two hours. I refused to sign the papers and was locked in a small room for three days. My parents came down every day begging me to sign. I finally capitulated. Being on a Form 1 meant I could no longer leave the ward at all, not even in the company of family or friends. I was very upset about the whole situation. Three weeks later, though, my mental state had improved and I was deemed well enough to leave the Clarke under directions to continue with my medications. Six months on olanzapine saw me gain thirty pounds. A common side effect, the doctors told me. I recently read that there is now a class-action suit regarding this drug, as many people became diabetic and suffered strokes due to the massive weight gain. I couldn't stand it, so I took myself off the drug.

From 1997 to 2001 I continued working at the Toronto District School Board. However, my job—and those of many
other colleagues—was about to be cut. I struggled with this, as I had been at the school board for almost ten years, but I eventually found work at the Canadian Race Relations Foundation. The atmosphere there was politically charged and stressful, and I became unwell and eventually had to leave the position. The following year my father died, and then I found a temporary job marking Grade 10 literacy tests for the Education Quality and Accountability Office. With the extreme stress of this job and the loss of my father, I found myself once again on unstable ground.

Between 2004 and 2010 I was hospitalized five more times, each time at Toronto General Hospital. I switched from Epival back to lithium, and the antipsychotic of choice had become risperidone. Although perhaps not as nefarious as olanzapine, it still caused weight gain along with the usual numbness and slowing of the mind.

In the summer of 2004 I was an outpatient in a group therapy program at Mount Sinai Hospital that caused me a lot of grief and anxiety, and at the same time I was not yet on disability so did not have the money to pay for my next set of prescriptions. I would take what medication I had left only every second or third day. Of course, chaos ensued within a week or two and I was hospitalized again. A few other times, I reduced my antipsychotic medication on purpose in the hopes of going off it completely, wanting to be rid of all the nasty side effects and extra weight. I never tried to go off lithium, as I felt it was my baseline and didn't mess with my mind or my weight. But the overall common denominators were always
extreme stress leading to lack of sleep, followed by increasingly erratic behaviour.

Sick again in 2010, I paid another visit to the hospital. I no longer remember what propelled me there, except that I was once again delusional, and as my family insisted, I didn't really have a choice. I couldn't look after myself at home, and it would be too difficult for my mother or anyone else in the family to look after me, either. Even though I was deeply resentful and scared, I never truly resisted going back to the hospital, perhaps because deep down I knew I couldn't function on my own and needed help. My family was always there for me, visiting me regularly during my stays, meeting with doctors and frequently checking in on me when I came out. I cannot stress the importance of family involvement in the healing process and of making them aware of the resources that are available (to name a few, CAMH and in particular its Workman Arts project and its Empowerment Council, the Mood Disorders Association of Ontario, Across Boundaries, the Gerstein Centre, the Canadian Mental Health Association, Sistering and the Creative Works Studio).

As usual, as soon as I got into hospital I felt like I was stuck in a prison and wanted desperately to get out. Programming cuts meant there wasn't much to do during the day. Watching television only fanned the flames of my various conspiracy theories (I believed the newscasters could all see me and read my thoughts; that the other programs were all about me, but were also often mocking me). I did a fair amount of lying around. I felt very strongly that if I lay on my right side, I was
offering resistance to the system. Along with refusing to eat most of the time, it was for me a way to give a finger to psychiatry. When I lay there, I could feel the eighth floor and all the people on it tense up and prepare for battle. It never took very long before a group of nurses would come down to check on me, eyeing me. They didn't say so, but their fake smiles and cold, hard eyes yelled at me that I was acting out and was to stop. When I wasn't lying around in protest, I made use of supplies from the art program that had fallen victim to Harris's mania for cost-cutting.

Art lends itself easily to my maddened mind. In the early stages, my mind is too erratic to focus on reading, writing or puzzles. During my 2010 stay at the Toronto General Hospital, I made one painting for each of my family members, flinging and dribbling paint about in my best Jackson Pollock mode. I was sure staff was hostile to my whipping brushes in the air, but my mind was jumpy and well suited to the frenetic activity. While I created, I thought about how I hated the condescending head doctors. Most of the nurses weren't much better. It seemed to be all about robotically lining up to take my meds and eat meals in silence with others. I often felt locked in a power struggle with them. I wanted out.

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