The Center Cannot Hold: My Journey Through Madness (32 page)

Even worse, I found myself identifying too closely with Uncle
Norm. Was that going to be me someday? Would I ever reach a point
where the idea of one more doctor, one more test, one more pill, one
more episode, one more hospitalization, would simply flip me over the
edge?

After I hung up the phone, I stood alone in my tiny apartment,
with suitcases packed and the rest of my life about to begin, and I
balled my hands up into defiant fists.
No! No!
That was him, in his life,
for his reasons; this was me, in mine.

A vital step in my survival, and a key reason for this trip, was to find
myself a good analyst. I'd learned, with the guidance of Mrs. Jones
and Dr. White, that without the fail-safe of talk therapy securely in
place, the rest of it wouldn't matter. I interviewed four (they'd been
recommended by friends, by colleagues, and by White), and in the
end, my choice was the one whom White had suggested. His name was
Kaplan, and his impressive professional resume included working
with many seriously ill patients at a Los Angeles-area hospital.

My initial visit to Kaplan's office was reassuring—it was
haphazardly decorated, with a collection of objects that didn't seem to
go together (lopsided stacks of books and papers and notebooks
everywhere, mismatched lamps, nondescript furniture). To me, it gave
ample evidence of his standing as a busy academic doing many
things—teaching, writing, and treating patients. Since my own office,
then and now, has always been a chaotic mess, I took heart in finding
Kaplan's to be almost the same. And it reminded me somewhat of
Mrs. Jones's—there was an implicit suggestion here that exterior
things didn't much matter, but that the journey to the interior
mattered a great deal.

It became clear in our first minutes together that Kaplan not only
understood my illness but was also comfortable with blending a
psychoanalytic approach with medication (which is not the case with
all analysts). But I wondered if he was prepared for the kind of
intensity and violence my episodes sometimes contained. Maybe the
man was getting more than he bargained for. "Don't worry about
that," White had told me. "Don't be too scared of her," he told Kaplan.

The rest of the to-do list—lunches and dinners with the people
soon to be my colleagues, and the search for a place to live—went
better than I could have hoped; in fact, I managed to get through it
completely intact. Heeding Steve's admonitions, I took my medicine,
ate the right food, got the necessary rest, and actually had a nice time.
The apartment I found—a largish one-bedroom—was in a modern
four-story stucco building, typical for the west side of LA, and about a
half hour to forty minutes driving time from the campus. Since I'd
determined long ago to never live on a ground floor—because who
really knew what was on the other side of the window?—I was
comfortable up in the air. After my high school experience of the
talking houses (a memory which unnerves me to this day), I had no
interest in a tidy little bungalow or cottage. And no yard, terrace, or
balcony, either, with trees I couldn't see around and odd shadows
lurking in the corners. I wanted only to be safely sheltered within four
inaccessibly high walls.

As for my future colleagues, everyone seemed eager to make me
feel at home, and they did. As we walked around the campus and I
began to get my bearings—here's the law school building, there's the
library, here's the faculty parking garage—I was acutely aware of the
warm sun on my shoulders and a kind of softness in the air.
This will
be good
, I thought.
This will be very good. Every thing's falling into
place.

Except, of course, for the not-incidental matter of my
unpredictable brain. In spite of my history, in spite of the diagnoses
and the prescriptions, the frequent delusions and the evil
visitations—and Kaplan notwithstanding—I still wasn't convinced that
I had a mental illness. Nor was I convinced I really needed
medication. To admit to any of it was to admit that my brain was
profoundly broken, and I just couldn't do that. And I couldn't let
others in on the secret, either.

I had decided not to tell people about my mental health status in a
professional situation (as opposed to a personal one), unless not
telling people would be an outright lie. For instance, in the law school
applications, every school except one asked if I'd ever been forced to
take a leave of absence from another school as a result of emotional
difficulties. Technically, I did
not
have to withdraw when I was ill at
Oxford, because I was doing a thesis degree, not attending classes. So
the answer across the board was no, and I was comfortable with that.
Stanford, however, asked if I'd ever had to take a leave, or reduce my
workload, because of emotional problems. There, I had to answer yes,
although in my explanation I focused on the depression, not the
psychosis. To do otherwise would reduce my hopes of ever having a
career—once it was on the record, all of my thoughts and writings
would be seen as merely the musings of a madwoman.
Ignore her,
she's crazy.
I could not allow that to happen.

My brain was the instrument of my success and my pride, but it
also carried all the tools for my destruction. Yes, the pills helped, but
each time I put them in my mouth, it was a reminder that some
people—smart people I trusted and respected—believed that I was
mentally ill, that I was defective; every dose of Navane was a
concession to that. More than anything, I wanted to be healthy and
whole; I wanted to exist in the world as my
authentic self—
and I
deeply believed that the drugs undermined that. And so I kept backing
away from them, tinkering with the dosage, seeing how far I could go
before I got burned. And of course, I got burned every time—even in
my denial, I knew that. But if the fire that burned me signaled my
destruction, it was also the same fire that got me out of bed in the
morning and sent me to the library even on the most frightening days.

Steve called me "The Little Engine That Could," and I was proud of
that moniker. Every time I'd been knocked down, I'd gotten back up
again. There was no reason why I couldn't keep doing it. I just had to
control my mind, not vice versa, and if I was careful, I would be able to
claim and fully inhabit the life I wanted.

When my years in New Haven finally came to an end, I said a
bittersweet good-bye to all my friends there, and to Dr. White in
particular. We'd made a good team—I was not only still upright, I was
moving forward. And so, on July 4 weekend, 1989—one year to the day
from the first symptoms of my brain bleed—I boarded the plane for
LA, this time for good. And this time, it was a much smoother ride.

The question, of course, was not so much
if I
would have a psychotic
episode as
when.

Packing up your whole life and starting all over again is high on the
list of major life stressors—it ranks right up there with divorce,
diagnosis of serious illness, being fired from an old job, jumping to a
new one, and grieving a death in the family. And then there was the
smaller list, the everyday list: Where's the grocery store? Where's my
bank? Where's the best place to buy toothpaste, or lightbulbs, or fresh
fruit, or to rent a movie on Friday night? When is the telephone guy
coming, and where's all my forwarded mail?

Add to this the schizophrenic's "regulator" and the need to rebuild
it once again. How, in a new and unknown landscape, does one
construct a completely predictable, familiar, manageable life, one in
which there are no surprises? And construct it quickly, because your
life literally depends on it.

Well, it helped that Los Angeles reminded me of home—the
suburban sprawl, the palm trees, the blue sky, the proximity to the
ocean. In fact, I soon decided that Los Angeles was a better Miami
than Miami was: better weather, better food, better movies, better
theater, no hurricanes (albeit an occasional earthquake), and (often)
less humidity. That said, everything else was a mess.

Steve was two thousand miles away; he'd begun his graduate work
at the University of Michigan in Ann Arbor. We spoke on the phone
almost every day, but that wasn't the same as sitting across from him
over pizza, talking away the whole afternoon. I missed him, and the
way he'd put his hand on my shoulder or gently pat my back, telling
me that everything was going to be fine. When was the last time that
anyone had touched me, or been able to reassure me, as he did, as
only he could?

And while Dr. Kaplan was good, he wasn't White (any more than
White had been Mrs. Jones). Everything about him was different;
particularly disconcerting was the fact that the chairs in his office
weren't in the same position as in White's—trivial to some, but the
effect was as though I were blind, had walked into a familiar room,
and discovered, by stumbling over it, that all the furniture had been
rearranged.

My colleagues on the faculty were friendly and welcoming, but
basically, I didn't know any of them. USC Law's faculty is relatively
informal and collegial on any number of levels—I watched with envy
as they greeted one another in the halls, read one another's papers,
and scheduled workshops together. When would that be me? Would
that
ever
be me?

I needed a strategy. I needed to get organized. I needed to make
another list: my goals and the steps I needed to take to achieve them.

First, there was the issue of tenure: USC required at least three
lengthy published articles; I would have four years to write them. That
part was simple—I'd spend most of my time in my office, working. I
knew that work, more than anything else I could do, would steady me.
In fact, four years seemed more than enough—in that time, I could
easily write four and probably even five papers. It didn't have to be
brilliant, it only had to be good, adequate, challenging work, of a
quality sufficient to get tenure. And if I worked hard enough and long
enough, I'd be able to get ahead a little and give myself some leeway in
case I got sick and needed time off—which was almost sure to happen.
It would be like putting work in the bank for a rainy day.

USC requires first-year faculty to teach one course each semester;
in an academic year, that worked out to one small seminar-type class
and one large class. As luck would have it, my first class was the
seminar, in mental health law, with only eight students. I knew the
material better than any of my students could have imagined; we
would consider such issues as civil commitment, the right to refuse
medication, confidentiality, and competency. So that was my plan.
When I wasn't preparing for or teaching that class, I'd be writing. No
problem.

From the very beginning of our first class meeting, I could tell that
the students were bright, lively, and engaged—overall, a good group.
Being with them would be an excellent use of my time, and theirs as
well, I hoped. Our discussions were wide-ranging, as I strove to find
the balance between the headlines, the history, the theory, and the
canon of law that applied to the mentally ill. One of the cases we read
was that of a medical student with a mental illness who'd been
expelled for scratching and cutting herself when she was upset at
administrators. Sometime afterward, she sought to be reinstated as a
student at medical school.

"Should expulsion even be allowed in this kind of case?" I asked.
"Or is this impermissible discrimination?"

Some students pointed out that in the interim since this person's
expulsion, she'd managed to get a Master of Public Health degree and
hold a responsible job. In addition, it wasn't a given that if she became
a medical professional she'd automatically pose a risk to patients—for
instance, she could choose to go into research. Indeed, even being a
hands-on doc was not out of the question: There's little evidence that
impulsively hurting yourself puts you at significant risk of hurting
others—that's an entirely different psychodynamic.

One student (a psychiatric nurse) made an observation that hit me
hard. "Of course mental patients should not be doctors!" she said.
"Particularly if they injure themselves. Plenty of people who hurt
themselves do go on to hurt others, even if not everyone does. What
would stop this patient, so impulsive, from injuring her patients?"

I gathered my wits for a moment, then asked, "Do you feel the
same about lawyers, who don't hold others'
physical
integrity in their
hands?"

"Would
you
go see a lawyer who was on psychotropic
medication?" she said incredulously. "Because I certainly wouldn't."

"Yes," I said. "Yes, in fact, I would."
And what would you think
about taking a class taught by someone on psychotropic medication?
I wondered.

And then there was the question of competency. "Should patients
have a right to refuse medication when they are in the hospital?" I
asked the class.

"It would be sort of silly to hospitalize someone in order to treat
him," one student responded, "and then not be able to treat him. It
would also cost a lot of money."

"But," another student chimed in, "don't we allow competent
people to make all sorts of costly and risky choices—for example to
sky dive?"

Now we're getting someplace
, I thought.

So class started well and I was making progress on my first paper,
on the concept of competency. But that didn't guarantee anything,
and one weekend early in the fall, after the adrenaline of the first days
had worn off, I felt myself slipping. I was in my office, alone, working
on an article. I started to sense that the others—the beings who never
seemed far off when I got sick—were in the office with me. An evil
presence, and growing stronger.
Why are they here? Are they trying
to take over my mind? Why do they want to hurt me?