Infinite Jest (15 page)

The attempt had been serious, a real attempt. This girl had not been futzing around.
A bona fide clinical admit right out of Yevtuschenko or Dretske. Over half the admits
to psych wards are things like cheerleaders who swallow two bottles of Mydol over
a high-school breakup or gray lonely asexual depressing people rendered inconsolable
by the death of a pet. The cathartic trauma of actually going in somewhere officially
Psych-, some understanding nods, some bare indication somebody gives half a damn—they
rally, back out they go. Three determined attempts and a course of shock spelled no
such case here. The doctor’s interior state was somewhere between trepidation and
excitement, which manifested outwardly as a sort of blandly deep puzzled concern.

The doctor said Hi and that he wanted to ascertain for sure that she was Katherine
Gompert, as they hadn’t met before up till now.

‘That’s me,’ in a bit of a bitter singsong. Her voice was oddly lit-up for one who
lay fetal, dead-eyed, w/o facial affect.

The doctor said could she tell him a little bit about why she’s here with them right
now? Can she remember back to what happened?

She took an even deeper breath. She was attempting to communicate boredom or irritation.
‘I took a hundred-ten Parnate, about thirty Lithonate capsules, some old Zoloft. I
took everything I had in the world.’

‘You really must have wanted to hurt yourself, then, it seems.’

‘They said downstairs the Parnate made me black out. It did a blood pressure thing.
My mother heard noises upstairs and found me she said down on my side chewing the
rug in my room. My room’s shag-carpeted. She said I was on the floor flushed red and
all wet like when I was a newborn; she said she thought at first she hallucinated
me as a newborn again. On my side all red and wet.’

‘A hypertensive crisis will do that. It means your blood pressure was high enough
to have killed you. Sertraline in combination with an MAOI
²⁸
will kill you, in enough quantities. And with the toxicity of that much lithium besides,
I’d say you’re pretty lucky to be here right now.’

‘My mother sometimes thinks she’s hallucinating.’

‘Sertraline, by the way, is the Zoloft you kept instead of discarding as instructed
when changing medications.’

‘She says I chewed a big hole out of the carpet. But who can say.’

The doctor chose his second-finest pen from the array in his white coat’s breast pocket
and made some sort of note on Kate Gompert’s new chart for this particular psych ward.
Crowded in among his pocket’s pens was the rubber head of a diagnostic plexor. He
asked Kate if she could tell him why she had wanted to hurt herself. Had she been
angry at herself. At someone else. Had she ceased to feel as though her life had meaning
to it. Had she heard anything like voices suggesting that she hurt herself.

There was no audible response. The girl’s breathing had slowed to just rapid. The
doctor took an early clinical gamble and asked Kate whether it might not be easier
if she rolled over and sat up so that they could speak with each other more normally,
face to face.

‘I am sitting up.’

The doctor’s pen was poised. His slow nod was studious, blandly puzzled-seeming. ‘You
mean to say you feel right now as if your body is already in a sitting-up position?’

She rolled an eye up at him for a long moment, sighed meaningfully, and rolled and
rose. Katherine Ann Gompert probably felt that here was yet another psych-ward M.D.
with zero sense of humor. This was probably because she did not understand the strict
methodological limits that dictated how literal he, a doctor, had to be with the admits
on the psych ward. Nor that jokes and sarcasm were here usually too pregnant and fertile
with clinical significance not to be taken seriously: sarcasm and jokes were often
the bottle in which clinical depressives sent out their most plangent screams for
someone to care and help them. The doctor—who by the way wasn’t an M.D. yet but a
resident, here on a twelve-week psych rotation—indulged this clinical reverie while
the patient made an elaborate show of getting the thin pillow out from under her and
leaning it up the tall way against the bare wall behind the bed and slumping back
against it, her arms crossed over her breasts. The doctor decided that her open display
of irritation with him could signify either a positive thing or nothing at all.

Kate Gompert stared at a point over the man’s left shoulder. ‘I wasn’t trying to hurt
myself. I was trying to kill myself. There’s a difference.’

The doctor asked whether she could try to explain what she felt the difference was
between those two things.

The delay that preceded her reply was only marginally longer than the pause in a regular
civilian conversation. The doctor had no ideas about what this observation might indicate.

‘Do you guys see different kinds of suicides?’

The resident made no attempt to ask Kate Gompert what she meant. She used one finger
to remove some material from the corner of her mouth.

‘I think there must be probably different types of suicides. I’m not one of the self-hating
ones. The type of like “I’m shit and the world’d be better off without poor me” type
that says that but also imagines what everybody’ll say at their funeral. I’ve met
types like that on wards. Poor-me-I-hate-me-punish-me-come-to-my-funeral. Then they
show you a 20 x 25 glossy of their dead cat. It’s all self-pity bullshit. It’s bullshit.
I didn’t have any special grudges. I didn’t fail an exam or get dumped by anybody.
All these types. Hurt themselves.’ Still that intriguing, unsettling combination of
blank facial masking and conventionally animated vocal tone. The doctor’s small nods
were designed to appear not as responses but as invitations to continue, what Dretske
called Momentumizers.

‘I didn’t want to especially hurt myself. Or like punish. I don’t hate myself. I just
wanted out. I didn’t want to play anymore is all.’

‘Play,’ nodding in confirmation, making small quick notes.

‘I wanted to just stop being conscious. I’m a whole different type. I wanted to stop
feeling this way. If I could have just put myself in a really long coma I would have
done that. Or given myself shock I would have done that. Instead.’

The doctor was writing with great industry.

‘The last thing more I’d want is hurt. I just didn’t want to feel this way anymore.
I don’t… I didn’t believe this feeling would ever go away. I don’t. I still don’t.
I’d rather feel nothing than this.’

The doctor’s eyes appeared keenly interested in an abstract way. They looked severely
magnified behind his attractive but thick glasses, the frames of which were steel.
Patients on other floors during other rotations had sometimes complained that they
sometimes felt like something in a jar he was studying intently through all that thick
glass. He was saying ‘This feeling of wanting to stop feeling by dying, then, is—’

The way she suddenly shook her head was vehement, exasperated. ‘The feeling is
why
I want to. The feeling is the
reason
I want to die. I’m here because I want to die. That’s why I’m in a room without windows
and with cages over the lightbulbs and no lock on the toilet door. Why they took my
shoelaces and my belt. But I notice they don’t take away the feeling do they.’

‘Is the feeling you’re explaining something you’ve experienced in your other depressions,
then, Katherine?’

The patient didn’t respond right away. She slid her foot out of her shoes and touched
one bare foot with the toes of the other foot. Her eyes tracked this activity. The
conversation seemed to have helped her focus. Like most clinically depressed patients,
she appeared to function better in focused activity than in stasis. Their normal paralyzed
stasis allowed these patients’ own minds to chew them apart. But it was always a titanic
struggle to get them to do anything to help them focus. Most residents found the fifth
floor a depressing place to do a rotation.

‘What I’m trying to ask, I think, is whether this feeling you’re communicating is
the feeling you associate with your depression.’

Her gaze moved off. ‘That’s what you guys want to call it, I guess.’

The doctor clicked his pen slowly a few times and explained that he’s more interested
here in what
she
would choose to call the feeling, since it was her feeling.

The resumed study of the movement of her feet. ‘When people call it that I always
get pissed off because I always think
depression
sounds like you just get like really sad, you get quiet and melancholy and just like
sit quietly by the window sighing or just lying around. A state of not caring about
anything. A kind of blue kind of peaceful state.’ She seemed to the doctor decidedly
more animated now, even as she seemed unable to meet his eyes. Her respiration had
sped back up. The doctor recalled classic hyperventilatory episodes being characterized
by carpopedal spasms, and reminded himself to monitor the patient’s hands and feet
carefully during the interview for any signs of tetanic contraction, in which case
the prescribed therapy would be I.V. calcium in a saline percentage he would need
quickly to look up.

‘Well
this’
—she gestured at herself—‘isn’t a state. This is a
feeling.
I feel it all over. In my arms and legs.’

‘That would include your carp—your hands and feet?’

‘All
over.
My head, throat, butt. In my stomach. It’s all over everywhere. I don’t know what
I could call it. It’s like I can’t get enough outside it to call it anything. It’s
like horror more than sadness. It’s more like horror. It’s like something horrible
is about to happen, the most horrible thing you can imagine—no, worse than you can
imagine because there’s the feeling that there’s something you have to do right away
to stop it but you don’t know what it is you have to do, and then it’s happening,
too, the whole horrible time, it’s about to happen and also it’s happening, all at
the same time.’

‘So you’d say anxiety is a big part of your depressions.’

It was now not clear whether she was responding to the doctor or not. ‘Everything
gets horrible. Everything you see gets ugly.
Lurid
is the word. Doctor Garton said
lurid,
one time. That’s the right word for it. And everything sounds harsh, spiny and harsh-sounding,
like every sound you hear all of a sudden has teeth. And smelling like I smell bad
even after I just got out of the shower. It’s like what’s the point of washing if
everything smells like I need another shower.’

The doctor looked intrigued rather than concerned for a moment as he wrote all this
down. He preferred handwritten notes to a laptop because he felt M.D.s who typed into
their laps during clinical interviews gave a cold impression.

Kate Gompert’s face writhed for a moment while the doctor was writing. ‘I fear this
feeling more than I fear anything, man. More than pain, or my mom dying, or environmental
toxicity. Anything.’

‘Fear is a major part of anxiety,’ the doctor confirmed.

Katherine Gompert seemed to come out of her dark reverie for a moment. She stared
full-frontal at the doctor for several seconds, and the doctor, who’d had all discomfort
at being stared at by patients trained right out of him when he’d rotated through
the paralysis/-plegia wards upstairs, was able to look directly back at her with a
kind of bland compassion, the expression of someone who was compassionate but was
not, of course, feeling what she was feeling, and who honored her subjective feelings
by not even trying to pretend that he was. Sharing them. The young woman’s expression,
in turn, revealed that she had decided to take what amounted for her to her own gamble,
this early in a therapeutic relationship. The abstract resolve on her face now duplicated
what had been on the doctor’s face when he’d taken the gamble of asking her to sit
up straight.

‘Listen,’ she said. ‘Have you ever felt sick? I mean nauseous, like you knew you were
going to throw up?’

The doctor made a gesture like Well sure.

‘But that’s just in your stomach,’ Kate Gompert said. ‘It’s a horrible feeling but
it’s just in your stomach. That’s why the term is “sick to your stomach.” ’ She was
back to looking intently at her lower carpopedals. ‘What I told Dr. Garton is OK but
imagine if you felt that way all over, inside. All through you. Like every cell and
every atom or brain-cell or whatever was so nauseous it wanted to throw up, but it
couldn’t, and you felt that way all the time, and you’re sure, you’re positive the
feeling will never go away, you’re going to spend the rest of your natural life feeling
like this.’

The doctor wrote down something much too brief to correspond directly to what she’d
said. He was nodding both while he wrote and when he looked up. ‘And yet this nauseated
feeling has come and gone for you in the past, it’s passed eventually during prior
depressions, Katherine, has it not?’

‘But when you’re in the feeling you forget. The feeling feels like it’s always been
there and will always be there, and you forget. It’s like this whole filter drops
down over the whole way you think about everything, a couple weeks after—’

They sat and looked at each other. The doctor felt some combination of intense clinical
excitement and anxiety about perhaps saying the wrong thing at such a crucial juncture
and fouling up. His last name was needle-pointed in yellow braid on the left breast
of the white coat he was required to wear. ‘I’m sorry? A couple weeks after—?’

He waited for seven breaths.

‘I want shock,’ she said finally. ‘Isn’t part of this whole concerned kindness deal
that you’re supposed to ask me how I think you can be of help? Cause I’ve been through
this before. You haven’t asked what I want. Isn’t it? Well how about either give me
ECT
²⁹
again, or give me my belt back. Because I can’t stand feeling like this another second,
and the seconds keep coming on and on.’