The Center Cannot Hold: My Journey Through Madness (8 page)

I re-created the regularity of my college life as best I could, by
heading for the public library right after coffee in the morning, and
spending the day there reading Aristotle and other philosophers;
there were some gaps in my philosophy training, and I needed to get
caught up. For lunch, I went to a local drugstore for a grilled cheese
sandwich and coffee; for dinner, I usually joined my parents and
brothers around the table, and struggled with the bare minimum of
social niceties: "How did your day go, fine, how was yours, fine." In
the evening, I listened to music in my bedroom, smoked endlessly,
and read some more. No one bothered me. The weekend family
outings had long since ended; my brothers were living their own lives,
my parents were equally involved in theirs. If anyone noticed that in
effect I'd taken my leave of them even while being physically present,
they said nothing. No one looking at me would have known there was
a storm going on inside. But there was a storm, and it was horrible.

With the routine of my academic curriculum gone, however, I
began to be regularly invaded by the strangest fantasies, very intense
and hard to escape—they weren't exactly hallucinations or waking
dreams, but they were extremely vivid and, for me, not entirely
distinguishable from reality. They'd come out of the blue, with no
warning, and no reason that I could understand. It was as though in
the absence of the familiar Vanderbilt routine, the fantasies had come
to fill the void, and I couldn't shut them off. Whole hours would go by
at night when I was stuck in this alternative universe, struggling to
decipher what was going on inside my head. Scenarios came and went
of their own accord—it was like being unable to get out of the theater
while demented movies ran endlessly through the night.
I have been
falsely accused of using drugs and put into a residential drug
treatment program. Staff from Operation Re-Entry work there. At
the program I spend time with no one. I speak hardly at all. I carry
my Aristotle book everywhere. Staff call me in and tell me I must
start socializing more. I can't. I am called in again and staff order
me to start talking. They say my Aristotle is a crutch and that I must
stop carrying it around with me. "No," I cry. I will not give up my
Aristotle!" Staff take my Aristotle away by force. I lose control,
tearing the office up in a wild frenzy, shouting at the top of my lungs.
Staff restrain me. Several hold me down and they call 911. The
ambulance takes me to the emergency room.

I became convinced that I was not supposed to talk, particularly
about myself. I was not supposed to ask for anything, not even so
much as a coffee refill at the drugstore counter. Those houses that told
me I was bad on that long-ago day—maybe those houses had been
right.

And that man I'd believed had been looking in my window at night
when I was a girl...I began to think that he was back, that I'd just
heard something outside...Every single night, when the house was
quiet and everyone else was long asleep, there came a moment when
my heart would begin to race. I'd break into a cold sweat, and my
breathing would become shallow and very rapid. I didn't know these
events were panic attacks; I only knew my heart was about to burst
out of my chest, and it terrified me.
That's it,
I thought:
Something is
wrong with my heart.

When I told my parents, they took me to a cardiologist
immediately; he performed a number of tests, none of which indicated
any heart problems. The doctor said he thought I was simply anxious,
and he advised against tranquilizers, concerned that they'd make it
even more difficult for me to concentrate. I wouldn't have taken them
anyway—if there was one thing I took away from Operation Re-Entry,
it was an absolute determination never to take any drug that altered
my mental state. So instead, the doctor prescribed Inderal, a beta
blocker which I believed was supposed to quiet my heart (it's also
prescribed for panic attacks, anxiety, and nervous tension). I didn't
know that the side effects of Inderal could include depression; indeed,
I felt both sad and sleepy fairly soon after taking it. But I stopped
feeling like I was about to jump out of my skin. The nights grew mostly
quiet, and I was able to complete my work.

At the end of the summer, I boarded a plane to Washington, D.C.
There I would meet the other Marshall scholars at the British
Embassy, and then we would continue on our way to Oxford. I didn't
really know how to act in this situation—what
is
the proper behavior
before a consul general, anyway? My anxiety began to ratchet up: I
had no idea how I was going to manage this, and then Oxford, and my
studies.

My mother had helped me find clothes, which was one of my least
favorite tasks; there were too many choices, I could never make up my
mind, and whenever I tried to picture circumstances in which I would
wear these new clothes, the thought alone made me anxious. Mostly,
we ordered sweaters and good pants from the L.L.Bean catalog, and
bought a couple of suits with blouses for dress-up occasions. I'd need
a coat, and a jacket. I'd need shoes that weren't sneakers. Perhaps I'd
need an umbrella—I was, after all, going to England. Somehow,
having the right kind of things seemed the armor one might need
when embarking on graduate studies in England.

The initial meeting-and-greeting in D.C. went past me in some
kind of haze. I forgot everyone's name as soon as we were introduced,
although I was gratified to see that almost everyone seemed as
nervous as I was. Of course there was protocol; to my great relief, I
didn't violate any of it, at least as far as I could tell. And then we were
off to Oxford.

Despite our common language, it's no secret that England and
America are vastly different countries, with perhaps the biggest
difference being the fabled British reserve. Many aspects of casual
conversation that feel quite natural to Americans are totally off-limits
in England, and it didn't take me long to learn that in my new
environment. One day, I asked a British friend where he planned to
spend his holiday, and he looked quite taken aback. I later learned
that such a question should never be asked, because the answer could
reveal someone's class background. The sunny, open, Latin-tinged
mores of Miami, combined with the Old South graciousness of
Vanderbilt, seemed a world away in the far older and more courtly
enclaves of Oxford. For example, cashiers never said, "Y'all come back
soon now!" or "Have a good day!" whenever we exchanged money for
goods. I often left a shop, food or package tucked under my arm,
wondering what I'd done wrong to be dismissed so coolly. Didn't it
matter
to them what kind of a day I had?

The weather turned cool, the sunlight dimmed a little, the days
became shorter. Adding to my general disorientation was an
educational system vastly different from the one in which I'd done my
undergraduate work. Oxford's program consists of optional,
university-wide lectures and seminars, plus meeting alone with a tutor
or supervisor once a week for an hour or less. Exams come at the end
of two or three years. For the weekly tutorial, a student reads a
number of articles and then presents a paper, upon which the tutor
then comments. I was accustomed to writing two or three long papers
over a four-month period, not one short paper a week. I couldn't
imagine being able to do it.

I made one new friend from America, a woman named Jean, who
was studying in London; we met on a cigarette break in the bathroom
at the British Embassy. Tall—as tall as I—and very thin and pretty,
Jean had studied to be a nurse until she met her doctor-fiance,
Richard, who encouraged her to go back to school and finish her
college degree. She did well, and ultimately won a Marshall
Scholarship to study linguistics at University College in London. She
was warm and approachable. I liked her, and she seemed to like me,
too. But she was in London and I was in Oxford; although we spoke by
phone maybe once a week, she was an hour away.

From time to time I got together with another woman in the
dorms. She was from Canada, and initially our friendship looked quite
promising. But something was happening to me—something that had
begun the summer before—that short-circuited our budding
friendship: I was finding it difficult to speak. Literally, the words in my
head would not come out of my mouth. Our dinner conversations
grew increasingly one-sided, and I was reduced almost totally to
nodding in agreement, feigning a full mouth and trying to express
whatever I was thinking with my face. The friendship trickled away.

And I couldn't speak on the phone with my family or friends in

America, either—I'd decided that it cost too much, that it was
therefore "forbidden." By whom, I couldn't have said; there just
seemed to be some kind of vague but absolute rule against it. Of
course, my family would have gladly paid the phone bill, but my
distorted judgment told me I did not deserve to spend money on
myself, or to have others spend money on me. Besides, nothing I had
to say was worth hearing, or so said my mind.
It's wrong to talk.
Talking means you have something to say. I have nothing to say. I
am nobody, a nothing. Talking takes up space and time. You don't
deserve to talk. Keep quiet.
Within weeks after my arrival in Oxford,
almost everything I said came out in monosyllables.

As I grew steadily more isolated, I began to mutter and gesticulate
to myself while walking down the street, something I had never done
on my worst days at Vanderbilt or in Miami the summer before. When
I heard the sounds I was making, I felt neither disturbed nor
surprised; for some reason, it helped me feel calmer. It seemed to
provide an arm's-length distance between me and the people who
were walking past me. Oddly, it was soothing, much like clutching a
well-worn blanket might have been to a frightened child. And so, with
no reference point outside my head (friends, familiarity, being able to
accomplish anything at school), I began to live entirely inside it.

And the vivid fantasies had followed me across the ocean.
My
doctor finds me huddled in a corner. He wants me to socialize with
other people in the program. I don't want to. They force me into a
room where there are other people. I am supposed to talk to them. A
man introduces himself, "Hi, my name is Jonathan." I do not
respond. "What's your name?" Again I do not respond. "Are you a
student here?" I mutter something to myself. My doctor comes over
and encourages me to talk to this young man. I start screaming and
run wildly about the room. Some of the attendants restrain me by
force.

What was real, what was not? I couldn't decipher the difference,
and it was exhausting. I could not concentrate on my academic work. I
could not understand what I was reading, nor was I able to follow the
lectures. And I certainly couldn't write anything intelligible. So I
would write something unintelligible, just to have a paper to hand to
my tutor each time we met. Understandably, my tutor was
flummoxed.

"This is not acceptable, Miss Saks," he said. He was neither angry
nor cold, but he was somewhat disbelieving. "Surely you can agree?"
he asked. "Because, you see, the work here is hard to make any sense
of."

Dumbly, I nodded, sensing the hard wooden chair beneath and
around me. I barely squeezed out a couple of syllables. "Yes," I said.
"Yes, I know." I just didn't know what to do about it.

Jean, my London friend who'd been a nurse, sensed from our
telephone conversations that something was going very wrong. I told
her I was just having a hard time doing the required work, but
evidently something else I said, or the way that I'd said it, let her know
I was struggling with thoughts of wanting to hurt myself. During one
phone call, Jean gently suggested that I talk to a doctor about seeing a
psychiatrist.

"Oh, no," I said, trying to force some levity into my voice. "I'm not
crazy or anything. I'm just kind of...stuck." Inside, another dialogue
was going on:
I am bad, not mad. Even if I were sick, which I'm not, I
don't deserve to get help. I am unworthy.

A few weeks later Jean's fiance, Richard, came to town. A
neurologist, Richard was somewhat older than Jean and I, and had an
air of casual authority. He intrinsically seemed to understand that for
some people, it was harder to be a student than to be a professional
working in the world. His presence was reassuring, not at all
threatening; in fact, his looming height and excess poundage gave him
the appearance of a large and generous teddy bear.

"Jean and I are very concerned about you," he said quietly. "We
think you may be quite sick. Would you mind if I asked you some
questions?"

"I'm not sick," I responded. "I'm just not smart enough. But
questions, yes. Ask me questions."

"Are you feeling down?"

"Yes."

"Loss of pleasure in daily activities?"

"Yes."

"Difficulty sleeping?"

"Yes."

"Loss of appetite?"

"Yes."

"How much weight have you lost in the last month?"

"About fifteen pounds."

"Do you feel like a bad person?"

"Yes."

"Tell me about it."

"Nothing to tell. I'm just a piece of shit."

"Are you thinking of hurting yourself?"

I waited a moment before answering. "Yes."

Richard asked still more questions; I answered yes to each one. As
dim as I was, it wasn't difficult to see the alarm on his face.