Brattleboro Stories—The Retreat

Book | Memoir | 30 hr read

A bipolar software engineer and writer cycles through seven inpatient stays at the Brattleboro Refuge psychiatric hospital after a suicide attempt, forming intense bonds with fellow patients (Faith, the oppositionally defiant bipolar woman who once jumped through a glass window onto a security guard; Spots, the self harming mental patient he falls for; Grace, the heroin addict with the perfect face and the handful of Skittles), while his psychiatrist Dr. Meggs delivers a skeleton diagram of his psyche that traces his humiliator/humiliated patterns back to potty training abuse; after discharge he ricochets through Portland (kicked out by his sister), Baton Rouge (three years with racist uncle Rusty and alcoholic aunt Susan in a house where the phrase "nigger pussy" is thrown around in casual conversation), and Nashville (manic episodes, police at the door, cops called by doctor emails), accumulating diagnoses from bipolar I to schizoaffective disorder and a tardive dyskinesia that leaves him horizontal 23 hours a day. Content warnings: suicide attempt, graphic suicidal ideation, psychiatric institutionalization, alcoholism and drug addiction, racial slurs, sexual content, childhood abuse, family dysfunction at industrial scale. "You should never bargain with the devil. But the thing is, she seems to be bargaining with me."

The Retreat

50

Let me tell you something. Let me tell you about culture.

Culture is one truth embattled by a thousand lies.

The lies fight to keep the truth hidden. They are effective for a long time.

Then one day in an epoch, that one truth takes hold and almost instantly transforms the culture, smoking out all the lies, clearing the room, then filling it with that one truth.

Then that truth becomes the thousand lies.

And another truth is born, and buried, within the thousand lies.

Here's an example: One of the cultures in the United States is the culture of continual war. The truth is that we are at continual war. The thousand lies are the lack of acknowledgement of the true number of casualties on both "sides," the policy of not showing photographs of the gore and carnage of war in mass media, the absence of declarations of war by congress, the outright lies justifying war in the first place—specifically, that some other country is an actual threat to our well-being. And pervasively, insidiously, the championing of freedom and justice to subtly program citizens to accept that we are right and they are wrong (because they want to take away our freedom and justice!). And the most unbelievable lie of all: that there is such a thing as us and them in the first place.

If you speak the lie, you are absorbed and loved and encouraged by the culture. You are paid and given food and a house and a uniform to wear.

If you speak the truth, you are fought by the bearers of the thousand lies. You are marginalized. People who love you will literally tell you to stop speaking—because if you continue speaking, they will listen, they will see the truth, and the whole floor of their existence will fall from beneath them. If you speak the truth, you will be systematically excluded by family, country, church, and state. The thousand lies are quite literally trying to kill the one truth..because the revelation of that truth will kill the lies.

That is one example of one culture in one place.

And in general, that is what culture is.

---

I kept seeing my substance abuse counselor, even while I was using—I knew I had a problem and was reaching out for help. It was, though, as they say, too little too late. Before therapy with that woman, each time, I considering jumping out the third story window to kill myself while in the waiting room. The therapist gave me a logic toy to play with one day and that made me very happy and relaxed.

There was a point where I was completely out of food except penne and mayonnaise—I ate my penne pasta with Tooler's mayo and cumin for a week straight. I learned to love the taste of this meal (you'll learn to love the taste of anything when you're as hungry I was—the day I got my unemployment check I went hog wild at the bars until there was nothing left to buy food, pay rent, utilities, do all those normal things that people do with money.)

I was so lonely I sat at the bar with the professor one night, and that loneliness compounded with hours of listening to the hate speech from that man, subtly directed at every group that he and I were not a part of, was part of why I sought out a very different kind of company that night. All I wanted was some coke—some powder—and if I had found this might have turned into quite a different story—might. But I found crack instead, wandering outside the new Metropolis to seek action and company. There was a double door there, and one side let up to the drug apartment I had been to before. There was a random black guy who was sitting on the stoop, and I looked at him and I knew. I knew this guy could get me drugs. Drug people can recognize each other, remember? I sat down next to him and I said, "So, what's going on?"

And he said, "What do you mean, 'what's going on?' "

And I said, "I mean what is going on."

And he said, "Can you get money?"

And I said, "Yes."

Boom. Deal. Done.

Double doors. One goes into the Metropolis—high-class people. One goes up to the drug apartment—low-class people. And I was both, an artist, one of those dangerous people who mix with all classes. And in that moment, I switched tracks, walking out on the Professor and all that is high class and walking in with my new friend, who would take me on a journey I will never forget.

I was already drunk, though at this point in my story that probably goes without saying.

Black dude introduces himself. Let's just say his name was:

"Kevin."

"Matthew."

Kevin makes a call. I hit an ATM that's right down the street. We get into a car. We drive to a hotel.

I stay in the car Kevin's friend is driving while Kevin goes upstairs to a certain room and buys crack with the money I gave him. Naturally he divides it into two packs and holds back half in a certain pocket in his jeans, then he comes out, slaps me on the shoulder, and grins.

"It's on."

I smile.

On our way to the next destination, Kevin and I have a discussion that reveals to me he didn't buy powder, he bought rocks, he didn't know I wanted powder and rocks are all they had anyway.

"It's good," I say.

Whatever. At this point I don't care what we do as long as we do something. Fuck it.

---

The car drops me and Kevin off at yet another apartment and we walk up a zillion stairs to like a fourth or fifth floor apartment, some maze, then back to this door which Kevin knocks on.

They let us in.

It's two people in the house: a man who looks like Victor from Se7en lying face down under a thin quilt, sweating. As soon as he hears Kevin's voice he's like: "Whoah man, who is this."

"This is Matthew. He's cool. Can we use your house?"

Of course we can use their house—'cause all four of us are getting high off the crack I bought. This is just part of how it works. They get something for providing a safe house for us to do it in. The skinny guy—it's the skinny guy and his wife or girlfriend—he opens a box on the coffee table and he's got needles inside. He shoots up something—I'm not sure what—and he sees me eyeing his needles a little too fondly.

Then we smoke crack.

The four of us smoke crack all night.

And Kevin pumps me for my money. He has way more crack on him than the retail value of what I supposedly bought earlier, so every hour or so we send someone out on a bicycle with my ATM card to get another two-hundred dollars.

Then! Magically! Kevin has more crack!

"So, Matt, what do you do?"

"I write. Like novels and stuff."

"Give me the address. Give me the address! I know you have it on the internet!"

I give her the address to Things Said in Dreams.

She prints out the entire thing.

"It's easier for me to read things on paper," she says.

"I'm the same way."

Giving your ATM card and PIN to a complete stranger isn't something you'd do normally. It is something that you'd do on crack. Then later when it was me going out on this decrepit bike around 4am to empty my bank account, leaving my bag with my iPad with a bunch of drug people who are on crack right this minute..is not something I would normally do. I rode that bike in crazy circles thinking what have I done and being scared the cops would see me and question me..be sitting in their car somewhere waiting silently for someone like me to come along. I was hardly able to ride the bike I was so sore from clenching from the crack.

And if you want to know what crack feels like..let's say you had a thermostat that instead of controlling the air, controlled your stress. The first hit off that glass pipe is like turning down the thermostat on your stress. Everything gets low..cool..quiet..all your problems have just gone away.

That doesn't last.

You get paranoid. Like skinny dude got paranoid about me in the early early morning and I had to leave because this motherfucker thinks I'm a cop. The genuine heart in these three felt bad I had emptied my bank account for us all to get high (and I'm sure they still had more for the three of them once I left) so they hatched a scheme where I would become a drug dealer with them so I could win all my money back.

In their presence I was like: Yeah, that sounds like a great idea. Thanks for you consideration!

In my own mind I was like: What the fuck?! That's never going to happen. I might be stupid enough to use drugs but I'm not stupid enough to become a drug dealer!!

I finally left when the sun came up and everyone is so sketched out about me because I'm a stranger that I figure I'm about to get shot.

I walked back in the early dawn, sobering up.

Oh yeah, sobering up off crack is not a pleasant thing.

In fact it's almost impossible to do by yourself, that's why people start one day and then smoke continuously until they have no money, no car, no job, no house.

I've smoked crack three times in my life, and every time it was followed by a breakdown—complete destruction of my job, apartment, city I live in. Crack is a very bad drug for me. And I hate crack. I'd much rather feel the effects of powdered cocaine, which by the way doesn't destroy my life after one night of using. Not saying it's good for me—but crack is worse.

My normal paranoia was on red alert: when I left my bag at the crack apartment to get cash, I thought that they might look inside and see the iPad and—not steal it, but—think I'm recording them like I'm an undercover cop or some shit. They prob'ly never thought to look in my bag. They didn't steal my iPad. They didn't kill me for thinking I was an undercover cop.

When I was at their house—at the beginning—it was like we were all friends. I felt like I was with people who understood me, who weren't concerned with silly rules like crack is illegal or drugs are bad for you or any of that bullshit. These were real people: they cared about my book, they liked art, and they understood that every once in a while you've just gotta smoke some crack.

By the end of the night I felt significantly differently.

Instead of six-hundred dollars in the bank I had zero.

Zero dollars and zero cents.

I had been here before.

No money. No job.

I called my ex-sponsor from the attic apartment, physically cramping, feeling like the inside of a skeleton, like not even sleep could cure this, and asked his voicemail if I should try to get into a detox program at the Refuge. He called back later and said yes, but I was already on my way down to the Refuge.

My sponsor said, "You can get crack in Brattleboro?"

"Yes."

"I didn't know you could get it this far north."

"Well, you can."

"Was it good?"

"If it wasn't good do you think I would have spent my entire bank account on it in one night? I fucking hate crack, but yeah, I guess, as crack goes, it was good crack!"

Motherfucker. Want me to call you next time I find some???!

I called the Refuge and their detox center barely wanting anything to do with me because I had only used crack one night and my alcohol relapse was like a week or two old. They didn't want to admit me because cocaine has no physical withdrawal—basically I could have slept it off with a short nap—and in their eyes, my recent alcohol usage was nothing. But I told them this was part of a much larger problem and there had been periods where I had drank or used cocaine for much longer.

"I'm just not sure you meet the GAF for admission."

"Listen to me. I need your help. I feel like I'm gonna die."

So they admitted me, and I walked there that morning, sore at every step from the crack.

51

I was physically uncomfortable during the admitting process. A physician's assistant tirelessly asked me his million questions he had to ask me before the let me in the detox unit.

"What day is it?" he asked me."

"Wednesday?"

"It's Sunday."

I laugh.

"Well, I'm recently unemployed, I have the luxury of not knowing what day it is."

He didn't find that funny.

"So you did crack last night and you've been drinking alcohol."

"Yes."

"We're gonna need a piss test."

"The nurse already gave me one."

"Ok..excellent."

He checks it off his list.

We go through a million other things that I'm not gonna go into. The actual detox process consisted of being on a 20-bed unit where they took your vital signs it seemed like once an hour. They measure your detoxification symptoms for whatever drugs you're detoxing from. They give you drugs to help you detox safely—in the case of alcohol, Librium. I only got one or two Librium because I did't display alcohol detox symptoms—I wasn't shaking, wasn't experiencing delirium tremens, and there is no physical detox protocol for cocaine, so..according to them I was well the moment I walked in the door. But I didn't feel well, and that's how I convinced them to admit me. They get all kinds of detoxers there—alcohol, heroin, opiate pills, but the most dangerous drug to detox from is alcohol—it's the only common street drug where stopping it suddenly can kill you. I learned that in one of my classes at the Refuge.

We had art class, meals, but mostly we slept and went to drug abuse education classes, where we were taught how addiction works and what an uphill battle we were going to have to fight to overcome it. One doctor calculated, roughly, the number of times we had successfully taught our brains that using a drug would make us feel better. Then he said we were going to teach our brains roughly the same number of times some other ways to feel better—we each had a hell of a lot of unlearning to do.

There was about one staff member per person.

The staff were incredibly organized and efficient—one of the most well-functioning teams I have ever seen in any context. They were cohesive as hell—I was jealous I never worked on a team that functioned so well as a team. They were truly a crew, like a crew of sailor Everyone had everyone's back. Their paperwork moved from location to location like the cogs in a machine.

Tyler 1 for me was classes, discussion, making friends..that's basically all you do in detox. Tyler was the name of the building. One was the floor we were on. Other floors were used for different categories of psych problems (and the Refuge considers addiction a psych problem).

---

When I first got there I was put in a room with two other guys. One was this crazy kid (he was in his mid-teens so he was a kid to me). He was in detox yet had brought a bunch of drug culture books with him to read all day (he skipped the classes) and he was like reading aloud from them to me and the other roommate and he was so excited to read about celebrity drug use and celebrity overdoses. This detox was just a perennial trip for him, insisted on and paid for by his parents.

After a day, the nurses asking me if I wanted my own room.

I said, "No I'm ok for now."

My roomie was like, "I'm getting high the minute I get out of here." He had pills in his car in the Refuge parking lot, he claimed—this fucker was going to drive home from detox high.

On my multiple stays at the Refuge, I learned that for some families, this was just a high-cost way for the parents to feel like they were doing something about their children's drug problems. They didn't actually talk with them or check with them or spend time with their kids, they just paid shitloads of money to send their kid to the Refuge for a week—throw money at the problem.

---

About the time I thought they were going to kick me out for not being toxified enough, they had me talk to a psychiatrist.

Her name was Dr. Joseph.

She took me to a small room with two chairs and a desk. We sat on the same side of the desk.

Dr. Joseph asked me if I'd ever been in a psych hospital before.

I said, "Yes."

"You look startled."

"I just..I forgot that I had been to one before. I haven't thought about that in a long time."

"Did you receive any diagnosis there?"

"Bipolar disorder."

It was the oddest feeling. I received my diagnosis back then and then years passed and the idea that I had bipolar disorder faded away, until now.

While meeting with Dr. Joseph, I recalled that I had been hospitalized in LA after calling a suicide hotline, and that I was diagnosed with Bipolar II.

"Oh yeah, it's all coming back to me. I never thought about it all these years. I remember how I got there..I was manic programming..just left work and programmed on my own projects at home for about a week. I was drinking potato vodka with orange juice and watching The Truman Show on repeat for the whole week. Then I was in an overcrowded holding room with so many patients..so many..we were sleeping on the floor—they kept us sedated. I saw my friend Ashley through hurricane glass talking with a doctor."

"What's hurricane glass?"

"It's that glass that has crisscross wires in it so if it breaks the fragments don't fly all over the place."

"Oh. Sorry. Please continue."

"Then my friend Ashley leaves—we wave through the glass. The doctor comes to me and says you're all detoxed from the alcohol and you didn't even show any withdrawal symptoms (I never do) and—he says—we were going to let you go and basically you had us convinced you weren't really suicidal without the alcohol but your friend—Ashley?—told us that you're very smart and very good at manipulating what other people think of you..and she said you'd tell us whatever we needed to hear in order to feel like letting you go was the right thing..so..we're going to keep you here for some more observation. I was a little miffed to have Ashley in my business but even then I knew she had done the right thing, and that it was a true act of love. I was never mad at her. That was my first serious mania that I know of—probably just the first one I was hospitalized for. Horrible detox (even though I showed no signs). Diagnosis. Prescription—Lamictal. Calm period. Medicine runout. And spiral down. I played Yahtzee! in that hospital with a homeless woman and a young guy who was there voluntarily, waiting to get into a residential rehab. The homeless woman said she'd stayed in Valley Village—which is where I lived!—and we exchange info and I told her she could shower or stay with me or get food or water anytime. And we talk about getting drinks even though we're both supposed to be sober as part of our programs. She tells me a secret: she's not hearing voices even though that's what she tells the doctor..she just wants to stay off the street as long as possible, so she pretends she's schizophrenic. How fucked up is that? And I came out of there a week later with a diagnosis of Bipolar II—fucking panel of psychiatrists gave it to me. I didn't really understand how having bipolar disorder would affect my life until..actually I don't even think I understand it now."

In fact it would take scores of psychiatrists, ten or so trips to the ER, seven admissions to the Brattleboro Refuge, three other inpatient psychiatric stays, one cry-for-help suicide attempt, many days crying in bed all day long, a lot of reading about bipolar disorder, and a detailed review of my past through the bipolar lens—all this over a period of about ten years—to start to admit that the diagnosis applied to me. I still don't believe it all the time.

"Do you have problems with gambling?"

"I know you're using that question to try to eliminate a diagnosis of bipolar disorder." (They say gambling is one of the signs of bipolar mania.) "I used to go to my meth dealer's house and play internet poker for three or four days in a row. We both had good incomes so it didn't matter if we lost ten or twenty thousand dollars. Sometimes we made money, high fived, and bought ourselves more meth (from ourselves). Does that count as gambling?"

"I think so."

"I thought so, too."

"What else has been going on this year?"

"Maybe," I say, "there's no place in this world for the words 'gay' and 'straight' anymore. Nor 'lesbian.' Nor 'bi.' Isn't everybody bi?"

I remembered my meth experience with my neighbor in Hollywood, experience with the Professor, and waking up in Dayton one night, drugged, with Jimmy sucking my dick and forever taunting me that, "You had no trouble getting hard."

"There was that scientist guy," I said, "from Wright-Patterson Air Force Base who was gay and I let him rub lotion on my back. Manipulation by older gay guys."

"What do you mean, manipulation?"

"Like Jimmy saying of me that anyone who shaves their head wants to be fucked by a man. Don't you find that an idiotic statement? I do. Then there's the Professor fingering my asshole and sucking my dick after getting me drunk and maybe drugged.

"Who's the Professor?"

"I drank A LOT at that time and I was never as cloudy as that night once the Professor filled me a new drink while he was in the kitchen and I couldn't see what he was doing..the point is I'll never know..and he asked me to hide in the bedroom while he had a rug delivered the next morning. He said if he needed help with the delivery man moving the carpet that he would come get me and I should just say I was his nephew."

"Matthew, slow down!"

"He was very concerned that someone would see me at his house. He was already pissing off his neighbors by bringing over young men every night. He fucked monks, college students, homeless kids—everyone. His pretense was that we were all his drivers—which technically we were."

"Do you want a cup of water?"

"I'll take a coffee if you're going out there."

"I don't think coffee is a good idea for you right now."

"No, I guess not."

"Water then?"

"No thank you."

The doctor flipped a page in her notebook.

"Do you have any family history?"

"Family history?"

"Yeah, any family members with mental illness?"

"Mental illness? Yeah. All of them. I have two cousins, twins, and there's hush hush talk about them both having drug problems, maybe bipolar, but I can't get any information about it because it's a taboo topic in the family. A cousin, maybe. You can't get any straight answers. Plus my dad cut me off emotionally so I'm pretty much in the dark about that whole side of the family."

"I understand. Let's start with with your immediate family."

"Let's start with my immediate family! Let's do. Let's start with my dad, he's a key figure. Absent father, workaholic—absent emotionally. Diagnosis-by-proxy from my sister's therapist is conjecture of course but says he probably has borderline personality. That anything he ever got right with us was by accident. Um. Sent me to a shitty college and when I dropped out and came home my parents were divorced and it was just me and my dad, eating hot dogs for dinner and watching soft core porn shit like Consenting Adults—have you seen it?"

"No."

"Well don't bother, it's a shitty picture."

"Anything more about your dad?"

"Sure. He made us shower with him until we were..too old to be showering with your dad."

"This is with you and your sisters?"

"Individually, with at least me, and also with my oldest sister."

"Any sexual abuse?"

"Not that I recall, unless you count staring at your dad's cock while you're forced to take a shower with him sexual abuse."

"Did he make you touch his penis?"

"Not that I remember."

"Did he touch you inappropriately?"

"I don't think so. But he would do stuff like this: one time me and my sister—this is much later—we're driving in the snow on some highway outside of Dayton, Ohio, and the van breaks down. We can't restart it—we don't know shit about cars. So we huff it up the road in the snow, find some lawyer's office full of a bunch of really unhelpful assholes who we had to practically con into letting us use their phone. This is two high-school kids. Before cell phones. We finally get ahold of my mom on her pager number. They're at lunch with a bunch of church people. They eventually show up in the other car. My dad's like, 'Where's the van?' and I'm like, 'It's just back that way a little bit,' so we drive back the way we came and Joanne and I must have walked longer than we thought because the van is not there."

"Maybe it got towed," I say.

My dad's hands tighten on the steering wheel. His foot grinds the accelerator into the floor. We speed down this snowy highway, twenty miles an hour over the speed limit, but the broken-down van doesn't show.

"Could you have walked this far?" my dad says.

"I don't think so."

Thirty seconds later:

"Could you have walked this far??"

"I don't think so."

"Well where is this lawyer's office you're talking about?"

"I don't know but if you let me drive, I can get us there."

No response from dad.

My mom, seated next to him, says: "Why don't you let him drive."

My dad hits the brakes, the steering wheel, and his window at the same time. The Honda fishtails and comes to a stop alongside the highway.

Everyone is quiet.

My dad is in the driver's seat with his head leaned back, eyes shut, radiating stress like we just lost the Challenger. Mom is in the passenger seat, relaxed except that her chin is resting on the palm of her hand. She's staring out the window looking the opposite direction as my dad. Joanne and I are in the back seat. We look at each other and she makes a tiny shrug and an even tinier smile—it's so tiny it only involves the subtlest crack in one corner of her mouth.

I know what it means.

It means: Well, bro, we could be here a while.

Now the argument takes place between my dad and mom, instead of with Dad and me. They decide to go home and call impound lots. Dad calls every lot in town and no one has towed a blue van. Leona—my littlest sister—gets home from a sleepover and sits on the second floor with her face pressed against the stair railing. She has gotten home just in time for the best part of the argument, in which my dad says to me:

"Matt. Were you the one driving?"

"Yes."

"So you were responsible for the vehicle."

"If you just give me the keys, I can take us back to where it is."

"So you know where it is."

"Of course."

He hands me a scrap of paper. It's actually exactly one-fourth of a piece of paper, scrap paper with advertising printed on the other side, that my dad has rescued from the recycle bin..god forbid we recycle when we could have re-used!!

"Write down how to get there."

He hands me a pencil.

"I can't write with this."

My dad's face turns a shade redder.

"Matthew, I want you to write down how to get to the van. Then I'm going to take you in the Honda and I'm going to fix the engine—"

"I'm not getting in a car with you."

"Why not?"

"Because you're angry. I'm not getting in a car with you behind the wheel while you're this angry. It's not safe. I won't do it."

My dad looks like he's going to shit a fucking dinosaur.

My mom is in the kitchen, making something. I don't know. She's doing something to keep herself from getting involved, because she knows that if she, her husband, and their first kid ever got into a fight all at the same time, it would be very much like assembling a critical mass of plutonium.

Joanne is upstairs with Leona. Joanne is doing insane ballet stretches where her legs form a straight line against the stair railing, one going this way, one going that way, and the whole of her is lying on the floor.

"Matthew, get in the car."

You can tell he wanted to say "fucking" but he censored himself. If he had said "fucking" to his son right there, Mom would have gotten involved.

"Get. In. The. Car."

"I already told you I'm not getting in the car while you're angry so if you want to cool down we can re-discuss this in half an hour or you can let me drive. Those are your options but I am not going to risk my life while you're driving angry."

Dad starts to speak again, but instead he goes out the front door and slams it—which is difficult to do with a very heavy, 1920s wooden door in a tight-fitting door frame.

I sit down on the stairs and do controlled breathing as I've noticed my heart rate's gone up.

Dad comes back in not five minutes later.

"Is it on highway seventy-five?"

"I don't know."

"Is it on highway seventy?"

"I really have no idea."

"Well is it on highway six-seventy-five."

"Dad, I don't know."

"How can you not know where it is if you were driving?"

"I don't look at the signs."

"What do you mean you don't look at the signs? How can you know where you're going if you don't look at the signs??!!"

"I just know what things look like."

"Well was it west of the lawyer's office?"

"The van?"

"Yes! Is the van west of the lawyer's office?"

"I have no idea, Dad, I don't think in directions."

"WAS IT SOUTH OF THE LAWYER'S OFFICE??!!"

"Van."

That's my mom from the other room. My dad's name is Van.

"What?" my dad says to her.

"Please don't raise your voice when talking to our son."

"I'm just trying to figure out where—"

"Just don't yell at our son."

My mom said this very quietly, but even Joanne and Leona heard it in their perch, upstairs. My dad might have the loudest bark, but my mom has the sharpest bite. You really don't want to wake that sleeping dog. And I didn't know it at the time, but they were both forming me, in this argument and many like it, to be something of a dog myself—one with the looks of a chihuahua, the smarts of a border collie, and the bite of a pit bull terrier with rabies and AIDS. At this point I'm trying to unlearn all that dog knowledge I learned from my family and become a proper human being. But it's hard, you know, the earlier you learn something, to unlearn it.

Dad decided to lower his voice to keep my mom in the kitchen. There are knives in the kitchen.

But he does point his finger in my face when he speaks.

"I want you to give me directions to the van so that I can go and get it."

I speak to his finger, not his face, since he thinks it's so critical to point it at me.

"I don't think we're speaking the same language about directions. I don't think of directions in terms of east, west, south, north—"

"Weren't you ever taught to use a compass?"

"I can use a compass. Ok? We've done plenty of compass exercises at camps. A compass is not going to get us to the van."

"Well can't you at least tell me the name of the highway?"

He sounds desperate, like a starving child asking for a single pea to salve his hunger.

"I don't know what highway it's on."

"Well Matthew, I just don't understand how you can be driving, and lose a vehicle, and not even know what road you're on."

"Dad, I am trying to help you. But something you're going to have to accept, if we're going to make progress in this conversation, is that you think in east, south, north, and west and in names of highways and I think differently. I think about how it looks: I can drive you to the van—if you would just let me drive—or I might be able to give you directions like: go here, look for this, turn left, go, look for that, turn right. You know what I'm saying? We think differently."

He whines again:

"But how is it that a grown man doesn't know if the van is north of six-seventy-five or south of six-seventy-five?? How can you even drive if you don't know that? How do you reliably get to your destination?"

"Because I just think about it differently than you, Dad."

"But north or south is a basic fact!"

"No! It's not!! It's a paradigm!"

"Matthew, are you telling me you don't know directions!?"

"It has nothing to do with directions!" I yell.

Dad gets real close to me.

"WHY CAN'T YOU TELL ME WHAT I WANT TO KNOW??"

Now my mom is in the room.

"Van."

Dad turns to her.

"He's right," she says. "It's not a matter of directions. He can get places—he knows directions. He drives all the time and he gets from here to there and back again. He doesn't get lost. I think if you just let him drive you to the van then you can call a tow truck and you can describe to them the location of the van however you like."

"Alright, Matt, go get in the car."

"Give me the keys."

"What?"

"I'm not getting in that car with you behind the wheel."

"Matthew, get in the FUCKING car!!"

"I don't think so."

"Then go to your room.

"I'm not going to my room."

"I TOLD YOU TO GO TO YOUR GODDAMN ROOM."

"You know what, fuck you."

"Fuck me?? Fuck me?? Do you still want to go to the Christmas dance?"

"The Christmas dance is not on the table just because you won't let me lead you to the van—"

"Oh yes it is on the table."

"Mom, is the Christmas dance on the table?"

Mom answers. It sounds like she had her mouth full:

"No. Not on the table."

My dad looks like a slug that just had salt poured on it: he's trying not to be fatally turned inside out, but it's inevitable. He fucked himself in this argument. He wants to yell. He wants to hit. But we don't hit in this family, we use our words. They may not be nice words, but he knows if he hits me, I won't bother with hitting him back, I'll call the police and he'll spend the night in jail.

I don't believe in half measures. It's either full patience..or the nuclear option.

"Ok, fine," my dad says.

He hands me the keys.

"You drive."

"Not while you're angry."

"I said YOU DRIVE!!"

He hits the keys out of my hand and they fall on the floor between us.

"I'm not getting in a car with you while you're angry whether you're driving or not."

"MATTHEW!!!!!!!"

"It's not safe. I'm not going to participate in an activity that might get one or more of us hurt just to find the van. We locked it. It's fine. If you take an hour or so to cool down and I determine that you're in a decent state to ride as my passenger in the Honda, then that's what we'll do. Your other option is you can let me and Joanne take the car, we'll find the van, we'll either write down directions that are acceptable to you or we can call the tow truck from the lawyer's office. If they're still open. They might not still be open. What time is it now?"

"Three-thirty," Joanne yells from upstairs.

"Yeah," I say. "They prob'ly won't be open much longer."

"Matt, if you're not outside in that car in thirty seconds then—"

"Then what? What are you gonna do? You have no leverage in this situation and you fail to see that I'm trying to help you. Let's go back to zero. The van is stuck in the snow, broke down, engine busted—whatever. We all want the van back. Do you think I want the van to be stuck in the snow unavailable to us to go do fun things as a family?? No, I am standing here giving you options that will get the van back, and you are refusing those options because you want to be angry. I think you just like being angry. But you are accomplishing nothing by acting out your anger toward me—are you getting the van back? Are you forcing me to ride in a car with you while you drive angry? Are you preventing me from taking Nadja to the Christmas dance in that van? No. That van will be found and fixed and I'll be driving it to the Christmas dance and I'll be dancing with my girlfriend no matter what you do."

I laugh.

I kick the keys toward the front door and laugh some more.

"So go ahead. Fuck you. You wanna hit me? Go ahead and do it. You wanna yell? Let's yell. Let's get good and mad and make zero progress at getting the van back. You know what I think about sometimes, Dad?"

"What, Matthew?"

"I think about the fact that you have a bachelor's degree in psychology and I wonder if you are applying anything you learned from your studies to this conversation—because it doesn't seem like it."

Dad rubs his face. There's a vein in his forehead that's thick as a pencil. I wonder if he'll have an aneurysm.

"You and your mother, you talk so much. Sometimes I can't take it. You talk and talk and talk and you can't give me simple directions! I just want to get the van and make sure it's ok! I don't want it sitting there on the side of the highway. It could get hit. People could steal it. Are you sure you locked it?"

"Yes, absolutely—the van is locked."

"Is it in the lane or did you pull off onto the shoulder?"

"It's fully in the shoulder."

"Was it smoking?"

"No. There was no smell of anything burning. The engine temperature was fine—right down the middle. It's like a belt or a battery or something."

"It wouldn't be the battery if you were already going."

"Dad, I'm not a fucking mechanic."

"I'm just tired," my dad says. "I'm tired of arguing with you. I'm tired of arguing with your mother. I don't have the capacity to go around and around just to learn that my son doesn't know basic directions."

See? That's the thing about my dad. He doesn't want to solve the problem. He wants to make you feel bad.

And at that point, I'm a senior in high school, I didn't have decades of experience dealing with self-serving assholes that need about fifty years of therapy before they can have a respectful conversation with their offspring. And, unfortunately, that person, my dad, was one half of my major role models, so my ability to deal with him was mostly learned from him, with what little intelligent twists I could put on it—which is to say, I didn't have the tools to be an adult in this situation. My dad didn't. I didn't.

His insistence that my directional methodology was inferior to his really hurt my feelings. Of course I wanted his approval. I still do. I just finally figured out, sometime in my thirties, that I was never gonna get it. But back then, disapproval from my dad hurt a lot. Intentional, wheedling, proactive, hurtful disapproval of how I think about directions—what an arbitrary facade under which to attack your son.

"Are you aware that women and men think about directions differently?"

My dad leans against the bannister.

"Typically men think in cardinal directions and women think in what you might call street sign directions. But that dichotomy is not completely accurate. Some people feel directions in a way that might seem paranormal to you but they're actually using one of the senses that isn't listed in the classic list of five senses. There are all kinds of ways to think about directions. I do it visually. I've never been lost in the woods. If I go to a place, I can always get back. I know what things look like. I remember specific trees. I remember rocks—a tiny little rock in a stream, I see it, I know I've been here before. I've never been lost in the city, either—I remember what everything looks like and I never read the street signs..they have nothing to do with my directional thinking, they help me in no way, they add no information to my directional knowledge and yet I never get lost. Joanne and I wandered around Philadelphia all the time when we lived there and we never got lost. Not one time. We took twenty-block detours to the main library, rode different trains than we were used to..one time I took the spur train by accident and ended up in Chinatown instead of Masterman, the Spring Garden stop. I came up the subway stairs into a part of the city I had never seen before. I was in the fifth grade. I just looked around and I knew which way to go. I was late to school, but I was never lost. I've never been lost. So you characterizing me as someone with bad directional skills is ignorant."

"Wha'd you say?"

"It's ignorant. It's ignorant of the facts!"

"I just can't win with you, Matt—you or your mother."

"That is because you are in the wrong and you are trying to defend an indefensible position."

"Why do I feel like I'm always in a courtroom when I talk to you."

"Well, I'll give you a hint."

"What's that?"

"I don't talk like this to everyone. I only talk like this to people who need to be disciplined, corrected, and punished for their wrongs."

At this point my dad is a grenade with no pin.

"Discipline! That's what we did wrong!! MY DAD BEAT US WITH A STRAP!!"

"WELL YOU SPANKED US!"

"MAYBE WE SHOULD HAVE DONE MORE!!"

My dad rushes me like we're about to have a physical fight.

I don't do physical fights.

His hands look like they're going to my neck.

He brushes my shoulder with his arm.

"Don't the fuck you touch me!!! Do not fucking touch me. If you fucking touch me again.."

"What?"

My mom comes in from the kitchen.

"What is going on in here?"

"Dad, I am asking you to step back from me. You touched my shoulder in an attempt to grab my neck and you should know that physical violence is where I draw the line. Mom, I'm serious, if he touches me I will call the cops and it will be a long time before anybody sees that van again."

My mom says, "Van, come over here."

"And I'm going to tell you both something, while I have you here. Mom, this applies to you as fully as it applies to him. I'm tired of all the church hypocrisy that goes on around here and I am instructing you to stop the hypocrisy right now."

Mom says, "What hypocrisy are you talking about?"

I say, "When we managed to get ahold of you from the lawyer's office, and you returned the page, and I told you that Joanne and I were stranded in the snow, did you come right away or did you finish your lunch at J. Alexander's?"

"We—"

"It's ok I already know. 'Cause we waited at that lawyer's office for close to two hours. So I know you didn't come right away. You waited. You had your food. You answer, with your actions, what's more important: your kids or your church."

"That's not fair—"

"I'm not done. We should be your highest priority, not those hypocritical assholes who Jesus would never have lunch with. Do you think Jesus would have said, Hold on, kids, we're going to order a ribeye and then we'll come rescue you from being stuck in the snow in the middle of Buttfuck Ohio with a bunch of lawyers..those fucking assholes wouldn't even let us use their bathroom!! Guess they thought we were gonna steal some toilet paper. If I had kids lost in the snow I'd be right there. You can eat at fucking J. Alexander's any day. It's not every day your kids have a car break down on them when one of them is a new driver and the other doesn't even have a driver's license! Did it ever occur to you that we might be scared??!! Walking along the side of the highway in knee-deep snow without jackets 'cause we thought we were just picking up a pair of dance shoes, not going on a five-mile survival trek!! That we're doing the best we can to get the fucking van back!!!?? So fuck you." (That was for my dad.) "And fuck you for valuing your stupid church people over your own children. We needed help. You weren't there for us. That's a problem. It's a problem with your parenting and it's a problem with your value system and it erodes the credibility of your religion, when a pastor of a church has such a low estimation of her kids!!"

"That's not right—"

"I'M NOT FINISHED. Ok? So you two listen to me right now. One: I will not be going to church with you ever again. That means Sunday worship, youth group events, Thanksgiving dinners, small group Bible study bullshit..I don't care what it is, I'm not going. There should be no argument about this since Joanne already skips church events to go to dance practice, so you have no logical reason to try to force me to go, given the precedent of Joanne not going."

"I'm not going, either," says my littlest sister Leona, from the balcony.

Mom fumes at me.

"Leona, can we talk about you separately."

"Fine," she says. "But I'm not going."

Mom tilts her head at me—not happy.

I just shake my head..very slowly.

"This is bullshit, what's been going on in this house. And you.." (I point to Dad.) "..are not in control anymore. You have shown yourself to be incompetent at controlling a household and being a father and at showing love so guess what, I am taking over control of this family and you will follow my rules from now on."

"It doesn't work that way," my mom says.

"Oh yeah?" I say.

And I walk up the stairs yelling about hypocrisy and idiocy and paradigms of thinking about directions and how fucking stupid it is that lawyers are working on a Sunday—it shows what scum suckers they are. By the landing halfway up the stairs I smeared rhetorical shit all over the institutions of both church and law and by the time I reach the second floor where Joanne lies zen-like on the carpet doing her stretches, I have informed my parents that The New Rule of Law is here and anything they do, I will counter with even more drastic measures, and that there is nothing they can do which I cannot and will not outdo at the drop of a hat.

"FROM NOW ON," I yell, "THE NUCLEAR OPTION IS ALWAYS ON THE TABLE."

"Matthew, what is that supposed to mean?"

"I'll show you."

52

So I go into my room, shut the door, and proceed to..well..show them the nuclear option. I break everything in the room, I break glass photo frames, I rip my precious black and white photos into unrecognizable shreds—photos I developed and printed myself, a painstaking process—I tore all my paperback books in half, even The Once and Future King, which is the thickest book I own. I destroy the metal mini blinds on my two windows, ripping them down, using the whole structure as some kind of accordion sword, beating the wooden frame of my bed, ripping my sheets to shreds, smashing the light fixture on the ceiling until it was shattered pieces on the floor, then broke the lightbulbs with what remained of the mini blind sword. Then I pushed everything off my dresser, a long, white, low dresser that had my boombox on it, my CDs, boxes of trinkets and necklaces, a can that contained Tuesday Walker's bra, a present from her. Boxes of letters from Anna Kiss. I beat it all to death with my sword and everyone downstairs was afraid to come upstairs. I imagined my parents huddled together at this common enemy but I doubt that was the case. My sisters went inside their rooms and closed their doors. I stopped hitting things with the sword and used my hands. I beat the door, the walls, pulled the metal cover off the heating/cooling vent. It was screwed into the wall but I ripped it out like it was held on with bubble gum. I broke my windows. And it was at that point that someone knocked on the door.

"WHAT?!"

Mom opened the door.

I saw the look on her face—basically Ellen Burstyn's face from The Exorcist.

She started crying.

"What did we do?"

She's sniffling.

"Where did we go wrong?"

"You two have no personal integrity."

"Listen to yourself," my mom says. "You're yelling about hypocrisy but there's no hypocrisy. We left as soon as we got your page and I called you back. That's why I got this pager. It's not for work—it's for you. Your father and I love you. We want what's best for you."

"Maybe you do but Dad doesn't."

"Your dad.." She struggles. "..is doing the best he can."

She take a step inside my room.

"Did you do this?"

She's holding my copy of The Once and Future King in her hands.

"I guess so."

I'm crying.

"How do you rip a book in half?"

"If you get mad enough it's easy."

"What are you so mad about?"

"The hypocrisy."

"There isn't any hypocrisy."

"You just can't see it, Mom—you're too close to it."

"Well give me an example. Because I'm staring at a room that in the space of three minutes you've made unusable. And you're scaring everyone. Your sisters are in their rooms crying. Your dad is downstairs crying, asking him what he's done wrong as a parent."

"He's done everything wrong! It's so obvious. Why can't you get it?"

"What I do know is that you just destroyed all of your favorite things."

"Things are nothing. You're too attached to things."

"Me? I'm too attached to things? Who are you talking to?"

"Everyone. Everyone. The whole world."

"But we're not talking about the whole world, we're talking about my son, who seems angrier in this moment than anyone I've ever seen—except perhaps my father when he was drinking."

"I don't drink."

"I know. I know that about you. Are you on drugs? Is there something I should know about?"

"I'm not on drugs, Mom."

"Ok well I thought it was fair to ask."

"Look I don't know. I don't know why I did what I just did. I am sad about it—yes—those are my pictures that I love of people that I love that took me a long time to set up and develop and print but I just felt I had to destroy them."

"Are you angry at the people in the pictures?"

"No. I'm JUST FUCKING ANGRY. I DON'T KNOW WHY, Mom. I have no idea."

I'm bawling.

My mom hugs me.

"Just breathe..ok? Just breathe."

I'm crying so much I'm almost choking. I'm shaking all over my body.

"It's ok," my mom says. "It's ok."

Then she left.

Closed my door behind her.

I sat on the floor and wondered what the fuck was wrong with everyone. I thought that my response was appropriate—not too much..in fact not enough. I had to stop all the hypocrisy and punish my dad psychologically and I was the one to do it because I had nothing to lose. All these other people—people at school, people at church, my mom, my dad—they had things to lose: jobs, money, houses, children, husbands, wives. But I had nothing, and someone who has nothing can do anything..or so my wisdom ran at that time. I was on top, of at least Dad. I had his number. He could never fuck with me again. There's this line from Casino that I like:

No matter how big a guy might be, Nicky would take him on. You beat Nicky with fists, he comes back with a bat. You beat him with a knife, he comes back with a gun. And if you beat him with a gun, you better kill him, because he'll keep comin' back and back until one of you is dead.

For a while that was a pretty good summary of my relationship with my father. And my bosses I met along my twelve-year trip through the software engineering world. Basically people fucked with me and I fucked them harder. I had nothing to lose. These people who fucked with me at work—they wanted to keep their jobs. I didn't give a fuck about losing my job. I wanted to lose my job. The nuclear option was always on the table. If someone revealed a secret I had confided in them to the boss, I'd reveal a bigger secret that they had confided in me to the boss. If my boss fucked with me, I'd go directly over his head, make friends with a vice president, and pretty soon my boss was doing anything I told him to, because I was telling his boss what to tell him to do.

I scared people.

I negotiated the biggest raises anyone had ever negotiated by making myself indispensable, then showing that to the hiring manager in the form of two lists, side by side: a list of the things they hired me to do (short list) and a list of all the things I was actually doing for them since they hired me (long list). Then I let them know that I didn't give a fuck about having a "career" at their company, that to me, even Mead Research or Anthem health care was a dead-end job, that I wasn't learning anything new by working there and I was only there because I personally liked them and I was doing them a favor. They gave me the raises I asked for.

I did the same thing in relationships, too. One girlfriend said I always put the break-up option on the table when we had fights. I said I didn't want to have constant fights with my girlfriend, and that's why the break-up option was on the table. I don't need you. You wake me up straddling me, screaming at me about some shit your friend told you about me that isn't even true..I'll cut you off like a five-dollar fishing lure stuck in the weeds.

Friend is disloyal? Let 'em know this is the last time we'll ever speak. And make it so.

That's the nuclear option.

53

"Do you have a lot of friends?" says Dr. Joseph.

I smile.

"No, but the ones I do have are awesome."

"I bet."

"Did your parents take you to see a psychiatrist?"

"No."

"Why not?"

"I don't think they knew that was necessary. If it was nowadays, they probably would have taken me to the hospital, I probably would have ended up in a psych ward, been diagnosed as having bipolar, and the next ten years might have gone a lot differently for me."

"Why do you say ten years?"

"I was seventeen then, I was twenty-seven when I was first diagnosed with bipolar. I just didn't know. I lived most of my professional life trying to make something work that was never going to work. The technical work was easy—too easy, I was bored. But my personality and especially my personality as affected by my mental illness..was never going to fit into work teams at any software corporation."

"Because..?"

"Because people who succeed in those corporations are tools."

"I don't think I understand the the sense in which you're using that word."

"A tool? Is a person whose most-developed skill is software engineering..who remains an idiot at software engineering. And he's proud of the level at which he operates. Companies don't mind hiring and retaining people like this because it's not really important that the entire team is functional. A few people do the work for the whole. That's how it's worked everywhere I've worked. Software gets made despite the fact that eighty percent of the developers couldn't find their pee hole with a flashlight and a magnifying glass. These are people who think that reading geek magazines like Slashdot every morning will make them smarter—which it will not. They geek out over new computer programming languages that had no business being invented in the first place! Basically like a horse with blinders on—you know, an asshole who walks around with his hands in his pockets and his head watching the carpet directly in front of his feet for lost paperclips and shit—a tool."

"A tool."

"Yeah, like a useless person."

"Who thinks they're useful."

"Exactly."

"Were there other incidents where your dad abused you?"

"Yes there were." I say it tensely.

"Will you tell me about them?"

"Yes. Do you want the Reader's Digest version or the Leo Tolstoy version."

"Leo Tolstoy, if you don't mind."

"Sure, but I'm gonna take you up on that cup of coffee, if you'll allow it."

"I'll get it for you."

Dr. Joseph leaves me in the tiny interview room.

I think of how long if I've had this disease, and how I forgot about it after I got out of a psychiatric hospital in LA. I mean I just took my Lamictal and went back to work. My emergency insurance from the hospital ran out, I stopped taking my medicine because I could no longer get it with the way health care was back then, I saw a psychiatrist who was supposed to brilliant (and seemed pretty brilliant to me) who told me I was on the cusp of having bipolar disorder and that the "geniuses" (said sarcastically) at the psych hospital I had just come from were people he went to school with and they didn't know shit about shit and he gave me some Lexapro samples and told me I sounded perfectly fine and that "true bipolar" was the guy running naked down the Santa Monica pier shouting obscenities. In retrospect, that psychiatrist probably wasn't as brilliant as I thought. He presented well, though, and I was hungry for insight.

Anyway how could I forget? How could I then go through five or six more years of life before I ended up in another psych ward (always a surprise to me!) and Dr. Joseph re-diagnosed me with bipolar disorder? And even then I didn't take it seriously! No, worse things were going to have to happen to me before I entered my current period where I know that I have to be aware of that disease, and others, every single day.

Dr. Joseph came back with two coffees and closed the door. She placed both coffees in front of me.

"Aren't you having one?"

She shook her head.

"I want to go back to the showers with your dad, him dancing around in his underwear in front of your mother's sisters, stuff like that. I want you to close your eyes and remember anything sex related that might have happened."

"Between me and him?"

"Between you and anyone. Between him and anyone. Between him and your sisters, maybe?"

I cringed when she said this last. Made an open-mouthed expression like I was in a beauty pageant and had the Vaseline on my teeth but the only shape I could make was the shape a wolf makes before it eats you.

I closed my eyes.

And I did remember something.

It was the end-hall closet in our house in Dallas. Either something had happened in there, or something was kept in there, and I was blocking out whatever it was. I had been going deeper and deeper into this closet all my life, but I could never get to the back. It was like the wardrobe in The Lion, the Witch, and the Wardrobe except in this closet was no Narnia—only darkness, shoe polish, and the smell of leather.

And as I went on about the secrets and fears and hidden things in the end-hall closet, I felt more myself than I had in year over year over year, since my first hospitalization, and it was because I was talking to a psychiatrist. I have complex things in my brain—a complex psychology. I need a psychiatrist like an addict needs a dealer—it's like I can't fully be myself without actively being the patient in a doctor-patient relationship. The psychiatrist helps define my identity the same way a dealer defines an addict's. There's a sense in which I can't be without a doctor, or a hospital—just like a novelist has readers, I have neurologists, psychiatrists, counsellors.

"You know what I do remember?"

"What?"

"Bipolar isn't just high and low, it's fast and slow, it's clear and foggy, it's sharp and dull. They call it a mood disorder but it's not exactly just moods—it's all these other qualities, too."

"I know."

She touches my knee.

"We're gonna get you some help, ok?"

54

Pretty quick I requested a room of my own because the dude in my three-person room was annoying the shit out of me with his 15-year-old self constantly talking about drugs and getting high and I guess I realized on day one or day two that I was there to recover.

I didn't want to smoke crack again.

I wanted to understand the conditions that occurred together to make me susceptible to smoking crack.

I decided that was a level of crazy I didn't want to be.

In one of our academic lectures on addiction, the teacher said something I'd heard before in NA: that breaking out of addiction is harder for smart people. Because smart people think they can solve their addiction by thinking. Why wouldn't we? We solved every other damn problem that way. But you can't think up a solution to the problem how can I use drugs successfully? because for some of us, there is no answer to that problem. We can't. We're addicts. That's what it means. We can't use successfully. There is no brilliant solution, no way to think your way through it.

You just can't use.

Which to a non-addict sounds so easy. To them they can't understand why you'd ever smoke crack in the first place. They don't understand that where they've learned ways to deal with universal problems like stress, the addict uses drugs to address those problems.

Unsuccessfully, but hey, it's the best we've got.

We didn't learn, growing up, how to handle stress in healthy ways. Or we did, but then we came across drugs and we learned a new way, a seductive, destructive way—but a way nonetheless.

So I got out of that room with the insincere 15-year-old and I got my own room and I went to every group and met every person in there and I discovered that the ones who went to group were all sincere about their recovery.

And I heard some of the saddest stories of my life in there—saw some of the saddest stories—people destroying their lives with alcohol and every other kind of drug. The worst was the old people. They didn't have much longer to turn around the ship, you know? And they had done what I had been doing—drinking and drugging—their whole lives. Except their whole life was 80 years. That was the thing: meeting those old people who were addicted to drugs their whole life, I mean if you have half a brain you have the same realization as everybody else in there..which is..if I don't make a change now I'm gonna end up like that guy. Eighty years old sneaks up pretty fast.

And every one of those 80-year-olds was once a 33-year-old who could have stopped then. And didn't, and didn't, and didn't for another 50 years.

---

I saw someone from my AA group at the Refuge. She worked there in the cafeteria and when she saw me, she said she was glad to see me and that I was in the right place. She even broke the rules and came out from behind the back of the serving area and gave me a hug—this old, frail, recovering alcoholic who would eventually fall and break her hip and lose that job at the Refuge, which job she always said she was so thankful for in our meetings.

And that felt like home, like the small world, for this woman I knew and had struggled with in AA, both to stay clean—for her to give me a hug was meaningful—her hug was special.

It wasn't all doom and gloom. I got to know each one of the staff by name, and they were so goddamn helpful it makes me cry thinking of it now. Here were are, a bunch of people with serious substance-abuse problems, people who had made all the bad, anti-society decisions in our fucked-up lived, and the Tyler 1 staff treated us with respect, with care..I mean they treated us like human beings, which was pretty amazing because, as substance abusers, we didn't even treat ourselves that well.

And my fellow recovering addicts, I loved. I loved them for the same reason soldiers love each other. We were in a deadly situation and we were trying to help each other survive.

Do you get that?

A conversation you have with a fellow addict might contain the one thing you needed to hear to stop sticking a needle in your vein. People think of addicts as worthless, as losers—but we're real people with value just like everybody else, just gripped by an enemy that will take you to places, psychologically, that most people don't return from. It's a battle, alright.

There's that Nietzsche quote I love so much: "Battle not with monsters, lest you become a monster." Well, that's the problem with drugs. Trying to do drugs successfully is like battling with this type of monster. Not only can't you beat it, but in the process of battling it, it turns you into a monster. It turns you from a civilized person into someone who would steal or kill for drugs. That's turning you into a monster. It's turning you into someone who would lie to your family and friends about how much you're using. That's turning you into a monster. That's why drugs are fucked up. You don't fight them and win. You don't even get to fight them and lose with your dignity intact. No, battle with that monster and it'll do something far worse than let you win or lose: it will turn you into a monster. That's some tricky shit.

---

After four days one of the nurses, Jack, came to me. He said:

"Matthew."

"Yes?"

"This is sad news and a little bit of hard news but your insurance company won't pay for any more days of detox for you. We used hardly any Librium with you on the first day, and you've never shown any symptoms of alcohol withdrawal..which is good because it means you're healthy..but it's bad because it means we're going to have to plan on sending you back into the bad old world..like..tomorrow morning."

"Ok."

"Do you feel ok with this?"

"Well, I have mixed feelings about it."

"Do you feel like you can leave without using?"

"Yes. I just wish I could have gotten some more of the classes here."

"Do you want, we can do somewhere and talk about it."

"No, Jack, thank you—but I'm ok. I'll be ok."

"Ok, you know where to find me. I'm sorry. We're at the insurance companies' mercy more than we'd like to be."

"I understand."

"But be glad. You're fully detoxed! You are a clean man!"

I smiled. That was a good thing.

Brattleboro Refuge Discharge Summary (1)

Patient Admitted August 30, 2011—Discharged September 03, 2011

Identifying Data

This is a 33-year-old single male who was working as a computer software engineer but recently lost his job [was fired for refusing to perform job duties which included stealing Adobe software]. He is living in Brattleboro Vermont alone. He recently moved to Vermont from California in January of 2011 [I omitted the move to Tucson and my stay at my mom's house for simplicity—you don't want these admission interviews to last too long]. He also works as a freelance writer [Heh. An unpublished novelist isn't exactly the same thing as a freelance writer, but whatever, admissions nurse, whatever].

Chief Complaint

"I'm here now because after seven weeks of being sober I started drinking again 10 days ago. Then a couple of nights ago I used crack cocaine." [No,] last night I used crack cocaine. It's 8am now. Two hours ago I was smoking crack out of a glass pipe in some strangers' apartment and if I wasn't high on crack right now I wouldn't be in this hospital, seeking your help.]

History of Present Illness

This is the patient's first Brattleboro Refuge and second lifetime admission. He was last admitted in the city of Los Angeles in 2008 for his depression [No, for suicidal ideation with a plan—I called a suicide hotline, they told me to call 911, police showed up at my motherfucking house]. He states at that time they diagnosed him with bipolar affective disorder though he does not give strong symptoms of mania [doesn't mean I don't have bipolar, bitch!]. He has had trials of Depakote which he stated gave him a headache [No, it gave me splitting headaches that made me inoperable] and he also had a trial of Lamictal which he was on for two months and feels like this was helpful for him. It was unclear as to why this was discontinued [It was discontinued because the emergency health insurance they gave me at the hospital expired, my employer did not provide health insurance, and Kaiser Permanente, the local hospital, wouldn't allow me to purchase coverage due to my now having the pre-existing condition of bipolar disorder—hence the Lamictal was discontinued]. He states he has a history of suicidal ideation although only when he is drinking. He denies having any plan. He has an AA sponsor currently [who is a pervert Christian douchebag] and has used AA as a resource for his sobriety. Patient has recently started seeing Eve Fox at Pastoral Counseling in Brattleboro.

Substance Abuse History

He has a history of IV drug use. He has a history of crack cocaine "a lot" [No, not a lot, like three times bitch! This is very important to get right—a lawyer who I later asked to represent me for a disability claim declined to take my case because of this sentence in my medical records. "With this much drug use," she said, "a judge will never approve you." We still don't understand, as a culture, that drug abuse is a symptom of bipolar disorder—denying help to a bipolar person due to their drug use is dangerous and costly. They think: Oh, this person doesn't have a mental disability, they're just a drug addict. It's not that simple—anyway]. Recently he has binged but is not using it regularly. He has a history of opiate use only recreationally and says he has never been dependent on this substance. He started drinking alcohol at the age of 23 and that for the last 10 days he has had a couple of bottles of wine and hard liquor daily. He was sober for seven weeks prior to this recent relapse though he does have a history of 11 months of sobriety.

Medical History

Recurrent kidney infections [actually, kidney stones—quite different from a kidney infection].

Family Psychiatric History

A paternal cousin with alcoholism and a sister with alcoholism. A distant cousin on the maternal side suicided.

Laboratory of Admission

Urine drug screen was positive for amphetamines and cocaine [When Dr. Joseph mentioned this to me in our first interview I was like: "Uh..yeah..oh yeah!..while we were smoking crack I snorted an Adderall." (No big deal.) "I wasn't trying to hide that from you all by not mentioning to the admitting nurse, I just didn't even think about it..I mean, it's Adderall, pshftt"].

Course of Hospitalization

Patient was admitted to Tyler 1 the dual diagnosis substance abuse treatment unit for alcohol dependence, cocaine abuse and mood disorder NOS [Not Otherwise Specified—means they have no idea what the fuck is wrong with you]. He was placed on the alcohol detoxification protocol and used minimal Librium during the first day of his stay [You can die from alcohol withdrawal—Librium reduces those chances]. No further withdrawal symptoms were noted warranting use of medications [I felt like Lindsay Lohan—her doctors declared her not an addict because she didn't have any withdrawal symptoms—by that logic I'm not an addict, either]. Patient was started on Lamictal at 25 mg daily while an inpatient and increased to 50 mg at discharge to address mood disorder. He denied suicidal ideation throughout his stay. Resources in the community were established with an outpatient psychiatrist [The appointment was a month away—I never made it to that appointment or ever met that psychiatrist as my situation was to worsen before then. That appointment was intended for someone who could survive for a month on his own to keep a date with an outpatient psychiatrist—I heard she was excellent, by the way—but I wasn't that patient].

Final Diagnoses

Alcohol Dependence. Alcohol Withdrawal. Cocaine Abuse. Mood Disorder NOS. Recent Kidney Stones.

GAF on Admission: 28.

GAF on Discharge: 50.

GAF is the Global Assessment of Functioning of a patient. It's a range from 1 to 100. It reflects a doctor's opinion of how well a patient is able to meet the challenges of life—how adaptive the patient is to this world.

My 28 on admission means, by the book, that my "Behavior is considerably influenced by delusions or hallucinations or serious impairment, in communication or judgment (eg, sometimes incoherent, acts grossly inappropriately, suicidal preoccupation) or inability to function in almost all areas (eg, stays in bed all day, no job, home, or friends)."

My 50 on discharge means, by the book, that I have "Serious symptoms (eg, suicidal ideation, severe obsessional rituals, frequent shoplifting) or any serious impairment in social, occupational, or school functioning (eg, no friends, unable to keep a job, cannot work)."

I suspect there is a relationship between the GAF on Discharge, the hospital's insurance coverage, and the hospital's willingness to release a patient whose GAF is below a certain number—but I'm just guessing.

Condition on Discharge: Fair.

Prognosis: Fair.

They set me up with an outpatient group therapy program called Starting Now. It was houses in one of the Refuge buildings.

A nurse does my final paperwork, unlocks the locked door which has been keeping me here for the last four days. I am no longer in detox. I am no longer in rehab. I am free to drink, or eat, or do whatever I want.

55

I walked out of Tyler 1, checked my bank account, which had one dollar in it, then I went to the church I used to volunteer at and begged their secretary for food.

"Um, yes, hi, I just got out of the Refuge and I don't have any food or money until I get my next unemployment check, which could be two weeks or more, and.." I start crying at this point. "..I just need some food to make it to the next time I get paid, so is there anything you can do for me, some cans or anything?"

This secretary led me around the kitchen—which used to be where I went to get extra food on the sly to give to extra-hungry homeless people when I worked at the shelter—and she gave me plastic bags and loaded me up with about four of them full of food, so heavy I could hardly carry them back to the house.

"Do you know where the free meals are around town?"

"I used to have a list, but I forgot," I say.

She writes them down for me, one free meal per day, at various locations around Brattleboro—what an organized town.

"Do you know about the Drop In Center?"

"Oh yes, I've been there before—I forgot. I should have gone there instead."

"It's ok, but they have food, too. If you run out before you get your check, go there, ok?"

"Ok," I said, sobbing.

I cried the whole time she was handing me stuff. That's the first time I ever straight-up begged someone for food.

I left and asked her name again—which of course I forgot—and in my fantasy world I was going to become a millionaire and buy back their Tiffany window and volunteer at the church every day and do something special for the actual woman who gave me food when I was hungry. In reality, I never did shit for them.

I carried the heavy bags of food up the hill.

There was a guy sitting with a suitcase on the stoop of a building and when I passed him he said:

"Don't worry about me. I'm just waiting for the homeless shelter to open up so I can stay there—my aunt couldn't keep me anymore."

"Good luck," I said, and he repeated what he'd said about the homeless shelter. (He was fine, sitting on a suitcase with all his things, on a street corner—just needed the homeless shelter to open up.)

He's totally fine.

Don't worry.

---

I snuck into the house on High Street, went upstairs quietly so no one would ask me where I'd been. But Krystal, the ho, came upstairs and knocked on my door. I was in the kitchen putting away my free food but I went to the door.

"There you are!" she says all cheerful.

"Hey."

"We haven't seen you around in a while!"

"Krystal, I'm kind of putting away the groceries right now."

"Oh. Can I come in? I'll help you if you want!"

I knew if Krystal came in we would end up fucking.

"Thank you, but no, I'm fine."

"Ok, well me and Tooler and Issa were just worried about you. What happened with your job?"

"What do you mean?"

"Well, you obviously haven't been going."

"I got fired."

"You got fired? For what?"

"It's a long story."

"I have time," she says.

She's so sweet and I'm such an asshole.

"That's very nice, thank you, Krystal, but..I'm a little overdone right now..with life..in general..so."

Then I just close the door in her face. Slowly, firmly, close the door in this human being's face.

I can still hear her voice through the wood.

"We're having cow heart tonight!" Krystal shouts. "Tooler said you're invited. She said she wants to see you."

"I doubt that," I say, and I don't think Krystal can hear me.

But Krystal, saddened, says, "No, she really does."

I go through a mini-recap in my own mind of "what my life is"..fucking drug addict loser who can't keep a job. Failed writer. Useless human being—hater of and pariah to society. To me, my life isn't a life where I can get invited to dinner to eat cow heart with some friends and sit alongside them as an equal and deserve to have fun just like they're having fun. I don't deserve happiness. I can't imagine myself as anything but an energy suck, a stumbling block and a burden and a monster who is always, ever, just about to ruin the moment.

You're about to have a simple dinner of cow heart and enjoy an odd set of company totally blissfully—I'm getting out of detox after my crack smoking and having no money cause I spent it all on crack and going to a church to beg for food and crying the whole time while they were giving it to me—that's my life.

Something about a kingdom of isolation, some future lyric to a musical that hasn't been written yet..the Ice Queen from The Player—archetypes of banishment and isolation, the person who feels most alone in a room full of fools. I wish I had company tonight, and it's right downstairs, three women of various qualities, including the unparalleled Tooler whose feelings I hurt by saying the apartment smelled like cat shit and beating her to the punch on moving to the third floor (and not telling her about it). I do this all the time—not just to Tooler. I'm with someone (friend, girlfriend, employer, brother, son, whatever), and they think we're doing something together, they think we have some kind of connection, and then they find out by nasty surprise! that I am not with them—not because I don't want to be, because I can't, I just can't feel that way about another person anymore. I'm closed, off, I'm not open.

But if I ever eat cow heart again, Tooler, it will be with you.

---

I hear Krystal descend the stairs and I grab my laptop. I write my family this email:

From: Matthew

To: Joanne, Leona, Sharon, Van

Subject: I need support

Family,

Last week I checked myself into a hospital to get help with alcohol and drug abuse, and bipolar disorder. I'm out now; I didn't have any phone numbers on me or I would have called you.

I need your support. I don't need you to learn as much as I have been, recently, about the diseases of substance abuse and bipolar disorder; I don't need prayers, gossip, judgment, or advice.

What I do need is contact. Since our family is not in one place that I can go to, I need you, I am asking you, all, to call me, sometimes, maybe once a week, and just talk to me. This will make a huge difference in my ability to feel ok in life, to not feel alone, and to feel like I'm connected to some sort of family or community.

Thank you,

Matthew

My mom writes back:

My dear son,

No judgment at all here, just so thankful that you did what you needed to do for yourself.

I love you,

MOM

Mom's email, her calls, were precious to me. She is the only one who called me or emailed me or ever mentioned this hospitalization in future conversations. No one else even responded to my email.

And maybe it was because they were scared. And maybe it was because they didn't know what to say. But Jesus Christ, have the strength to help someone out who has fallen to the ground and is reaching up for your hand.

---

And sometime that day, getting out of detox, I find this journal entry in my computer:

Driving around Brattleboro, I feel blessed. Being on the mountain, the same. I feel fortunate to be here, to be alive, to be able to be alive here. I can't predict the future and I can't control anything in the world but me, but I am opting for hope, now, that things will be wonderful for me. That I will not be my own downfall, but that I will live healthy and happy and published and rich, and that I will get healthcare and a car and maybe even love someone again. I would love for life to go amazing for me, for me to be someone who gets to be truly happy, fully happy, deeply happy..who gets to live large.

And part of what I hope is that writing books can be my way of being rich..that I do continue to write things that people love, and that they love more and more, such that I have a bounty. That is motivation to write, alongside the idea of creation and exploration of human nature..the idea that when I write, I am writing something that will bring me further bounty because of the love it inspires in someone else..in many many many someone elses.

With alcohol, it just has to fall away. I'm not going to do clean dates, I'm not going back to NA/AA. I'm just going to be oblivious to it as an option, given that it doesn't tend to improve my state..and so, based on that same criteria for choosing relationships (the criteria that you only spend time with people whose company you enjoy as much as or more than your own)..based on that criteria, alcohol is less useful to me now than it ever has been before.

Write books that people love to read. Make them happy. Make myself rich. Hike. Eat. Love. Meditate. Create new things: books, movies, and then my game/world. Maybe a restaurant or two for fun, if/when I'm able to do that comfortably.

Believe that what I have written, and what I write next, will be the ways that I get to live in Brattleboro..that that creativity and the effort of love that I give to my writing, to my stories, will give me bounty to enjoy this place, and the places that I love, in this world.

Oh god, oh universe, oh everything, how far I fall, and fall, and fall, and continue to fall.

56

There was a woman Laura, who I saw at almost every AA or NA meeting I went to, was in a wheelchair and wore wheelchair gloves. I was always friendly with her and she was a good person to talk to. Then one day I saw her while I was sitting outside the Metro on the steps and I had come out to smoke and enjoy and sun and I felt guilty that she was seeing me outside a bar, and normally I would never explain myself to someone, but I thought with all the 12-step meetings we'd been to, she deserved an explanation.

"I'm just drinking water," I said. It was true, I was hanging out at the new Metro just drinking water—but even then, I knew I was going to drink again, even after detox I would relapse again on alcohol, maybe even that day at Metro.

Things like that kept happening. I saw the Refuge meditation guru, Drew, at a show at Metro again I felt like I had to explain to him that I was only drinking water, even though I was sitting at the bar, just so he wouldn't think I relapsed. We both enjoyed the music and he took my seat at the bar after I left not long after talking with Drew because I didn't want to drink and I knew the longer I sat at that bar the greater chance I would order a drink. For me, part of AA and the Refuge outpatient programs wasn't just not drinking, it was feeling I had to prove to all these sober people and program administrators that I wan't drinking, which was a burden to me, not completely placed upon myself—I mean they were piss testing us.

So I'm sober, I'm over my crack excursion, I'm doing Starting Now at the Refuge every evening and my bartenders know I'm sober and then I'm crossing Elliot Street and Walsh, headed into Whit's, shouts at me across the street saying:

"YO! TEMPLE!! My birthday gathering..you know, as in I'm going to be a year older?"

"Right, I'm with you so far."

"We'll be at kips tomorrow and DAY DRINKERS ARE REQUIRED TO ATTEND."

Meaning she expected me and Mike to be there.

She goes into Kip's with a boyfriend.

I never went to her party because of my not drinking at the time and I knew if I was around Walsh I would drink—I would do anything she wanted me to. Then, some days after her birthday, I saw her and her same boyfriend and she was like:

"Why weren't you there?"

I looked at the guy she was with. Short, short hair, looked like a church boy.

"Why I wasn't there," I said. "I'm not drinking right now, Walsh."

She made an open-mouthed, what the fuck-type expression, she didn't know how to process this information. She was so confused she didn't even ask why.

"Alright. I guess I'll see you around then."

"Yeah, I'll see you around."

The two of them turn and go in the direction of her apartment.

---

Ok. Let me tell you about this outpatient substance abuse program goofily named Starting Now.

It was at the Refuge in the evenings. This is late summer. Sometimes when I ride my bike down there it's warm, sometimes it's becoming the cold of winter, sometimes it's raining so hard I just walk my bike back in the dark, after the program ends, up the hill, through town, then up the High Street hill back to the house.

The program is from six to ten, four nights a week, with no food or drink allowed, which really sucks if you're somebody like me who needs to each and drink little bits throughout the day to maintain my sugars. I mean it's part of my mood management that I have figured out, and my mental health program is interfering with my mental health. I explained this to Drew and the other program letters and they were like: Refer to rule a) NO FOOD OR DRINK.

Ok, whatever. I thought we were all adults but I guess not.

They gave me tons of personal history forms to fill out and some of my answers qualified me for a joint Princeton-Refuge study on PTSD. Having carried around almost unbearable guilt for all these years about doing ecstasy with my girlfriend Rebecca and her dying and me living, I guess they thought that I was still feeling PTSD effects from that. The PTSD study was done by the perfectly professional, sympathetic, sexy/cute but always right and proper Cleo. I wanted to fuck Cleo, for her to be my mate: the perfectly sane with the perfectly crazy. I would just get up from my chair where the two of us sat in a closed-door room, say, "I know this will disqualify me from the program but," and then touch her tit in the naughtiest, freakiest way, thumbing her nipple and pulling her onto the floor all in one motion. She wore this perfectly pressed white blouse that I wanted so bad to see wrinkled on the floor.

But I didn't do that. I answered a million questions about PTSD experiences and took sixty dollars from her while I fucking smelled her like a serial killer.

One night instead of all strangers I saw Matt Mattson's mom at Starting Now! It took us both a while to figure out who the other one was, then we realized we had done drugs together at her house..when we realized this we looked at each other and laughed. I guess she wanted to quit, too. After the program she drove me downtown where I had last locked my bike, and that was the last time she went to Starting Now. Maybe it just wasn't for her. Maybe seeing me there was fucking with her anonymity. Either way she split and decided to get clean on her own..or went back to using.

I had a week between when I got out of detox and when I was due at Starting Now, so I had time to drink and still leave three days for the alcohol to leave my body before I went to the outpatient program that did piss tests. I was always doing this. Piss tests during the outpatient program were always known, so for a while I drank during the days where I knew I had at least three days before a piss test. I was trying to get sober. Sometimes I made it a whole week. Sometimes I drank on Thursday night, knowing that all the alcohol would leave my body in 72 hours—I knew this, of course, because they taught me this at Starting Now.

The classes at Starting Now were completely useless. If I had to pick an actual class that I liked more than all the rest, I would say, strangely, the diet class.

The teacher's name was Paula. She was wacky like an 80s dance teacher. Or maybe like an 80s pop star, like Tiffany, with crimped hair and pink leg warmers.

Tiffany always makes me want to drink cognac.

Anyway.

This is the woman who in the first class I took with her said,

"Does anyone want to hear my five-second poop talk?"

We all looked around the room at each other and no one said anything.

Paula goes: "Ok, here it is: Munchkins bad, crawlers good."

She smiles.

"That was it," she says, and moves on to the rest of her material.

I talked for at least twenty minutes with the nutritionist after class. There are two things I remember from her class: This thing about calories versus calories from fat and the acceptable ratio between the two. And her poop talk. She has us all captive in this Starting Now classroom and she says, "Do you want to hear my ten-second poop talk? Yeah? Yeah? Anyone?" I mean what could we say? We had to listen to her poop talk. It was more like a two-second poop talk, but like any good wisdom, it's packaged in a way that's impossible to forget!

---

I hated small group.

I hated listening to other people share.

I thought it was pointless for me to share..and I'm a small group kind of guy. I used to love camp and church study groups when I was a teen. I even worked as a peer leader at a national Christian youth conference. I led fucking small groups.

But in this group I just wanted to jump across the circle and choke whoever was speaking.

That's not a metaphor or some kind of literary device.

I wanted to jump across the circle and choke whoever was speaking.

It did occur to me that, unlike some people there, I wasn't being required by a court to attend these meetings, and many, many times I almost walked out. I'm 33 years old, I'm paying to be here, just like film school, I can walk out any time I want. Nothing is holding me here but me. That's how my thoughts ran much of the time.

I try to think of the very first small group I was ever in, and I think I get it.

When I was in the seventh grade, my homeroom teacher got to pick five students from the class to attend a once-weekly stress-relief group. It was like stress management techniques. The teacher picked me, Joseph Pollard, Lindsay Krey, and two other people I don't remember.

On Friday morning we got to skip homeroom and part of our first class to go to a little room off the side of the library. It was full of old, broken overhead projectors and film projectors and the librarian had cleared out a space and set up six chairs with no desk part to them—just regular chairs for sitting. The person who ran the group was college aged and I don't know if her knowledge and kindness or her brown hair and symmetrical face were what attracted me most, but I liked her in a multidimensional way. She started by acknowledging that Masterman was a difficult school (it was a school for smart kids) and how pressure from our parents or our teachers or even pressure from within ourselves could cause us stress, and she said she was there to teach us methods we could use anywhere—on the bus, in our classrooms, in our beds at night—to relieve stress. And that is what she did. She taught us progressive clenching/releasing relaxation, where you start with your feet and clench every part of your body as hard as you can, then relax it as much as you can. She taught us thought exercises kind of like a precursor to Anthony Robbins, where we could use funny symbols in our brain to represent something scary, how we could learn to be more realistic about the impact of negative situations—basically asking ourselves What's the worst that could happen if I fail this test? If my father hits me. If I don't live up to my own expectations. The class was very helpful, it didn't last for more than about ten weeks, and I liked it because of the stress exercises which were new to me and also I liked it because, when we didn't have our eyes closed, I got to stare at Lindsay Krey (who I had a crush on) and I got to look at this teacher of ours who I had a much deeper kind of crush on. I liked being in a small group of five and I felt special for having been picked to be in that small group of five.

My thinking about why we were picked didn't go very deep. I just had a vague idea that we were the five most special kids in the class and by being special and smart we had earned the right to be in this special program. But that didn't make sense. Joseph Pollard, though he was one of my closest friends, was not exceptionally smart and he was extremely undisciplined—the next year he wasn't even in Masterman, he was in a military academy at his parents' orders. I must have been an adult looking back on that experience before I realized why Mrs Tedesco chose that particular set of five children for a stress management class—it was likely because we were the most high strung, stressed out, neurotic people she could identify.

When I first went to the Refuge, I was thirty-three. I didn't know what the word anxiety meant. The first day I was in Tyler 2, head nurse Michelle handed me a book called The Anxiety and Phobia Workbook. I was like: I don't have anxiety. I'm suicidal. Michelle said: Talk to your doctor. But apparently I had anxiety by the seventh grade. And I probably had it a lot earlier than that. In my thirties, I told my mom I had realized that I had a lot of anger and that I thought I might have had it for a long time. She said: "You've been angry your whole life."

Not that anger is the only emotion I've been feeling my whole life, but that since her earliest memories of me, even as an infant, I've been mad. Mad at my father. Mad at her, because she didn't understand what I was saying. Even the story of my first word: I was lying on the floor pointing under my crib saying, "Ball! Ball!" and for a long time my mom said, "What are you saying? There's no ball under there." She didn't even think I knew what a ball was, so she assumed I was just making some random sound that just happened to sound exactly like ball. I got angry and she finally looked under the crib, and "Lo and behold, your favorite ball that you loved to play with, had rolled under your crib, and you were asking me to get it for you, and I was standing there getting frustrated with you because I thought that what you said wasn't making any sense. But it made perfect sense! You were saying 'ball!!' " And, my mother says, "I learned something that day. I learned two things. And that is that when someone is saying something that you think is nonsense—even though it may be nonsense—you can never, ever assume that it is. I took a huge step as a mother that day."

"What step?"

"Humility," my mother says, with wet eyes but she's laughing. "That's a good general lesson. But the other thing I learned, and this is true about your sisters but it may be especially true of you..is that..and this is a hard lesson to learn as a parent, but..I learned about you something that I don't think your father ever has, and that is that your kid may be smarter than you. Even with twenty years of life experience on you, that ball situation, as silly as it may seem, has been one of the defining moments of my life. I can't assume, even of a one-year-old, that I know more than someone. Age is tricky like that, and it hurts. When you're a sixty-something-year-old pastor with multiple degrees, many varied life experiences, and I would like to think I've picked up a thing or two along the way, but I don't know when a twenty-year-old who is editing my article for publication on the web, is going to offer me advice on what I have written..and that I won't disagree with what she said!"

"I know, Mom. I know. I've felt that in AA and NA. I was in this meditation meeting in Tucson and I was thirty, thirty-one, and this woman shared, who got clean when she was seventeen, and now she's twenty-two or twenty-four or something—she couldn't have been older than twenty-five—and she says one of the wisest things I've ever heard, and I'm just sitting there, with this humility—like you mentioned—at the golden drops of wisdom coming out of this young mother's mouth. I had to re-evaluate my whole world the night that woman spoke, just like you said..I mean wisdom could come from a motherfucking rock if you listen hard enough."

"What was the piece of wisdom she shared?"

"That whatever you're feeling right now, you're feeling because that is what you chose to feel."

"Wow."

"Yeah. Yeah. Aside from some technical difficulties related to people with mental illness, that's one of the most profound things I've heard. I think it's a very hard thing to realize, because admitting that that statement is true involves taking responsibility for our own emotions and our own minds, admitting we are not always reactive but sometimes proactive and that the wiser we are, the more proactive we are likely to be about our own mental state..which is something I think generally people aren't all that in touch with."

This is the kind of conversation me and my mother have.

I love her.

---

(As I write this, Mom just said, "What are we gonna do tomorrow?" and I said "Blow up the house?" It's some kind of serendipity but this is a good example of the nihilistic, depressed, gave-up things that I was saying in the Starting Now group meeting that caused the meditation master, Drew, to ask me to see his teaching partner, Lisa, the counsellor who suggested that the things I was saying in group were what they called "suicidal ideation" and asked me how I might feel about spending some time inpatient.)

So yeah, not only was I hating small group and wanting to kill the other people in group with my bare hands, but this one trip to the Refuge for group, the Starting Now workers finally fucking caught on to this—they thought I was saying suicidal things in small group. Which I think is a little extreme..I have no idea what I said in those groups..all I know is I didn't say anything mean to anyone else but I really didn't give a shit about anything and I felt nothing satisfying, especially that group, and I'm sure I raised questions about the usefulness of me being there.

I mean the guy sitting next to me..what's wrong with him? He had six drinks, he got a DUI—but look at him, he's perfectly happy, he's willing to do his classes so he can get his license back, get back to his girlfriend and his drinking and his pointless fucking life. When asked for a few words to describe how he felt, over a period of weeks being in class with this mentally resilient construction worker, he only ever answered one word to describe his feelings: "strong."

The last night I went to that meeting, the night the facilitators pulled me aside to suggest I might be suicidal and inpatient care might be appropriate for me, I might have responded to this construction worker. I might have said said something like:

"Strong isn't a feeling."

"Matthew, it's Chris's turn and he can answer however he wants."

"Ok, well, I'm just saying, we're talking about issues of the mind and Chris—no offense, you know I like you and you and I agree on lots of things and I support you in your recovery and all that, but you don't seem to be answering the question that's being asked of you. You feel 'strong.' Like what? Your biceps feel strong?"

"Yeah," he said, and he rolled up one sleeve and flexed a bicep."

"You got a pair of guns there, no doubt, my brotha, but I don't even think you need to be in this class. Based on what you've shared, you're not an alcoholic or drug addict, you're not mentally ill according to the DSM..I don't even think you should be here."

"I agree," Chris says.

"Wanna wrestle?" I say.

"Sure," Chris says.

"Just be sure you break my neck at the end," I say.

Chris and I hugged and wished each other the best at the end of the meeting—it was his last, he had graduated to return to being a chronic drunk-driving citizen again—but I guess what I said about him breaking my neck is why the leader of the meeting, Drew, the meditation guru of Brattleboro, said he wanted to me to talk to Lisa, the other teacher, in her office when the meeting as over.

It could have been that.

Maybe.

It could have been other remarks.

Like when Ronald, this 60-year-old with an alcohol monitoring bracelet was droning on, taking up 20 minutes of an hour-long sub-session with his incessant talking about nothing, I might have said something like,

"I hope I die before you finish this story."

"Matthew, let Ronald talk."

"He's talking, he's talking—no one can shut him up."

"Ronald deserves his time."

"Ronald deserves his time. Which is about five minutes. So now he's eating into Chris's time and my time and Ellen's time—"

"Why don't you focus on you—"

"I was! That's why I said: I HOPE I DIE BEFORE THIS FUCKING ASSHOLE FINISHES HIS STORY. That's an I statement. I was talking about my feelings."

This whole time, Ronald keeps talking. He has no conception of this interaction going on around him.

"If he hits the thirty minute mark, I'm going to end that motherfucker."

"Right on." Chris bumps my fist. "This guy is disrespecting the group. Ellen deserves her share."

"I will fucking end you," I said, in a real nice way.

Ronald never heard a thing.

But Drew did.

57

And that's how I found myself Talking with Lisa after a Starting Now night was over.

Drew was very nice about it. He said,

"How would you feel about talking with Lisa for a while?"

"I'd feel good about it," I said. "I don't think I'm getting much out of small group."

"That's what we'd like to talk to you about," Drew said.

So I was in Lisa's office.

She started out with basics.

"Are you still going to AA?"

"Yes, sometimes."

"What do you think of the people in your 7am AA meeting—I know you go to that one pretty regularly, right?"

"I'm kind of hit or miss on that group right now because they don't know how to separate religion from AA which demonstrates that they don't even understand their own text."

"How do you feel about the people in the meeting?"

"How I feel about the AA people in meeting? I have a very bad attitude toward them. I feel like I would hate picking up a one-year chip someday, that somehow it would be a failure on my part. I always felt that about jobs."

"Really?"

"Yes. I thought they were such a repugnant waste of time that doing well at them, even working with certain companies, was an embarrassment to me, a defilement of me as a human being. Some companies I worked for, I don't even put on my resume because I'm too embarrassed to have worked there—I feel that my association with them is a blight on the quality of my life."

I cried when Lisa asked me if I wanted to go inpatient and I said,

"That feels like a good idea."

She said, "What you might be feeling isn't sadness, but relief—a friend of mine who has lifelong depression says she feels relief when she gets so suicidal she needs to go to the hospital."

Lisa calls reception and tries to get a bed for me that night in Tyler 2, but they're full. She gets a bed for me for Friday.

She says, "Can we make a safety contract that you won't hurt yourself before then?"

"Yes but I'm not guaranteeing that I'm going inpatient on Friday?"

"Why not?"

"I'm just not ready to make that commitment."

"If there was a bed ready tonight would you be more willing to make that commitment?"

She was good. She kept me talking. She sat there and long time and listened to my mixed-up bullshit.

That woman—Lisa Whatever Her Last Name is—is one of the key people who've helped me in my life.

"You were in detox before Starting Now, weren't you?"

"Yes. I was released from detox after four days because I had no withdrawal symptoms and my insurance would no longer pay for it. I stayed clean and sober at times, went to meetings at time, and now of course this outpatient treatment, but when I stop drinking my problems get worse. I know that sounds like a cop-out—"

She touched my knee.

"No. It does not. It sounds like you have another mental illness, besides addiction. Ok? That's what it sounds like."

"Well I do! I had forgotten I had been diagnosed bipolar years before."

"When was this?"

"About six years ago LA. I recognize that you and Drew have pulled me aside and I realize that I was irate defiant suicidal or something—"

"And homicidal."

"Oh really?"

Lisa nods.

"Gosh. I didn't even realize the suicidal part until you pointed it out to me in your office."

"I think you'll feel that sense of relief I was talking about earlier when you go in, because you'll know you're safe because somebody else will be looking after you. I think you have stress around what you might do."

"To myself??" I was choking up big time on that one.

"To yourself or others."

"I do feel a kind of relief." I was crying my eyes out. "How did you know?"

"We just thought some of your remarks in group were alarming."

"What remarks were alarming?"

"When you said..that everyone—"

"That everyone should just blow their fucking heads off? That remark?"

"That one and others. It falls into the category of what we call suicidal and also homicidal ideation."

"Maybe it's not suicidal. Maybe it's just boredom."

"Boredom with what? With your life?"

"How about with that motherfucking group? Bunch of fucking dotards. No reasonable person can be expected to sit through that group four times a week. It's bullshit. I'm not going back to that group, by the way, just so you know, that group is bullshit."

"You said that."

"Well, it's true. Sometimes I like to emphasize things by repetition. Like Mr Snakeskin Boots back there. He's here for drunk driving. He's legally required not to drink for a year since his conviction, which is parole, and going to this group. You know what he told me? He said the minute that year is over, he's gonna drink again. I just can't be in a group like that, with fake-ass motherfuckers. I think if he blew his head off it'd be better than the lie he's living. I know you can't tell someone else they're an alcoholic, but do you know how many DUIs this motherfucker has?"

"Matthew, I'm not concerned about Chris—"

"Mr. Snakeskin."

"Chris, Mr Snakeskin, whatever. Chris isn't making death threats during group."

"I didn't make a death threat."

"Technically, you did, when you said you were gonna blow everyone's fucking heads off."

"No, I didn't say I'm going to blow your fucking heads off. I said Everyone should just blow their motherfucking heads off. That's just friendly advice. To end their suffering."

"Are you suffering, too?"

"To end our suffering."

"I have a responsibility—legal as well as a conscientious one—to make sure you're safe before you leave this building. Drew was concerned by some of the things you said in group, not just tonight, but other nights as well. Drew is a good friend of mine. We care about you."

This woman turns her chair so she's facing me, eye to eye.

"I want you to commit to spending some inpatient time here. Friday or tonight if I can get them to let you in tonight."

"Why?"

"Because I'm concerned you're suicidal."

"Suicidal. Hm. Suicidal. Well, I've been suicidal in the past."

"When?"

"Since the tenth grade. I bought a book on suicide and my parents paid for it and my mom was the only one who showed any concern, and I told her not to worry, it was just an academic interest and she didn't bug me any further."

"You think she should have been more proactive?"

"I think when a tenth grader buys a book on suicide, his grades go from A's to F's, he's skipping school when he never did before, he shows up at his girlfriend's house—not fucking her in the basement—but because she's the only one who can comfort his deep soul cryings, emotional breakdowns, whatever. I just needed a friend!"

"How often have you felt suicidal since then?"

"Constantly!! Constantly. I mean what is the point of this life? If you think, then you must be suicidal. Only people like Mr Cowboy Boots who shoot for the lowest rung on the ladder are happy. He's not thinking of the meaning of life—he's just gettin' while the gettin's good."

"But we're talking about you. And I think you're in danger."

"Danger?"

"I think you may be a danger to yourself."

I laugh.

"Yeah, I am. I'm the most dangerous person I know."

"Do you have a gun?"

"No."

"Do you live with someone?"

"No."

"So you're going home tonight to an empty apartment?"

"I guess so, yes."

"Right now, how are you feeling about spending some inpatient time here? You said you were comfortable with it earlier."

"I just got out of Tyler 1."

"Have you drank since you got out?"

"Yeah like once or twice. But mostly I've been sober AND IT IS NOT WORKING."

"Tyler 1 is detox. Tyler 2 is a psychiatric unit. Tyler 2 is where I'd like you to go."

"In Tyler 1 they taught us that addiction is a psychiatric problem."

"Everyone has their ideas on that. I view addiction as a disease, like the flu. Anyone who's exposed has a chance of being infected. You know what the difference between a drug addict and a non-drug addict is?"

"What."

"The drug addict has tried drugs."

"You don't believe in the whole 'addict mind' thing?"

"Uh..no. Not exactly. If you want I can call down to admissions again and see if Tyler 2 can take you even without an empty bed. They may be releasing someone in the morning. Would you like me to call again and see if I can get you in there tonight? That way you don't go home to an empty apartment."

---

Let me point out something here.

Lisa is being extremely lenient with me here. She is catering to my will to a degree that shows how deep her humanity runs. We are in a psychiatric hospital. At any time she wants, Lisa can call for the guys in the white coats to come to her office, give me a shot of Benadryl, and take me somewhere—they've got places they could stash me.

In fact, as Lisa referred to earlier, she has a legal obligation not to let me leave the hospital if she thinks I'm suicidal.

So she is being extremely respectful with me and giving me a truckload of patience and leeway.

---

"What is Tyler 2 again?"

"It's mostly a psychiatric ward. A good portion of people who go there are suicidal. You'd be safe there. They check on you every fifteen minutes to make sure you're ok."

Something about this mechanical fact starts me crying.

Lisa offers me her tissue box but I won't take it. She sets it on the table next to me.

"I just— I just—" I'm saying.

I shake my head and sob.

"I've been keeping myself going so long on nothing. In college it was vapid. It was vapid before that. Everyone is vapid, have you noticed?"

"Yes."

"I don't know why I'm crying."

"You started crying when I mentioned that you'd be safe in the hospital."

"I did?"

She nods.

"Tell me the story again. About your friend."

"You wanna hear that story again?"

"Please." I am broke down, eyes flooding, shaking with release.

The counsellor leans in to me.

"I have a friend. I've known her since we were little girls. And she's had to go into the hospital..during various periods..throughout her life. You might imagine..that she feels dread..she feels shame..because she can't trust herself..she can't be safe around herself. But you know what she tells me?"

I'm sniffling, saying, "What?"

"She says what she feels is relief."

I nod.

"Wow," I say.

She is describing exactly what I'm feeling: relief. Relief that I wouldn't have to be the only one taking care of me, looking after me. Relief that someone else believed not just that I had a problem but that Life had been difficult for me. Not just regular difficult—like good days and bad days—but difficult like "I have to constantly control myself to not do things that scare other people and I have to convince myself to stay alive even when I have absolutely no reason to do so, even when I feel useless no matter what a good job I do, when I am unmotivated by things that motivate anyone: money, sex, love, reputation. I don't care about any of those things. I'm like a chess player who will sacrifice his queen—but not because I'm Bobby Fischer and have some seven-move combo that's gonna kick your ass with superior intelligence combined with superior creativity. No. I'll sacrifice my queen because I don't give a fuck about losing—losing everything. If I had a grenade I would have no hesitation punishing myself and everyone else in that remedial therapy group by blowing all of our heads off at the first utterance of a phrase from Mr Snake Boots. I'd kill us all just because I don't fucking care. I've been pushed to the limit so many times that I don't believe in anything—sex, love, money, security—I don't believe in any of it. To me, a job interview isn't an opportunity to get a great job and make money and contribute my creative and technical skills to an exciting company. I'm thirty-three. I've been around that block way too many times to get excited about a job interview. A job interview isn't an opportunity—it's a waste of my fucking time. Fuck the paycheck. Fuck the apartment. Fuck the car. I don't even care about your sex: women, you can take your pussy elsewhere. Play your games with some twenty-three year old who still has the energy, who's still willing to put up with the drama and the games and the bullshit just to cum inside you, just to hold you on his arm, just to mentally get off on possessing you momentarily. Those are things I don't care about anymore. I don't care about anything anymore. In fact my whole life has been a process of stripping myself down of everything that's unnecessary. And now I've stripped myself down to nothing."

"We're gonna get you some relief."

"That's what I feel," I say. "Just talking about the hospital. Relief."

And I go into a major cry, and Lisa gets on the phone and sees if she can get me a bed in Tyler 2 tonight.

58

Lisa couldn't get me a bed. We talked a lot more and she believed my safety contract with her—which was genuine—and we agreed on a Friday admit date to Tyler 2. This was Thursday. Friday was tomorrow.

On Friday, Gretchen stalked my bicycle. I don't know how else to put it! The crazy girl put flowers on my bicycle when I wasn't around and my bike was locked to a street pole. I came back to my bike and first thought, Wow, some stranger put flowers on a stranger's bike, how nice. Then I realized it was Gretchen and she was straight-up stalking my fucking bicycle!!

I unlocked my bike, placed the flowers on top of a trash can for someone else to enjoy, and rode to the Refuge.

---

First trip to Tyler 2.

I ate lunch standing in the Refuge lawn with my bike propped against a tree just to have someplace to eat my Subway sandwich before I went inside, where I was sure they would take my food away.

I walked all around the square between the buildings, hugging the trees and seeing as much nature as I could, knowing I'd be inside a locked ward for as long as they wanted to keep me. I videoed these pinwheels the children patients had made..they were in two circles in front of the main entrance to the hospital. They spun in the wind and had messages written on them.

I took a long ride around the Refuge on my bike, knowing I was going to be admitted, knowing I might not see outside for a long time, parking next to my favorite tree and hugging and kissing it, then locking up my bike and going inside to be admitted. I cried uncontrollably in the lobby and the meditation guru came up to comfort me. He knew what was going on because he talked to the woman who pulled me out of my birches class to check on me and me just saying, "I'm sad," and bawling.

The meditation guru sits with me. When he sits I cry even more—I am destroyed. He puts a hand on my knee and just sits.

"Are you going inpatient for a while?"

I cryingly nod yes.

And we just sit. Why? Because that's what fucking meditation gurus do.

---

The intake process is just you, bleeding your soul out, while you do a bunch of insurance paperwork..piss test..interview with the physician's assistant where he tries to determine what the fuck is wrong with you..stripping your clothes off..body search..they note all your tattoos..you put on Refuge sweatpants and they put all your real clothes and your stuff in a paper bag for the Tyler 2 health techs to sort out..being led upstairs by the physician's assistant, turned over to the Tyler 2 desk..getting a toothbrush and shampoo..skip skip skip..etcetera..etcetera..skip..etcetera..skip skip..then it's late at night and you're in the snack room, tricking out the vent on the microwave to melt the icing on your Pop-Tart and some sly girl with a baseball cap comes in, hiding her face, and then she's standing in your face, saying:

"Do you remember me? Do you remember me?"

And I do. It's Spots, the most interesting thing in Brattleboro (besides me).

"What are you doing here?" she asks.

"I'm here because they said I had suicidal and homicidal ideation."

"Oh!" she says, and she lays a hand on my chest. "I thought you worked here!!"

"No!"

"And I was like, fuck, this might mess up my customer relationship."

I'm quiet.

"Do you remember the time you came in and drank all night and you left me a twenty-dollar tip? Or were you too drunk to remember?"

"I..yes..of course..I was drunk but it's coming back to me. I remember we had a conversation and I thought I had found the only person worth talking to in Brattleboro."

"Well the worst part—no ego, but—you probably had," she whispers.

"I'm sure of it."

"Fuck, so you're here as a patient?!"

"There's one more thing. I wanted to make love to you, that night, because you were the most beautiful thing in Brattleboro. Did I say that before?"

"Yep, you said the same exact thing when you came in that night. I'm surprised you remember."

"I don't. I thought I just made that up just now."

"No you told me before."

"What did you say?"

"You'll have to find out," she says. "I wasn't sure if you really liked me or if you were just drunk."

"Well if I left you a twenty-dollar tip then I was trying to get your attention, so that means I really liked you."

"Uh huh."

"I was probably trying to make sure you didn't forget me."

"I already would have never forgotten you after the conversation we had..which I'm guessing you don't remember either."

"Hah. Not really. I just remember you were brilliant and a spark and I wanted to fuck you."

"What's a spark?"

"You know..someone who hasn't lost the light in their eyes..someone who's still alive while situated in the wasteland."

"And you..you still have the light in your eyes?" she asks me.

I say, "You tell me."

She says, "You have a bonfire."

And she turns and goes, leaving me in the Tyler 2 snack room, by myself, with a melted Pop-Tart and my loneliness.

---

Ok so Spots' name wasn't really Spots. It was some other name that we'll leave aside. See, Spots and I had art class together, and one day I drew this funky, punky-looking zebra with mohawk hair and (instead of stripes) I gave it these bold, unrealistic black spots and when [this exceptional specimen of a human being I call Spots] saw it, she loved it, and I gave it to her, and she hung it in her room, and from then on I called her Spots.

She gave me something in return: her personal copy of Girl, Interrupted which I read at the Refuge. Watching Girl, Interrupted the movie on my computer between visits to the Refuge became tradition for me. I don't just do something. I do every aspect of it, I study it, I master it, I go deeply into to—and I found it comforting, while making this series of visits to the Refuge, to immerse myself in psych ward culture.

And I'm so pretentious. Like I'm somehow proud that I read Girl, Interrupted while in a psych ward. I think that's cool—I do.

I do research on my disorders. I'm all meta about it. So I don't just have this straight idea of being in a psych ward—to me this is like a literary experience. I make up my own worlds. When I was getting my MRI, I wasn't getting an MRI. I had a whole other experience going on there that's a secret so I'm not going to explain it. But I'm not just living life—I'm playing a game. So what you think we're doing, from your perspective, is not what I think we're doing, from mine. To me this interaction is completely different from how anyone else would describe it, but I map my reality onto the shared reality with metaphors, so I can still participate in your world, when really my experience is that I'm in mine.

Isn't everyone doing that?

Are they? How would I know?

Those are just parts of my imagination I'm conversing with. Don't try to keep up. Just keep reading.

---

Just keep reading about eating steak with your hands at the Refuge. It's easier than trying to use a plastic fork with no knife. Because there's no silverware in a psych ward—lol—there's not even a plastic knife on a psych ward. So you have your two basic choices: 1) use the edge of your plastic spoon as a knife, which works pretty well, or 2) just pick the motherfucker up and eat it with your hands. The more times you've been in a psych ward, the more comfortable you become with choice #2..because after enough time spent in psych wards you start to realize there's a much larger problem to be solved (YOU'RE IN A PSYCH WARD) and that eating steak with your hands is completely minor compared to this larger problem.

But it's a transition, yes, the first time you give up with the plastic utensils and pick up a steak and eat it with your hands—you start thinking of yourself in a different way. And you stop giving a fuck what other people think about you in a way that may never go away once you leave the ward. It's kind of like soldiers who have trouble transitioning back to civilian culture after they've lived war. Once you've been to a psych ward, do you ever, really, truly give a fuck about normal culture ever again? I'm not sure I ever gave a fuck about it in the first place.

After you get out of the psych ward, you'll be in a restaurant. The person sitting next to you screams:

"There is a hair in my corn!"

And you look at them sideways like:

I've eaten steak with my fingers.

Hey, newbie—deal with it.

I don't see what's so gross about a hair in your food anyway. Don't you taste your lover's hair, don't you take her in your mouth?

But you know, hair isn't for everyone.

Some use the edge of the spoon for a knife.

Some eat steak with their hands.

You meet all kinds of people in the psych ward.

59

Like The 17 year old I met in Tyler 2—suicidal chick they were sending home. Her name was Olivia. She had been in hospitals for the last two or three years, starting with a suicide attempt. She couldn't get into the outpatient program she wanted because she had a suicide attempt within the past 30 days. Believe it or not outpatient and even inpatient programs for suicidal people have limits on the number of past suicide attempts and how recent they were. This girl, poor Olivia, she was too suicidal to go to any psychiatric program in America—she just wanted to kill herself too damn much and when people actually kill themselves in mental hospitals, it's very traumatic for everyone who works there and all the patients and also it's a big problem for the hospitals' insurance coverage. Yeah. So Olivia had to stop going to hospitals and go back home to live with her parents, which she was obviously nervous about. She was just waiting around at the Refuge to go home when her family was ready for her. Do you believe that shit? No mental hospitals would take her since she had too many recent suicide attempts!! This is the person who needs help the most and no one will take her because she's an insurance risk. Taking her as a patient is basically saying: you will kill yourself in our facility and it will fuck up our insurance so—sorry!—go kill yourself elsewhere.

Notebook entry:

seventeen-year-old girl with a skin condition..she was—if you can believe this—too suicidal for a psych ward

Or the young guy—Ross—who used to walk the halls of Tyler 2 imitating the catatonic body positioning of that young woman who had seizures and came in with police, handcuffed to a wheelchair. When she came in we were all asked to move into the TV room and they closed us in there to give her some privacy—you know, so we wouldn't make fun of her for being brought in by the cops. And we all wondered from the next room what kind of monster was being admitted that she was brought in handcuffed to a wheelchair. We didn't know if she was a boy or girl at the time and I think we were all pretty much thinking Hannibal Lecter was being admitted to the ward—which wasn't a scary thought, we would have been delighted to have Lecter with us. Turned out it wasn't Hannibal Lecter but this cute, smart, totally nonviolent girl named Liliana. Anyway Ross—who was there because his parents caught him eating mushrooms—he would walk around with his neck crooked and his hand held up like Liliana, even talking with mental health workers and claiming he had the same conditions and had taken the same seizure medicines as Liliana. Classic Munchausen—GTFO MF.

---

A more sympathetic character was Chad, who was one of the patients who was present in Tyler 2 every time I went that fall and winter—Chad will be a permanent resident in some psychiatric facility for the rest of his life. I don't know what was wrong with him, in terms of an illness, but he was one of my friends on the ward. I always took time to talk to Chad and be of use to him when I could. Mostly he needed the company. Any he got it. He was often on one-to-ones, which means one staff member to one patient—there was one staff member whose constant, 100% job was to pay attention to Chad and make sure he didn't hurt himself or anyone else. With Chad, either was possible. He didn't want to hurt anyone, he was just easily triggered—if something stressed him, he could go from laughing and jovial to repeatedly stabbing himself in the wrist (deeply) with a pen that somehow made its way onto the unit and that Chad had somehow stole. He was constantly masturbating in his room even though he was on one-to-ones—he didn't care who was watching. Poor guy..his doctor probably never explained to him that he wouldn't be able to cum on his antidepressant. And his one-to-one had to sit by Chad's open door watching him masturbate. I recall this one woman saying, "Maybe it's not gonna happen, Chad. Maybe you should give it a rest for now and try again later."

But Chad was a determined sort of dude.

A favorite activity for Chad was rapping in the middle of the residential hallway. He would stand there and do rapper hand movements and do his best to make up raps:

"I'm Chad and I'm bad. I'm even so bad I'm totally rad. You never heard a rapper who had my badness. In fact I'm known for my antics. Yo, Matt, he's a crazy cat. He might seem like a normal Jack. But underneath his skin he'll never let you win. Behind your back he'll prob'ly cut you with a razor blade."

"Hey!" says his one-to-one. "That's not cool!"

"It doesn't rhyme, either, I say. Chad, Chad, he's so bad, he'll take a patient and make 'em smile when they sad."

"Yeah!" Chad would say.

"Tyler 2, I don't mean to be rude, but we gotta do something about this food."

"Yeah! You're a rapper!"

"I heard back in the day the food was fun to eat. But that's before it got taken over by a consulting company. The staff, they do the best they can, but their hands are tied..by the man."

"That's it, Matthew let's be rappers together."

"We are rappers together, Chad, we're the dopest rappers in Tyler 2. They used to have Marshal..but now all they got is me and you!!!"

I slap Chad's hand.

"Hey! No touching!" says the one-to-one.

"Alright, Chad, keep rapping, I got to go talk—"

"To your bitches!" he yells.

"No, that's extremely rude. Don't say bitches."

"Ok, you gonna go get with your females," Chad says.

"That's still rude. They're young women. That is the preferred term."

"Oh, is that the preferred term?" Chad asks. "Because for me the preferred term is bitches."

I leave him there, standing in the middle of the hallway, and he goes back to rapping. His one-to-one works a Sudoku.

---

Then there was Arlo, who tried to kill himself by jumping off a highway overpass. But all the cars slowed down and he ended up just breaking his legs. Arlo ate five ice cream sandwiches every day when the unofficial quota for the ward was like two per delivery.

---

On the way down the hallway I come across Rainbow, the pink-haired med nurse who I fell in love with.

"Come here. I owe you meds."

"If it means I get to talk to you, Rainbow, I'll take cyanide."

"Don't say that—I'm gonna have to report that!"

"It's ok, Rainbow, we'll do it like Romeo and Juliet. You won't have to report shit."

She was safely cordoned from me by a half-height door. I had fantasies of hooking up with her and her being the stable side while I was the wild side of our relationship. A med nurse living with and supporting a psych patient..and me making her so happy.

Rainbow once said she hoped to see me around town sometime and this was fuel enough for my imagination to see us hooking up and living together, a med nurse and a graduate of the ward she worked on. I wondered if she was thinking the same thing. I would lick her pussy every day and fuck her until she came 12 times and her pussy would be throbbing for me each time she handed out a med cup to a psychiatric inpatient and she'd be running to get home to me and I'd be lying in her bed like Prince with a half-unbuttoned shirt and like furs everywhere and a real tiger. (That's what I was thinking anyway.)

She did, though, she did flirt with me my first day every time I came back to Tyler 2 after being out in the world a while. She said she knew I lived in Brattleboro and she kept hoping that she might run into me at In the Moment (record shop) or the Food Co-op or something. Me too, pink-haired med nurse, me too.

I was like, "Oh yeah, I shop there..In the Moment..uh huh..Food Co-op..yeah, yeah."

She says, "If you weren't my patient, we could do something together, like.."

"Oh yeah, I'd love to get together and do something with you. I think I know what you mean. I think I know what you mean. We could get together."

"Exactly," she says, "Get together."

"It's fun," I say, "when two adults find a private place where they can get together and enjoy each other's company."

"Alright. You're gonna get me in trouble."

Rainbow leans out of the med station window and looks both ways. She hands me my medicine.

"Now take this, before you get me fired."

I take my medicine, swallow it with a plastic cup of water, and throw away the tiny paper thimble the med nurse hands you your pills in.

"If you got fired, that would make you a bad, bad girl," I say.

"And what would you do about it."

"I'd pull down your pants and spank you till your butt was as pink as your hair."

"Seriously, you've got to get out of here. I'll see you for your ten o'clock meds."

I lean in and whisper, "Is your pussy wet?"

And Nurse Rainbow says, "Go," in a way that means she wants to be taken seriously.

And out of respect, I go. But I can't get that pink-haired freak out of my mind, and I wonder what I did so wrong in life that that's going to be the extent of my interaction with her—verbally crossing the patient/caretaker boundary—instead of actually being at Rainbow's apartment and actually spanking her white ass and actually making her butt cheeks turn the color of her hair and then turning her over and fucking her pussy so good and licking and biting and sucking every part of her body that her face turns the color of her hair. Damn, if I wasn't a mental patient me and Rainbow could be having so much fun.

---

Then there was Sadie. Sadie I met on the the couch, both writing in our journals in the group room waiting for evening meditation—there was electricity, we could both feel it, sitting in sock feet and pajamas, two of the more cogent residents of the ward.

We hardly spoke, but gave each other the space to be non-objects the way men and women rarely do. I viewed her, and it was clear she viewed me, as a healing person in a healing place—and neither of us was about to shatter that peace and protection by behaving with respect to the other as a sexual thing.

I didn't view Sadie as I view a sister—nothing like that. It's just that I could see that Sadie's mind was a deep pool, the kind of pool that must be approached slowly and with a certain ceremony. We sat for an hour and spoke nothing, and I loved it. Just to know someone else was reflecting at the level of journal writing was enough to be said between us.

And women aren't the only ones treated as objects—I bloomed in the safety, with Sadie and with others, that we couldn't touch each other. There is something so human and respectful about that, reminding those of us who have spent time in psych wards and other no-touch spaces that—hey, wait!—you can't just touch me. That there are rules, that I can set limits, about who touches me. That I don't belong to anyone.

I felt—I felt it in the air—that Sadie and I were respecting the brokenness of each other.

I'm an empath—I feel other people's feelings so deeply that I take them on. This is very dangerous..for me. Because I can't be happy when someone I love is hurting, distraught. And combined with a role I learned in childhood—please all the adults so they don't get mad at me—I am left, as an adult, with some just impossible relationship goals. I don't understand the boundary between you and me (as well as I could) and because of this I spend a lot more time than necessary feeling, experiencing other people's angst, when on my own I'm pretty much fine.

They say there is a thin line between genius and madness. But after 11 stays in five different psych hospitals, I can definitively say that there is not "a thin line between genius and madness." Madness does not imply genius—but where genius is found, madness often is too.

Check this out:

If there is such a thin line between genius and madness, why can't I choose which one I want to be?

---

I suppose I should tell you about my doctor. My first stay in Tyler 2 I had horrible Dr. Criminal who released me early (while I still had suicidal thoughts). During my release process, Spots said:

"Look, you're clinging to the bed. Look at your body language. You're not ready to go and you'll either kill yourself or you'll try to kill yourself and you'll be back in two days."

The releasing nurse also had a problem with me leaving, as I was bawling and sniffling and she said she wanted my doctor to talk to me again.

Dr. Criminal came back in.

"Are you suicidal?"

"I don't know."

"Do you have a specific plan?"

"I guess..no."

Dr. Criminal determined I was ok to go. Didn't even put me on an antidepressant. Initially I was discussing with another patient about who my psychiatrist was. She was incredulous.

"Dr. Criminal. Like a criminal..like one who breaks the law..and that's your psychiatrist?"

"Yeah, that's my psychiatrist. Dr. Criminal. And yes, that's his real name."

The head nurse, after speaking with me, thought I was unsafe and left and had the doctor come and do a third evaluation of me and he let me go, even though the head nurse was shaking her head the whole time. Dr. Criminal (who all the staff called "the old-school psychiatrist" even though he was the youngest one), treated a depressed, suicidal patient with two previous diagnoses of bipolar disorder, with no medicine, just a suggestion to go to an outpatient program. I'm mad about that. I wasn't at the time 'cause I wasn't all that aware of what was going on back then, but the more time I have to think about it, the madder I get. I walked out of that hospital and tried to kill myself. And after that, when he and I saw each other on the ward and hospital halls, we shared a special kind of look that not many people get to share: the maybe if you had believed the bipolar diagnosis, I wouldn't have attempted suicide look. We never said a word.

---

There was this guy Mark who was in the Refuge after going psychotic from some bad ecstasy. I was friendly to him at first, then he was in ALSA (the Adult Low Stimulation Area—basically a higher level of security—ward within a ward) and while he was in there he yelled constantly, banging on the ALSA door when I was staying in the room right by ALSA for my suicide attempt. He seemed ok before they put him in ALSA, then he flipped out and became Captain Caveman, then they let him out and he was always weird after that, like the kind of guy if you passed him on the street you would just hope he would keep walking..forever.

Then I was checking out and Mark was hovering over me while I was at the contraband closet collecting all my street stuff and he saw that I had an iPad charger in my bin.

"Say, man, can you loan me that?"

"What?"

"Your iPhone charger, mines's broke."

"I don't think this will work with your iPhone. It's for an iPad."

"That's not what I asked you, is it?"

The nurse I was with called for help down the hallway:

"Uh..Mark's ramping!"

"So is you going to loan me the shit or is you gonna puss out?"

I didn't answer. It was just me, the nurse, and this guy whose brain got fried by—whatever drug?—and he's standing over me. I put all my stuff in my bag and I was real ready to get out of there when Mark's facial expression: Jack-O-Lantern smile. He holds out his fist like an invitation to bump the rock and I put my fist out and this motherfucker punches my hand so hard it needed an ice pack.

"I see how it is," this wannabe thug says. "I'll see you around town."

"Ok," I say. "Yeah. We'll do that."

"Is he making fun of me?"

"Just don't say anything to him," the nurse tells me.

"I can't tell if this guy is making fun of me or not."

The nurse says, "He's not. Just go. Mark, go meet me by the med station."

So I went to my first group at Birches with an ice pack on my hand and a story to tell of how it got there. My social worker-led peer group asked me why I had an ice pack on and I told them some brain-fucked asshole punched me in the hand on my way out the door.

"He did the bump the rock thing and when it was his turn he punched me instead!"

That added mystique to me. These people had never been to Tyler 2. They were living in a peaceful house, watching TV every night with their only stipulation that if they drank they would be kicked out of the house. They weren't living in a place where somebody might punch you for any reason, ever.

On the last night of my Dr. Criminal hospitalization I wrote all these cards about it being like trying to sail a paper boat across the ocean—as in life: it's like trying to sail a paper boat across the ocean—and I put those cards all over the unit: on top of the TV, in the freezer, on the nurses' station desk, everywhere.

That was a cry for help.

Someone could have picked up on that..Spots did..did she show it to the nurses? I don't now. But someone distributing that message all over the ward on his last night should not have been allowed to go.

Brattleboro Refuge Discharge Summary (2)

Patient Admitted September 23, 2011—Discharged September 29, 2011

Identifying Data

This is a 33-year-old male with bipolar disorder NOS, alcohol dependence and stimulant abuse abuse admitted September 23, 2011 for depression, suicidal ideation and homicidal ideation.

Chief Complaint: "Depression."

History of Present Illness

The patient was recently discharged from the Refuge after completing alcohol detox. He has been depressed and irritable and states that he drank once since his last admission. When not drinking he has experienced mood lability and irritability. He describes a good response to Lamictal in the past and this was recently restarted. He does not believe that it is helping him yet but he reflects that he is not yet on the target dose. He describes homicidal ideation towards people who have hurt him in the past including his ex-boss, people who disrespect him in general and people who treat him lower than others. Specifically he reports significant anger towards his ex-boss who he believes fired him without cause. He denies any history of auditory or visual hallucinations. [On the entrance interview one time, into the Refuge, they asked about homicidal and suicidal thoughts and I had both, I wanted to kill my ex-boss and I wanted to kill myself. Do you have a plan for killing your boss? Yeah, I would stalk him while his pudgy butt was hiking and fucking shoot 'im in the head!! Do you own a gun? No. Then how are you planning on shooting him? I would buy a gun. Obviously!! And your plans for killing yourself? I would do it in a bathtub. Do what in a bathtub. Cut myself, deeply. And then there would be no more me, and no more problems, and my family wouldn't have to deal with me. I'm sure your family would be very sad if you killed yourself. I'm sure that some of them would be, I say. And I'm sure that some of them would not.]

Course of Hospitalization

The patient was admitted to Tyler 2 on September 23, 2011 [Tyler 1, where I was before, is mainly a detox unit—Tyler 2, where I was admitted this time, is mainly a psychiatric unit.] Urine drug screen done on admission was negative. Screening physical exam was unremarkable. Treatment during his hospital stay consisted of medication management and group therapy [There was no group therapy—Tyler 2 has excellent classes on medication, coping skills, art classes, yoga, meditation, but I never did any group therapy in Tyler 2.] Medication changes made during his stay included: increasing his Lamictal dose gradually to a final dose of 100 mg at bedtime and starting hydroxyzine for sleep. He tolerated these medication changes without any adverse events. Over the course of his hospital stay he reported a gradual improvement in his mood. He was without any reported or observed psychotic or manic symptoms throughout the duration of his hospital stay. On the day of discharge he denied suicidal ideation, homicidal ideation and he convincingly contracted for safety. At the time of discharge he did report significant ambivalence and anxiety. However after careful reflection and conversation with several staff members he concluded that discharge was a safe and appropriate decision and that although the thought made him anxious he realized postponing facing this would not help.

Final Diagnoses

Bipolar Disorder NOS. Alcohol Dependence. Stimulant Abuse. Kidney Stones. Social Isolation. Financial Problems.

GAF on Discharge: 50.

Condition on Discharge: Stable and improved.

Prognosis: Good [Well, I guess they fucked that one up because the next time I came back it was in an ambulance after a suicide attempt].

60

But they did release me to the Birches program. Sadie was there and we exchange numbers and hug, we say, "It's good to see you." She says she'll drive us to a meeting sometime. I hope Sadie is sober today. As I write this, after some years have passed, I hope that woman did better than I did and has been sober all this time. I know it's hard—if it wasn't hard I wouldn't fail at it so often. I just want to believe that that woman's life turned out fine, and that she's arranging the chairs or that she's tonight's speaker at a speaker meeting somewhere. I guess I just liked her. I know I'm getting all teary, but seeing Sadie in Birches on my first day was a wonderful sight, wonderful eye contact—my misplaced hope for myself is on some woman named Sadie that I hardly knew..that's fucked up.

I follow my same pattern from Tyler 2 and before—of my entire life—of getting mad at assholes. This dudebro guy in small group who liked to brag about physical violence during his share time, the mushroom-addled schizo dude who thought all his doctors were crazy and that he was connecting with beings from another universe.

And I started seeing Sadie around town, on the street and at AA meetings, and I desperately wanted to, but I was in no place to fall in love.

---

I'm grocery shopping one day—after the events of this book—and it's me and my mom. And I'm paying, this whole mega shopping expedition is courtesy of my food stamps. I'm pushing the cart, and I see some carbonated blood orange juice in glass bottles—beautiful. I grab a couple of those and a couple of the grapefruit, too. I put them in the cart, and as I look up, my mom has gone ahead—she didn't know that I had stopped—and I saw her watching me pick out juice, and I saw the expression on her face..and..it was..an expression of pure disgust.

It said: Who do you think you are to pick those out? What do you think you're doing? Like I don't even have a right to put something in a grocery cart without her permission. The message is total disapproval.

Like her telling me when I was a kid, about my writing. What she said was: Don't show this to anyone or else they'll think I raised you wrong. She thinks that my creativity (which is sometimes viewed as oddity) reflects poorly on her. Sometimes I think we had a disapproving parent and an approving one, but other times I wonder if it's more realistic to say we had two parents uninterested disapproving unloving, who don't show love, don't do love..they don't admire us, hug us, love us.

---

And I'm in this morning social group in Birches, at the Refuge, and someone is talking about hugs and I simply say:

"My parents didn't hug me. I mean occasionally they hugged us, but they never showed their love through touch, with a hug, you know, just the touch of a hug."

This fat-bellied bodybuilder wrestler wannabe dudebro says:

"I'm sure your parents love you."

He's all dismissive and he starts to go on talking about his bodybuilding schedule, which in my mind is irrelevant to this group therapy session, so I don't feel bad interrupting him.

"But what I'm telling you..is that my mom..never hugs me."

"I was talking," this bodybuilder says.

"Well I'm talking now. I don't think you understand what I'm saying. My mom never hugs me."

"I'm sure she loves you, dude, don't worry about it."

The social worker jumps in:

"I think what he's trying to say, Frank, is—does your mom hug you?"

"Yeah, we hug all the time. We's real tight."

"What Matthew is telling you is that his mom doesn't show love through touch."

"You wanna be touched more by your mom, dude? Where do you want her to touch you?"

"Frank, don't mess with me. This is group therapy, not a place for you to tell us how many reps you do to work out your glutes or whatever. This is an emotional discussion. The fact that you just brought up sexual abuse says more about you than it does about me. If you want to tell us where your mom touched you, ok, but share about yourself, don't respond to my share, you got that?"

"What did you say to me?"

"I said: 'You got that?' "

Frank is sitting next to me in this group. He's huge, everything about him worked out except his flabby belly which I guess is from him losing weight. He turns his body to me and starts getting close to me, trying to intimidate me.

I say: "Frank. Sit back down in your chair. This is a group therapy session in a mental hospital. It's not a wrestling ring. You're getting all hard and aggressive like you're gonna fight me or something? Yeah? You're gonna throw a punch in a mental hospital? If you hit me, I'll just sit here and take it, I won't do a thing and about five minutes later, some nurses who can bench a lot more than your faggot ass are gonna give you a shot of Benadryl and carry your limp dick to a locked ward with a padded room and you'll share that ward with a guy name Mike whose brain got fucked up on some bad ecstasy and if you think I'm crazy..or if you think you're strong..well, you haven't met Mike."

"Are you threatening me?"

"No, I'm just telling you what happens when you punch someone in a mental hospital. So sit your faggot ass down and don't ever get in my face again. I'm in this group to heal. I'm not gonna let you or anyone else get in the way of that. This is a group therapy session. I don't know if you know how dumb you are, but if you just wanna come in here and talk about your workout routine and how all women are 'bitches' and act like you're some kind of gangsta in Brattleboro Vermont, then fuckin' leave. Just fuckin' leave."

"Mrs. Scalliano, you're gonna let him talk to me like that?"

Mrs. Scalliano, the social worker says, "Everyone gets their turn to speak here."

Frank jumps up and stands right in front of his chair. He's like flexing his muscles and tightening his fists and doing all this faggoty-ass bodybuilder stuff. He starts hitting the palm of one hand with the fist of his other.

I laugh.

"Why are you laughing, punk?"

"Because it's a group therapy session, and you're trying to start a fight—like a fucking fist fight. That's all you ever talk about in here, is how you kicked this guy's ass and you kicked two guys' asses at the same time. That's your solution out there, that's your solution in here. I just think you're funny."

"It's not gonna be funny when I beat your motherfucking face in."

The social worker says, "Frank, leave the room."

"Oh, no, go ahead," I'm laughing, "beat my motherfucking face in! I welcome it!"

"You're sick, you know that?—Like truly fucking sick."

I'm cracking up so much I can hardly breathe.

"I'm in..a mental hospital..of course I'm fucking sick!!"

Frank fake punches me, suckering, pulling the fist.

Mrs. Scalliano stands up and puts her hands on Frank's shoulders.

He instantly, reflexively, turns to her. It looks like he's gonna hit her.

Kelli, this little borderline girl that I desperately want to fuck, stands up. She looks like she's been in a fight or two.

Mrs. Scalliano helps Frank out of the room. All the while, Frank acts like she's the only thing holding him back from kicking everyone in the room's ass. I look around. Nobody looks scared. Melissa rolls her eyes. Courtney says:

"I'm glad he's leaving. I'm tired of that punk calling women 'bitches.' "

Frank breaks free of Mrs Scalliano and comes back into the room and he's like:

"ALL WOMEN ARE BITCHES. NOBODY'D WANT TO FUCK YOU, YOU ALCOHOLIC WHORE!!"

Now Mrs Scalliano is yelling down the hall: "Need help!"

The program nurse says, "You want me to call it?"

Our social worker says, "Yes."

Frank is intimidating Courtney now and I'm finding myself surprisingly calm. My pulse is normal. My anxiety is low. Maybe all this time spent in Tyler 2 is paying off.

The PA shouts: "Code gray, Birches short hallway!! Code gray, Birches short hallway!!"

Frank is up in Courtney's face like: "I'LL CALL YOU A BITCH ANYTIME I WANT!"

And I'm like, "No you won't."

"Wha'd you say, you fucking psychopath?"

"Frank you can call me a psychopath all you want—actually I enjoy it. But if you insult anyone else in this room, if you call women..that word..again—"

"Then what you fucking psycho?"

"If you actually thought I was a psycho you wouldn't provoke me."

"Yes I would, because your Hannibal Lecter bullshit is no match for my guns."

He holds up his arms like Popeye and flexes his biceps.

"Actually, Hannibal Lecter bullshit beats your guns any day."

"Oh yeah, and how is that, if I kick your ass?"

"Because, you flabby-belly fucktard—oh, don't you think we all notice that? Don't you think we all don't know that you used to be Fat Frank, and all your bodybuilding bullshit is just your way to distance yourself from the days when you were just a fat motherfucker that girls didn't want to fuck and guys didn't want as part of their crew. You can build up those guns pretty quickly, can't ya? But that extra skin on your belly, from when you were fat—that's gonna take a long time to go away, I'm talking years. And for the next two years, when you look at that belly fat, when you feel it between your fingers, you're gonna think about me, in this moment, and how Courtney, and Kelli, and all those other girls you wanna fuck—including your ex-wife—will never fuck a fat-ass aggro motherfucker like you who calls women bitches and you're gonna wish you threw a punch, got me somehow, some way, but you never will."

He steps right to me.

"You'll never lay a finger on me, and when I get out of this hospital, I'll spend maybe ten minutes thinking about you, ten years from now, when I write my memoirs. But your ass is gonna spend the rest of your life being needlessly pissed off at me for telling you off like a bitch in front of all these girls I see you staring at every day. I'm daring you, you fucking meathead asshole, lay one finger on me. But you can't. You're not a tough guy. You're just a fatty little kid with no friends who doesn't get laid because you're fucking disgusting—physically, mentally, every other way. Look at that fatty belly, fucking loose skin. You've got more camel toe right there than any of the fat bitches you ever talked shit about in small group."

"Brattleboro's a small town," this guy says. "I look forward to seeing you on the outside."

"Yeah you and everybody else."

"I'm serious, I will fuck you up."

"Good luck with that, 'cause you'll be in jail, faggot."

"Why is it ok for him to call people 'faggot' when you all won't let me call bitches 'bitches?' " Frank whines.

But before anyone could answer his question two super-huge Whopper-style dudes came in, popped a needle in Frank's neck, then just stood there holding him by the arms for about the three seconds it took Frank's eyes to roll back in his head and his whole body to go limp and he was still awake, still talking about bitches and how all his earthly problems stemmed from evil things they had done to him, right back to his mom, but now he was doing it real quietly and bubbles were coming out of his mouth. The nurses put Frank in a wheelchair and took him away, I assume to Tyler 2, where he could see what the definition of crazy really is, and find out that he fit right in.

61

It saved me a little to see Sadie every day in Birches. Even the colors she wore. Like this burnt orange turtleneck for fall. And she was such a peaceful person. Sadie was number one on my list of people who would never hurt me physically or psychologically, and you have to love a person for that.

She seemed well and solid. But you can't see these things from the outside. She was prob'ly freaking out inside.

I know I was.

Maybe I wanted attention. Maybe I needed more attention than I was getting. I was just going on gut. For me that meant freaking out wanting to bite through my own tongue to make myself bleed—that was how the idea occurred to me. I went to the birches program hallway but skipped classes to lie on a pale blue couch at the end of a line of staff offices (including Dr. Criminal) and I laid myself down on that couch and attempted to bite through my own tongue. Tongues are very strong, it turns out, but I was able to give myself a great deal of pain and aggravate my TMJ to the point that it still bothers me today, five years later.

Then I pulled a pushpin off the message board at Birches and I took it into the bathroom with me. I thought: if I poke myself in the arm enough times, along vein lines, I can kill myself with this little pushpin. I was so excited that they had forgotten to remove all the deadly weapons from the area. I mean I was in a different kind of place. Birches was a place for people who were pretty much stable, to learn some techniques about how to deal with your life. I wasn't sure I wanted to live mine.

When I came out of the bathroom, Lisa, the counselor, was there and she looked at my face and she looked at the pushpin and she said I think you should give me that and I did and she said you're looking worse than the last time I saw you and I said I am worse and she said do you want to talk about it and I said:

"No, I don't want to take up any of your time."

She said: "I have time."

And she let the group she was in go on to their next meeting and she sat with me in soft chairs right outside the main room of Birches that due to its windows everyone called "the fishbowl."

Every question Lisa asked me I just sobbed.

I was unable to make myself speak.

I just looked at her face and her kindness made me so open to everything in the world that I hurt more than everything in the world. If you're bipolar, you're probably like Yes, he gets it! about that last sentence and if you're not, you're probably like What the fuck is this dude talking about? Isn't he overreacting?

I'm bipolar. Of course I'm overreacting.

Lisa took me to my social worker. The three of us sat in my social worker's office and the two of them talked.

"He had this," Lisa said, cupping the pushpin in her hand.

"What's he going to do with that?" Mrs Scalliano said.

"I think he's suicidal," Lisa said.

My social worker came to me and it was like was interrogating me, where she should have been dealing with an emotional being. She said:

"Are you suicidal?"

I just shook my head and cried and bowed my head.

"Why don't you take your medicine? What's your PRN"

"Clonidine?"

"Yes, that's seemed to help you in the past."

"Clonidine doesn't do a single goddamn thing for me. It's just that time passes and you think the pill did something."

"So you just need some time to pass."

"If I meditated, that might help."

"I think he needs to go back inpatient," Lisa said.

"I'm his social worker. We're handling things here just fine."

"That's why he's hiding out in the bathroom considering self-harm with this!"

"How could he possibly hurt himself with that?" my social worker laughs.

"Do you want me to show you?" I asked.

"See," Lisa said. "I don't think he's safe enough for Birches."

"Well, I'm sorry, but I do. We'll release him back to Tyler 2 if we think it's necessary."

Lisa threw up her hands. She knelt to me.

"Come find me if you need me. Ok? You know where my office is. You have my card. Promise me."

"I will, I promise."

Then Lisa left the room and my social worker was like giving me a hard time for involving someone else from the Refuge in a supervisory manner and I didn't have time for her ego bruises so I just walked out in the middle of her talking.

Lisa had insisted that I was in trouble, and I was.

There were more pins on that board.

I was going to impress us all with the amazing damage I was going to do to my arms, wrist, and neck with one of those tiny little pins. That could be a whole lot of puncture wounds and a whole lot of blood. And in my wrist, in my neck, it could be as deadly as a knife.

When I was on that couch, I bit all the way through my own tongue trying to make myself bleed enough to be admitted to the hospital. I had fantasies of being taken care of. I knew I needed to be in the hospital and wanted to do whatever I could to make others see that. My suicide attempt was the same thing—begging for help—trying to demonstrate to others how severe my situation was. To make them pay attention to me.

But I also wanted to die.

Like when I sent my suicide "threat" (notification) email to my family, and was thinking of cutting myself in the bathtub, I wasn't trying to get into the hospital, I was looking for a way out of my life..a way to end my life..a way for this to be the end—of suffering, yes.

Wanting to punch myself in the arm with a pushpin, meditating with my iPad timer and going crazy biting through my tongue on the couch at Birches, seeing Lisa and she took me to my social worker and they argued, each, for how sick or well I was at that particular moment. Lisa was right, though, even though my pushpin idea was silly from a certain point of view, the key element, which Lisa got and my social worker didn't, was that I was ready and willing to hurt myself at any moment—exact reason unknown.

But I could do it with a pushpin—I could do major damage—I could do it with a pair of scissors or a shoestring or a plastic liner from a trash can. Remember cutting off the wart. I had other late-night excursions in the bathrooms of our family..like the night I first shaved my head in the tenth grade with nothing but a pair of scissors and a disposable razor..no clippers. Both nights were just a lot of night and a lot of quiet, locked in there, with a lot of clock to think about my life and (in the case of the wart) all the female attention I wasn't getting because of that wart—overcoming that was worth a lot of pain right there. See, the pain was not going to be a problem. I could have killed myself with a stapler or a piece of dental floss.

We had status reports at the end of the day in Birches. Everyone else was putting 4s and 5s on a scale of 1 to 5 of how safe you were, and I'm putting 1s and 2s. My answers to questions on the reports disturbed the program nurse who led the end-of-day class and she often asked me to stay after to talk about my safety

"Right here the question was, 'Name one thing you learned in the DBT class with Nathan Jennings.' "

"Right," I said.

"And your answer is, "If you want to waste your life, then listen to what other people say."

"Asterisk," I said.

"What?"

"There's more on the other side, an expansion of the initial text connected from one place to another on the leaf of paper by the sign of a star."

She turns over the paper and reads what I have written very quietly, under her breath:

"I am sorry I was ever born. I am sorry I was ever born. I am sorry I was ever born. I am sorry I was ever born. My parents did not know me then nor do they know me now. It's unfortunate (for them) when people don't understand me in conversation. I am capable of anything because I am not held back by anything. People have no idea what's about to happen. What does that mean?"

" 'People have no idea what's about to happen?' Well, it's true: people, in general, have no idea what's about to happen."

"Do you know what's about to happen?"

"I'm in the dark as much as you. But you never know when someone might be in small group and they might have their larynx ripped out."

"By who?"

"By any type of animal that rips out larynxes, I guess."

"What does this mean?"

The program nurse points to the covering I have applied to the entire form, front and back, in tiny writing—my Birches daily summary sheets were always the best.

"I can't even tell what it says, it's so small."

In a bored, protective voice I say: "You can't imagine it away..and you can't imagine it there, either."

The program nurse leans back and looks at me, trying to figure me out.

"That's what this says?"

I nod, a tear lingering.

"You must have written it two-thousand times."

"It was worth it," I say, and get up. "I'm just going to the water fountain. Don't worry, I'll be back in a minute and we can discuss my safety."

---

My social worker and her multi-PhD counseling intern spoke to me about my daily summary sheet from the day before.

Her PhD intern said, "This writing is so small I can barely read it, and I've seen your handwriting, and it is small, but it's never been this small before."

"There's so much of it. How could you have done this all in one day?"

"Well I skipped all my classes so I had plenty of time."

"This is so small I can't read some of it."

"Do you think you were manic when you wrote it?"

I'm quiet.

"Do you think you're manic now?"

"Actually," I say, "I don't think I know what that word means."

They gave my summary sheet to the program psychiatrist, Dr. Le, and she called me in to talk about it.

"This is a very unusual check-in sheet."

"I haven't seen as many of them as you have but I suspect that's true."

"Are you manic?"

"You know what I figured out recently?"

"What?" she says.

"I figured out that I'm not a psychiatrist. You know, I've done my own reading so I think I know what I'm talking about, but I don't. I can't diagnose myself so from now on I'm just going to live my life and let you all handle the diagnoses and such."

"Do you think you're safe off the ward?"

"Yes, I am able to perform all normal functions without help."

"Are you suicidal."

"No, not specifically. But I am having some meaning of life issues."

"There's someone I'd like you to talk to."

"Ok. Who is it?"

"The director of the Birches program. His name is Dave. I just want you two to chat, ok? Are you amenable to that?"

"Sure."

"Great. I'll see you later."

62

"Dave"—David Something with a very long German name met with me that day at 11 o'clock. His office was filled with plants. This is how our conversation went.

"Hello."

"Hello."

"Tina asked that we talk a bit. Is that ok with you?"

"It's fine. You have a beautiful office. I love all the plants."

"Thank you."

"Did you bring them in all at once or collect them gradually."

"Ahh..gradually. Actually I just started with one plant and then one of my colleagues assumed that meant I liked plants especially and he brought me another, and this action repeated itself until you see the jungle I have the privilege of taking care of now."

I laugh.

"It is a jungle."

"So why do you think Tina and I wanted to speak?"

"I think she thinks I'm suicidal and she wants to cover her ass by having the program director talk to me."

"Actually I wanted to speak to you anyway. I like to have a brief conversation with all of our clients who start the program and then talk to them a little later to see how things are going. But yes, Tina did specifically mention you to me and she is worried about suicidality."

"Well I don't know what to tell you. The most helpful thing I can say is I don't specifically want to die—which is what I understand suicide is—but I do want out of my current life as I see no way forward in it so I do I have suicidal thoughts even though I don't think of myself as suicidal. I'm not sure I'm organized enough to actually kill myself."

Dave laughed.

"You know? I'm so confused about how I feel it's like jumping off a merry-go-round—my chances of completing anything with much intention seem fairly small to me at the moment."

"You're very disarming. That's what Tina said about you."

"Isn't that what we try to do in relationships? Disarm the other person, friend or foe, so that we can intellectually/emotionally/physically/spiritually have our way with them?"

"What would it mean to spiritually have your way with someone?"

"You might want to inspire them."

"So you would disarm them first so that they would be pliable to your inspiration?"

"Yes."

"Do you find it easy to disarm the staff here?"

"Yes. Except for you."

"You don't have to say that."

"I'm not. You're on point. I would never want to disarm you."

"Wouldn't want to, couldn't, or are you just disarming me with that remark?"

"I don't think that's how it works. For me, at least, there aren't people I can disarm and people I can't. There are people I can disarm and people I wouldn't want to."

"And the ones in this latter category. They are.."

"People I like."

"Do you like many people?"

"No."

"How many would you say?"

"Five."

"I think you're doing pretty good," Dave smiles.

"Yeah, the world is a lonely place."

"Is it, for you?"

"Yes. Isn't it for you?" I ask.

"Yes I suppose it is," Dave says. "Most of the time."

"What's your purpose in life?" I say.

"Helping people who need help," he says. "And you?"

"I don't know. I don't seem to have much use to this world."

"But what use do you have to you?"

"Is that the way you're supposed to think about it?"

"It's one option."

"I'll have to get back to you on that one."

"Ok. Dr. Le says you're a writer."

"Yes, I'm a failed novelist."

"Why failed?"

"Because I want to hit my head against that wall until there's a purple spot on my face the size of a basketball."

"That's what I want to help you with."

"Yeah?"

"Yeah. You've been diagnosed a few times—by a few different psychiatrists in different clinical settings—as having bipolar disorder. Do you think this is accurate?"

"How would I know?"

"I'm led to believe you're well read on all the common psychiatric diagnoses. You have your own copy of the DSM—is that true?"

"I have a stolen PDF."

"And do you think bipolar is the correct diagnosis?"

I look this guy straight in the eye.

"Yes. The diagnosis fits like a glove. And I don't see any other diagnoses that fit any better."

"And you like cocaine?"

"What's not to like?"

"I agree," says "Dave" the program director of Birches.

I look at him and he smiles.

"Aren't you afraid I'll tell everyone the director of Birches has done coke?"

"No," he says.

"Fuck," I say. "Which is it? You're not afraid I'll tell or you're not afraid of anyone finding out?"

"I'm not afraid of either. This whole conversation you've indicated no desire to hurt me. I don't believe you will suddenly start being someone who is out to get to me. And I don't give a fuck if anyone knows I've used cocaine."

"Sucks to be so easily read."

"Not when what is being read is such a complimentary fact."

"What fact is that exactly."

"Your kindness."

I start to cry.

"Why did you cover your daily summary report with tiny writing that says that you can't imagine it away nor can you imagine it there?"

"I'm trying to communicate with them in language they'll understand!!"

"I'm sorry you don't find our staff very smart."

"Dr. Le is. But my social worker..she's so basic. It's hard to get a good evaluation from someone who's far less intelligent than you. You know what I mean?"

"Yes, unfortunately, I do."

"From personal experience?"

"I think you know the answer to that question is yes."

"You know, this is simultaneously one of the most depressing and comforting conversations I've ever been in, so I'd like to congratulate you for that, but I have to go now. I have to deal with some petty business—the mail—applying for Social Security—all this junk my social worker wants me to do over lunch. Will you forgive me if I leave now?"

Dave holds out his hand.

"It was a pleasure talking with you."

"With you, too," I say, and I leave his jungle of an office, closing the door behind me.

---

My social worker did want me to start my Social Security application at lunch, but I had more important things to do. I went by the post office and picked up a box of copies of my own book, Things Said in Dreams, that I had made for myself on some website. I had said I was going to publish a book so—fuck, there, boom!—it was published.

I also looked for my next unemployment check—but it wasn't there.

I took my book to local book stores to try to get them to carry it. Of course none of them would. For all the buy local rhetoric that's so fashionable these days, no one was willing to put a book by a local author on their shelf. Of course they had whole shelves for local authors, but after one glance at the opening page of my book they definitely weren't going to carry it. Their local authors shelves were for Vermont housewives writing novels about apple pie—shit like that.

On the way back to the Refuge I saw the Birches program director and as we passed each other, crossing the same street in opposite directions, I could see in his eyes a genuine look of appreciation for our conversation earlier, and I gave him the same look, and it made me feel like a human being for the first time in a while.

63

Killing yourself is a funny thing.

Well, it's not funny. If you're unsuccessful, and you live, no one in your family will understand you for the rest of your life and it will will mar your family history forever. That's a best-case scenario.

If you're successful, and you die, you will destroy some part of everyone who was close to you, forever, people will end up being mad at you instead of sad for you—they had their selfish reasons for wanting you around.

Plus, if you're like me—and like a lot of people—the final act of suicide is an impulsive one. Some people plan for months, yes, or years—but for me I was just walking innocently down a hallway of a psych hospital when I realized I had all my prescription medicine in the pockets of my cargo pants. I walked past the receptionist. I sat in the waiting room. I knew I had prescription sleeping pills with me and I felt compelled to kill myself.

Nothing was going my way. I had lost my job and so was about to be homeless in the winter in Vermont. Plus the humiliation of losing your apartment, which had happened to me once before in Los Angeles—it's just not how your life is supposed to go. So I sat in the waiting room of the Brattleboro Refuge, knowing what I should do: hand over all my pills to the receptionist and say, "I'm not safe with these right now. Will you please take them for me before I kill myself."

Instead I walked out the main double doors, said goodnight to the woman behind the desk, took a whole bottle of pills without water and then handed the bottle to the security guard and suggested he call an ambulance.

So, I mean, no, suicide isn't funny. But there's an element of chance that permeates all of life—and this element of chance comes into play with suicide as well. If I had more money in my bank account and could afford to pay my rent, I might have been just depressed, but I might not have been as suicidal, because I would know that each night after my classes at the Refuge, I was going to have a home to go to, where I could at least have the dignity to sleep in a bed and bathe, shower, shit in a civilized way.

And the mind itself is a maze of elements of chance..there's no telling, with someone like me, what kind of chemical tide occurring in my brain will push me to elation..or will push me to despair. With bipolar, often there's no external reason we feel the way we do. The best way to explain it is to say that our emotions are like the weather—there's no reason it rains, it just does—there's no reason for a beautiful day, they just happen sometimes.

Bipolar people seem irrational to neurotypicals—with good reason. People with normal brain chemistry don't feel sad for no reason. They think there must be some iron-clad, logical reason for killing yourself, but that's not the case. Something like 90% of suicides are carried out by people with a major mental illness (bipolar disorder, major depression, or schizophrenia). Yes, stockbrokers sometimes jump out of buildings when they lose all their money, but most of the people who kill themselves have mental illness.

One of my Vermont psychiatrists, when I told him I liked to write, brought up Ernest Hemingway and said, "Matthew, as a person with bipolar disorder, you can't afford to drink. Alcohol is not only a depressant, but as I'm sure you know it's a disinhibitory agent. Think of Ernest Hemingway. If he hadn't been drinking, do you think he would have killed himself?"

"Maybe not."

"Maybe not," Dr. Sbarro said. "Why risk it? One out of five people with bipolar disorder successfully kills themself. For the general population it's one out of a hundred. You need all the inhibitions you can get, and that means no alcohol, no drugs, get regular sleep, and don't get angry—anger is a killer for bipolars, trust me, I see ten people a week with your condition, and you need to do everything you can to live a calm, measured life."

Dr. Sbarro trailed off to me—well, I stopped listening. I was thinking about Hemingway. What if when Hemingway put that shotgun in his mouth, he missed, chipped a tooth, had to go get an emergency crown and forgot to kill himself. I'm just saying: there's a tragic element of chance to all this. Or if your person is unsuccessful at suicide, maybe that element of chance isn't only tragic, but also glorious in the worst possible way.

I left that small group that night feeling so low, seeing only dead ends, knowing I shouldn't drink but not knowing how else to console myself. And I wasn't drunk—I had stopped buying wine, stopped going to bars. Sobriety was a requirement of Starting Now, and I was giving it a try.

But when I stopped drinking, things got worse. After a few days sober, I get a little bump, physically—I feel better for a second. And when I'm sober my body feels better, no doubt. But there's a reason I've been drinking all these years—past the early days of experimenting with and enjoying feeling tipsy—alcohol calms my mind.

And I have a very busy mind.

It's too busy for it's own good, actually—ask anyone with bipolar disorder. I remember the first time a psychiatrist asked me if I had racing thoughts. I said I didn't know what racing thoughts were. I didn't—because mine are always racing. You mean there's another way than chaos brain? Yes, they told me, but to this day, even on lithium, that's just how my mind is—I overthink things to a paralyzing level. I'd heard horror stories of people turning into zombies on lithium, being unable to create. Not me. The therapeutic level for me is twelve-hundred milligrams a day and that shit doesn't slow me down one bit.

Alcohol, however, does slow my brain down, and it's a magical substance for me. It frees me from the burden of too much thought. I really can't socialize with normal people unless I'm drinking, and no, it's not because sober me is too afraid of social contact without alcohol to bolster my courage, as AA's brilliant theory goes. It's because people like me better when I'm toned down a little, when I'm not as sharp, when my thoughts are slow enough that we can tolerate each other.

Also, alcohol helps me sleep. I remember times, in my early twenties, before I really started drinking, when I would wake up for weeks in a row at 1 or 2am with my girlfriend lying next to me, and the only thing I could think to do was quietly go to work and move some pointless project forward—but it gave me a sense of loyalty and it gave me something to do on those sleepless nights.

When I stop drinking, I stop sleeping, I'm even less inhibited in some ways, I am completely out of control socially—a general terror.

But when I made my suicide attempt, I was completely sober, completely clean off drugs. That was part of the problem. When I'm drunk or using and I get depressed, I drink or use more and it gets me through it. When I'm clean and sober and I get depressed, I look for ways to kill myself. Drinking and using was a way to not kill myself—and I'm glad I had that cushion for as long as I did.

I lied down on a picnic table and looked up at the stars and thought about those sleeping pills and then I thought: Maybe tonight is the night.

Maybe I'm ready to let go to my present—my future is empty. Better to die here in a place that I like than die freezing as a homeless person somewhere in the woods. And maybe they would save me. And maybe they would help me this time, realize I had something really fucked up about me and not just send me out in the world like Dr. Criminal.

I knew I should have handed my sleeping pills over to the receptionist because of what I was about to do, but I didn't do it. I sat right next to her in the waiting room, borrowed her phone, but I didn't know who to call. My Brattleboro Refuge emergency card had a list of numbers on it, and the first one was the Brattleboro Refuge, which is right where I was sitting, and I still couldn't ask for help from them.

It was embarrassing.

I mean admitting to someone that you're about to kill yourself unless they help you..that's a little weird. I had such a strong impulse to take those pills—and a slightly weaker one to ask for help.

So I took the pills.

I sat on a picnic table and I took the pills.

I took one, dry swallowing it. I knew one would have no effect on me. Then I took two. I knew two would put me to sleep in 20 to 30 minutes. Then I took three, then four, and I knew that there was a threshold here where if I took enough, I wouldn't wake up. So I kept taking, and taking, and I took until I thought I was across that threshold. Dry swallowing them became easier and easier, as my intention strengthened. I mean if you have trouble dry swallowing sleeping pills when you're trying to kill yourself, you've got problems. Are you trying to kill yourself or what?? I took enough that I was sure I would die without a trip to the emergency room then I tossed the rest of the bottle in the grass.

In fact I hadn't made up my mind about whether those pills would kill me but I was prepared to die if that's what happened. I just dried up, came to the end, felt so alone, so cold, so empty. I rolled the dice, thinking this was a way to get the attention I needed (after not being taken seriously by my last psychiatrist on my last visit to the Refuge). Then I got off the picnic table and walked up to the security guard. I handed him the empty bottle and said, "You might want to call 911."

I started walking away from him while he called 911. He came after me and had me sit on a bench by the front entrance and wait and while I sat there I wondered if I would die.

64

There it is, the ugly truth. My suicide attempt wasn't really a suicide attempt. It was a cry for help. And I'm worried people in my family who read this will take me less seriously now that they know. Because I do have problems. And they need attention. And I could have died, even though I didn't want to, I was that close.

In my suicide attempt I didn't want to die. I wanted to get back into the hospital, because I knew I needed more and better treatment. So I took a risk. I took some pills that could have killed me—but not too many. Just enough to have my attempt taken seriously and get me admitted back into the Refuge. I could have messed up and taken too many pills and died. But it was worth it..to have the chance that I would get into the hospital and have a serious psychiatrist treat my bipolar.

Someone like me can't just walk up to the admitting window at the Brattleboro Refuge and say, "Hey, I'm suicidal, please admit me." They would admit me, but they wouldn't take me seriously. I needed them to take me seriously. That's the problem with looking like you're ok on the outside, being well spoken, being intelligent: you don't fit the picture of someone who is in extreme distress, sometimes not even to trained psychiatrists, even after they've interviewed you extensively.

But I got what I wanted. A three-week stay in a mental hospital, with a good doctor this time, and someone prescribing medication for my bipolar disorder.

One thing I think is telling about this whole situation which I haven't explicitly mentioned yet, is this: when I went out, I didn't tell any of my family or friends. I didn't leave behind any justification nor did I feel the need to explain myself or even reach out one more time to say I love you. I didn't write a suicide note—I think that says a lot right there. Other people's thoughts and feelings were of zero importance to me at that moment.

My problem isn't between me and some people running around this planet like ants. My problem is between me and the stars.

I wasn't trying to make a point to anyone I knew. I didn't want to connect with my family through my suicide. I didn't have any last words I wanted to share with anyone. All those relationships were severed or meant nothing to me at that point. There was no one to talk to, not even to say goodbye.

Although I'm asking you to see this as a cry-for-help suicide—because it was—you have to know that I was in a suicidal state performing a suicidal act. In the movie version of Michael Crichton's Sphere, Dustin Hoffman plays Sharon Stone's psychiatrist. He's discussing Stone's character with their mission leader. Hoffman says:

"It was a passive attempt."

The mission leader: "A passive attempt?"

Hoffman says: "Yes. People who really want to kill themselves get a gun and shoot themselves—or go over a bridge. They don't call up their boyfriend and say: 'I just took twenty Nembutal..help me.' "

That's what I did. I took twenty Vistarils, which had been prescribed to me for sleep. I took them in the courtyard of a mental hospital, with a security guard visible to me at all times. I didn't take the whole bottle of pills. I guessed at a high number of pills that would put me in the hospital with [whatever effects] without taking enough that I thought I couldn't survive those effects. Then I emptied out the rest of the bottle, sprinkling the pills underneath a tree, certain in my paranoid mind that someone would find them—that they would scour the grounds like the crack team from some police procedural. I worried about that for days, that in the ER some doctor would come up to me holding my prescription bottle and say, "We found half a bottle of Vistaril scattered under a tree at the Refuge. You want to tell me how many of these you really took?"

But I dry swallowed at least twenty of those pills and in the ER doctors did all kinds of blood tests. It was late and there weren't many people on staff, so they took my blood twice—once when I first got there and once many hours later, in the early morning. When they came back with the results, some doctor walked up to my bed and he did question me about how many pills I took.

"The whole bottle?"

"Well I was using them normally for a while, so it wasn't the whole bottle, but I took what was left of the bottle."

"How long had you been using these normally before last night?"

"I don't know..two weeks..one week? I really have no idea."

"The problem is," this doctor said, "we're not seeing high levels of Vistaril in your blood, so.."

"I don't know what to tell you," I said, hysterically. "I took what was left of the bottle."

"Was it like..forty..fifty pills?"

"Something like that. Maybe the charcoal got it out of me, I don't know, I'm not the doctor. Obviously I wasn't thinking clearly if I'm trying to kill myself with my sleeping pills! I wasn't exactly counting them out one by one. It was dark. I was outside. I couldn't see how many pills were left in that bottle. I took what was left of the bottle. That's all I can tell you."

The doctor stood there looking at me skeptically, holding my Vistaril bottle up at the level of his head.

If he had stood there one second longer I was going to bring up the fact that somewhere in this dinky hospital's process, there had been a breakdown by which a suicide patient's initial blood draw had been lost (the second nurse who took my blood told me this) so the data he was looking at was based on my blood after they had made me swallow a bunch of charcoal that binds with poison in your stomach in a way that your intestines can't digest it, and after I had been lying awake all night drinking water and having a fucking IV drip clearing up my blood for hours and hours and hours while I awkwardly tried to make the security guard who was assigned to watch me, laugh.

He was friendly, but he didn't laugh. He just sat in his chair and made sure I didn't try to kill myself again.

Anyway the blood this doctor was looking at was taken seven or eight hours after I swallowed those pills—of course the levels are going to be low, don't give me a hard time about it.

The doctor lowered the prescription bottle, looking at me doubtfully. He walked away. It made me want to kill myself right there in his hospital.

While Dustin Hoffman's psychiatrist character in Sphere has a point: taking pills is one of the least lethal methods of suicide (jumping off a building, hanging, and shooting yourself in the face are much more effective), attempts by overdose are by far the most common way of trying to kill yourself, so even though suicide by overdose fails most of the time, it still results in a huge amount of deaths just because people do it so often.

---

When I was in my first interview with Dr. Meggs, my psychiatrist at the Refuge, she passed along to me this information from the ER doctor at Brattleboro Memorial that there was very little Vistaril in my blood, but unlike the ER doc, she did it in a non-threatening way. She wasn't accusing me. She was completely neutral. We were just discussing facts. I told her that his data was based on a 5am blood sample, that they had lost my blood taken when I first arrived at the ER, and, with her head lowered, looking at my chart, she shook her head—but not at me, at Bratt Memorial, and I finally felt I had someone on my side.

She gave me some different medicine for sleep, but told me we were making a deal.

"I'm only giving you this if you'll promise not to..try to kill yourself with it. You have to assure me that you will not do that or else I won't give it to you. While you're here, you'll be getting it from the med station, but when you get out, I'll only give it to you in one-week prescriptions. So it's going to be a pain for you, you're going to have to refill it every week, but I have to make sure that you don't do what you did before. Understand?"

I nodded tearfully, and sniffled.

"Do you want a tissue?"

I shook my head and wiped my nose on my shirt.

"Oh and another thing," my doctor said. "You can never abuse this. I'm saying this for your own good—not because we don't want you to die (that's one thing)—but I want you to be able to sleep and if you try to hurt yourself again, and you use this medicine, no one will ever prescribe it to you again. Ok? I want to help you create options, not cut them off."

---

An implicit statement here was that no one would ever prescribe Vistaril to me again, since I used to to try to kill myself. And that's true. No one ever has. In fact, when I got out of the hospital, and moved to different cities, there were about five years there where I couldn't even remember the name of the sleeping pill I had used to overdose. Doctors would ask me and I just couldn't remember. I think my mind was protecting me—why would I want to remember the medicine I used to risk my life to get back into the hospital? I think my brain said, "No, we're going to keep this from him for a while, until we think he can handle it. He's not ready to think specific thoughts about the specific pills he used that night, used to manipulate a security guard into calling 911, manipulate an ambulance to drive my half-conscious self to the emergency room, manipulate two nurses to make me swallow two big glasses of this charcoal mixture that may have saved my life.

Or maybe not. Maybe if I had been able to go home after I swallowed those pills—or if I had been able to refrain from taking them—I could have woken up in the morning feeling horrible or beautiful. But I couldn't have gone home that night. I was never going to leave the courtyard of that psych ward. Something was going to happen. I might have slept in the grass and forced the security guard to call the cops and come arrest me or kill me, but I wasn't leaving that courtyard that night. Something in me, starting during my outpatient class, was slowing down, not making sense. Something unavoidable and fatal was rising up in me. When I went to the bathroom downstairs I knew I had those pills in my cargo pocket—I had all my pills with me. I looked myself in the mirror and just as I used to lie to myself so deeply when I would get in my car and say: I think I'll go for a drive. Maybe to the grocery store. Maybe back to work..when I knew just underneath my lies that I was going to the bar..just like that, when I stared in the mirror of the Refuge bathroom I told myself the lie that maybe I'll just go home and try to sleep off this depression, maybe tomorrow I won't feel like giving up..I knew right then, when I realized I had sleeping pills in my pocket, that I was going to take them. When I walked past the receptionist, enclosed in glass in the Refuge lobby, I knew that the smart thing to do was to go up to her, give her my pills, and say: "I don't feel safe with these right now. Will you hold them for me?" I knew that. But I was on a track, my actions were determined.

I sat in the lobby and meekly asked the receptionist if I could sit here for a while. She said fine, if you need to use the telephone or anything, let me know. I said I'd like to use the telephone. She slid open a window and pushed an old-style telephone out for me. I thought of who to call. I had been in the Refuge, inpatient, twice before—right?—once for pointless rehab off a week of drinking and one night of smoking crack that was too much for me to get over alone. I reached in my wallet. I had my Brattleboro Refuge emergency card with me, with the twenty-four hour emergency number on it (which would ring the woman who had given me the phone, sitting right next to me). The card also specifically reminded me that in an emergency I should call 911. I imagined an EMT crew busting through the front doors of the Refuge—thirty feet from where I sat—and them finding me huddled in a corner with the wire stretched from this phone into the receptionist's cube. You called 911 from a psychiatric hospital..because you're suicidal? Why not tell the woman at the front desk? The admitting door to the psych units was just on the other side of that desk. I was exactly where I needed to be. I knew what I needed to do to avoid a suicide attempt. I just couldn't do it.

I thought of those times in the tenth grade when me and my best friend were walking together in a long hallway, approaching a place where you would have to go either left or right. And his class was to the left, and my class was to the right, but we'd talk about free will and wonder if we had any. Could I actually go either way I chose, or was choice an illusion, was everything determined? It seemed at the time that there was no way to know, but even then, the more we both thought about it and discussed it on our way down that long hallway, the more it seemed like choice was an illusion—just a feeling you had, mostly after the fact, that was there to torture your mind with major and minor regrets.

You ever do the wrong thing when you know what the right thing is? Ever cheat on a monogamous relationship? Make a totally unnecessary dangerous move on the highway? Take a drug you know is dangerous, just because you're curious?

I've done that a lot. And maybe I'm stupid. Or maybe I'm smart, and exploratory. Or maybe it all is determined, and there's no such thing as choice, and we're just watching a movie that none of us can change.

Free will is a metaphor. It's useful to us to organize the complex reality we're experiencing. But that's all it is—a metaphor. It's totally false, but we need it as one of the little pieces of magic by which we construct an identity—also a false but useful metaphor.

There is no way I "could have done" anything, that night, but feel low and tired in my outpatient class, feel my stomach sink like a block of ice, feel like a baby without a blanket—too cold and neglected, alone. That Brattleboro Refuge card, the emergency plan written on it, a collaboration between me and Michelle, the head nurse, was useless to me. The emergency numbers of people who loved me and I could call in an emergency? 1) I didn't feel any of them loved me. I was suicidally depressed! Love was not something I was feeling for anyone and it was not something I felt I deserved. If anyone said they loved me, they were pretending. What if I do call my old friend Ashley, my mom, my sisters? How do you discuss that with them? Hi, I want to kill myself. Can we talk? That is not a discussion people prepare to have. Maybe we should. I was too ashamed of my feelings anyway—if for no other reason, I didn't pick up the phone and dial one of those numbers. I didn't leave a note—what is there to say? If I kill myself, that's the statement. Ending your own life? That says pretty much all there is to say.

I gave the woman back her phone. I left her and said, "Good night!"

"Good night," she said.

I feel so cut off—so alone. And I've felt this way forever.

I hate myself. I feel like an idiot, like everything I do is wrong or displeasing to my parents. Maybe to me. I don't know. I can't even get a job anymore. It felt good to a small degree to do useful things for Mead Research or Anthem, even though it was meaningless work, unchallenging work. At least I made my bosses smile.

My bike was chained to the rack at the bottom of the stairs. The security guard was doing his rounds in the parking lot, right where expected. He was part of my plan. I went to a picnic table and fumbled in the dark to figure out which of my bottles was Vistaril. I could see by the light coming from the double doors of the Refuge, barely, and I opened the bottle and started dry swallowing pills. Like I said, I knew with the first few that I was just putting myself to sleep. But I kept taking them. And I knew that with each pill I took, the chance of this being a cry for help and this being the last night of my life, increased. I took another, and another. Dry swallowing pills is hard but I made it work—I needed to—just like when I was in high school, embarrassed by a wart and my parents would not or could not afford to take me to a dermatologist, I got up in the middle of the night and I used a pair of scissors that almost broke with the force it took me to cut through human skin. It was pain beyond pain, but I could not take one more day of the girls at my lunch table looking at my hand and seeing a wart on my finger. That wart made me feel untouchable, and that was pain for me much greater than the pain of cutting around the skin, deep enough to take out the root, in the bathroom with the door locked and my blood running into a porcelain sink. But I did it piece by piece, I cut that wart out of me, with disgust so visceral I can still feel what it's like to use a pair of scissors to cut off the side of your own finger, to cut through your own skin, removing the prints such that they'll never grow back, such that to this day I have a scar on my right index finger.

But there's no wart there.

And it's a reminder. That I can walk through almost unbearable pain. That I can do what is necessary. That I don't need anyone else to solve my problems—I can solve them myself. If not with an injection or dry ice at the dermatologist's office that I could not get to, I would handle it myself, the old way, with willpower and a pair of scissors.

Inside the little bio of Emily Brontë at the end of Wuthering Heights, it says that she was once bitten by a rabid dog. It then says that Emily used a "red-hot iron" to cauterize her own wound. She didn't tell anyone and no one knew until someone saw the scars. I don't have a girlfriend—but if I did it would be Emily Brontë.

---

I took my pills, I looked up at the clear sky, the stars. I thought how many people throughout history and probably tons of intelligent creatures on other planets had looked up at the stars as they killed themselves. With each pill I cared less, and with each pill I wanted to die more. I wanted that to be my last sight, so I lied down on the top of the picnic table and adjusted my glasses, and I looked at all those tiny little stars.

I was on the edge, you know? I didn't know how to proceed with my life—I didn't know how to take the next step. And I confused that with death, or I considered death a solution. I didn't have a job. I was losing my apartment. I didn't have friends anymore, since I stopped drinking. I wasn't having sex. My family was far away. My dad had chosen, long ago, to ignore me, and I was just now catching up. Man, if I had a kid who was homeless (as I had been once long ago), or if I had a kid who was up in Vermont (and he was just in Delaware), and my son had called me or emailed me weeks prior to say he had been in rehab, then in a psych ward because mental health workers in his outpatient support group thought he was suicidal, I would have flown my ass up to Vermont, or gotten on a train, or walked up that motherfucker until I got to my son, and I would have held him, and rocked him, and I would have cried for us both. Because the world is rotten, but without somebody to hold you, it's impossible.

The stars grew blurry with my tears.

I didn't even wipe them away. I just took my pills.

And I didn't know if I was the manipulator or the manipulated.

I didn't know if I was in control or if I was being controlled.

But I remembered, somewhere within me, that I didn't want to die. If I twisted around the definitions, I wasn't suicidal, I was actually just lost.

So I took my last pill and there were like eight of them left. Or maybe twelve. That's just an estimate from the sound they made when I shook the bottle. I got off the picnic table, went to my favorite tree, watered that monster with Vistaril, and went to the security guard.

I think my tree slept well that night.

The guard looked uncomfortable as I approached him but I knew he didn't carry a gun so I wasn't worried.

I handed him the prescription bottle. It was open, empty, without the cap.

"What do you want me to do with this?" he said.

"Well, you might want to call 911," I said.

And I was laughing. I was laughing and crying in this poor guy's face. He pulled out his phone. Dialed 911.

"Yes, this is Mitchell Anderson. I'm with Akai Security Consultants and I've got a young man here who—No, Akai, A-K-A-I. He came up to me and handed me a prescription bottle, it's a big bottle—No, Akai, alpha, kilo, alpha—Listen, I need an ambulance at the Refuge right now. This guy took, I'm assuming—how many of these did you take?"

I'm hysterical now. I'm grabbing the guy by the collar of his jacket.

"What does it matter? Hahahahaha!!"

Then I'm burying my face in his jacket and crying and snotting all over him.

He firmly pushes me away.

"See that bench? I need you to go sit on that bench."

I look at the bench.

"Yeah, that's him. Right. The Refuge. We're right at the main entrance. You won't miss us."

He clicks off.

"Would you please sit on that bench?"

I go to the bench. I sit.

The guy comes and stands in front of me.

I bend over and cover my ears and my face with my hands and I start weeping—tears, uncontrollable breaths. I look up and see the stars are still there. I look up at the guy and I take a huge breath in. Huge breath out.

"Why do you want to die?" he says.

"Because everything is a huge farce," I say, and I raise my arms as if to include everything..everything..the security guard, the Brattleboro Refuge, my outpatient class, myself, and all those tiny little, huge little stars that are raining down before me.

65

Sometime in the night they switched security guards on me. They didn't handcuff me to the bed or anything, but at first they had this guy—literally the hospital security guard—sitting in a chair watching me. We talked some, mostly me making wild jokes that he definitely did not think were funny:

"What happened to the guy who tried to kill himself by taking 100 pain killers? After two he began to feel better."

No laugh.

"Ok, you'll like this one. I can tell you're a smart guy. So there's this physicist walking across the Golden Gate Bridge. He sees a man about to jump. Just before the man jumps, the physicist yells: 'Don't do it! You have so much potential!' No? Not into the physics jokes, o-k. Hmm. Ok. Ok. This one's good. You can't not like this joke. If you don't like this joke, there's something wrong with you, and I don't even like jokes. Here goes. Why did Hitler kill himself? Because he saw his gas bill."

Fuck.

"That went over like a lead blanket. Do you mind if I talk."

"No. I don't mind. I'm here to keep you company."

"And make sure I don't kill myself."

He shrugs.

"I have a lot more suicide jokes that are much sicker but I'm sensing you're not into the whole suicide joke thing right now, so I'm gonna leave those alone..you're welcome."

The guy smiles with one side of his mouth.

Then somewhere around 3am that guy had to go fill out security guard paperwork or something so they sent in the janitor. Guy looked like he'd lived in Vermont forever. Coveralls (Dickies), boots that could cut through a lake of ice, a hat that covered most of his face. He asked the security guard if I'd been any trouble, the security guard said no, and then this Vermonter sat in a folding chair by the door of the room where my bed was. He put his head down, his hands cupped over his forehead where I couldn't see his eyes. He sighed.

"Long night?" I asked.

"Yeah," he said, not looking up.

"You always work nights?" I asked.

He looks up at me. "I used to work days. Fifteen years I worked days. Then my wife died so I don't have anything to really do when I go home, so they needed someone to work nights and I said, 'What the hell.' Now I like nights better."

"Nights are better," I say.

"Because of the people?" he asks.

"Exactly. Day people are aggro—"

"What's aggro?"

"Aggressive. Slang they use out west. But night people—customers and workers—it's a whole different vibe."

"It's a whole different speed!" he says.

"I know, man. Day people'll run you over just to get to work five seconds earlier. To a job they fucking hate."

"Exactly right," this guy says. "Exactly."

"You get many suicides in here?" I ask.

He sighs heavily. "Two or three a year."

"Got any advice for me? Like words of wisdom past suicidal victims have passed on to you, that you could pass on to me, so I can live my life better?"

He looks at me for about nine seconds and then says:

"Don't kill yourself."

Don't kill yourself! That's his advice! That's why I love these fucking Vermonters: they're so down to Earth, so simple, so practical. I mean, yeah, what else is this fucking custodian going to say? He's no psychiatrist. It's like telling a drunk: Don't drink alcohol. It's advice so simple it just might work. Don't kill yourself. Don't drink alcohol. Don't take a selfie with a rattlesnake. Life is hard—ok it's really hard. But along with being hard it's also simple. You know what you need to do. Doing it is the hard part. If you ever need advice, I recommend you skip the internet, skip the psychiatrists, and find yourself a Vermonter. They've gone all the way around the complex stuff and come back to the simple—and that's what you need when you're in trouble. You don't need a philosopher. You need a guy who works the night shift, knows what it's like to lose a wife, wears Dickies to work, mops the floors without comment, and when he sees a snake or a bear on his property, he doesn't ask it how it's feeling—no—he grabs his shotgun and blows the motherfucker's head off.

That's the advice you need.

66

In the morning they put me on a stretcher and take me away in an ambulance to the Brattleboro Refuge. I feel embarrassed and stupid and the EMTs say, "No, you're getting the help you need."

During the ambulance ride from the hospital to the Refuge, I felt like a schmo that I tried to kill myself and this is really my life situation. This shit here is real. Talking to the EMT in the back with me.

He was like, "How do you feel?"

And I was like, "Stupid."

He was very encouraging.

"How did you get here?" he asked.

So I went through the whole thing in fast speed. "Suicide attempt in the Brattleboro Refuge lawn. Jump back a little. What had started all this was me getting stressed with work, starting drinking again, losing my job, getting drunk and lonely enough that I blew the rest of my already-failing bank account to smoke crack with a couple a strangers, coming out of it in the morning like: Fuck, I have no money. No job. I'm going to get evicted. And being so mad at myself that I smoked crack again. I fucking hate crack. But that's the only way you can get cocaine when you're dealing with poor people!! Next came a week of rehab, this Refuge outpatient program where they observed me and said I was acting suicidal. So I had a first hospitalization where Dr. Criminal didn't do a good job—his name is actually Dr. Criminal, yes, I'm not making this up..like there's a guy in the midwest who sells RVs, his name is Tom Raper, no lie..so Dr. Criminal didn't take my suicidality seriously, didn't even really pay attention to me to be honest, during a week-long stay in the fucking hospital. It's like, you're a psychiatrist dealing with suicide cases, you can't exactly phone this shit in. Now here we are presumably at my next admittance..after a suicide attempt..or was it?..maybe I'm just crazy enough to risk my life to get back into the hospital to get the help I THINK I FUCKING NEED. This could be my way of asking for help. I could have just said I was suicidal but when I did that my doctor didn't listen. He discharged me before I was ready to go and without diagnosing me or giving me any medicine. SO THAT'S THE BRIEF VERSION, SINCE YOU ASKED, MY DROOGIE!!"

The EMT looked at me, totally calm, and said, "I hope you get the help you need this time."

They admit me. The EMTs leave.

The second I got on Tyler 2, I went up to the nurses' station and said:

"I am requesting a doctor change."

Michelle said, "Who would you like?"

"I don't know I just need to try someone different this time. Spots swears by her doctor, can I have her?"

"Actually for you I'm going to suggest Dr. Meggs."

"Great. Thank you, Michelle."

"You are most welcome," she sings.

That little event that just happened was one of the most fortuitous events of my life. Yeah there was transference and countertransference but in a way there had to be in order to have as productive a doctor-patient session as Dr. Meggs and I had over the next three weeks and beyond. I was a special patient to her. She was a special doctor to me. Given the circumstance, that was what was needed, and that was thankfully what I got.

On every visit to the Refuge after my suicide attempt, I saw Dr. Criminal as we passed each other in the hallway. Those were always awkward looks! We never spoke. I wondered how he felt, and I always nodded at him respectfully. As I mentioned, one of the substance abusers counsellors tried to explain to me that "He Dr. Criminal is old school." That was supposed to mean he didn't believe in prescribing a lot of medication. I was never mad at Dr. Criminal back then. I was very pragmatic—I just wanted to solve my problems, I just wanted to get the help I needed. I wasn't into blaming anyone (but myself).

But looking back at Dr. Criminal now—yeah I'm mad. A patient comes in on the recommendation of your own staff because he's expressing suicidal ideation in his outpatient rehab class. He's been diagnosed bipolar by two hospitals now—one in California five years ago (where he ended up after calling a suicide hotline) and then diagnosed bipolar again after being admitted to the rehab unit of this very hospital. At least throw a brother an antidepressant, you know what I'm sayin'? All he gave me was sleeping pills and a weak anti-anxiety med.

---

My first interview with Dr. Meggs.

My first interview with Dr. Meggs was incredible as a clinical example of doctor-patient exchange. I wanted to talk and she was ready to help me do it. I quickly found myself crying uncontrollably and this psychiatrist I had known for thirty minutes gets me to reveal something I'd never spoken about to anyone— doctor, family member, anyone. Part of the reason I never talked about it is I didn't realize it wasn't normal, but somehow Dr. Meggs asked the right question to unlock the fact that during my potty training period, my dad would humiliate me by making me clean my own shit out of my shitty underwear with my bare hands, rubbing my underwear in the toilet to manually clean them. Dr. Meggs told me that was an act of humiliation of me by my dad. She told me we learn how to relate to people from our first relationships and one of the first relationships I learned—thanks, Dad!—was humiliator/humiliated, and that she thinks ever since then, I've been playing that same game with others, only with me in the humiliator position because I wanted to make sure I was never in the humiliated position again.

Best therapeutic lesson of my life. Right there. Dr. Meggs.

Boom.

Yeah, head nurse Michelle—thank you—thank you for picking that doctor for me.

Holy shit.

I started crying tears of catharsis that moment and I've been crying them ever since, right up to today as I type this fucking sentence.

Right as I typed that period: tears of catharsis.

Whoah.

I'm been humiliating others because I was taught to do so before I learned to talk.

I've been making myself humiliation-proof since before I learned to talk.

In thirty minutes of talking she gets me to share something I've never shared before with anyone in thirty-three years of life and multiple years of therapy. In her notes she writes, "Patient is very labile" which means I was weeping like they do in the Bible, wailing, crying my fucking head off.

I told Dr. Meggs that Dad used the bathroom (took a shit) with the door open in the first floor bathroom near the breakfast table where us kids were eating breakfast, that he's obsessed with taking a shit the same time every day and precisely manipulates his diet with fiber to achieve this. That he showered with us to a late age. That Mom tells us stories that he couldn't deal with us (his family) in the early days in Dallas, Texas and he would disappear to Florida for weeks at a time and write Mom letters about how he just couldn't handle the stress and responsibility of having a family.

When confronted about this, Dad flatly denies it ever happened, even though, when scanning Mom's old stuff for her, I found the letters, written in Dad's hand, postmarked from Florida. Even in the face of me telling him I've held the letters in my hand, read them, seen the postmark, he denies that ever happened.

My hate for putting together furniture, yard work, mowing the lawn, fixing things especially plumbing, and carpentry..I have strong negative associations of doing those things with Dad and memories of Dad yelling and cussing at inanimate objects that didn't do what he wanted them to do. To this day I have a strong, decompensatory reaction to lawn mowing, putting together IKEA furniture, any kind of house repairs..I was always the guy holding the flashlight while my dad did the real work. He never explained what he was doing or included me in it—he just made me hold the flashlight and yelled at me when it drifted into the wrong place.

My mom had her sisters over to visit when my parents were newly married. Dad came out in his underwear and acted like it was completely normal and acceptable to be conversing with his wife's sisters in his underwear.

Mom was like: "What are you doing?"

Dad dances around a little so my mom's sisters can see the outline of his cock.

"Nothing," he says.

"Go put some clothes on!"

"Why?"

My mom's sisters squirm uncomfortably on the couch.

Dad says: "What's wrong? Why is everyone so tight about human sexuality? It's natural. It's part of life. God made it. Anyway my dad put the down payment on this house so even though we're married I figure this house is at least fifty-one percent mine."

He jumps up and down, in just his socks and underwear, and his penis bounces with him. Fifty-one percent.

"Does anyone disagree with that figure?"

After Mom and Dad divorced, Dad and his new wife had sex in the same tent where his daughter, my sister, was also an occupant. He didn't care for the effect of this on her, or was just so clueless and insensitive that he didn't think it would have an effect.

After Joanne shut him out of her life for five or ten years, he stopped inviting her to Thanksgiving. When I accepted, and was at his house with Leona, I discovered that he hadn't invited Joanne and that became a pivotal point in my period of anger toward him. If you are the parent, you keep inviting your children—all of them—to holidays until you're dead or not doing any more holiday parties. Years later I sent email to my dad and his new wife making fun of her face and calling her a "chipmunk bitch" (which is exactly what she looks like). I told him in those letters [voicemail, actually] if he ever again failed to invite Joanne to a family event that I would kill him. Then I told him I was going to come to Delaware and kill myself on his porch so he'd never be able to forget me. He filed a restraining order. I was in California coming down off crystal meth at the time and felt much more reasonable when the drug worked its way all the way through me. But I have always wanted my dad's attention. I think I still do. But I know by now that is something I will never, ever have.

---

Memory of squatting over the cooling vent in the floor, looking out the picture windows, and taking a nice warm shit in my underwear. Then Dad, gruff voice, yelling at me in the bathroom and making me wash the shit out of my underwear in the toilet.

"Did you play with fire as a child?"

"Yes, up to the ninth grade I made my own bombs, traps, explosives. I had my own mixtures of wax and rocket fuel that would burn and I set ants on fire with caps and a magnifying glass. My mom was terrified. These were large fires I was creating. My dad and I almost burned down a state forest playing with fireworks in the summer."

"Did you wet the bed?"

"Until the third grade, at least."

"How often do you deal with thoughts of suicide?"

"Every day."

"Every day?"

"Yes."

"Since when?"

"Since high school."

"Well, we're lucky to still have you with us, aren't we?"

"Uh..I'm not sure what modicum of luck that furnishes for you or what degree of unluck it rains upon me."

"Well I think we are lucky you're still with us. Will you allow me my opinion?"

"Yes, of course."

"If you think about suicide every day, how come this is your first attempt? How have you overcome the desire—or the temptation—for so long..for years?"

"It's a discipline. Mostly I just keep in mind that like any of us, I could die any minute, so why rush it? I mean the reality is that this may be the last conversation I ever have with anyone, so I might as well enjoy it. Obviously I'm of two minds on the subject—I am struggling, sometimes very intensely, to be able to enjoy life in this society, with the actual people who are present for me to interact with..but also I do find great joy in experiencing certain types of moments."

"Like what? Give me an example of a moment you enjoy."

"Anything. Like drinking a glass of water. Or..mostly..talking with smart people."

"Sex?"

"Yes, I enjoy sex, especially if it's with someone I love, or at least a friend that I'm sexually attracted to."

Dr. Meggs is taking notes furiously.

Our session lasts a full hour that day.

It is one of the formative hours of my life.

"I probably shouldn't tell you this—I could get fired for telling you this but there's a certain school of thought..well at least some people say that life starts after your first suicide attempt. Don't repeat that. But since you've already done it, you might as well think of your attempt in as positive a light as possible. That's what I'm thinking anyway. Anything else you want to tell me?"

"Yeah. In LA I used to change my number every night. Sitting in front of a movie, eating enchiladas and drinking wine, I'd call my carrier and request a new number, any number, just something that no one I knew, had—to guarantee no one could call me. Paranoia? Need for security? Need for isolation? Not being able to trust people, in general..my dad."

Dr. Meggs nodded like that made perfect sense. And I was glad it did, to her.

"And you know what else?"

"Tell me."

"I have this memory, my last night in LA, talking to my dad on my cell phone in my second-floor room of Gideon's crack motel. And when we were done, even though I needed help desperately and my dad was the only person who could give it to me, I felt like such shit after my conversation with him, that I felt something that had been an undercurrent all my life, but had never surfaced until now—I wanted to kill myself. I can't blame my suicidality on my dad, of course. It's my psychology, it's my responsibility, as far as I can do anything about my psychology. But the fact remains, that after a certain point in my life, every time I had a conversation with my dad, the things he said, the things he didn't say, and the spaces in between, made me feel very clearly that my dad did not want to have a relationship with me, even a one-call-a-week relationship..and as I thought back, as far as I could remember, I knew something that was so harmful to my psyche that I could hardly let myself believe it—and that is that my dad and I have never had a meaningful relationship. The only thing he got right was taking me and my sisters to walk in Fairmount Park when we lived in Philadelphia. I loved playing with my sisters on rock formations. But Dad walked along behind us, probably thinking about his childhood and his dad. There was no relationship. We didn't play together. We didn't talk, except for when he told us it was time to go home. That was the only thing he got right. The rest of it was stuff like forgetting to pick me up from the SATs, when it was an hour after the test had ended and all the students and teachers had left and locked up and I was standing alone in an empty parking lot in the winter, in west Philly, doing breathing exercises so my body wouldn't shiver so much..that's when my dad finally showed up. He wasn't going to waste any of his time getting there early to be ready for me when the test ended. He got there when he knew he wouldn't have to wait on me. It was that way with every after-school activity me and my sisters did. He was always late, one-hundred percent of the time—and that sends a powerful message.

"So I was in that crack motel realizing for the first time that listening to Dad talk made me want to kill myself. He let me know—and he has let my sisters know—over and over that we are not priorities in his life. Work takes priority over his kids. Sex takes priority over his kids. Home improvement projects take priority over his kids. His cats take priority over his kids. Once he called me, telling me Tiger, his cat, had gotten hit by a car and died. I couldn't find a honey drop of empathy within me. How about don't leave the front door open when you have inside cats? was the only sensible thing I could think to say. But of course I didn't want to suggest that he might have been partially responsible—that thought, with a cat, with his kids, would have been too much for him to take.

"So I changed my number. I thought, why should I be accessible by voice to a man who, when he speaks, drastically increases the chance I will kill myself tonight."

I told Meggs I spent my childhood trying to please my dad, to figure out what I could do that would make him happy.

She explains to me that probably nothing I did would have ever made him happy.

"But I think in general, my number changing didn't have as much to do with my dad or Josh from work calling me and pretending to have a relationship with me that they did not have.

"It was my fear.

"It was just my fear of being close to other people.

"But, I mean, Josh, my dad..those weren't people who had any kind of benefit to offer me. They were leachers, manipulators, and I think M. Scott Peck would agree with me that both of those people were evil in the greatest sense of the word."

And then later I was talking about how:

"I hate strip clubs. Except the part where they spread their pussy lips and it's all red inside—I like that part. I mean this is LA, this is meth, and this is how motherfuckers like Josh English dream of (and talk a bunch of shit about) fucking strippers, but I've actually done it. But Josh took me to my first strip club I ever went to and had me drive even though he knew we'd both be drunk—obligation to the superior employee at the company (how could I say no?). I hate strip clubs and I pretty much hated what they had to offer.

"But you know what I do want?

"What?"

"I want somebody I can talk to sixteen hours a day, fuck the other eight, and drive across the country in a pickup truck for the rest of our lives. It has to be somebody totally crazy, or I'd never be interested, so my best chance of meeting this person is in a psychiatric ward. Unfortunately I don't plan on spending too much more time in the psych ward, as it's not my favorite place to be, so I figure AA meetings or meditation retreats, those might be my last great hope for places I could find some beautiful, formerly crazy person who is currently in the business of getting well."

I'm silent.

So is my psychiatrist.

So I talk some more.

"What I never told anyone then, and what I'll tell you now, re: my suicide attempt, I just knew I needed to be back in this hospital, I knew I needed this kind of care, but better than I had under Dr. Criminal. I did what I needed to do to get back in this building, simple as that. I communicate well. I look ok from the outside. I seem smart. So it's hard for me to get the care I need. You know what I'm talking about, about how a doctor makes an assessment not just on symptoms but also on class? I did something that would make my doctor take me seriously and I made sure I had a better doctor than the one I had before. I needed help, and I was willing to risk my life to get it."

"Next time just come to the front desk."

"Would you all have known how dire my circumstances are if I had done that."

Dr. Meggs looks at me deeply.

"I don't know."

---

"I want to say: It's sad when the person in the family who's tried to kill himself and has been to two different mental hospitals and the most therapy of everyone seems (most of the time) to be the family member who has it most together, psychologically. But it's not sad, it's not even surprising. When people don't seek help, sometimes it is because they don't need help—but sometimes it is just because they aren't seeking help. Ironically, the person who survives a crisis may end up with better help, better coping skills, and a generally saner mindset than those who cope on their own without occasionally leaning on the professionals.

"It's just like alcoholism: if you drink in a way that causes you problems so small that you never become aware of them, you may ultimately find yourself in worse shape than the alcoholic who drinks to the point of crisis, has to face their problem, and stops drinking. A recovering addict in Tucson shared with me his theory that everyone is an addict, but that we all have our own trajectory of addiction. If your trajectory is low, you'll be causing yourself drug-related problems all your life without ever being forced to face the cause of those problems. If your trajectory is high, you'll either a) die, or b) you'll be forced to face the reality of the role addictive drugs have been playing in your life, and you'll have a shot—just a shot—at living without them.

"I think of it as the pebble/boulder analogy."

"What is that?"

"If you're walking on a path, and over time all these little pebbles are getting in your shoes, but they're so small you don't notice them, you may be in worse shape at the end of the walk than a person who finds a boulder in her way, totally obstructing her path. She won't be able to ignore the problem. She'll have to address the problem of the boulder one way or another before she can continue on the path. Better to encounter a major obstruction than a minor bump. One you're forced to deal with; the other, ignored, causes more pain over time."

During our talk, Meggs and I talked about the grand and the small, the abstract and the concrete.

I told her that I feel bad for not paying my rent lately—that that was one of my biggest stressors—and Dr. Meggs literally responded by saying:

"Shit happens."

"Is that your professional opinion?" I laugh.

She says, "Well, let's just say we have bigger fish to fry."

This was a huge perspective shift for me. And it didn't just apply to recently. I've been making out the losing-my-apartment stuff as huge, and minimizing the mind-not-working stuff, all my life. My jobs have always been my #1 priority, even above my own needs—making sure everything goes great on the job has been my primary objective since my first computer programming job. Guess what? I learned that from my dad. That was the example he set: even when it came down to job versus family, with him, job won. And I became the same way.

And it took many more visits to the hospital and many more years of my life to deeply understand this: that all these ages I have been sacrificing my life and my mental health to make job and apartment and girlfriend work out, when my priorities should have been my mental health and then all those other things. I shamelessly blame my father's influence in stressing the all-important work ethic..work at all costs, never let the mission fail, the job as a whole is more important than me as an individual. I'm expendable; the job is eternal.

That kind of thinking almost killed me.

But in the end, we're all building sand castles. You're going to die. How about live a jaw-dropping life on the way down.

And to my critics, really, walk in my shoes: try to stay alive, with bipolar, even on lithium, without killing yourself. Try to live through psych hospitals, and mania, and depression, and see if you wouldn't make the exact same decisions I did.

End of meeting with Dr. Meggs.

67

Then someone brought me my lunch in my room. It was Michelle, the head nurse, and I picked at my food. It was dry hamburgers and I had to apply all the ketchup and relish and mustard packets that came with them to make them possible to swallow.

A girl came by, maybe 19, covering her mouth with her hands. Then she opened up a window in her hands so she could speak.

"I'm Faith."

"I'm Matthew."

"You tried to kill yourself?"

"Yeah." (I start crying.)

"Don't feel bad," she says, and she shows me her arms. "I've tried to kill myself lots of times. You'll be ok."

Patient info is supposed to be private, so how Faith knew I tried to kill myself is unknown. But she was the only patient who came by to comfort me. She was so accepting and comforting, and I found out we both have bipolar! We talked at the door (because you're not allowed to go into people's rooms) and an old woman from next door butted in and offered me her lunch but I said I already had one and that's the only time I saw her—that was her last day at the hospital—and by the time you read this she'll probably be dead.

Faith was so matter of fact. There was no charge associated to suicide with her..she didn't have any stigma, any judgment. She talked about it like we were discussing basketball scores. How you did it, when you did it, did they take you to the ER, what happened at the ER, were the ambulance drivers nice? I was in a new world now, where suicide wasn't a hush word. Even in my family, as open as we are, it's not something people feel comfortable just discussing. I think that's because of the why question—in my family setting, there's always the question of why you would want to do that. It isn't understood. But in here, with Faith, it was understood: a) you were ill. b) life sucked.

I mean, god, doesn't everyone understand how hard life is and how much life sucks for me? They probably don't. They're probably able to tolerate what me and Marlon Brando call, "The horror, the horror." And some of them are actually enjoying it.

That is a truly horrifying fact to me—that some people are actually enjoying this world.

Faith left, re-covering her mouth window with her hands.

---

Then I thought I was all cried out and I found my hunger for that second hamburger and I went to the break room to get some ketchup for these incredibly dry hamburger patties and I was just standing there in front of the refrigerator with the door open and I started to cry silently, and then I was wailing like a dog who lost her baby puppy to a traffic accident, lost everything that was important to her in the world. I didn't care who heard me me, I didn't care that the refrigerator door was open, I didn't care about the ketchup or the hamburger patties or how anyone in my family would perceive my actions or if I died or lived, if I ever made another step forward in my useless, useless fucking life.

And that is when I wailed the most—I sounded like an animal who was being tortured right then. The night before I had wanted help—so I cried for help. I did what I had to do to get back into this hospital. But now that I was here I knew something about myself that I hadn't even known taking those pills, rolling the dice with my life, looking up at the stars. And that was this: I may not have really wanted to die..but I really did not want to live. And those two things are a lot closer to each other than one would like to think when trying to figure out if you or someone else is really suicidal or "just" crying for help. If you are crying for help by rolling the dice with your life, then you really are suicidal.

In the break room of Tyler 2 in the Brattleboro Refuge in Brattleboro Vermont, standing in front of a refrigerator full of milk and juice and zillions of disposable condiment packages..that was my precipice. Staring at what I had come for—ketchup—I could neither grab a handful of ketchup packages nor close the refrigerator door and not grab them. I could not go back—I could not undo a suicide attempt, the scariest part of which is that I didn't take it all that seriously—and I could not go forward: I did not know how to live my life..in this world..with these people..everything up to now had been jobs that made me wish I had never been born and people whose talk and whose minds made me wish they had never been born..I deeply hated this world and thirty-three years of genuine and optimistic and energetic attempts to fit into high school and college and corporations made me want to die. It did. It always had. I had only endured for this long out of what I now know is an extraordinary sense of optimism.

And maybe staying power, persistence, determination to solve a problem..that cannot be solved.

I wanted to die when my mom dropped me off at preschool and I wanted to die every first day of school and I wanted to die when I met the young men I would be living with in my dorm at Ohio University and I wanted to die in every single job interview I've ever been to and I wanted to die on the first day of every job I ever worked because it was all these people running around doing things that made absolutely no difference to the world—it was all empty—and they were doing it anyway. Either they had gotten used to the emptiness, sometime in their lives, or they didn't know it was empty—both were horrifying.

I could not move—literally and figuratively. That's why I was standing in front of the refrigerator in the break room with the refrigerator door open, down on one knee, then down on two, one hand on a flimsy wire shelf to stabilize myself, the other covering my face. I have been stuck before. I have stopped walking on the sidewalk and stood there for an hour, unable to move because I can't justify moving on in my life, until a friend came along and un-stuck me. I have been stuck other times, I have been trapped in mazes, chasing phantoms and running from them. But I have never been stuck like I was in that break room, not before or since, in my whole life. I was crushed, crumpling, threatening like some black hole to go supermassive, reach the size of the entire universe then disappear—nothing—a speck of dust collapsed upon itself, leaving no evidence of the torture it had been living under for three decades..just..gone.

Then there was a hand on my shoulder, and I could see just what my tears allowed, but a gentle voice was there and someone closed the refrigerator door. And then this mental health tech—taller than me, taller than my father—wraps his arms around me and hugs my shoulders, holds me tight against his chest, and I can feel his breath, and I can feel my breathing, and we synchronize, and my breathing slows, and we are one animal, wrapped together in arms, two brothers become one brother, two cells become one cell, and my convulsions calm and my wail becomes a weep and my weep becomes a sob and my sob becomes a cry and, with the comfort of a stranger who has maybe never even felt what I felt, but who knows, simply, that I need a hug, my cry becomes a tear, just a single tear coming out of my left eye, small enough that I can wipe it away with my index finger.

Now that I can see again, I see this kind man who took me into his arms when I NEEDED A GODDAMN HUG!! That's all I needed right then, was for someone who had some peace in them to give me a goddamn hug. And someone did, this mental health tech who I only had one short conversation with, days later—and when I say short I mean he and I have shared fewer than twenty words with each other. But that hug—that hug—was the hug that so far I have needed the most in this life. And someone gave it to me. A stranger—who like any good mammal will take care of babies it didn't even give birth to, babies of another species—a stranger gave me that hug. My own parents have never hugged me like that. My mom doesn't like to touch—the closest we usually get is a high five—and my dad gives that weak slap-hug that men do so they don't get close to each other. I'm not like that. I need touch. After the first night we slept together, my friend Astrea said, "I never knew how much I like to be cuddled." Yeah, that's how I do it—I want you to know all night long, through your sleep, through your dreams, that I love you. I want your body to feel that I love you. And when I give hugs to people I really love, I touch their heads. I put one hand on their back and one hand on their head. Now that's a hug. And that's the kind of hug I need..and that I have gotten so rarely in my life.

Our conversation was impossible to understand, even by us—he said there are rules about mental health technicians touching clients, but that he thought this was a case where breaking the rules was a good choice and I said thank you. That hug is exactly what I needed, exactly when I needed it, and I told him I was glad he broke the rule because that hug helped me start to survive again. And it is an event I will never forget, my entire life.

---

The next day after my suicide attempt I didn't realize I had black chalk residue all over my face from the hospital and I knew how horrible I must have looked when David the RN took my vitals and right after that for Dr. Mary Alice Meggs's initial meeting with me, where I was wailing and weeping. But it quickly sunk in with me that I was in a place where, as Dr. Meggs had put it so succinctly, we had bigger fish to fry.

---

My first night in Tyler 2 after my suicide attempt, I put a note on the outside of my door asking them to please kill me. I think I used the word, "execute." I'm not sure. Then I lied down to go to sleep.

This mental health tech named Frank came in when he was doing his rounds and sat down on the side of his bed and said he wouldn't kill me. He had the note in his hands.

"Why do you want us to kill you, Matthew?"

"Because then it wouldn't be suicide, you know, but I'd be dead anyway. Don't you do executions here?"

Frank laughed.

"No, we don't do executions."

I cried.

"I heard you tried to kill yourself," Frank said.

And I said, "Yeah. I guess I didn't try hard enough."

Frank laughed. "See. That's good. You still have your sense of humor. A sense of humor can be like a flashlight in dark situations like this—believe me—I've seen it many times. People who are able to keep their sense of humor have a powerful tool that other people don't have. Because humor is a perspective..on life. You know what I mean?"

I nod.

"You can see a thing as funny, or you can see it as sad. Most things are both. But if you can choose which was you see a thing—even for a second—you're in a lot better position than someone whose perspective is chosen for them."

And as Frank talked to me I remembered something.

A me I used to be.

I am at dinner. It is the first city I ever lived in. Someone says something funny, and someone else makes a play off of it. I feel my lips curling. And I put my fork down. There will be no eating for me for the next few minutes. My mom says, "Swallow."

I swallow my food.

Then I laugh.

And I laugh.

And everyone stops eating.

And even my dad smiles.

What is funny to everyone else is hilarious to me.

My laughter is so out of control, the joke echoing in my brain, that I clutch my sides to try to keep it in, but it builds and builds until I am holding onto the table to keep myself from falling off my chair. But that's exactly what I do, as my family watches. They laugh tamely and I am laughing out of control, mouth open, hands on my cheeks and and the top of my head.

Then I slide off my chair like some thick mixture of flour and water and I am rolling on the wood-slat floor, filling the dining room with my response to some tiny intellectual pun, or more likely some subtle piece of irony, and I roll on the floor, dinner to me forgotten, and my parents look at each other and they can't help but laughing, and my sister Joanne, usually the serious one, is looking around at everyone for cues that it's ok for her to laugh at me laughing—not even at the original joke, which everyone has forgotten. And my littlest sister Leona, in a baby chair that attaches to the surface of the dinner table in a way that never looked safe, is laughing and laughing and laughing and she throws her fork down, and it bounces across the table, and I can't see my parents, but I'm making eye contact with Joanne and Leona, and they are laughing purely because I am, Leona so young she can't even speak, but she gets in on the frenzy of the thing, and either my mom or my dad—I can't remember which—says to the other, "Well, there he goes," and takes a bite of their food.

See, this was a nightly event. Because I could find something funny in every conversation. And the world wasn't just small-chuckle funny to me—it was fall-on-the-floor-laughing funny to me..every single night.

That is a goddamn happy childhood right there. And I remember doing that as far as into the second city we lived in, even when at first the neighborhood was so scary to us that on the first night we ordered pizza in, huddled together in the living room, and listened, outside, to the sounds of gunshots and screaming. There were crack vials on the sidewalk, burning cars on the street. But I still fell on the floor laughing at dinner, and I laid there till I was all laughed out, till my sides and my cheeks hurt and my mind had fully comprehended just how fucking funny this world can be. Then I would climb back into my chair, straighten my placemat, and look at my mother's eyes—the only one to still be paying attention to me at that point in my laugh recovery cycle. She was taking in every detail, trying to figure out if this was something to worry about or if it was something normal. That's the analysis she would have been doing. And I don't know what conclusion she came to, but eventually she looked away, and I returned to my food—with maybe a little straggler laugh—and my mom suggesting I do one at a time, laughing and eating, so I wouldn't choke. So I exhale and return to the communal activity, but inside me I was full, and light, and clear, and bright. Humor has always been a way I tell someone's sharpness, and my ability to respond to it a way I keep grips on my own health. When I was a kid, some things were so funny to me that I literally lost control of my body, in my echoes and convulsions, and fell on the floor laughing. Like Cecilia: I fall on the floor and I laughing. Jubilation. She loves me again. As a fourth grader, and before, I had that kind of laughter, that jubilation that is spoken of in the Bible—trumpets, cymbals—a kind of laughter we don't think is possible today, that is reserved for the times when God spoke to people directly and Goddesses took their pleasure from men..times when there was real cause for jubilation and not a daily mass of horror on the television, which seems to have been invented solely for the spread of not just fear but terror into our homes every night we watch it. Only children, who have not learned yet to fear, can fall from their dinner tables at a puzzlebox of wit, convulsing and snorting and breaking up on the floor.

---

That night I dreamed that someone was banging the back of my head against a bathroom counter, pink tile like the Dallas bathroom, as an infant—the tile was breaking like a dry cracker, my malleable little skull taking the hits and misforming itself to protect what was within.

68

Every other Saturday was sing along with David the RN who played the guitar and belted out the lyrics which were laminated and spread out on the floor and we each got to pick a song to sing and Faith sat next to me and maybe because we were both bipolar we belted out the lyrics and I liked her sitting next to me because she threw it all out there and didn't care what anyone would see or hear. And I was the same way, belting out the lyrics with Faith and David while all the other patients sat there meekly mouthing the words to the songs.

You're in a psych ward, god dammit, if you can't let loose here then you can't let loose anywhere! Almost everyone you meet here will be gone in a week!! Do you care what they think?

I picked Brown Eyed Girl and when we actually sang it, it made me cry so much I left the room.

I loved Faith for the way she sang, and I thought she really got something right about life that way. And I feel like people outside of psych hospitals are so god damn unemotional and I think you're all really missing out on life—no less. Faith and were sitting next to each other when Brown Eyed Girl came around and she looked at me, scared, while for the first half of the song I was belting it out with her even as I had begun to cry. I sat there belting it until the tears were streaming down my face and Faith was looking from me to David to check and see if I was ok but David the raucous RN was jamming away on the guitar keeping the music going. I didn't care who saw me cry—if you're in a mental hospital, and you're that self-conscious, maybe you're in the wrong place. But eventually the emotion got too much for me, and I'm not sure which brown-eyed girl those lyrics were killing me over, if it was Rebecca, or if it was my sisters, or my Mom, or—more likely—none of the above, just a song of love and laughter and light hitting me so hard in my chest that I was beaming it out like a prism and I had to get up from that room and leave.

And Faith will come after me, when the song is over, and check on me sitting in the cushy chair outside the social workers' office, and she'll break the no-touching rule for a second and hold my hand and tell me it will be ok.

And I will lean forward, and really break the no-touching rule, and put my hand and my lips on that girl's head long enough for it to mean thank you.

---

Now a week will pass, and a Saturday without a sing along will come, and it will be sad, and in the psych ward's slow way another week will pass—of washing clothes, changing safety levels on the nurses' giant whiteboard, going through the motions of changing clothes and taking a shower.

And two weeks later it will be another sing along, and almost all the people will be new, except David the RN who belted the lyrics and blasted the guitar and me and Faith, the only two bipolar people in the place, and a couple other regulars.

I won't care if they call me Lewis Carrol 'cause faith is twenty (or nineteen anyway, she's of age) and I'm not fucking her—not that I wouldn't—but in here she's my friend because we have the same disease, and we understand each other, we understand it when we cry and when we rage and when we hop around like bunnies and slam our hands on the desk saying "Yahtzee!!" scaring all the nurses. Faith is my friend because we both have bipolar disorder, and yes, that means we are attracted to each other, as whatever—as everything—but I do know that it's good to have a friend in a psych ward.

Faith at the Refuge, the only place I ever saw her. I saw her there over multiple visits, at first gaining her trust after seeing her as an interesting person who was enemies with everyone. She had a ball or a stuffed animal or something and I asked her if I could hold it. She says "No," of course,

"You're not gonna give it back."

Finally I convince her to do it, with copious promises, and the instant she gives it to me I give it back to her—and from that moment on Faith trusted me.

I loved her, with all her ODD and bipolar and violence and craziness..wanting to hug, wanting to fuck, even though she's crazy..but having a real connection with her.

This one mental health worker brought a whole bunch of his own feelings to bear and compared me to Lewis Carroll for having an innocent thing for young girls.

"But Lewis Carroll never did anything with Alice Liddell," he said, counseling me unnecessarily.

"And I'm not going to do anything with Faith—but I do like her unnaturally," I admit.

But it's not true: I would fuck Faith if she also wanted to. Why not? She's nineteen, not fourteen! That's of age. She's mentally ill but so am I! She has bipolar disorder—so do I! Does that render you unable to make decisions about who to have sex with such that you should never have sex in your life? Faith and I would have been as good a pairing as any..and we were good company for each other in a psych hospital, and it didn't really matter if we wanted to fuck or not because that wasn't going to happen in here!—Mostly what Faith and I wanted was a friend!

But that guy honed in on me and felt it was necessary to give me a talking to—like I needed a talking to on how to interact with Faith! This mental health worker sat me down and basically accused me of something untoward, of being a pedophile, when we're talking about a thirty-something and a nineteen year old! Totally legal, totally above board—and all she and I ever did is talk!

Besides, if anything, it's Faith who has a crush on me, not the other way around! Fucking bullshit. The one friend I have in Tyler 2, the only other bipolar person, and this guy is trying to drive a wedge between it, talking about Lewis Carrol and Alice Liddell and all that shit. You try being in a psych ward and having the staff tell you not to hang out with the person you connect with most!

Sex? No sex? Who fucking cares!

I'm talking about psych ward friendship, and that shit is rare and you take it when you can get it. Asshole. I'm not going home to a wife and a family and a town full of friends every night—I'm living here, not like you, working a shift and then going home.

Don't fuck with my friends.

And that's the funny part: of all the things this health tech thought Faith might be to me, it never occurred to him that she might be exactly what I needed most: a friend.

Men in our society get a bad rap like the only reason we exist is to take advantage of people sexually. Well guess what, some of us are respectful, delicate, careful people who love other people regardless of sex and I think I speak for all of us when I say I don't appreciated being treated like a monster!

Spots got it. I mean Spots was on my level. I was flirting with Spots. I was not flirting with Faith. Spots said:

"I get it. You two are friends. You both have the same brand of crazy and in a place like this how could you not be friends? I have friends like that—you know that guy Jon with Asperger's?—I like to talk to him doesn't mean I want to jump his bones. No, you need your Faith. And she needs you, too, in a way maybe I wish you needed me, but you and I share something different."

"What, that I want to lick your pussy while I'm sucking on a lollipop?"

"Well, that, and—"

"That I want to stick a lollipop up your butt and then slather it all around my mouth?"

"You don't even, know, boy. I would do things to you that would make your granddaughter blush."

"I hope that's a promise," I say.

"Oh. It is," Spots says.

If you can't see the difference between me and Faith, and me and Spots, then I'm doing a really bad job as a narrator.

---

I had more scalp dreams that night. This time it was a dream that someone cut my hair with a razor, and took off some of my scalp on the back right side—I woke up with that side of my head hurting.

69

I saw Donald Mutebe in the employee parking lot of the Refuge. I was out on a walk with patients and he was coming to work and he saw me and realized I was there as a patient and there was this moment on his eyes where he wondered what could possibly be sick enough about me that I was in the Refuge but then he just accepted this black box of illness and we approached each other and he gave me a loving and a strong hug and I loved that man, that African man who had a child with Darling Nikki, that man who had bought my car for drinking money, that man I had shared a few wonderful drinks with. We clicked from the start—good conversation between Mutebe and I—quality fucking person.

---

I was telling Dr. Meggs..

..about that time..

..I had heard Mom and Dad arguing, when I was maybe four, and I went to them and said,

"Are you guys getting a divorce."

And my mom's answer was, "No, not right now. Your father and I have no plans to get divorced." And she looked sternly at my father. And she said, "But that is something that happens sometimes to people's marriages."

My dad's answer was to look at me square in the eye—he from his great height up there to me at my lesser and lower place closer to the floor—and say, "No, your mom and I will never get divorced."

Which was obviously—even to my four-year-old mind, not something he could know. It was not something someone could be certain about—so why was this adult (the big person) telling the child (the small person) something that was so obviously out of the realm of what he could possibly know..why was he telling me this as a fact when it couldn't be a fact, to him, to me, to anyone.

I remember knowing, at that point, that my father could not assess what I knew. And most importantly—and this was scary to me as a child—he could not assess that in some ways I knew more than he did.

Dr. Meggs says, "He was trying to comfort you."

"I didn't need him to comfort me. He wasn't capable of it. I never felt safe around him so all I needed was the fucking truth."

"How do you feel now?"

"I feel like I'm breaking down."

"Put it in more specific terms."

"Ok, it seems architectural—like I'm a building whose pieces are falling off. Like my mind is beams screwed together with bolts, and those screws are coming unscrewed, and those beams are falling right out of my head. It's like my sanity and my culturedness are structural—like an uncompleted skyscraper—and the structure is coming apart. Does your mind ever feel like that?"

"No."

Then we meditated together. She asked me first if I wanted to.

I said, "Yes."

After some struggling with the plugs and the light switches and the relationships between them, we had her little music player working and a man was leading us through a guided meditation.

The doctor sat in a soft chair, back straight, mouth open.

I sat in a soft chair and did my best to focus on the meditative words.

After a while I was able to focus on my breath at the point where it came in through the nostrils, one of the places the guided meditation suggested focusing on.

My thoughts swirled, too. The meditation went quickly.

"How was that for you?" my psychiatrist asked.

"I was able to focus on the breath some of the time."

"That's good if this is your first time meditating! Is it?"

"It's one of my first..the first was a long time ago and I don't think I got it."

My psychiatrist asked me how that went for me and the simple respect of caring about my experience got me teary again. I felt honored my psychiatrist would meditate with me. Even to take ten minutes out of an extremely busy schedule to lock us in this room that was all windows on one side and looked through fall trees and up into the mountains. I felt honored.

You know, maybe that's a big part of the psych ward experience. Out there, you're the crazy one and you're disrespected, disregarded even by your family. But in here you're the client, and people respect you because it's their job—it's their job to feed you, to keep you safe, and to try against the odds to heal you.

---

There was an autistic guy, Daniel, who wrote numbers all over newspapers and worked jigsaw puzzles and never talked to anyone, including his doctors. Well, his doctor was Dr. Criminal, and when Dr. Criminal would approach Daniel, Daniel would lead him to the Patient Bill of Rights which was framed on the wall which I suspect only Daniel had ever read, in the entire history of patients and doctors roaming the halls of Tyler 2. And he would lead Dr. Criminal to this tiny-print document and point to the relevant sections and explain, in indecipherable English, how his patient rights were being violated—and I'm sure they were. Daniel let loose a storm of verbs and adjectives and maybe threw some pronouns in there and according to everyone except Daniel it made absolutely no sense.

Daniel insisted he was being held against his will—illegally.

Dr. Criminal explained that he needed to take his medicine or he wasn't going anywhere.

Daniel, like Chad, was at the end of the line. He had probably been arrested for some minor criminal act like an altercation with his neighbors, and through that altercation he was discovered by the Vermont mental health system, put here, and determined not to be able to live on his own.

But one time Daniel did speak to someone else.

I had been there three weeks and I always nodded to Daniel when I passed him and said, "Good morning," even though he never said anything back and apparently all those little gestures added up because one day at lunch I sat across from him at a square table and he opened up to me and spoke volumes.

The only thing he ever said to his doctor was point to the patient regulations on the wall and repeat, "I have rights!" Everything else was unintelligible.

But today I was in a conversation and it was like talking to John Nash—there were bits I could understand and I had to learn to talk all over again and listen quickly—but we made out a decent exchange about how the weather would be changing soon. Of course to Daniel, this was measured in exact numbers—the weather predictions he had read—where to me it felt more like a painter, like Degas, washing broad strokes to form a dress and then inciting a portion of the canvas with a concentration, a detail, to indicate a face. So our metaphors had a lot of room to cross, but we got them to cross, and I was speaking and he was hearing me and responding and I was hearing him and understanding a great deal of the words in his slurry and I think when you threw the whole thing together you could call it a conversation.

When I got up from the table, when I eventually left the hospital, every time I left the hospital, every time Daniel and I said goodbye, came Daniel's refrain: "Good luck to you, sir. Good luck to you." Repeated.

---

And speaking of refrains, for a while there was this crazy old T2 woman who is in a wheelchair and the staff were all confused as to why this woman had been transferred here and wasn't sent to a regular hospital. She had an oxygen tank and was old, old, old.

When she get's going, she gets going:

"My cats need their attention 'cause you can't just take people from their homes and leave twenty cats behind!"

"You have twenty cats?"

"Twenty-two to be exact. And the little ones can't reach the food basket so you see the problem there, don't you. You have a college degree, don't you?"

"Yes, I have three."

"My problem is I don't want to die in a hospital. That room back there is even shaped like a coffin—you shaped it that way on purpose, didn't you?"

"As far as I know, none of the rooms were intentionally shaped like coffins."

"Well take another look! That one you have me in is a straight-up coffin, you ask me. I want to die at home."

"But there's no one at your home."

"My memory of all my chirren is there!"

"But your actual children..where are they?"

"Oh they moved all over the place. They don't want nuthin' to do with taking care of no old woman and I don't blame 'em. They gotta wash me and I gotta wear diapers—do you know what that's like?—sitting there watching Family Feud and you shit your pants, gotta wait days for some home health worker to come along and change your drawers."

"Well that's why you're here. I'm going to go now—"

"No, Dr. Meggs, you're the only one who ever treats me nice in this place."

De. Meggs smiles.

"I will back to check on you in a little while. I have to check on another patient now."

"IS SHE DYING?"

"No but everyone here has problems."

"Just transfer me out of here. My physician signed the forms. I just want to die at home."

She never stops talking and that she is going to die soon seems to be actual fact and also a fact clearly known to her. No matter what she says, her closing refrain is, "I want to die at home."

That's all this woman wants, in the whole world, is the dignity of dying in her own fucking home. I don't know, but that sounds pretty solid to me.

70

And that whole thing where I told Dr. Meggs about when I asked my parents if they were getting divorced and my mom respected me and gave me a real answer, while my dad treated me like a kid and gave me a bullshit answer..and Dr. Meggs said something I hadn't thought of, which was that he was trying to reassure me..but the point was I knew more than he did about the situation, and I'm not sure I ever got that point across to my doctor. I was four at the time..I might have been younger than that.

And my doctor telling me during meditation..we take our first breath when we are born; when we take our last breath, we die..we meditate together in the sun room with a CD. Afterward she asks,

"How was that for you?"

Memories of Rebecca, the first time I meditated was probably in that stress-relief class in the seventh grade, the second time was with Rebecca.

Dr. Meggs suggesting I think of guiding my thoughts back to the breath as if I were guiding a puppy I loved back to the training papers.

"You're not angry at the puppy, you're just guiding him back to center."

"Did you make that up in response to my shit story I told you about my dad?" (Like I was thinking she was that brilliant of a psychiatrist.)

"No," she says, "I just stole it from something I read. So don't quote me on that, it's not an original idea."

"I won't quote you," I promised.

---

Seeing a young kid who had escaped his ward, his floor, and the building. And seeing him dragged back in by two security guards. Thinking about kids spending a significant portion of their childhood in places like this and that being a hard thing to think about, possibly because we see the kid inside ourselves as him, the real little boy crying as he's locked up again. He might not even understand why he's here or what's happening to him.

On walk outside after it had snowed when it was only me in the whole ward who was on level green, so it was just me and the nurse who did my checkout the first time I left Tyler 2 and she had Dr. Criminal come in and do a second assessment because she thought I was unsafe to leave. Anyway the two of see that Gretchen has left flowers on my bike, which has been chained up in front of the institution this whole time and the nurse says,

"How nice, do you want to bring them in?"

And I say, "No, it's kind of an unhealthy relationship."

Back in the Refuge it's me and Spots in the window room.

"Why are you back here?" she asks.

"Suicide attempt. Why are you?"

"Suicide attempt. You can talk to me," she says. "We're the same. You can say anything you want to say to me—we're in a psych ward. All the social rules are off. This is not a coffee shop conversation—you know what I mean?"

We show each other our tattoos. She asks if mine is big and gangsta. I take my shirt off and she's like:

"My god, it is big and gangsta. High five."

"High five to you, Virgin Mary." (Which is what her tattoo is of.)

Spots smiled.

Spots and me make up our own refrain, which allows us to get out of any activity we don't want to do, once we leave this place. It goes something like:

"Oh, no. My doctor said if I do that I might have to go back to the hospital."

"Oh no. If I chew gum my doctor says I might end up back in the hospital."

"I'm sorry. We can't have sex 'cause if we do, my doctor says I might have to go to the hospital."

"Shhh—if you keep speaking I might have to go back to the hospital."

Spots laughs.

"If you look at me for one more second my doctor might make me go back to the hospital."

We decided that at least in our heads we would say things like this, that even if we didn't tell anybody, we would live like this.

This is how a 3½-week visit to the Brattleboro Refuge goes. It's just minute after minute without your usual distractions. Minute after minute of waiting for the next activity, which will save you from the passage of time. Boredom followed by laughter. Not being able to touch anyone.

Lunchtime.

Art time.

Substance abuse class.

For level greens, outdoor play time.

Going outside. Seeing Donald and being like, "What are you doing here?" and he was like, "I work here."

In this huge grassy field, everyone kicked a ball around—except Spots, who sat by herself far, far away from everyone—and except for me, who did handstands and cartwheels and somersaults and rolled around the grass making loud and joyful sounds. Matt the spineless substance abuse counsellor said,

"Do you think you're a little manic?"

And Spots, from far across the lawn, yelled:

"Maybe he's just happy to be outside."

Goddamn right, Spots—why does everything have to be diagnosed?

The meditation guru, Lisa, and someone else who they worked with come and visit me in Tyler 2 (they find me coloring) at a table with Winehouse and friends) and they're looking at me like they're proud of me and I'm like:

What are these people proud of me for..trying to kill myself?

I was so callous about and careless with my own life, it didn't strike me that they might be happy that I was alive, that for them, this was a success story and they had seen others before me go the other way..leave their group and never come back because they were dead. We hugged. They smiled. They said I was welcome back in their program anytime I wanted and I said ok but inside I was like Why would I ever go back to that program? It depressed the hell out of me. It's totally not where I belong, with a bunch of otherwise mentally healthy recovering alcoholics—I belong in here, with the people who are crazy even when they're sober. Anyway it was nice that they visited but it made me feel like a failure.

"What's wrong?" Winehouse said when they left.

"I just feel like I let them down. They were trying to help me. Then I just walked out of their program and tried to kill myself. I feel like they don't know I care about them, that I'm thankful for their help."

"They stopped by because they like you! Did you see their faces? They just missed you. They're you're friends!"

I look at Winehouse skeptically.

"You think nobody likes you."

"I guess..I think that is true that most people don't like any particular person."

"You think too much. They just miss you and they're glad you're ok. You have a hard time letting people in to love you, don't you? I do too, don't worry. We're fucked up."

She cocks her head to the side.

"Why do you think we're in Tyler 2?" she says, and laughs.

I have a sick look on my face and I say:

"That's more response than I got from my own parents."

"Did you try to kill yourself to get your parents' attention?"

"Not primarily, but that would been a nice side effect."

---

I went for snacks on a break from Tyler 2 with Spots. We both had green level and if you asked ahead of time, a mental health tech would walk you down to the Refuge snack shop as a way to get off the ward, buy some necessary supplies.

I had money but Spots suggested she buy me whatever I was buying that day with the deal that I would take her out to lunch "on the outside" for Indian sometime to make up for it.

"Hold up, Spots, are you asking me on a date?"

She blushed, hard.

Lynne, the mental health tech who did the morning meditation was there watching us.

"Is this just payback for whatever you're buying me today or are you asking me out on a date, Spotty Spots?"

She looks at me like Why are you making me say this out loud?

"Yes, Mr Temple. This is a loaded gun. If you play your cards right all kinds of things could happen."

Now I was the one blushing.

I picked out a whole bunch of stuff for Spots to buy.

We bought Faith dot-to-dot books because she asked for them..but she wanted ones with big dots so she could work it with her tremors..but all they had was ones with like a thousand dots per page. I looked twice for her but that's all they had. I got her some puzzle books in case those keep her occupied.

"Mmm, I can't wait for my Indian food," Spots said.

I went up to Lynne and put my arm around her and addressed Spots:

"Are you sure this is really a date?"

"It's a live grenade," she says, "—no pin—fucking may happen."

"How do I make that happen?"

"You say the right things at dinner."

"Well—" I start.

"Yeah," Spots says, "I know you, I know you'll have no trouble saying the right things. You know I live on Oak, we're practically neighbors."

"This is excellent," I say. "Then my walk of shame will only be like two blocks!"

"That's assuming I let you fuck me in my bed," Spots says.

I'm keeping an eye on Lynne. She's looking at us like, Yes! I have just seen two high-functioning mental patients make plans to fuck the crazy right out of themselves. Score!

71

Lining up by the ward's locked entrance/exit for art class or to go to lunch in the downstairs cafeteria always took twenty minutes because everyone had their own unique agenda that had nothing to do with leaving the ward, and this agenda must be followed before joining the rest of who were already lined up waiting.

I took to eating every meal upstairs to avoid this problem, even though I had level green. A bunch of other patients did the same thing, so then the staff made a rule that if you had the proper level, you had to go downstairs to the cafeteria to eat.

Now I'm going to tell you about something special, that happened on one of those trips downstairs to the art room.

It was a simple thing.

But you know how simple things are..sometimes they hit you in just the right way that they stick with you forever.

And this was one of those.

I was standing at a table drawing, and I looked over, and through a doorway into a smaller room, I saw Spots working the pottery wheel with an apron on and I fell in love a little—with her beauty and her sadness. The old-fashioned-ness of the apron, the dirt-hands creativity of the potter's wheel. Like all true things I cannot describe it. All I can do is flail like a fish on a dock and say, "I fell in love with a girl at a pottery wheel." But that's what happened. I fell in love with a girl at a pottery wheel.

And that would be the only time I fell in love in the ten years before or the ten years after my trip to the Refuge. I'd been so isolated, and would continue to be isolated—and the bar had been raised so high by past loves and past friends, and my own personality had developed so specifically and eccentrically that while meeting acquaintances became so natural that it was almost no work at all, meeting someone who thrilled me such that I could be in love with them became so rare that I stopped hoping it would ever happen for me again. I met girls I wanted to fuck—I fucked some of them. But as for being in love, I think it requires an extraordinary match and I may be far more fortunate than most to have found it once—or even twice—so long ago.

I may have told you this in another book already but there was a realization of how at home I felt doing arts and crafts on the permanent-resident side of the first mental hospital I stayed in. This is in California. I specifically thought: I would rather spend my time making sailboats out of popsicle sticks with these so-called crazy people than spend another minute in a corporate office of my choosing. To me, the crazy people aren't the ones in the psych ward—that kind of crazy is usually a deficiency that makes people nicer than usual, because they have to appease mentally healthy people to get their basic needs met..they (we?) are dependent on others, which tends to break you down and make you more polite and caring—no, to me the crazy people are the ones who have developed enough underhanded, lying, snake-tongued illogic to run a company or please the sociopath who does.

If it's between successful people and crazy people, I'll take crazy people any day.

People at this crafts table said please and thank you—people at my job intentionally sabotaged my work to make me look bad even though we work for the same company. Somehow these depressed, schizophrenic, institutionalized, brain-damaged people knew something that my college educated, condo dwelling, engineer coworkers did not, and that is that we're all on the same side. And by we I actually mean the whole universe.

---

"No but check this out, see what he's saying." That was Spots.

A bunch of us were sitting in the main room eating ice cream sandwiches, Spots had grabbed my notebook, spun it around, and tapped on the page.

"That's what I'm talking about, right there."

She gives me back the book.

"Read it," she tells me.

I read:

"There is no prison / that can take freedom; And there is no freedom / because no prison can take it."

"You see? You see?!"

Spots stands up and makes a whooping motion with her ice cream sandwich. Little droplets of vanilla ice cream splash around the room.

The nurse tells her to sit down.

"I'm sitting down. But I'm telling you, you better listen to this shit this motherfucker is laying down, because you got a rare bird up in this cage right now. Tell her what you're saying."

She points at my journal with her ice cream sandwich and I'm lucky none of the drops get on my paper.

"Oh I'm sorry! Did I drip on your philosophy?"

"No."

"That really scared you, didn't it? You thought I was gonna drip on your paper. Would you ever let me write on one of your pages? What if I take a pen and just do..this."

She makes the tiniest mark on the edge of one of my notebook pages.

"Are you trying to provoke me?"

"Provoke you right into my pussy," she mouths the words so only I can see them. "Tell 'em your fucking theory."

"It's not a theory—"

"It is a theory. It's a fucking brilliant theory about freedom. And a proof. That it doesn't exist. Read that thing again. And explain it. Most of these mental health techs never went to college."

"Actually," one of the mental techs who's sitting on the edge of this conversation says, "mental health techs have to have a bachelor's degree."

"Marlboro College doesn't count," Spots says. "Educate these motherfuckers."

"Well I was just thinking about being stuck here, and I was thinking about people on the fourth floor or people in jail who are stuck behind walls for longer than I've ever been, and I was thinking about The Shawshank Redemption and Nelson Mandela and it hit me that if you are the kind of person who even walls can't imprison, then there's really no such thing as prison..because if it can't take away your freedom, then it isn't functioning as a prison. It's not doing its job. If it's not imprisoning your mind, then what is it imprisoning—we know from being in here that what matters most is the mind—if you can't imprison my mind then you can't imprison me. If in general you can't imprison people's minds then in general there are no prisons."

"But tell 'em how you wrote it."

"I'm stuck between two versions, but the main contender is: There is no prison that can take freedom; And there is no freedom because no prison can take it."

"Do you hear what this motherfucker just said??!!"

Spots flails her ice cream sandwich and a single drop of ice cream gets on my book.

We have a two-second staring contest in which it is decided that neither of us will ever do anything to hurt the other, even if one of us crosses the other's line.

Spots leans over the table, dripping her ice cream sandwich all over Brigham's drawing, and licks the drop of vanilla off my book.

"I'm sorry," she whispers. "I promise I'll make it up to you."

"What got into you?"

"New med. Dopamine. Makes me want to fuck."

"Jesus."

My mind is flashing through fantasies of her licking a single drop of vanilla-flavored precum off the tip of my cock.

"Tell 'em how you redefined freedom."

"It's more of an obliteration of the concept."

"Then tell 'em that."

Spots leans back in her seat.

"Well," I start slowly, "if there are no prisons that can take freedom..because the mentality of the people is such that no prison can take it.."

"Can take their freedom."

"Right. Then a surprising result arises..which is that this valuable concept of ours..freedom..so important in history and class and race and gender struggles—"

"You sound like a fucking feminist, I love it."

"I am a feminist."

"Fucking hot."

Spots is gnawing away at her ice cream, not even looking at me.

"So if freedom is so strong in the mind of the prisoner that they functionally cannot be imprisoned, then the concept of freedom—as beautiful as it is and as much as we strive for it and think we need it—freedom disappears. There's no such thing as freedom if no prison can take it! Because what is a prison for? To take away your freedom. So if no prison can take it, then it never existed in the first place. There is no such thing as freedom if there is no such thing as a prison. They need each other to exist, see? For some people, there is freedom and that freedom can be taken away, via prison. For others, since prison cannot take away their freedom, then it means that there's no difference between being in prison and being out of prison..and hence—"

"Hence. Love it."

"And hence what they might have called freedom on the outside, really doesn't mean anything because no matter where you put them, nothing fundamental changes in their minds. If you can't be imprisoned, you can't be free—it's all the same. In a strange way freedom implies that you have something to lose. But if you are prison-resistant, in the sense that prison can't take anything away from you, then you must never have had anything to take away in the first place. Hence you never had freedom from the start."

The room is quiet. Every patient. Every staff member. Health techs are perched on countertops. Nurses' pens have stopped writing their reports. Psychiatrists have stopped in the hall to listen.

Spots broke the silence.

"That's my boy!" she bellows. "You see that book? Every page he's got fifty sayings like that, all worth a philosopher's weight in salt..pure..fuckin'..titanium nitrate bath melodies for a dream queen. That's, my, boy. Now watch him eat fifty eggs."

I laugh.

Some other people laugh—patients.

"I bet none of you know what movie that's from," Spots says.

"Cool Hand Luke," John says, from behind the nurses' station. John is bald and compulsively wears rugby shirts to work and he's one of the kindest nurses on the ward. He's worked in prisons, actually.

"Not you, motherfucker! Ever thought of giving someone else a chance to answer?"

Some nurse says, "Change the language."

Spots says, "I ain't changin' nothing."

This is Spots craving her night meds.

"Then your green level is gonna change to nothin'," says the nurse.

"Nothin'?" Spots says, and she looks like she's gonna do something stupid. That huge Virgin Mary tat makes me think Spots on pain meds could be a tough customer.

"Hey Spots. Remember? Sometimes nothin' can be a real cool hand."

Spots turns her eyes away from the nurse, where they had turned into the eyes of some Brazilian gangster—containing the bile of poverty not even poor Americans could understand—and she turned her eyes to me, and I swear they did this reptilian move like Miley Cyrus on crack, some CIA replica designed to take over the world, and those eyes blinked once and all the alien evil was gone from her, and she was sad..Spots addicted to pain medicine, Spots whose mother was dead to suicide, Spots who had no way out of her current relationship except to pack her suitcase with A-quality art supplies and come to the Refuge. She looked at me and knew that I knew why she was there. And she wiped a tear from her eye and laughed. Then she laughed and laughed and laughed, looking up at the ceiling and looking at me and she laughed like only someone who has tried to kill themself can laugh—really it's only at that level of self-hatred that life gets truly, deeply, insanely funny—and she laughed with all of that truth and all of that depth and all of that insanity, like she had just been exposed to an hour-long Anthony Jeselnik routine compressed into one second, and she was laughing at that.

There was nothing funny going on in the room anywhere but inside Spots' head. The laugh wasn't contagious. It was scary. It was unexplained. It was over the top. It was inappropriate for the situation. Patients started to leave. Philosophy and ice cream sandwich time was over, and by the time most people had left, Spots' laugh had turned into a cry and she was sitting upright, brushing wet hair out of her face, looking into my eyes, and I could tell what she was doing. She was role-playing all her hate for her boyfriend, for her mother, for her father, with me, and I felt the hate, and was glad when bald headed, rugby-shirt John came and took Spots by the shoulders and helped her up and helped her down the hallway to her room, all the way down at the end.

I stood up and closed my journal. I started cleaning up Spots' art supplies—hundred-dollar colored pencils, oil and chalk pastels of all sizes, pencil sharpeners which had somehow been allowed on the ward (they contain razor blades!), and her huge, off-white, eighteen by twenty-four inch drawing pad whose paper's coarse texture caught Spots' gestures so well.

She was drawing a goddess. But to me she was a goddess.

It's like this: people who hurt that much, either hurt so much that they die..or, like Obi-Wan Kenobi, every time you strike them down, they become more powerful than you can possibly imagine.

I was desperately hoping Spots was one of this last kind, because I needed to know that somewhere in the world there was another like me.

72

Thirty minutes Spots was back like, "Night meds let's party!"

Yeah, hers were pain meds, so to her it was a party. And I was glad she had them, so she wouldn't be in pain and because I liked Spots on meds a lot better than Spots off.

I'm playing Yahtzee with Spots and two others. Spots is yelling at me to stop mixing the dice and it took me a second, and another girl saying, "Stop! Stop!" to realize I was shaking the dice with a motion similar to the jerk-off motion.

"Just throw the dice!" Spots was saying, before I realized what my dice-rolling movement reminded them of.

And I'm like, "Why?" and I make the motion again.

Spots catches my wrist in her hand to stop me.

"You're in a psych ward with horny women just roll the fucking dice."

So I roll.

I get Yahtzee.

I stand up, I run to the nurses' station and bang on the desk three times and yell "Yahtzee!"

I sit down without looking. I ask Spots what their reaction is and she says she thinks I scared the new girl nurse.

---

At Spots' request, we listen to audiobooks just the two of us in the sunroom, lying down and wishing she would touch me, feeling content. She was sharing something that was special to her with me—Spots and I developed a relationship in the ward. I even told her how I felt about her and she said you've seen how I react to you—you can see that I feel the same way.

I told Dr. Meggs that even Spots and I, who know each other from the outside, are aware of making this a time to focus on our own selves, but I imagine if I was a psychiatrist of a suicidal patient that seeing him attracted to someone wouldn't bother me a bit.

Spots and I started meeting at certain times of the day to work on our web design business and talk about how its website will work and look. And every night we met in the hothouse room to listen to audiobooks on her iPad. I laid down close enough for her to touch me, but she didn't. We were in the wide window room. Spots was so close—I wished she'd touch my hair, touch my head in a caress. We listened to a recording of one of her favorite books on her iPad and she was happy at the end of each chapter when she asked me if I was enjoying it and I said yes. I said,

"I give you looks, and I think you can see in those looks that I like you, that I want more of you."

And she said, "I think you know that I give you those same looks, too."

And I did. The deadliest of those look exchanges had happened that day at lunch with the two of us sitting across from each other at a square table, coloring, with two others at our sides, and there were just two looks: one from me that asked a question..and one from her, held long and steady, that answered it.

This is something Spots wrote in my notebook that I've never showed anyone:

when she makes me cum my feet cramp

or when she cums, her feet cramp

"This is your personal piece of heaven.

You can have it whenever you want."

When the tally is taken at the end of my life, please no one claim that I was given a short portion of love.

73

I tripped inside the Refuge, flirting and talking with that one art therapy instructor. Tripping in the mental hospital, that first time I realized it in art class, talking to the art instructor and we found each other fascinating—she was totally into the weird things I was saying and drawing and I felt out of control morally like I would say or do something inappropriate. How I would trip every day, and make art at the height of my trip.

That one time I felt it coming on sitting down on the floor in the med line talking to the old woman getting a hard on at the medicine and needing to hide it so I sat down. The poor sweet woman who was standing next to me in the med line when I had to sit down to hide a medicine-induced woodie—me sitting on the floor outside her room listening to her tell her sob story.

She's an alcoholic who lives with her husband and they both drink together but she's obviously the one with the real problem because she's in the hospital (lol..designated patient, anyone?).

And the medicine was getting to me, fracturing me—can you feel it?

When I sat down in the med line because all these serotonergic medicines were getting me so excited my dick was getting hard. Talking with the old woman with the walker in front of me.

I notice this woman—twenty, thirty—at a table eating breakfast. We've interacted before but now she has compassion in her eyes—probably because I'm sitting on the floor like a lost child. I call her Winehouse—something about the hair and general badassity of the two (her and Leona Winehouse) paired them in my mind. Then the med nurse (remember Rainbow?) leans out the window and looks down at me sitting on the floor and says,

"Why don't you come up here and we'll get you fixed up."

So I stand, trying to hide my erection, and take my meds.

Winehouse slides out a chair with her foot and invites me to a table full of girls. She asks me questions and opens my juice for me because my hands are shaking. She cares for me like a mother and makes sure I'm ok before I leave her sight.

She was brilliant to me.

And how my art changed when I was tripping, to this very detailed almost technical muralistic form and how Dr. Meggs could see the change in my art when I pointed it out to her—and that fascinated her about me that I could see that.

The first time I was tripping in the art room confiding it to a patient who was about to be released and telling him not to tell anyone because I wanted to keep tripping.

And then leaving the room for the trippiest check-in ever with Lynne in the hallway, telling her I was seeing the shapes of words in my eyes and her saying I was saying some bizarre things, then getting passed of to Dr. Meggs, crying uncontrollably, the clock moving with one second taking like five seconds, her taking my pulse and walking me through breathing meditation: breathe out anxiety and stress, breathe in sky/I'm ok.

For days then, chasing the sunlight with a piece of copier paper, sitting on the floor by the nurses' station looking at a blank piece of paper in a ray of sunlight, catching the last glimpses of my texture hallucination. What you would have seen if you looked at me was a thirty-three-year-old man staring intently at a blank piece of paper. But that's not what I saw. To me that paper was a petri dish in fast motion, a universe of movement and form, changing, growing, performing just for me.

---

I see the dietician, Paula, and she's like:

"How's it going?"

And I'm like, "Great, I'm learning a lot of things about my mind."

And she's like, "What?"

And I said, "Like maybe a little psychosis isn't a bad thing for a writer!"

"Ahh! There's a way to look at it! Think of all the psychotic people out there who have no idea. At least you're aware of it, you can manage it and even use it like you say!"

"Exactly!"

"You're just here for a checkup," she says.

She obviously had no idea what I was here for or what had been going on with me (or maybe she did) but she treated me like a well human being who was capable of insightful talk with her.

And we had in the residential hallway, paused, as she took another, newer patient somewhere, maybe to check in to the ward, and (as always in my life, and it's usually with therapists or psychiatrists) I felt like a human being simply by the action of having an intelligent conversation with someone.

We talked a while about the somewhat random-seeming basis by which it is decided who is in and who is out of the mental hospital, and other fairly progressive thoughts. Paula and I just clicked. We'd say hi in the hallway and twenty minutes later we'd be standing in the same spot talking ardently, and she'd have a patient with her standing mostly silent while we talked up a storm and then she'd have to go—but I got the feeling that with me and Paula, the conversations were bottomless.

---

I remember asking Dr. Meggs if we might talk about a release date. I was scared I was taking up too much hospital time, time that someone who needed it more could be using.

And Dr. Meggs said, "I'm not even going to begin to talk about a release date with you until I understand the events leading up to that night of my suicide attempt and I feel sure that they won't happen again."

That made me feel safe, like someone was looking after me in a way I had needed many times in my life but hadn't been able to get. You see? Sometimes I need someone to protect me from myself.

---

There was a day I was walking to the fitness/game area with about five patients and the clueless substance abuse counselor Matt and we walked by the sober house where the Birches people stayed and the borderline girl who had flirted with me in social work group (even though she had a boyfriend) came over and hugged me and wished me well and I thanked her but I didn't remember her name. But I know you're out there somewhere, now a borderline woman, and you're reading this, and I want you to know this little paragraph is for you, because your hug meant at least enough to me back then to put a little paragraph in my book thanking you, now.

---

Ready to get trippy again?

Imagine yourself on like eight serotonergic meds with a history of psychedelic drug use.

You're in art class—regular art class, on the ward.

You are starting to hallucinate looking at a blank piece of paper and you turn and look at the guy next to you (who you've never seen before) and he says,

"You're seeing things, aren't you?"

And I said, "Yes but don't tell anyone because I think the medicine is causing the hallucination and I don't want them to take it away."

Then I start drawing and writing this amazing stuff and the beautiful young art teacher comes over and we have this amazing conversation about art and Everything and she said,

"What you're doing on that paper is amazing!!"

And we connected so well and I told her:

"I'm having some kind of medication effect that is affecting my ability to tell what is appropriate and what is inappropriate in action or talk and I am really enjoying this conversation but I am afraid that I might say something inappropriate to you without knowing it and I don't want to do that."

She said, "Why don't we just enjoy our conversation and we'll deal with that if it actually happens."

(By the way, I definitely recommend that all future psychiatric care take place in art museums.)

She wasn't scared.

I agreed and we went back to our wonderful conversation about art and humanity and life and I was saying all these brilliant things and she was recognizing and appreciating my genius and she was able to converse with it.

And she was beautiful and I could see her and smell her and hear every beauty of her.

Then Lynne came and said, "I can see you're having a beautiful conversation here but would you mind if I borrowed Matthew for a check in?"

The art teacher said, "Sure, if that's ok with you."

I said, "Yes."

And the art teacher said you might want to tell Lynne about what you were telling me about what you're seeing on the paper, and the appropriateness/inappropriateness boundary difficulties you were describing. I agreed and went with Lynne.

This was my most bizarre checkin with Lynne and my panic attack streaming tears thinking I'm going to die the clock seconds ticking away like minutes and Dr. Meggs staying by my side taking my pulse and helping me breathe out fear, breathe in I'm ok. She thinks it was a panic attack, I think it's a side effect of clomipramine. Dr. Meggs stays with me for what seems like a long time..I feel guilty for keeping her but I'm glad she's there..she takes my pulse with just her fingers and her diving watch, never uses her stethoscope..and she has me breathe out panic, breathe in calm; breathe out humiliation, breathe in security and comfort; breathe out chaos, breathe in a deep blue sky..

Then, while I have my eyes closed, breathing becoming more regular, she tells me a story. She says, "When I was in medical school, one of my teachers taught me a lesson. He said, let's say you walk into a triage situation, and you're in charge, and you have this kind of surgeon doing this and that type of surgeon doing that and everyone's running every which way and you don't know the state of the patient but there are five different monitors telling you gobs of information and you walk on the scene, and it's your job to save the patient's life. What do you do first? And do you know what this teacher said said to me? Don't answer—keep breathing. He said the first thing you do is check your own pulse."

Of course she's making that into a metaphor for what I should do with my anxiety. And she tells me this while she's taking my pulse during my medicine-aided panic attack and while she knows that I have an OCD anxiety that is literally about taking my own pulse.

I understood why Dr. Meggs told me that story, understood it in a basic way, right when she told me. But its meaning has deepened for me over the last four years or so and I have only recently come to understand it as a story about metacognition—you know that term? Thinking about thinking, knowing about knowing? What I was doing when in the fifth grade I marked my own test—I knew all the answers I had gotten wrong. I wasn't just thinking about the test, I was thinking about my thinking about the test.

One of the painful features of bipolar is that you don't think you have it. Every doctor I see, I try to get a new diagnosis, genuinely believing that I might not really have bipolar, that somehow the twelve (or twenty) preceding psychiatrists I've seen have been deluded, that they've just based their diagnosis on the previous diagnosis and the first diagnosis was wrong. And going along with this is the even stronger effect of not knowing when you're manic.

Denying that you're manic is a symptom of mania—that's a very weird thing to think about. And this is how I understand Dr. Meggs's triage story now. When I wake up in the morning, I have to notice my first few thoughts. This is kind of like meditation, too. Notice your thoughts and notice something about them. Is that a paranoid thought? Am I worrying? Am I having ideas of reference—thinking things have special meaning just for me? Do I feel expansive? Irritable? Grandiose? Are my thoughts spiritual in nature. Am I thinking things like, I feel like I'm on a new plane of consciousness—an example from the other day. Some features of mania I am unable to have metacognition about and I need to rely on those around me, which is very hard.

And if mania is bad enough, you just flat out don't know that you're manic. It's like trying to know you're in a dream, as the characters in Inception are trying to do. Cobb says, "Well, dreams, they feel real while we're in them right? It's only when we wake up that we realize something was actually strange." It is hard to realize you're dreaming, but there are clues. Same with mania. That's metacognition about your dreams, about your mania. It's a funny thing: Once someone tells you (or you read) that denying you're manic is a symptom of mania, it creates metacognition—at least it has in me.

Insight is mentioned in three out of seven of my Refuge discharge reports. In my last reports, Dr. Meggs lists "relatively good insight into his mental health issues" as one of my strengths. And it is. Reading about bipolar does not cure me of my bipolar, but that metacognition, that insight, helps grease the rails for me to be an active participant in my treatment. When I meet a new doctor, I often understand why they are asking the questions they are asking, what they are trying to determine. I am more apt to do self-checks—for hallucinations, suicidal ideations—I am taking my own pulse.

---

VINCIT QUI SE VINCIT is a Latin phrase which is carved into stone above the school where I marked my own test. I kept asking the teachers at that school what it meant, and no one knew. So (being that this was before the internet) I wrote it down and kept it with me, waiting to meet someone who could tell me what it meant. Then one Sunday a new couple came to our church. He was a student, and she was working to support his studies.

"Studies of what?" I asked.

"Latin," he said.

So I pulled out this piece of paper and showed it to him.

He translated it, and said: "Vincit qui se vincit. She conquers, who conquers herself."

I have loved that saying ever since.

I have it tattooed on my back.

I believe it's a very important idea.

Maybe it should say: She conquers, who knows herself.

Or: She knows, who knows herself.

I don't really think you can conquer. I don't really think you can know, either.

But maybe you can know a little.

I know once I saw Inception I became more aware I was dreaming. I think we all did. Because we thought about Christopher Nolan's concepts a lot. And I find now that I have more lucid dreams, and more dreams where I'm aware I'm in a dream, than before I watched Inception five times in the theater, countless times after. You know what my favorite thing to do is, once I realize I'm dreaming? I go up to someone, a dream character, and I say:

"Guess what? You're not real. This is a dream. I'm dreaming!"

And the person says, "Well I feel real. How do you know I'm fake?"

And I say, "Because in a few seconds, I'm going to wake up, and all of this will be gone."

And they say: "How do you know that I'll be gone? How do you know that I'm not really me, and that dreams aren't just a way for our minds to connect that science hasn't discovered yet?"

And then I wake up.

And I don't know.

74

Dr. Meggs, with her swimmer's watch and rugged shoes, looked more like she was a deep-woods camper than a psychiatrist.

Twenty-four patients to the ward, maximum—and we were usually at the max—and only three psychiatrists among them. That meant each psychiatrist was seeing eight patients a day, and one of their requirements was that they actually meet with each of their patients face to face every single day. Sometimes you'd get five minutes, sometimes you'd get an hour, but if you got five minutes it was because those doctors were smashed—they had to do research on your condition and your past hospitalizations, communicate with your family in some cases, go to team meetings to coordinate your care with nurses, mental health techs, nutritionists, social workers..and they also had to deal with the occasional death, seizure, or fight on the ward—I would say working as a Tyler 2 psychiatrist is one of the most stressful jobs in the developed world, right along options trader and air traffic controller.

Oh and trauma surgeon.

Yeah. Working in the ER has to be extremely stressful. An ER doctor makes the difference between your physical life and death. That's hard. Of course if requires special knowledge.

But I think a psychiatrist's job is more complicated. Diagnosis of a physical trauma can surely involve seeing past false indicators. But diagnosis of the mind..that, at its most difficult, must involve a great deal of doubt—greater than that encountered in the emergency room—because the system you are dealing with (the mind) is less understood than the body. It's loads more complex. We haven't really developed the proper tools to deal with it yet. And it's more subject to masquerading than physical problems—even though there are well-established textbook definitions for various kinds of bipolar disorder, bipolar disorder remains extremely complex to diagnose. As in: it takes an average of ten years to do so. Imagine if it took ten years to diagnose patients in the ER—by then they'd all be dead. It's just a lot more complicated to figure out someone has bipolar disorder than it is to determine if someone has a crowbar stuck in their head.

75

Me and Spots sitting in the main room watching this woman Judy who was constantly falling over even with a cane and Spots says,

"She shouldn't be here."

Spots went around insisting to the nurses and mental health workers that Judy should be in an ER. And Spots was right, because two days later Judy died, she collapsed in the main room by the nurses' station. Spots tells me this later because I was out of Tyler 2 by then, but I saw it, too: I was downstairs in the cafeteria and heard the code blue and saw EMTs go in and come out with a stretcher with a dead woman on it and I knew it had to be Judy.

---

On a Sunday, at the Refuge, I met with Michael Miller, who used to be the director of the clinic (like over the whole Refuge), who now comes back one weekend a month to meet with patients.

"You're a smart person, aren't you?"

I ask him how he knows that.

He says, "By the way you answered my previous question, I can tell that you're articulate."

I tell him my theory that cellular automata may have infected my brain and we both agree that it could be true.

He says, "It sounds like something out of The Matrix."

This conversation is the bright point in my day, the chance to speak to someone intelligent. So many of my conversation partners are so dull.

I know I have some strange theories about programming and the mind, and when I'm manic I consider them more realistic. But they are theories—even when manic I am able to doubt them. And of course I'm more likely than the average Joe to think of ideas related to programming—I've been programming computers since I was a little kid. And, the concept of programming brains or "mind control" isn't a far-fetched idea, even among common culture of the mentally healthy variety—we as the public have at least been led to believe that governments have been working on (and may have achieved some successful results with) mind control. To suggest that my brain may have taken on the ability to operate a simple program suggested from the outside is not really a crazy idea. Right now, not manic, I don't believe that has happened, but even if I am less lucid than I think, I think I'm lucid enough to make the reasonable suggestion that a) brain programming is something we will see accepted widespread as reality in short order, and b) it may already be occurring on a very large scale, to a depth and degree hard for us to fathom, as we fucking speak.

Mr. Miller shakes my hand.

"Great talking with you."

"Great talking with you, too."

Lynne comes up to me.

"How was that?"

"It was great! That's a very smart man!"

"That's great," Lynne says. "I'm going make a suggestion to you, that I just thought of."

"Ok."

"I think it might be good idea for you to spend ten minutes out of each hour lying down in a dark, quiet room."

When she said that I was thinking: How can I possibly manage a job while doing such a thing?

But Lynne continued. She said, of the psych ward we were standing in:

"This is probably too much stimulation for you, even. You've got so much going on inside your mind, you don't need a bunch of noise and junk coming at you from the outside. Conversations stimulate you. Like the conversation you just had with Dr. Miller—whatever you guys talked about—got you running..ramping."

"It did?"

"Yes. You went in there calm. You came out out of control."

"That's right!" I said. "I've had to stop working on projects before or thinking in areas that got me far too excited! I have to limit phone calls with smart people to half an hour. My brain is just like that!!"

I have no idea how she knew I had a lot going on inside my mind—I didn't realize it was that observable to some people—but she was right. I also didn't realize fully until years later that Lynne's suggestion for me absolutely implied that she didn't see me going back to a work situation—what office is gonna let me lie down in a dark, quiet room for ten minutes every hour? At that point I still thought I had to work, I still thought I could. Who knows what the future will hold, but I know, today, at the time of this writing, there's no way I could work the jobs I've worked before. I hate the word, I think it's a misnomer, and I hate to say it about myself, but I am in some ways disabled.

---

In a meeting the next day with Dr. Meggs, I show her the evolution of my art, as is hung on my walls and which creates a beautiful mural of color for anyone walking down the drab hallway of Tyler 2. I left my door open most of the time so people could see it. But what I showed Dr. Meggs is the break in style between what I was drawing before and after starting the clomipramine. Before the clomipramine my art was chunky and friendly—big lines, the zebra, Spots—after clomipramine I started drawing these incredibly intricate abstract line art/word art things that were like they were done by the completely different mind of a completely different person. I explained to her the feeling of obsession and patience which I had now that I didn't have before, and when she looked at the art, she saw exactly what I meant. She titrated me down off the clomipramine to a very low level to address a possible allergy to clomipramine and the texture hallucination I'd been having.

She was looking at me in a way I had never seen before.

"What?" I said.

And she said, "I'm just impressed as hell that you figured this out."

---

The worst thing about being in a psych ward is waking up to go to the bathroom. The shock and fear and isolation and anti-homeness, strange-land-ness of waking up in the night to go to the bathroom and realizing you're in a psych ward..then you realize you are not leaving today, you will be here for days, weeks, months (this is one of the worst realizations I've ever had..waking up in the middle of the night to go to the bathroom and realizing I am in a locked psych ward and not cozy, home, in my own bed).

Then you actually get to the bathroom. You open the door. You thought all you were doing was getting up in the night and going to take a piss—that would be adventure enough—but when I open the door, the whole space is flooded with fluorescents, Chad is leaned against the stone-block wall with one foot on the floor, one foot on the seat of a toilet. The curtain which would have kept that stall in privacy has been pulled back so the whole stall is visible. Between Chad's legs, on the wall, on the floor, on his hands, is shit. He is digging up his ass with his fingers, removing the shit from his ass, and it is falling onto the floor. When it doesn't, Chad smears it on the wall.

Chad looks up at me in slow motion. He recognizes me. He knows I recognize him. There is no need to wave. Chad and I are closer than that. We're in a psych ward together—all formalities are waived. As Spots says, This is not a coffee shop conversation. As I look at Chad and his array of shit, I know that's true—no politeness here. I let the door close behind me and walk to the stall opposite Chad's. I know what his problem is—he's constipated. The industrial food plus his meds make it so he can't take a shit. Half the patients in here are constipated. I have wanted to do exactly what Chad is doing—I have had that exact same impulse, have had such bad constipation that I've been sitting in a stall trying to shit and completely unable to do so that I have thought of sticking my own fingers up my ass and trying to dig the shit out of there. But I never actually did it. I either zen master meditated myself through the pain of squeezing that industrial-medicated log of psych ward poop out of my delicate little asshole, or I ate fruit for three days, or I asked the nurse for a laxative.

Chad was one millimeter farther over the line than me, and he actually dug up his ass and pulled the shit out of himself. The man needed relief.

I finished pissing and flushed the toilet—must maintain my own illusion of civilization. Said bye to Chad on the way out and he said bye to me. I thought about reporting Chad's situation to the night nurse but the conversation that would occur between us seemed like it would be either awkward, funny, or unbelievable, so I decided to do what everyone in the place had been encouraging me to do: I focused on my own healing and just went back to bed.

In the morning, all the nurses on morning shift were talking about some "incident" that had happened at night—something that was so hush hush that even normally loose lips wouldn't speak a syllable on this one. I sat in the main room eating my breakfast, finding some humor in the psych ward staff keeping secrets about psych ward patients from psych ward patients. These first shift nurses were asleep in their beds when Chad was excavating the poop from his rectum, at the time when I was standing next to him taking a piss. The nurses with the hushed secrets that patients were not allowed to hear, learned about Chad's poop excursion at their 8am handoff meeting with the night shift. I was there, man, I was there—my own personal Vietnam. And let me tell you, soldier, after months of living in a psych ward, it would take a lot more than the sight and smell of Chad digging feces out of his anus with his own fingers to mess with my head—that shit was just business as usual.

At night, too, trying to squeeze in a masturbation session, orgasm on Celexa between fifteen minute suicide checks..especially after what I had just seen Chad doing..impossible.

Some nights I'd arrange all the furniture in the main room until it was perfect for me and then I'd sit in one of the gliders and rock away my extra energy or else sit at the round table using my special way of climbing into the chair (push the armed chair all the way in and then climb over the back) and I'd read, write, take notes in my notebooks.

Some say that when a person is overly controlling of their external environment it indicates a chaotic inner life. I tend to agree.

---

Dr. Meggs asked me to remember what and how I felt when I felt suicidal and to tell her next time we met. I said cold chills in my stomach and other things. She told me to get a heated blanket and combat the suicidal feeling on a sensory level. Only use that blanket when I feel suicidal.

"I attempted suicide partially as a way to get people's attention, to get people to take my mental illness seriously. My dad never even called."

Dr. Meggs said, "He's never going to."

"Mom says I escalate my behavior to try to get his attention. And she says that nothing I'll ever do will get his attention."

"Based on what you've told me about him, I believe that your mother is right. He is a sick person and he doesn't have the emotional capacity to relate to you in the way you want to be related to."

"I think that's right. And I do pretty well when I forget about him and don't open up to him. I hadn't written him in four years till tonight. And I think I need to go back to that strategy of pretending he doesn't exist. It works the best. It's too painful to know that my dad is still alive, out there in the world, and he has no idea what's going on with me..and doesn't care."

Dr. Meggs loaned me her personal copies of Pema Chödrön books—Don't Bite The Hook. This is what I would read late into the night in the main room with the night nurse John looking over me. I didn't just read them—I studied. I took notes. I read and re-read.

And I remembered how I used to follow people to their house in my car if they cut me off in traffic when I was twenty.

My psychiatrist and my mom both said I'm a very angry person. But the trick is to not bite the hook, of course, to stay on your own trip..when you follow someone to their house because you want to scare them, to kill them, you're no longer on your own trip.

Staying in a mental hospital for a few months is good practice in staying on your own trip because in the hospital there is always someone trying to get you to go on their trip, to enter their psychological reality..and you need to decide if you really want to go there. Same with my dad: do I want to be on his trip? Do I want my trip to be modified by him in even the slightest way? The answer is no. I'm on my own trip of creation and sobriety and compassion, which I believe is the point of the 12 steps.

---

Eventually Dr. Meggs lets me leave. Maybe she did keep me here longer than necessary because she liked my company. If so it was mutual—it didn't have to be sexual, it was never inappropriate, but, hey, there's nothing wrong with people enjoying each other's company once in a while, even in a psych ward, even between doctor and patient. But when we both felt it was safe for me to leave, my doctor set a discharge date and I prepared myself mentally for leaving the security of the Refuge.

Some say life doesn't begin until after your first suicide attempt, and while I cannot recommend you attempt suicide, there is a sense in which this morbid phrase is true. There is nothing that can give you a stronger love of life than either witnessing death or escaping death—especially if you were the one trying to visit death upon your own head.

It's a wonderful thing to fail at.

Brattleboro Refuge Discharge Summary (3)

Patient Admitted October 5, 2011—Discharged October 27, 2011

Identifying Data

This is the second Brattleboro Refuge third lifetime admission for this 33-year-old single white male loser. Patient is currently unemployed computer software engineer and a writer. Patient lives alone in Brattleboro Vermont.

Chief Complaint

"Because I took a bunch of pills last night. I got angry yesterday and that's not a good thing for me because I go inward." [Yeah, look, what I was trying to express is that anger is dangerous for me because I was raised not to hurt others, so when I'm angry with others, I point that anger at myself, and unfortunately for me that means removing myself from the situation..through suicide.]

History of Present Illness

On admission the patient reported that on discharge from Tyler 2 last week he returned to his outpatient program. States on admission that yesterday "it went wrong for me." I had a lot of "rising energy and felt anger and rage. At times like that thoughts come to my head about suicide but I had not been planning anything. I had not been planning suicide during the week. However last night I took the pills." Patient feels helpless and hopeless all the time. "I can't make myself hike anymore even though that's the main thing I love to do." The patient does not know how many pills he took but he took the entire bottle.

Course of Hospitalization

On admission to Tyler 2 patient wrote "I'm mixed up. I'm lost. I have no idea what to do." [Have felt this way most of my life btw] Stated "I thought I was getting better but I knew I really wasn't. I don't know if I wanted to really kill myself. I'm just confused. I just don't know." On admission to Tyler 2 the patient reported extreme mood lability [emotional instability], racing thoughts, and ambivalence with respect to the fact that he had not completed his suicide attempt. Patient was begun on clomipramine and Lamictal was increased. In addition the patient was started on clonidine for anxiety. Clomipramine was slowly titrated up with good effect however patient reported odd visual disturbances with the clomipramine and in the end the clomipramine was discontinued despite its having helped with his obsessive thought process. In addition patient was introduced to meditation and breathing exercises as a way of controlling his panic attacks and anxiety. [I don't think I've ever had a panic attack, but my psychiatrist Dr. Meggs disagrees. When I first came to the Refuge, I didn't even know the definition of "anxiety," though clearly the word characterizes my behavior.] Trazodone was added for sleep with good effect. Patient was also begun on buspirone for anxiety. Celexa was added for depression with intent to maintain a low dose secondary to the patient's bipolar disorder and concern about inducing mania. As we had to discontinue the clomipramine secondary to visual disturbances, the patient was begun on risperidone to which he immediately responded with good effect. Ultimately the patient began to feel well with decrease in obsessive thought process and improvement in terms of mood and was discharged to the Birches IOP Program [Intensive Outpatient Program—five days a week, six hours a day—group therapy led by a social worker, classes on substance abuse and mood disorders, dialectical behavioral therapy, individual meetings with whatever psychiatrist was on duty, and an end-of-day evaluation and safety check (meaning, how likely are you to kill yourself tonight?—I tended to do poorly at safety checks and was often held late for an extended one-on-one discussion with the program's nurse, Ms. Irwin)]

Final Diagnoses

Mood Disorder NOS. Alcohol Dependence in Early Remission. Cocaine Abuse in Early Remission. OCD. Nephrolithiasis, Recurrent [kidney stones]. Financial difficulties secondary to unemployment. Close relationships with his sister and his mother.

GAF on Discharge: 40 [By the book, a GAF of 40 means I have, "Some impairment in reality testing or communication (e.g., speech is at times illogical, obscure, or irrelevant) or major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood (e.g., depressed adult avoids friends, neglects family, and is unable to work; child frequently beats up younger children, is defiant at home, and is failing at school)"—I think that's pretty accurate]

Condition on Discharge

Patient is well groomed, cooperative, makes good contact. There is no psychomotor agitation or retardation noticed. Speech is within normal limits. Mood is described as "anxious but excited." Affect constricted. Cognition is intact. Thought process is logical. Content is non-psychotic. Patient denies auditory or visual hallucinations and no overt signs or symptoms of psychosis are noted. Patient denies suicidal and homicidal ideation. Denies cravings. Denies pain. Patient not deemed an imminent threat to self or others.

Prognosis: Fair.

Note: at this discharge I was on eight different psych meds.

I'd always been resistant to taking psych meds, from the first time my therapist suggested I see a psychiatrist for anti-anxiety meds. If I had started taking psych meds sooner, I suppose it's possible I would have been less likely to try illegal drugs—who knows. But the first time I was locked in a psych ward in Los Angeles and formally diagnosed as bipolar, I became willing to try pharmaceuticals (Lamictal), and when I was locked up in a psych ward in Brattleboro after a suicide attempt, I was totally willing to take whatever Dr. Meggs, my psychiatrist, prescribed. The antipsychotic she gave me, I took for several years with positive effect. Unfortunately, it gave me tardive dyskinesia, which is irreversible brain damage to the dopamine receptors which causes uncontrollable muscle movements which hamper social interactions, cause excruciating muscle pain, and increase your chance of suicide.

During our final checkout, Dr. Meggs sat beside me on the bed in my room.

"I was trying to work these jobs, for years."

"You were trying to push something that didn't fit."

"I needed mental help so bad but I didn't know it. I would just park my car in a mall parking lot, take my sunglasses and wallet with me and start walking. As they say: I just couldn't. And I would never go back. I think I wanted to walk out for my life, for real."

"Being alive is hard."

"No shit girlfriend."

"It's good to remember where our bad times were."

I exhale.

Dr. Meggs asked me if I was still seeing the texture thing.

I looked at the wall. I said, "It's there but it's faint. I know you can't release me if I say I'm still hallucinating, but I'm not going to lie to you. I've been as honest with you as I can up to this point and I'm not going to start lying to you know."

I didn't see what she checked on her form, but she let me leave. On her way out the door she leaned back inside my room and said:

"Don't forget to breathe."

My doctor, my best psychiatrist, saying that to me, making those her parting words, etched them into my mind more permanently than VINCIT QUI SE VINCIT is etched into stone over my old school.

"Don't forget to breathe."

I won't, I said to myself at the time.

And for a single moment, since then, I haven't.

76

I got out of the Refuge on Thursday, was walked by a nurse directly to the start of day at the Birches program because they release you directly from Tyler 2 to Birches—there's no chance to just leave and go home or go out and kill yourself again.

Later, though, I did get home after my three and a half week post-suicide attempt stay at the Refuge after going to the pharmacy and buying movies and getting Indian food to go, at Spark's suggestion, and setting out all my prescription bottles on the red carpet. There were eight of them. And I thought: Is this what's going to keep me healthy? Is this going to prevent me from dying by suicide? And they all had different schedules, once a day, once in the morning and once at night, sometimes with meals, sometimes with water. Sometimes it was two pills. Sometimes it was half a pill and I had to break it with a splitter. For the first few days, I wondered if I would have to do nothing else but stay home and manage my medication, watch the clock to swallow every little speck of medicine at the right time, in the right way, to keep myself alive. And I took a picture of them, all lined up like that. I posted it on my blog. I was proud of all that medicine, because it was proof that I was really sick. Your friends and family don't know what to think when you tell them you're feeling low or suicidal. But they trust a psychiatrist—a psychiatrist has been to school. And when a psychiatrist thinks you need eight distinct medicines to keep you alive and healthy, and you take a picture of those eight brown bottles lined up next to each other on the red carpet, it's imposing. When people see it, they start to think: Oh, shit. My brother's really sick.

On my second day of Birches, I ate breakfast by myself in the large Refuge cafeteria. That's when I heard the code blue, then saw EMTs take the woman out on a stretcher, knowing it was the one from Tyler 2..Judy..and Spots telling me about it later, how she just fell over and none of the nurses or mental health workers even noticed. Picture of Spots standing at the nurses' desk saying again and again, louder and louder, "I think Judy is dead."

I was pulled out of class right away to talk with the Birches psychiatrist, a rotating position now filled by Dr. Sbarro. He asked me if I was with anyone.

"No."

"Well if you do decide to have children, you might want to pick a partner who doesn't have bipolar disorder to lessen the chance that your kids will have it."

And he mentioned Hemingway after I said I was a writer—remember?—and he said it's important for me not to drink because alcohol lowers your inhibitions, including the inhibitions that keep you from killing yourself.

"None of the medications I'm putting you on will kill you by overdose..they would just make you really uncomfortable. And by the way that Vistaril you took wouldn't have killed you either."

Thank you, doctor, for telling me that even my suicide attempt was ill-designed—thanks so much, buddy, for telling me I even suck at suicide.

"I had a recent patient who you remind me of. She didn't have enough aspirin or any lithium or any sleeping pills. She said the antipsychotic she had she was sure wouldn't kill her because she had a psychiatrist who knew of her previous suicide attempts and he told her which pills she had would kill her and which wouldn't."

Lol. Great psychiatrist, eh? I think he told me this little story to keep me safe, because he knew my suicide attempt was a cry for help type.

---

My social worker found me meditating on the floor during break in the hallway and told me to go downstairs and eat with my classmates, that it would be good for me. I felt like the first day at a new school, but my classmates were instantly welcoming, waving me over and getting me a chair. It was like they already knew me, or assumed they did, assumed we were all alike (and we were).

When I was outpatient in Birches, I stole cheeseburgers from the cafeteria because I didn't have any money. Grabbing them when staff weren't looking and leaving through the entrance of the caf, back to the table with my fellow birches people. As Bruce Wayne says, you cross a line the first time you steal food so you won't be hungry. This line is not completely described as a moral line—you are acting against your morals yet acting in accordance with a greater necessity. Yes. There is a greater necessity than being moral, than living in accordance with your particular values. It is the deepest need. It is the need to survive.

But I stole hamburgers even when I was paying for them by fact of being inpatient.

One night decades ago I rented a limo, stopped at a convenience store and stole Doritos right in sight of the clerk and security cameras. The point was I can do whatever I want and you won't say shit. And I was right. And I still am. Right is something you take.

I snuck hamburgers from the the small cafeteria inside the Refuge inside empty Fritos bags inside my pockets..then showing Faith once we got back to Tyler 2, removing the Fritos bags from by cargo pockets and then revealing that each one contained a hot triple cheeseburger..that's how it's done..and her being impressed. Then polo shirt John seeing me chilling in front of the nurses' station eating a burger after they practically patted us down to make sure we weren't sneaking food up from the cafeteria.

He's like, "Did you sneak that up here?"

And I nod and take another bite. He just shakes his head and goes back to filling out some form. Everybody was always getting caught trying to sneak easy shit up there, like a piece of string cheese and they'd get caught..I could get a whole hamburger up her..times two..and not get caught. But there was this one dude who was like the master..he used layers of ice in a soda cup to keep an ice cream sandwich cold..it was like he built a mini-refrigerator and even I was impressed with the technique.

That one girl (Winehouse) relapsed—I heard this after she hadn't showed to class for a couple of days..and Sue had relapsed with her. They were shooting coke and I wanted to relapse with them so badly.

You know? You're eating lunch with the Birches kids..you get one happy moment and then that was the last time I saw half of them because after being in Tyler 2, after being in Birches, they relapsed to shooting coke into their veins—which sounded fine to me—but it's like, what are you doing? Are you getting clean or are you hitting the needle?

---

I didn't particularly like Birches—for me, that program was a way for nurses to daily evaluate me as the highest suicide risk in the group and daily recommend that I see a Birches psychiatrist, who daily recommended that I go back to Tyler 2. In my medical records from that hospital it doesn't say "suicidal"—it says "chronic suicidality." That's right folks, I hate this world and everything in it, including you, everyone I've ever met or never met, the whole system, seen and unseen, every job I've ever had, every business I've ever come in contact with, and me—I hate me most of all, deeper than almost anyone can imagine. I hate my faults. I hate my strengths. I hate that I'm here. I hate that someday I won't be. I'm terribly maladjusted to this world, and I'm smarter than most people, and with that slightly smarter brain I judge every single one of you who thinks it's an accomplishment to do well at your job, succeed at parenting, fake-ass romance, rising through the ranks of corporate success..none of that is worth anything, not to me. I never found pride at making more than my dad when I was twenty-three—I was embarrassed to be wasting my time at such a lowlife position at a Fortune 50 company. That's right: lowlife. If you work at one of those companies you are a lowlife, no better than a used car salesman or an assembly line worker. I was embarrassed every day I worked at Mead Research—mostly embarrassed to be working alongside people for whom working at LN was the achievement of their lifetime. Most of them are still there. They have a house on a golf course and make three or four times the median national income. Most of them have zero talent. Maybe one out of forty programmers at that company can write code—and no one made it an art. Frankly, to see myself associated with those people, who to me were dumb, talentless, and spiritless—that was enough to make me want to kill myself right there.

Of course I have bipolar, and that'll make you want to kill yourself for no reason at all.

But bipolar or not, whether among children, grandparents, soldiers, or whoever, the less life sucks, the less people kill themselves. I mean look at Iraq: toward the end, more of our soldiers died from suicide than in battle—that has to tell you, coarsely, that their lives sucked. Most of us think that the idea they were fighting an unjust war maybe got to their heads a little. You know, killing foreigners even for the tenuous ideals of "freedom" and "democracy" is hard. But when you've killed people to protect your country for a threat of WMDs that everyone knew didn't exist before the war started..yeah..that might create a problem of conscience in a US soldier that can only be fixed by a bullet to the brain. At the very least it paints a picture for the soldier, for all of us, of a world that sucks.

---

The Birches program really left me feeling alienated. In Tyler 2 you could cry whenever you wanted to, no one would even notice. Birches people were generally functioning on a higher level than that. They're outpatient people. Some of them have jobs and some of them have come here ten years ago and are just back for a "tune up."

(That old guy who was all gregarious and happy and flirting with Ms. Irwin, the program nurse—I think that's the only reason he came back, was to have dinner and nookie with that beautiful redhead who was about his age.)

The guy who sat in the corner and listened to music from his phone on earbuds the whole time.

The young woman who was on disability and was taking time to figure out her mind and heal before she someday goes back to work, maybe, living with her mom and her cats.

The violence meathead dude in Birches we met earlier whose every other sentence ended in how he just needed to kick someone's ass..body building freak..and he would refer to women as bitches, in groups containing men and women. We all complained and when confronted about it by program administrators bodybuilder dude decided he'd had enough of the program, he was above it, he didn't need it, he didn't like to be told not to call women bitches—so he left, like a fucking bitch.

In drawing class, everyone said my picture was the best—they gave me compliments and I was friendly back. But I wanted to scream, to kick chairs over, to interrupt certain people when they were speaking and inform them of how dumb they were and that their words were a waste of time to my ears.

And some people I wanted to fight.

Actually just one guy. The mushroom/LSD guy, he was so disruptive and so disrespectful that I wanted to jump across the room and grab him by the throat and bang his head against the fishbowl window over and over and over. Fucking asshole. That's something that really irks me: someone who's crazy who doesn't know how fucking crazy they are. This guy is telling me that he's opened up a portal to inter-dimensional beings and he's incredulously offended when Dr. Sbarro tells him that actually he's just done waaaaaay too much mushrooms and LSD.

Now look, I ain't no simpleton—the idea that inter-dimensional beings connect and communicate with us through hallucinogenic plant life is a perfectly reasonable theory in my world. But when you deal with multiple/alternate/psychotic realities, you have to remember this one, the one reflected by the cultures of the people on planet Earth. I'm not saying you're not talking to inter-dimensional beings when you trip. All I'm saying is—and this is what I say to myself—I am sitting in a mental hospital, and they don't let people into mental hospitals who aren't crazy (in the sense understood by most humans). So that's why I wanted to kill that mushroom/LSD kid: because he was always disrupting Birches groups by unzipping and unclipping and unbuckling and re-buckling his backpack, paying zero attention when other people were talking. He had the loudest backpack in the world.

That was the thing that bothered me most about this red-headed crackhead dude in Tyler 2 that I told the fuck off?! He was constantly saying he didn't belong in Tyler 2 and he didn't need treatment, and the arrogance in that drove me off a fucking cliff. Same with this LSD/mushroom guy. He irked me to no end. I wanted to shout at this motherfucker: You're in one of the world's best psychiatric hospitals. How the fuck do you think you got here? Remember the admissions process?—all those questions they asked you?? If you weren't fucking crazy you wouldn't be sitting here. Because, guess what, your ass in that chair is costing somebody a lot of money.

They say, though, that the people who really push your buttons are the ones that are a lot like you—but just a little different. The first time I was in a psych hospital, ten years ago in LA, I didn't think I needed to be there. I thought drinking was my problem. I didn't have any way to conceptualize bipolar disorder—that I had a mental illness that ran so deep in me that it had been affecting every aspect of my life probably for my whole entire life and that all the while I managed to stay completely unaware of it, completely ignorant that I had one of the three "major mental illnesses" (aptly named) that make your reality so incompatible with most other people's that you really can't relate—it was a miracle that I had done as well as I had, for as long as I had, in the normal world. So I felt a little compassion for mushroom guy. This was his first time in a psychiatric hospital. It was my fourth? Fifth? I didn't get this on the first try, and it was ok if he didn't, either.

---

After getting out of the Refuge, on Spots' suggestion, I bought myself art supplies, a good meal, and some movies, taking it all to go, up to my attic apartment and enjoying myself..watching Girl, Interrupted while eating Indian food. The night I got out of the Refuge and like all such nights after Spots suggested it, I treated myself to many purchases, sex toys (with a crazy manic sexual talk with the older woman who owned the store) and I bought a ton of movies, as always, used DVDs from the corner record store. One of the movies I bought was Girl, Interrupted, which I had always liked but now was obsessed with since I had stayed in a couple of mental institutions, and I still had the copy that Spots gave me inside the Refuge of the book, which I took great joy in reading while I was within the confines of a locked ward of my own.

In my attic apartment, I bought a membership to one porn site because I knew that on the Celexa I would need some serious help to get off. I fucked my artificial pussy and watched some of the cutest girls I've ever seen sitting on couches, fingering themselves and making themselves cum. But I couldn't join them. Everything I did felt good. The sensation of the pussy rubber was good. My brain activation was good. I was responsive to the teenage models. But I couldn't cum because of the damn Celexa. They say, "sexual side effects" on TV—that's the sexual side effect of antidepressants: you can't fucking cum while you're on them!

Another time I got out of the Refuge, when I went to Whit's to get my special meal, Jill wrote a special message on my to-go food after I got out of the hospital. Donald Mutebe was there, drinking, and he said:

"You know, with the Refuge, it's a business, and when they decide whether to admit you, if you're on the border, they might admit you even if you don't need the help, because it's money to them—you know?"

"Yeah, I know what you're saying, my friend. I hear you."

He was implying that I didn't need to be there—or might not need to be—and I wasn't sure if he was doing me a favor or harm by saying this.

"I'm just saying don't let it determine your life," he said.

Then Jill brings the food out and I read the message on the styrofoam container. It says something about hugs and kisses and I love it.

Donald knocks his hand on the table.

"I'll leave you to your dinner, my friend."

"Thanks, Donald."

"Just don't see yourself as a diagnosis."

I nodded.

---

I skipped my second day at the Birches program, left a crying message on my social worker's voicemail telling her I couldn't go back there. She eventually called me back and said she needed me to come in on Monday, they could help etc. I just lied on my bed sobbing. I wrote my family an email telling them that I had been in a psychiatric hospital and explaining the reason why (I thought they might want to know).

I can't find the note note now but basically it said I was in the hospital for a suicide attempt and I'm fine now. The end result was that my dad never even responded—neither did a lot of the rest of my family. Those are those times when you reach out to the people who love you the most and they just shake their heads and refuse to take your hand. I thought I was alone before my suicide attempt—no—a suicide attempt is something a normal will never understand, and once you do it, you are not more welcome, you are less.

After I left that message for my social worker, I went out to soothe myself with smoke and drink. They piss tested us on Monday when I did go back to the Birches program, and I must have had just enough time to clean out because my Friday drinking didn't show up and I hadn't drank the rest of the weekend. I didn't really care if they kicked me out of the Birches problem. Not that I'm a big rebel or anything—I follow rules that I think make sense. But trying to kill yourself is breaking one of the ultimate rules, and once you break that one it puts everything else in a new perspective. I was suicidal—I had bigger problems than displeasing my social worker by not showing up to group on time.

77

Gretchen's proved herself a true stalker when she went to the pharmacy to meet me there when I had mentioned I would likely be there, then she got mad because I didn't show up at the pharmacy—she met me there even though we never agreed to meet—I was just telling her about my day.

I was like, "Gretchen, I don't need help picking up my medicine. If I make an agreement to meet with you in the atrium to talk, that's a date and you can be mad if I break it. If you ask me what I'm doing this afternoon and I mention I'm going to the pharmacy after my Birches outpatient class, and you show up at the pharmacy at a certain time because you know when my class gets out, that's not a date—that's you stalking me. You have no right to be mad about me not telling you that my plan to go to the pharmacy changed because my Birches class ran late! I had an evening class and there wasn't time for me to come all the way up here to the Hotel Pharmacy before my next class!"

I started thinking Gretchen was part of the reason I was crazy—I actually had the thought: I want to go inpatient again just so I don't have to deal with Gretchen's crazy stalking motherfucking bullshit!

And later, much later, very close to now, I occasionally return to thoughts of hiding in the psych ward. If I could hide in a nice enough psych ward—one with internet, where I could write my books—where I could hide from my dad and my mom and my insane aunts and uncles and grandmothers and cousins and neighbors and former coworkers and bosses..I would. Because I've been in the hospital and I've been out, and if we make the distinction between mental illness and crazy, all the crazy people are out here.

78

I went back to Tyler 2 for some reason. I don't know—maybe they thought I was suicidal.

I got into the first fight I ever started. All the other fights I'd ever been in were like four guys kicking my ass on the playground because I was white.

There was this guy—his name was Schizophrenic Mike—and he often looked like he was faking to me. Faking being ill. Like there was this gleam in his eye that the only reason he was there was because he wanted to escape being in jail or something. But I don't know—that could just be my misinterpretation. What I know for sure is he was walking up behind all the girls and standing there looking down at them and making them uncomfortable.

So I told him to stop.

And he didn't stop.

So I provoked Schizophrenic Mike into starting a fight with me. I had laundry in the laundry room. Schizophrenic Mike was wandering around the ward—this is at like 6am. I kept telling him:

"Don't touch my fucking laundry. Don't touch my fucking laundry," over and over and then, "Don't go into the laundry room. Don't go into the laundry room," and then, after he was in the laundry room, "If you open the top to that dryer I'm gonna kick your ass," real quiet, where I thought no one else could hear.

In case you weren't clear on this, this is as scene where I provoke a deeply schizophrenic mental patient into starting a fight with me so he'll be blamed and I'll be the victim, helped by nurses and apologized to by psychiatrists—yeah, just wanted to make sure you had the picture.

These aren't thing's I'm necessarily proud of. I'm just saying what happened.

So I coax this fucking mentally twisted motherfucker into opening the top of the dryer and I had been taunting him all this time and I finally said, "Mike, that's it, I'm gonna have to [dialogue withheld because it's too awful] and he runs at me, like I knew he would, like I was preparing for, and before he can punch me I reach out and grab his throat and I squeeze like I'm gonna kill that motherfucker. Both our glasses falls off. His hands go for my neck. He sees what type of fight he's been drawn into. This isn't a punch you and make you bleed fight. This is a choke you until you die fight. I have to tell you I feel great—maybe not joy, but—satisfaction in remembering this. Because sometimes a man is a dog. And sometimes a dog needs to be put down. I squeezed, and squeezed, and pressed with my thumbs, and I shook his head back and forth like I wanted a grape to fall off the stem.

I don't have any guilt about this fight to this day, even though he was schizophrenic. You don't go around making all the women uncomfortable. It fucks up the vibe of the whole joint. When you have a system, work system for instance, psych ward for instance, and there's a bad seed, that bad seed must be removed for the sake of the whole system. I've had bosses who didn't understand this, and that bad seed ate away at their company from the inside. I wasn't about to let this asshole mess with the peace of the ward. He needed to go to ALSA, and I did what was necessary to send him to ALSA.

The fight was broken up almost instantly by nurses and mental health techs—the Tyler 2 fire crew works awesomely in situations like this.

They instantly put Mike in ALSA and checked on me and apologized and soothed me and gave me my PRN for anxiety. They sat me in the vitals chair and took my pulse and all that.

Fuck you. I win. You lose. That's how we do that.

---

Spots says she heard I got into a fight.

I say yeah, I guess I did.

"Did you kick his ass?" she says, nodding.

"I don't know. I didn't do near as much damage as I wanted to. They broke it up pretty fast."

"You kicked his ass," she laughs. "That's what everybody is saying."

I am secretly overjoyed that Spots thinks I won the fight.

"So what is everybody saying, exactly."

"That you're a badass psycho motherfucker and not to mess with you."

"Oh, no," I say, "I wouldn't hurt a fly."

"Unless you thought he was messing with the girls on the unit. You're a trip."

"Is that really what people are saying?"

"Scouts honor," Spots says, making the peace sign with her fingers. "They're saying you're a psychotic unglued motherfucker and that you never even punched him you just went for his neck and tried to kill him!"

"Damn right," I say. "I was gonna squeeze the air out of that fucker's body."

Spots screams, "THIS IS NOT A COFFEE SHOP CONVERSATION!! Woo-hoo! Alright, my friend, right on, you kill that motherfucker!"

She has her hand out to bump the rock.

So I bump the rock and her fingers go exploding all over the place. I do the same thing and our hand bump looks incredible, like we planned that shit, but all I can do is go back through all the times I got beat up in school and think that this is the first fight that I both started and won. It only took me till I was thirty-three.

Being in the psych hospital does something to you. When I had my hands around that motherfucker's neck, there was no holding back. I was one-hundred percent trying to cut off the air supply to that fucker's head, which, I guess, could kill you or at least make you pass out.

I did it just right, too, played every nurse in that room so that they saw Mike attack me and it looked like all I was doing was defending myself from a very random attack—all I was doing was standing outside the laundry room, pacing peacefully, waiting for my clothes to dry. (Quietly talking shit to him to make him come at me.)

He ended up in ALSA, and I was given an anti-anxiety pill.

The rush was incredible, though—I can see why people fight—the high was better than cocaine, my heart was beating a mile a minute. And when the nurses sat me in the vitals chair I was saying things like:

"If you let him out of ALSA I'll kill that motherfucker!!"

To which head nurse Michelle said:

"You're not helping yourself."

She was giving me this stern look.

"Helping myself what."

"You do want to leave, don't you? Language like that will only keep you here longer."

"I don't care how long I stay here."

Michelle goes back to writing in my chart.

There are a lot of patients and doctors in the main room now. Guess they heard there was a show. Also it was shift change.

"I'm sorry, Michelle."

She looks at me.

"I didn't mean to say I wanted to kill him. I don't want to kill him."

Michelle makes a nice face. Maybe now she'll write that in my chart.

"All I meant to say," I say for the benefit of the audience of patients who are sprinkled around the room, "is that if any of you, doctors, nurses, whoever the fuck you are, let that motherfucker out of ALSA I will beat that fucker's head against the wall until he's bleeding from the back of the head and they have to sew tiny little fragments of bone back into that motherfucker's skull with dental floss. I will fuck that fucker so hard he will—"

"Hey! We don't need to hear this!"

"Ok, that's fine, you hear what you want to hear and you see what you want to see, as the man says. All I'm saying is that fucker stands around the room looking down girls' pants, staring girls in the face, and I don't like the girls I'm stuck in a psych ward with to feel on edge, 'cause when they're on edge they'll be fighting and that's worse than any fight between two guys. I don't like it when people disrespect women!"

"Ok, ok. Do you need a PRN?"

"Fuck the PRN."

"Do you need a shot?"

"Hey, Michelle, I can be as calm or as wild as I want to be, any time I choose."

"Do you believe that?"

"Look, now I'm calm."

"Please stay that way."

"No problem. But if you let that fuckhead out of ALSA while I'm still in this hospital I will KICK HIS FUCKING ASS!!"

Michelle stands up, comes around the nurses' station, kneels in front of me and says sweetly:

"You already kicked his ass, the way I hear it. What do you really want?"

"I want peace. He was making the girls feel uncomfortable."

"That's our job, ok? Your job is to focus on your own healing."

"Well you all are not doing your job."

"You don't think we're doing our job?"

"Not in Mike's case. Ask any girl in here. He's walking around, standing right behind people, staring people down."

"Well you got your peace, didn't you. He'll be in ALSA for a while."

"Good."

"Maybe next time you can try talking to one of us about the problem."

"I did! I told every fucking mental health tech in this motherfucker about that motherfucker—"

"What I hear is that you need to calm down. Do you want me to get you that shot?"

"That won't be necessary. I can calm myself down."

"Then do it. And don't make any more death threats. The laws out there..?..apply in here, too."

"Ok, I'll calm myself down. I can do it myself. I don't need help."

"I know."

"I'm going to my room to meditate."

"That sounds very wise. Do you want me to bring your breakfast to you?"

"No thank you. I'm eating breakfast with Spots."

Michelle blushes, smiling.

"You have a crush on her, don't you?"

"Well," I say, looking at Spots, "if by crush you mean I want to strip her down and fuck her from behind while looking at that big-ass tat of the Virgin Mary on her left arm and imagine I'm fucking the real Virgin Mary then yes, I have a crush on her."

Michelle stands up.

"Thanks for that imagery," she says.

"No problem. Our baby is going to be the prophet Jesus, by the way, but we'll treat him as our best friend."

"Ok," Michelle says, going back behind the nurses' desk.

"When is Michael coming out of ALSA?"

"Don't worry, it won't be today."

She looks directly at me.

"And the way you've arranged it, he'll be on one-on-ones when he does get out, which'll probably be in about a week."

"A week of peace," I mumble.

"What?"

"A week of peace!"

Michelle shakes her head. She mumbles something.

"What was that?" I say.

She mouths the words to me: Thank God.

She rolls her eyes and shakes her head.

"Yeah, see, you motherfuckers'll be thanking me that motherfucker's in ALSA."

"Go to your room. And stop using that word. Don't come out until you're calm."

I get up from the vitals chair, make my way by Spots, brushing my hand from one of her shoulders to the other, touching the bare skin of her neck at the top of her shirt.

All the while I'm saying:

"Yeah, everybody does and says one motherfucking thing while thinking and doing another motherfucking thing. And you're not allowed to talk about motherfucking shit. If I talk about motherfucking shit, I have to stay here longer. If you talk about motherfucking shit, you get fired. Isn't that weird? If you talk about it, you have to leave—if I talk about it, I have to stay. But it's the same motherfucking shit, either way. This ward is full of motherfuckers writing shit in charts—you would think they computerize this motherfucker. Get some iPads up in this motherfucker. That whole fuckin' records room down there?—You could fit that whole fuckin' room on a hard drive 'bout this big. Turn that records room into a spa/sauna thing, you know, with the hickory chips and and guy/girl showers that are clean—not like these fuckin' showers up here—I'm talking some guy cleans them out with bleach every day. And—and—before you ask—because I get this question a lot—you were gonna ask me what does the guy who pushes the cart with the medical records do now that the whole fuckin' Refuge is automated with heads-up displays and high-class electronics and shit. Well, I'll tell you. I have an answer for that. What he will do is..something more human. What's that guy's name who pushes that cart? Pedro? Well now fucking Pedro can sit outside painting paintings and maybe he'll be the next Monet or Manet or whatever. Or maybe he can be Diego Riviera—is that a painter? Right. But the point is, Pedro who pushes the records cart is doing a job below his human standing. Pedro—you might not know Pedro but I've talked to Pedro on many occasions—and Pedro happens to be a very talented and deep motherfucking human fucking being. I don't like for Pedro to be pushing a records cart when Pedro could be utilizing one of his more human talents. That's why I say we need to automate this whole motherfucker. From top to tip."

I'm walking backwards down the long hallway to my room.

The discharge nurse—I think her name is Sharon, like my mom—calls out to Michelle, who is still up at the nurses' station:

"Should I give him the shot?"

This Sharon has the shot ready, and she's right next to me. Back in the day (or in a shittier mental hospital) that would be Haldol but here it's just Benadryl—they're not trying to knock me out for days, just calm my motherfucking ass down a little, take a six-hour nap, wake up like a sloth, that sort of thing. They just want me docile and I'm not docile right now and I know Sharon and Michelle are thinking this, using that exact term—docile—so I say:

"I'm docile! I'm docile!"

I put my arms in the air like a black man about to get shot by the police and I turn around in a slow three-sixty like I'm showing them I have no weapons on me. Then I sidestep into my room, and close the door, leaving Sharon holding a shot of Benadryl that will now have to be thrown away, thankfully, 'cause that's no way for anyone to take a nap.

I've never been given the shot. That's because, for an out-of-control person, I'm unusually interested in staying as in control as possible, especially inside psych wards. That is definitely a place where you want to stay on top of the game.

I take a thirty-minute nap, then go back out into the main room. I refrain from using the word motherfucker. I sit down and eat breakfast with Spots and she tells me that I won the fight with Mike and I just try to imagine Spots' voice moaning while I eat her pussy out.

Years before, when I was in film school, I told this guy if he didn't stop blocking my view of the screen where my movie was playing that I was going to "kick his fucking ass." I picked up a gobo arm—a big metal pipe used on film sets—and he's lucky he moved 'cause if he hadn't I would have beat him until he was crawling off the soundstage on a pair of bloody stumps. Oh and also with no head.

I get mad sometimes. It's called irate bipolar mania, and you really don't want to mess with it.

79

I hate how now that I have this diagnosis of bipolar disorder, now that I'm "mentally ill," people think that somehow means I'm less capable than them. No. Even though my mind doesn't work correctly in this very specific way known to doctors, that does not mean your healthy brain is more capable than mine! Actually, I'm still smarter than you, I still see the situation more clearly than you (unless you're my Mom), and I can still do way more complex things than you. And I've read more than you. So don't try to act like just because I'm ill, suddenly you're the expert. My best psychiatrists don't even do that to me, and they have PhDs. They're smart enough to know that I'm smarter than them, and therefore they have to treat me with mutual respect or else I'll just start fucking with them.

It sucks when one of your role models is Hannibal Lecter—I always say if Hannibal Lecter and Björk had a baby, they'd have me. You know the part in Hannibal where Agent Starling goes to see Barney at his apartment and Starling says:

"So when you turned Dr. Lecter over to the Tennessee Police—"

And Barney says, "They weren't civil to him. They're all dead now."

"Yeah they only survived his company three days. You survived him six years at the asylum. How'd you do that? It wasn't just being civil."

And Barney says, "Yes, it was."

Well, I'm a little like Lecter in this way—I like to be treated civilly. And I don't claim to be unique in this way. This is a common meme or else it wouldn't have shown up in these universally famous stories about Hannibal Lecter. And unlike the fictional Lecter, usually us real-life Lecters don't actually kill people for their disrespect, for exasperating us with their dullness. But we kill you socially. We kill you emotionally. We kill you at your job. And some of us sub-serial killer psychopaths kill you psychologically, planting little seeds of doubt inside your mind where there they grow as tall and as immovable as baobabs. Not even the little prince can save you from this type of Lecter. And that's the type of Lecter that I am.

I push, and I push, and I push you till you have to move.

Which is unfortunate.

Because that's the way I've been pushed.

And I know better than anyone that if you get pushed too far, you never come back.

---

You know how I got under my dad's skin? His new wife was disrespecting me, and neither of them were doing anything to try to blend the two families..it was just like Eva now owned my dad and he no longer had a relationship with his kids or his former wife, not even civil communication. So I told my dad that I predicted his relationship with Eva would end before his relationship with me did. Instantly, he ended his relationship with me, and I haven't heard a loving thing from him since. He probably doesn't even consciously remember me saying that, but somewhere deep in his mind he is trying to win, to prove me wrong, and he's doing everything in his power to stay with Eva and to never speak to me, so that my prediction will ultimately be wrong. I hope it tortures him, the pride of maintaining his rightness over me, but I never thought Eva was good enough for my dad, and I let them both know it. Eva has kind currents within her, but deep down she doesn't have the muscle for real love—and in that way, maybe she and my dad are perfect for each other.

If my dad was a full, whole, complete, mature adult, he would have never let me get away with insinuating such a setup. But he has never acted like my parent, and so, functionally, he hasn't ever been my parent. I grew up with a certain lack of guidance from him, which my mom filled in as much as possible, but I am still unruly, untrustworthy of those I call adults (even though I'm thirty-eight I don't consider myself to be one). I never knew kind authority from my dad, and I have zero trust that there is kind authority now, in bosses, police, government. To me they're all un-trustable. And unfortunately that isn't just the way I color the world according to my childhood psychology—it's the truth about many of those who govern.

I recently told my dad about my tardive dyskinesia, which keeps me lying down twenty-three hours a day—lying down stops the clenching. I sent him an email. And I heard back?—nothing. It would be unwise to try to interpret his lack of response, but doing as little reading between the lines as possible, I will say it hurts for my dad to ignore such an announcement from me.

As far back as I can think, he and I had the push/pull of neglect and abuse. He would ignore me until he needed me to hold the flashlight for some project he was working on. Then he would yell at me for holding it wrong, and physically force my hands to the right position. He would never give me details of what he expected from me, and then he would get mad when I screwed up some plan that was only in his mind.

On prom night he let me borrow the van. I drove my date and two of our friends to dinner, to the dance, to a cornfield where we all lay on the roof looking at the stars, and then to one of the girl's houses for the night. My agreement with my dad was that I'd have the van back by midnight. It was a Saturday night, church was the next day, and he planned to drive my mom (who was the pastor of the church), me, and my two sisters to worship, using the van as we did every Sunday. But I never planned to have that vehicle back by midnight. They had my mom's Honda that they could use to get to church and me not coming home that night was a calculated fuck you to my dad. He didn't respect me; I didn't respect him. That is how it's been for as long as I can remember.

And lying on top of that eight-passenger van with my friends, looking at the stars, making out with a smart and beautiful woman, I imagined my dad getting madder and madder as midnight came and went. I never thought for a moment that he was worried about me, as my mom was—I knew he was mad. That's his primary emotion. He tries to control things—when they don't work out he gets mad—unfortunately I inherited that pattern. I really don't remember the kisses between me and my girlfriend that night. The thrill of disobeying my father, however, is something I will never forget.

---

Living constantly with the ultimate option as a real option is difficult, but it also gives you power. Everything else is nothing compared to ending your life. I used to find myself in salary negotiations, and they'd be like we're going to give you a ten-percent raise, and I'd be like twenty. One piece of advice: don't ever try to bargain with somebody who doesn't give a fuck. With me, the nuclear option is always on the table. When you say:

"We can't give you twenty."

Then I say: "Friday will be my last day."

See, you came into this meeting with some false assumptions. Like the assumption that I want this fucking job, that I'm as desperate as you to maintain a residence where I can impress my friends with the ultimate goal of getting them to take their clothes off and have sex with me. Fuck pussy. I've had enough sex to last a lifetime. That was your first assumption—that was where you went wrong.

And faced with the new choice, in the new reality, they give me the twenty-percent raise. Like I said, don't ever fuck with people who have less to lose than you.

When I'm living every day hating life to the point of wanting to die, words like "no" and "fuck you" and "this relationship is over" come easily to me. I had a girlfriend named Rishi. She always used to say, You're too quick to play the break-up card. That's right. When I find myself, day after day, in pointless, abusive arguments with my girlfriend, the break-up card is on the motherfucking table. Why? Because I don't want to spend one more day arguing with you. Hence the nuclear option. Life is too short for me to spend my time doing anything but the most exalted thing I can pull off.

Most people, they'd rather settle for mediocrity.

For me, it's either the brightest moment possible—or nothing.

80

There was a schizophrenic woman named Crack Bitch with stringy gray hair, shit-stained gowns, she never spoke and she was tall, long arms, and every once in a while she'd go ballistic, knock her dinner tray off the table, send everyone's food flying. She'd stay in her room all day screaming and banging on the door.

The street borderline coke addict—Winehouse—who herself you'd never want to fight, said to me one day while we were eating, after Crack Bitch threw her tray, Winehouse said:

"I heard that bitch heard screaming in the walls. She was ripping through drywall to save the people she thought were trapped in there. That bitch has that crazy strength. She could fuck up anyone in here. You see those arms? One swipe and that bitch would have you on the floor. That's crazy strength, you know what I mean?"

"Yeah."

Winehouse punches me in the shoulder.

"Don't act like you don't know what I'm talking about. I saw you fuck up that Mike kid the other day."

"He was staring at the girls."

"I know, I saw."

"He was making them uncomfortable."

"I know! He was creeping the fuck out of me."

"I didn't like it. I hate people like that. He was fucking up the flow of the unit."

"Well you fucked that motherfucker up."

"Did I?"

"Oh yeah."

"I don't remember. I was tranced out."

"It looked like you were trying to kill him. You had your hands around his throat. You didn't throw a single punch. From go, you were trying to strangle that motherfucker."

"I've never punched anyone in my life."

"Really?"

"Yeah, I was a straight-A student. Science fair and shit."

"When did you go crazy?"

"Tenth grade."

"Well, I wouldn't want to fight you."

"I wouldn't want to fight you either!"

"For real?"

"Yeah, you intimidated me for the first few days."

"I thought you were stuck up," Winehouse says.

"Everybody thinks that," I say.

"Then I saw you sitting on the floor in the med line fucking rocking back and forth and shit, talking to that old lady. You remember I invited you to sit at our table."

"Yeah. I needed that."

"I wasn't sure you'd even remember, you looked gone."

"The reason I sat down is because the meds they're giving me make my dick hard. I don't want to walk around Tyler 2 with my fucking dick sticking out. I know it's a fucking psych ward but Jesus."

"Seriously?"

"Yeah."

"You think we could take her, the two of us?"

Winehouse is looking at Crack Bitch, her stringy hair mostly covering her face.

"Fuck no," I say.

Winehouse laughs.

I ask, "Do you think we could take her?"

Winehouse leans forward. She uses a low voice.

"That bitch should be in a cell. I'm afraid of that bitch and I ain't afraid of nobody."

Winehouse drinks the rest of a milk.

"Don't ever fuck with crazy people," she says, while still swallowing. "Because crazy people.." She puts the milk down. "..will fuck your ass up."

"You don't seem crazy—you have borderline, right?"

"That's the latest diagnosis."

"Well you don't seem crazy to me. You just seem like..someone I'd like to hang out with."

"Thanks. You're awesome."

"Do I seem crazy to you?"

Winehouse puts her hand on my hand.

"I gotta be honest with you."

"Ok."

"I can tell you're smart—well not smart but I can tell you're a fucking genius, from your notebooks and the way you talk to people. You're a manipulator. But not the mean kind. I see how you work the staff, you get them to do exactly what you want. But you always have to be in control. You could prob'ly get any one of these motherfuckers fired if you wanted to."

"I thought about it the other night. I was going to write a letter to the clinic director on this one health tech."

"Why?"

"He was glorifying guns and war."

"Yeah, and that rubbed you the wrong way?"

"Yes it did."

"Did it make you angry?"

"Extremely."

"That's what I'm talking about. You're angry. You cut people off sometimes, don't you?"

I nod.

"You think of them as less than you if they cross a line you don't want them to cross."

"I just don't like being disrespected."

"But what are you willing to do to people who disrespect you?"

I take my hand from under my fellow psych mate's.

"Here is my problem," I say. "I shouldn't have had to deal with Mike. This place is crawling with techs and nurses and psychiatrists and of all those adults no one stood up for the women Mike was staring at, intimidating..days this was going on, almost weeks, and no one did a thing."

"So you stepped up."

"So I stepped up and I restored order and safety in a place where people need to feel safe so they can heal."

"By strangling the person who was causing disorder."

"I wasn't going to kill him, ok. It was a very controlled situation that was designed to send him to ALSA and give everyone—especially me—a break from that bullshit. I tricked him into attacking me first so he would go to ALSA and I would be viewed as the victim—"

"And you would have the nurses fawning over you and giving you PRNs and checking your blood pressure and apologizing to you that he attacked you and guaranteeing you that he would be in ALSA for a week, so you could feel safe and not have to worry about being attacked. Yeah, I saw all that. I don't know if you remember but I was up early that morning and I was in here 'cause I couldn't sleep. I saw exactly what you were doing, even though you fooled just about everybody else in here. But I know your psychiatrist is Dr. Meggs, and I know she's prob'ly the only fuckin' ho in here as smart as you."

I looked Winehouse in the eyes.

She was looking back at me.

I said, "In high school I had this girlfriend, Tuesday Walker. And once she said to me, 'Matthew, sometimes I don't know if you have absolutely no control..or entirely too much.' "

Winehouse is nodding, picking up her dinner tray. She knows that I know what she's been talking about.

"So you think I'm crazy."

"Matthew, I love you. I'd hang out with you outside of here—I think we should do that. I think we should fuck—though I have a boyfriend so that has to be on the d/l. And I'd love..love love love to shoot coke with you. You seem like you'd be a lot of fun to do drugs with. But when it comes to crazy—straight up—I think you're the craziest person in here."

81

Those words were running through my head even after I got out of the Refuge. I was going to my stylist and all I could hear was Winehouse saying: When it comes to crazy—straight up—I think you're the craziest person in here.

And then I would respond: "Yeah, well, if you think I'm crazy you should meet my family."

Then Winehouse would say, again, When it comes to crazy—straight up—I think you're the craziest person in here. And I would think about that, and what it meant that she thought it, maybe even what it meant about me.

I get out of the Refuge, shave my head (my hairstylist hates me for this, almost won't do it).

"So what I've been up to?" she asks.

"I've been going crazy," I say. "I'm a Refuge person, be scared." Etc.

She shaves my head and is like,

"Maybe we can do something fun with it next year," all pouty.

I buy a Hermione Granger Time-Turner and some black-and-white checkered sunglasses. I'm sitting at Matt's food cart. He makes a burger to my specification and it's so beautiful he asks me if he can take a picture of it.

"It's your burger, man—you made it."

"But it's your idea—you're the creator behind the burger."

Lol. We both take a picture with our phones. Then I eat the motherfucker, and it's so damn good..then look who shows up.

I put my burger down, sourly, it's already ruined for me the moment I see Aaron step up from the sidewalk onto the concrete plate where Chris's food cart and this seating area have been arranged.

"Do you two know each other?"

"No."

"Well this is Aaron, he's a quantum physicist."

"Oh, nice."

Aaron sits down.

He and Matt are small talking.

And it takes me a while to remember what had happened, when I saw him, because I was so drunk the night before..but eventually during this friendly conversation between him and me and the owner of the food cart, I remember that I had gone to Whit's and I was so drunk I didn't even remember that I'd blacked out, but I started to remember what this asshole had done to me, how he had treated me the night before.

"Oh yeah," I say, stopping the conversation. "I remember now."

I'm looking straight at Aaron.

"I had a bit to drink to it took a while for it to come back to me but I remember now."

Aaron is silent.

Matt is silent.

I tell Matt, "I was at a table with this asshole last night—at Whit's—and this condescending motherfucker was telling me not to hit on girls he liked in Whitman's, even when they were flirting back with me, saying I was less than him. Yeah. I remember now. If I hadn't seen you today I prob'ly would have never remembered that, because I had a lot to drink and I did black out—I'll be honest about my part—but, Aaron, what you said to me made me very angry. And thinking about it now it making me very, very angry and tell you one more thing and that is not only did you make me angry but you wronged me—as a human being—by indicating with your actions you thought I was less than you, and we're gonna work this out, right now. And now that I'm sober, I think you'll find me much less reasonable a person."

Aaron gets up from his chair and walks away from the burger cart.

I stand up.

"Don't ever treat me that way again and don't let me ever see you ever again in Whit's I hope we're clear on that. I said I hope we're clear on that!"

"We're clear," he says, and I just thirst for the day I get to beat a quantum physicist's skull in with my bare hands.

Matt says, "I'm sorry for having him around. I didn't know he had offended you."

"No, it's ok. Thank you but it's fine. I overreacted, I admit that—just 'cause a guy offends me doesn't mean I have to insert a poisonous caterpillar INSIDE HIS DICK!!! No, I'm sorry, you want peace at your burger stand and I want to be able to come here too so I'm going to leave—"

"You don't have to."

"No, I'm going to go calm down and when I come here in the future I will have processed my feelings about that little lying-ass vegan farm toad. Pot-smoking motherfucker. Fuck me if I see him around town again today. YO AARON: DON'T EVER SPEAK TO ME AGAIN AFTER THAT SHIT YOU SAID IN THE BAR."

He was waiting to cross at the light and he gave a little head nod without looking me in the eyes.

"GO BACK TO PERMACULTURE AND ORGANIC VEGETABLES."

For his poor fucking sake the light will not turn green.

I light a cig.

"THAT GIRL IS NEVER GOING TO FUCK YOU BECAUSE YOU DON'T HAVE THE BRAIN. YOU'RE NOT A QUANTUM PHYSICIST AND YOU NEVER WILL BE. YOU'RE JUST A FUCKING POTHEAD. YOU WORK IN THE FIELDS. YOU'VE GOT DIRT ON YOUR HANDS FROM PULLING CARROTS OUT OF THE GROUND. DO YOU KNOW HOW MANY TIMES YOU'VE BEEN AROUND THE BLOCK, BORN AND RAISED IN BRATTLEBORO? ABOUT ONCE. I'VE BEEN AROUND THE BLOCK ABOUT A HUNDRED TIMES MORE THAN YOU. DON'T EVER SPEAK TO ME AGAIN!! I HOPE YOU UNDERSTAND HOW SERIOUS I AM ABOUT THIS AND I HOPE YOU UNDERSTAND I HAVE THE CRAZY TO BACK THIS UP!!!"

Fortunately the light changes.

Then he comes back! The fucker walks back to the hamburger cart and stands there.

I sit down and smoke my cigarette.

"I will fuck that girl."

"No you will not. You have a brain that will keep that girl interested for about five minutes. Whether I'm sitting at that table or not, you're never gonna fuck that girl. Know why? 'Cause you're an asshole. Girls don't like assholes, and neither do I. You know my friend Donald?"

"Yeah, I beat his ass in chess the other day at Mocha Joe's."

"No you did not. You know those two girls who were with Donald when you played him. Yeah. Well those two women are my housemates and when they got home the other day they reported straight off that you got your ass kicked by Donald. It doesn't matter whether you won or lost—what matters is you're lying all around town that you beat Donald. You're weak—that's why you lie. Now get the fuck out of here before I go ballistic on your organic produce asshole. I'm serious. Know your station. This is a table for me. You are a fucking mouse."

You know what the crazy thing is? He turns out to be Gretchen's friend and Gretchen doesn't see anything wrong with him!!!!!! (Which indicates that..what, exactly?..is wrong with her?)

And that asshole is so weak he didn't even deny anything I said about him..he just stood there with his head low and nodded at every insult I threw his way. I'd rather have someone argue back, even if they're trying to hurt me—at least they have a spine—I can work with that. But people who hit the ground when you're just starting to lace up your gloves..fuck..that's pitiful.

But what do you expect—he's a fucking vegan.

And you know what, Gretchen was vegan, too.

That's prob'ly the only reason she liked him. If two vegans meet, and one is like a virgin church girl and the other one's Charlie Manson, they'll become soulmates because they're both vegan. That's all vegans care about, is if you're a vegan, too. If I handed a vegan a million dollars, they'd be like: No, I can't accept this from a carnivore. And I'd be like, I eat vegetables, too, bitch—it's omnivore, not carnivore. I'm not a fucking T. rex.

82

I called my dad.

I asked him if he remembered the potty-training thing.

He said, "That never happened. Bipolar people have something called fixed delusions."

He said that I made it up.

That the reason I thought it happened was because of my bipolar disorder.

Now that I had a diagnosis, my dad had a whole new set of reasons to excuse his behavior, deny his behavior, say that his behavior was ok.

And I thought: Wow, this person really would use my bipolar illness against me, as an out so he didn't have to be honest with me, with himself, with future counselors, with the family, with anyone.

And that hurt.

But he never was honest, even before he had my bipolar to use as an excuse, and I wonder how much his tendencies have affected me. How much am I a liar because of him?

---

Remember when I wanted to apply to Cornell to study architecture?—a pipe dream since I'd never be able to afford it, nor was either parent offering me somewhere to stay between academic sessions. But I wanted the hope of just applying, and even though I was thirty-two at the time, Cornell still required tax information from both my parents. Mom gave me hers. The last thing I needed to complete this application was my dad's income.

He wouldn't provide it for me.

He wouldn't even reply to my emails or return my calls. Without him providing this little piece of information, I would never be able to even apply to go to school to learn something I was interested in. And my Dad wouldn't help me.

But that's not the worst part.

In order to induce him to call me back, I escalated the situation, cc'ing his sister Louise and my cousin Joel and asking them to put pressure on my dad to call me back, exposing his lack of support for me to his sister and my poor cousin just because they were related. I said in my email to them that I had called Dad a bunch of times and he hadn't called me back. You know what my dad said? He denied that I had called him at all. And his sister took his side, saying to me, "You better be careful what you say, we can check the phone records." And I was like: Check the phone records bitch—your brother is a liar. He went to all this fucking trouble not only to not help me apply for college but also to lie to his sister to make him look good and claim that I was lying, when in fact, he was lying. That shit is sick. That's the type of shit I want to have nothing to do with in my life. I should have just told that college my father was dead.

So I told my on the phone, "I remembered you making me clean my shitty drawers as a kid with my hands during potty training."

And he said, "Well, Matt, that never happened. It may be a fixed delusion of bipolar."

Then I punched a hole in the vaulted ceiling and that's the last time I ever spoke to my dad of my own volition. (He visited my sister Leona's house while I was living there and we had minimal contact. Leona said she was worried about Dad's visit and I promised her I wouldn't say anything substantive or argumentative to him..a promise I kept to the letter. My dad was so rude and controlling with Leona and her husband that by the end of the trip they were literally begging me to tell him off. But I didn't, reminding Leona I had promised her her I wouldn't engage in any conflict with Dad while he was there. When he first arrived Dad and I hugged and Leona cried like it was some sort of reconciliation but based on his lack of communication since then, it was no reconciliation for him, and I can tell you that from my perspective it was just going through the motions..that hug didn't mean a thing to me.)

I felt terrible and violent and hurt after having the conversation in the Refuge which revealed my dad's humiliation of me during potty training..and now that I confront him with it and said we have to deal with that and some other truths before we could have a real relationship, he denies it ever happened and says it's just a "fixed delusion" of bipolar disorder!

"Dad," I say, sobbing, "I need help. I have a major mental illness that makes me want to kill myself."

"Yes, bipolar disorder," he says.

"Right," I say, "bipolar disorder!"

Dad says, "Well, Eva and I looked up hospitals and one of the best mental hospitals in the world is right there in Brattleboro—it's called the Brattleboro Refuge—have you tried calling them?"

"Dad. Have you been reading my emails? I've spent the last two months in the Brattleboro Refuge! How can you be this out of touch with your children? If you had read a single email I've sent you in the last two months, you would know that I've been in and out of the Brattleboro Refuge three or four times!"

"Well, Matt, I get a lot of email."

"But let's say you had a work colleague and they had been emailing you for two or three months about the same subject—I can't imagine you'd be able to do so well professionally if you spent as little time reading work emails as you do reading email from your children!"

"I'm having tome technology issues on my end. I have this new iMac desktop, I think they call it, and my email's all screwed up—but this is a great system, have you heard of these..new..Mac..desktops?"

"Yeah, iMacs are great. Did you get the email where I say I tried to kill myself?"

"Matt, I've got a call on the other line. It's work. I've got to take this."

"It's eight o'clock at night, Dad—do you really have to take it?"

"Ok, Matt, night night. I'll tell Eva you said hi. Glad you're doing well. Gotta go now. And hey!—Have a great time in Vermont!"

I call my dad on his potty training shit

He denies that it ever happened and

Blames it on bipolar delusions

Then I punch a hole in the ceiling and start screaming and destroying stuff like I did in high school when I couldn't take my parents fighting anymore.

I blame him and him alone for being in the position to make smooth the relationship between our two families, maybe not between Mom and Eva, but at least between everyone else, and him choosing instead to take his new wife and new child into the fold and completely ignore and abuse the rest of us. When it was his turn to watch Leona, he waited till my little sister was asleep, then left to go fuck his girlfriend at her house. Not his future wife, but someone he met through the personal ads in a local newspaper. So he's fucking tons of women that he met through personal ads right after he and Mom split as if he had been waiting to do this all along, as if he was only staying faithful to our mom out of rote—some rule learned through childhood religion.

And the kicker: Dad denying his trips to Florida when Joanne and I were little, leaving Mom and us two kids in Dallas because he couldn't take it, couldn't take the fact that he had gotten married and had kids..the weight of it was too much for him. I learned about this only because I was going through Mom's boxes, at her request, scanning old photos and negatives and cards that friends had sent, family had sent, and I came upon this series of letters from Dad to Mom, as he was in Florida and she was in Dallas, revealing none of the content of what he was doing in Florida but they were outpourings of his admissions that he did not feel he could be a good father and that he did not want to be a father, how he felt this push/pull of loving my mother but not being able to be with her. He couldn't handle the emotional stress of being in a relationship.

And when I confronted Dad on the phone about these trips and asked him what he was doing in Florida, he said it never happened. He had made an occasional business trip to Alabama maybe, but "I never left you children and your mother."

I said, "Dad, I read many, many letters, five or ten, from multiple trips to Florida, in your handwriting, postmarked from cities in Florida, addressed to my childhood house in Dallas."

He said I must be mistaken.

I said how could I be mistaken, given what I've seen??

He didn't know, but he would never admit that he had written Mom letters from Florida, or ever left us to go on week-long trips there, which I had seen indisputable evidence of and had discussions with Mom about, so I think that lowers the chance of them being some wild delusion the likes of which I have no reason to believe I've ever had. I've asked Mom since then about us discussing those letters, me handing them to her when I found them, me reading them, and me making secret scans of them for my own later perusal. Those letters exist. I have to convince myself of it over and over, though, with the evidence, because of Dad's denial—his lying.

---

When an authority figure lies to you, it makes you crazy. They call it crazy-making. Because how could your dad lie to you about such a thing? You take on the responsibility yourself: somehow it must be me that is wrong, even though all the evidence points the other way.

It's like September 11th—you grow up expect you can trust your government but when the official story they tell you about what happened on that day just doesn't make sense with evidence agreed upon by tens of thousands of PhD scientists who are willing to risk their university careers by signing their names to petitions that say the government is lying, it's crazy-making.

Someone is lying, and if it's between gobs of independent, educated, scientific researchers and a government who has every chance and history of lying, collusion, and breaking the law, then the only conclusion—which is brain-twistingly hard to come to to—is that your government really is lying to you.

The one you grew up learning to trust—your government, your father—really is the one who's lying, and the only one you can trust is yourself. You have to come to strange conclusions like my dad is either bald-faced lying or insane and in the wider case, you have to admit ultimately that the government controls the media, that odds are even Rachel Maddow is bought and paid for by the CIA. You have to choose between the comfortable fantasy and the harsh reality and most people choose the first and it's understandable that they do.

Because when you're holding a letter written in your dad's handwriting and the envelope is postmarked from Florida, and your father is telling you he's never even been to Florida..well..it's time to either comfort yourself with some extremely-hard-to-believe lies..or it's time to face what Marcellus Wallace might call "a hard motherfucking fact of life." And if Marcellus Wallace was here to further advise you, he might suggest that "it's a fact of life your ass is gonna have to get realistic about."

83

Then I'm in Vermont going to the ER in a cab vouchered by the Refuge who I called first. Them checking me for drugs and finding I was clean but hyper, making all kinds of jokes with the phlebotomist/admissions dude.

And before that going downstairs and talking with the new first floor housemate (Krystal, the friendly whore) and me feeling like I'm tripping, on serotonin prescription drugs and mania. And when I told Krystal that I felt like I was tripping, she said she already knew. She could tell. And then the trippy part started to rub off on her! Then I told her in a minute I was going to the hospital and she was like why and I said I had bipolar disorder and she said she figured it was something like that.

The call ends.

I put the phone down.

Then I started breaking things.

I get so mad I punch a hole in the vaulted ceiling—freaking out and hitting the ceiling, throwing stuff around my apartment, as violent as I had been since that one time I was a kid and I destroyed my room. I was completely out of control, like a fucking mad dog. Hung up the phone and that's the last time I ever called him. Talking to him made me want to kill myself. On the camping trip we went on a few years earlier to smooth things over, on the last day I determined that if I was going to be in a relationship with this person, I would have to drink. I was screaming and yelling and breaking everything in sight and I remembered a time in tenth or eleventh grade when I did the same thing to my bedroom in my parents' house—ripped the mini-blinds off the windows, tore books in half, destroyed everything but my computer. My parents didn't know what to do with me—I wish they had sent me to the doctor. I'm only able to have this memory now that I have been re-diagnosed with bipolar disorder, this memory of ripping my room to shreds, tearing The Once and Future King in half, destroying the venetian blinds 'cause I was so irate with my parents' arguing.

All my life, I've been trying to get my dad's attention..and even a suicide attempt didn't accomplish that. I escalated and escalated to get some positive attention (love) from him but nothing worked. And I gave up after that suicide attempt, because his reaction to that (discounting my childhood memories of potty training as fixed delusions of bipolar disorder) was enough to finally convince me that he doesn't care to have an authentic relationship with me. Apparently he feels good sending one email a year to his son. I read those letters for a while, but no more..I just archive them without reading them because they're all about him, how it's going with him..there has never been an "us" there.

Remembering in conjunction with my dad's humiliating toilet training, my mom taking my temperature in my butt while I lay on my parents' bed—how it felt cool and straight and smooth going in. It wasn't sexual, it wasn't a violation, it was just easier than her getting me to hold a thermometer still in my mouth without biting it or moving it around such that she couldn't get a measurement. Thermometers had mercury in them back then..

Anyway after I punched the hole in my ceiling in the attic apartment in Brattleboro, I called the Refuge and the nurse took notes, then told me to go to the hospital. I called the Refuge and they asked me my symptoms.

I lost it.

Talking with the new housemate downstairs (Krystal—the whore?) and feeling like I'm tripping.

I lost it.

Like when I told her that I was feeling trippy and she said she was picking up on my trip energy.

I went to the hospital in a cab with no money..but the Refuge called the driver so he can get a voucher.

The hospital blood tested me for drugs, found none.

Here's the check in nurse: "Are you psychotic?"

(Laughing maniacally:) "How would I know?"

I am laughing so hard it involves every muscle in my body. I point at the interviewer guy.

"If I was psychotic.." (laughing) "..how could I possibly know if I was psychotic. Psychosis is a reality-testing problem. If I'm psychotic, I can't tell, to some degree, great or small, what is real and what isn't. So if I can't do that kind of testing, then how could I ever know for sure that I was or was not psychotic. I could think I was fine but that feeling of being fine might be a delusion..and a delusion..is something that you believe..that's false..that you continue to believe even once you've been presented with evidence to the opposite. I don't call that delusion, though—I call it backbone. You following me on this one?"

"Yeah I'm following you."

"So I think I'm gonna have to leave that call to you, on whether or not I'm psychotic, ok boss?"

"Ten-four kemosabe."

"Now you're speaking my language, Tonto."

I shake my head.

"I'm glad you're not a Native American or what I just said would not have been funny."

"You think Tonto is racist?"

"Have you seen the show? The whole fucking show is racist. This whole country is racist. I had a job—"

I interrupt myself with laughter.

My interviewer is looking at me, perplexed.

"Yes, I know it's hard to believe, but I had a job."

"Did you have to leave because of your bipolar disorder?"

"I was fired. I don't know that it had anything to do with my bipolar disorder. Why would you say that?"

"Just tell me about the job."

"I forgot what I was going to say about it. My mind is like a glitterbox."

"I think you were talking about racism."

"Of course. Race-fucking-ism. The American pastime."

"America's pastime is baseball, my friend."

"No, America's pastime is racism, always has and always shall be. So I had this job. Are you going to argue me on the America's pastime point or can I continue my story?"

This big guy shifts in his seat.

"I think you should continue your story."

"Ok, but you have to remind me what it was about."

"Racism."

"Right! It's a good thing we're here together 'cause I don't think I could carry this conversation on alone."

"Did you get fired for your job for being racist or something?"

"No. I got fired because my asshole boss asked me to pirate a copy of Photoshop and I first of all told him I wasn't going to do it and second of all I reported him to Adobe."

"He fired you for that."

"Yep."

"That's wrongful termination, dude. You should get a lawyer."

"I'm working on it."

"Good. So where does racism come into it?"

"Oh, just this guy I had to sit next to. Connecticut native. Lived in Bratt all his life. When it was just me and him in the office he wouldn't shut up about how when he moved here as a kid there were like eight black people in Brattleboro—which is a ridiculous statement, I mean no one knows how many black people there are in Brattleboro. Even the census doesn't know exactly how many black people are in Brattleboro—you know? What if a black person goes over to New Hampshire to buy some watermelon and fried chicken from the Walmart—I'm kidding, I'm kidding, I was saying that ironically, trust me, I've fucked Kenyan strippers, I've fucked other black girls, I love black pussy—but I'm saying, let's say a black person crosses the bridge into New Hampshire to go to the Walmart to buy..whatever..whatever a person of any color would buy, you know, fuckin' Slim Jims and shit..fuckin' 5-hour Energy to give them enough energy to get through the work day so they don't get that two o'clock feeling. Do you know how dangerous those drinks probably are?"

"They must have gotten by the FDA."

"The FDA. The FDA. Are you a nurse?

"What do you mean?"

"I mean like are you an LPN, RPN—"

"RN—"

"RN, LP, EP, EPA, I'm talking about..do you know..these experiments they do on people on mushrooms..people who eat hallucinogenic mushrooms..and, yes, the chemical in psilocybin mushrooms—or it's actually the chemical that your stomach turns psilocybin into, because psilocybin isn't what makes you trip, which is why you have to eat mushrooms..you can't smoke 'em or stick 'em up your butt or anything..you have to eat them so that the right chemical transaction takes place in your stomach and then you trip—and these scientists found that while you're tripping on mushrooms, yes, your brain does run a little bit slower overall, but in this one area of cognition or with this one type of cognition called leap-ahead association or multi-hop association or something..that's increased while you're tripping, and this kind of leap-ahead cognition is what allows you to, say I mention concept A, and concept A is related to concept B, and concept B is related to concept C. Well, when you're on mushrooms, if someone mentions concept A, you're more likely to make the association to concept C than someone who isn't tripping. So, on the one hand, that's psychotic thought, because non-tripping people are like what the hell? What the hell is this person talking about? But, on the other hand, it's creative thought and it's inventive thought. It's actually deeper and more complex than the thought being done by a non-psychotic person. The problem is, there are more non-psychotic people than psychotic people, so when someone says A, and you're the only person in the room who says C, when everyone else says B, everyone thinks you're crazy 'cause they didn't understand the leap you made. Which is an important lesson: which is..when you don't understand someone (or something), you can't logically conclude that it's because the thing you're observing doesn't make sense."

I sit back in my chair. I'm sweating. My mouth is dry. I feel high as fuck. The colors are bright. The textures are crawling over the walls and the chair and the face of this admitting nurse.

I say, "The only thing you can logically conclude, in a case like that, is that you don't understand."

"So tell me about this theoretical black guy at the Walmart."

"The one buying Slim Jims?"

"Yeah."

"Ok well here's what I propose."

I lean forward again.

"Let's have him put back the 5-hour Energy because that'll prob'ly give him a heart attack."

"Alright."

"And let's have him pick up some organic spinach and a shotgun."

"Why?"

"Because. I don't want this to be a typical black guy. I'm thinking organic spinach because it's a typically white item—people think of some rich bitch buying that shit, like my upstairs neighbor—well, my downstairs neighbor—but that's a different story, all I can say is don't you sometimes want to just go up to some strange woman and simultaneously put your hand down her skirt and inside her panties and play with her cunt while you kiss her on the mouth and simultaneously you take a hand and you stick that hand up her shirt and you touch that girl's nipple, I mean real nice, run your finger around it until that shit is hard as a diamond."

"So that's the rich bitch that would stereotypically buy organic spinach."

"Right. Are you with me?"

"Yeah. Some of the details are a little fuzzy but mostly, yeah."

"Good 'cause I'm working on my continuity. Is it improving?"

"No."

I laugh.

"Well good luck to us both. I'll try to finish this up."

"No worries. We've got time."

"You're saying that because it's Thursday night in Brattleboro and there aren't any other patients and that's the reason you haven't kicked me out of your office yet?"

"No, I'm gonna kick you out. We're waiting for the results of your drug test."

"Oh. Is that what we're doing here?"

The guy nods.

"Do you remember me taking your blood a few minutes ago?"

"That's was only a few minutes ago?"

"About ten."

"Jesus Effing Christ it feels like we've been here for hours."

"Try to relax. You want to do some deep breaths with me?"

"Yes."

We do some. He breathes. I mirror him as much as I can. It's moments like this when I admit to myself that I have bipolar disorder. I'm manic. I've read the textbook symptom lists enough times to diagnose myself almost as well as my psychiatrist. There are tricky symptoms though. On the large scale: people who have bipolar disorder tend to disbelieve their diagnosis. Yeah. Bipolar affects some part of your brain in a way that makes bipolar people unlikely to accept that they are bipolar. That's diabolical, right there. And on the small scale: one of the symptoms of mania is that the person doesn't think they're manic. They deny being manic. That's insidious. But once you know this, once you've read about that symptom enough times, even your crazy manic brain has a chance of realizing, from within mania, that you're manic. I can't always realize it, but sometimes I can. It's kind of like realizing you're in a dream: very hard, but with practice you can do it more often.

I exhale.

I tell the nurse, in a much slower, much calmer voice:

"The guy that sits next to me—who used to sit next to me, before I got fired—he used to say these ridiculous things like, 'When we moved here there were only eight black people in Brattleboro.' And that pisses me off from a couple of angles. First, I don't like fucking racists. I expect that shit in the south. I expect it from my uncle, my grandmother. But I guess I have unrealistic expectations—it's not rational for me to assume that because I'm in Vermont there won't be racists. I recognize that. One of my psychiatrists noticed that pattern in me maybe five, six years ago, and I've been doing it for a long time before then, I don't even know how long: I create an unrealistic expectation for someone, then I get mad at them when they don't satisfy my expectations. This guy who sits next to me, so what, he's a racist. But this is at work. It's a place I don't even want to be—the only reason I'm there is to make money so I can pay my rent and eat and not be homeless. We're not exactly saving the world. We make trash cans—actually that's not true. We—they—buy trash cans from some people and sell those trash cans to other people. So, I mean, we don't even make anything. We're just an unnecessary middleman. And I don't want to have this sales guy talking in my right ear about how when he moved here there were eight black people in town and now there are three-hundred and twenty-six. I mean, these are suppositions and guesses posing as facts and I know I'm the psychotic one but I don't like to hear facts that couldn't possibly be true. These are things that cannot be known. Yet this sales guy says them as though they are bona fide facts, exactly known, indisputable. It just messes with my sense of right and wrong."

The door behind the nurse opens. A girl in scrubs hands the nurse a piece of paper and closes the door. My guy looks over the paper and sets it on his desk.

"Your drug test is clean."

I think about telling him off, or at least saying, "I know." I know that I haven't done any drugs lately—you don't. So the purpose of this drug test is to tell you that I'm clean, not me. I already know that I'm clean, because I've been with myself this whole time.

But I don't tell him this. He's just trying to be nice to me, and the fact that I knew what the results of my drug test would be, before they ever drew the blood, is not what's on his mind. He's just narrating his own discovery. He's not thinking about the situation from my point of view. And that's ok. He sat with me and let me talk a thousand miles a minute and he didn't get up and walk away, which he could have done. He could have put me in a room by myself when I had a desperate need to talk to someone. But he didn't. He listened to me create wild scenarios like the theoretical black man buying organic spinach and a shotgun from the Walmart in New Hampshire just to illustrate that my workmate's clairvoyant census of Brattleboro's black population was very likely inaccurate and therefore a waste of my motherfucking time. He did that for me, this nurse, and in doing so he helped me..and..also..he earned my respect.

84

I was looking at my texture pattern on the big, painted walls of Brattleboro Memorial. A crisis team member eventually came and cleared me as not a danger to anyone ("yourself or others"). I got a voucher-based cab ride paid for by the Refuge to Brattleboro General. They had a hard time understanding my behavior given I tested negative for alcohol or any other drugs—but they're not psych people..they don't understand bipolar disorder.

I tell the nurse the story Dad told me, garbled now in my mind, of a bisexual he met at the sawmill when he skipped college for a year. Dad used to sing me Edelweiss as I was falling asleep or even say The Lord's Prayer, which at the time I didn't mind so much. But one night he told me the story of some interaction he'd had with a bisexual man who worked at the sawmill and I don't know if he told me details—I don't remember any details—but his conclusion, which I remember clearly, was that bisexual men were dangerous and to be kept away from, and that somehow God's law forbade it—though my dad certainly couldn't cite the appropriate chapter and verse.

Nothing he said on this topic carried the seriousness for me that it did for him. Maybe he had a homosexual experience with this man—I'm not sure. I was five years old and sex wasn't a complete picture on my radar. It wasn't till much later that I was able to parse his story at all. But it was a terrible bedtime story, you have to admit. You're putting your kid to bed—this isn't confessional hour with your sex therapist. Stick to Edelweiss—which he sang beautifully and gently and caringly, and like it meant something to him at least—even say The Lord's Prayer if you absolutely have to.

But Dad and I have been like that forever, from my childhood to the time he and Mom got divorced: he's the confessor and I'm his priest. I sit there and listen to everything that went wrong with him and Mom—heavily filtered through his lens, of course—when really he should have gotten counseling. But my dad is too afraid to go to counseling. He refused after three sessions to go to marriage counseling with my mom because telling the truth about his own faults is so painful to him that he will do anything to avoid it.

I refuse to move on with him in a relationship until he and I have an honest conversation about some of the fucked-up shit he did to me as a child. But he won't have that conversation with me. Denies it ever happened. Blames my bipolar, says it's all a delusion—which is extremely manipulative and fucked-up in itself to use a bipolar person's mental illness against them, to try to convince them that the opposite of truth is true.

But I know what happened.

I understand, from hundreds of hours with psychiatrists, the nature and shape of my delusions and they're not that major. I need my dad to face the facts. But my dad is too weak to do that and odds are we'll go to our graves having said not a single word more to each other than we've said to this day.

---

At the hospital, they put me in a white room with a video camera. I jumped around, I laughed, I hallucinated. I called my sister Joanne and told her my predicament. A Crisis Team worker released me after an interview in which I was determined to be not a danger to anyone, including myself. They called a cab and it was the same guy who drove me there. We talked: he used to be a programmer..moved here and couldn't find work..sound familiar?

Being manic and going to the hospital.

Going to the ER.

The same cabbie on the way there and back.

He used to be a programmer but moved and couldn't find work. I pay with a voucher both ways and apologize for leaving no tip.

I go into the apartment feeling just as insane as when I left.

Eve Fox calling me back on my home number from her home number:

"I'm worried you're going to kill yourself."

I must have left her a suicidal message earlier.

"No, I'll be alright. I'm not going to kill myself tonight, I promise. I'm sorry I worried you."

"And you'll go back to the Refuge tomorrow."

"Yes, absolutely, those guys will take care of me. Really, Eve, I'm so sorry I worried you and I'm sorry for bothering you at home but I'm totally fine."

Hallucinating my ass off.

In a conversation where I think I have caused my housemate to begin hallucinating?

Fielding voicemail from my therapist from a suicidal phone call I don't remember making?

And you think I've lost my mind?

I don't think you understand what that means.

It's not a one-time deal.

See, each day I lose my mind, and at the end of the day I don't find it—I just lose it, and lose it, and lose it again.

85

The next day walking to Birches, I saw a yellow tree in snow. I went to my social work/group therapy thing but was immediately called to Dr. Sbarro's office. Dr. Sbarro, along with Ms. Irwin, the program nurse, did a few quick tests and diagnosed me with serotonin syndrome, then indicated my status was "grave" on his summary report. They sent me back to Tyler 2.

I mean like they checked my pulse, tapped my knee, asked me a couple of questions and they were sure I had serotonin syndrome.

Check in was more exciting than usual.

This nubile physician's assistant did my check in with the usual guy present. It was a thrill to be touched by her and she had such a pretty face. She did the entire physical exam after the regular PA asked me if that was ok. I said yes, and at the end of the session I thanked them both and told the trainee I thought she was professional and caring—very appropriate in her interaction, asking me if it was ok for her to touch me here or there before actually doing so. I think that's a generational thing—young doctors don't assume, as older ones do, that they can just touch you wherever they want without asking. I like the new way.

And even with some nubile trainee who I would allow to touch me anywhere because of my own sexual desire, I still like the new way.

Brattleboro Refuge Discharge Summary (4)

Patient Admitted October 27, 2011—Discharged November 4, 2011

Chief Complaint

Zha, as he prefers to be known, presented with a chief complaint "because I took a bunch of pills last night." [I guess they must just copy and paste these forms—I only made one suicide attempt. Or maybe they just consider this event to be the crucial event at the center of my many hospital stays.]

History of Present Illness

The patient had been hospitalized inpatient here at the Brattleboro Refuge and went out, but was quite depressed as a consequence of bipolar affective disorder, and made a suicide attempt. He was readmitted and then transferred here [the Birches Partial Hospitalization Program, an IOP or Intensive Outpatient Program] after stabilization. He sees Eve Fox at the Brattleboro Counseling Center on an outpatient basis, and has had a number of episodes of bipolar affective disorder and three previous psychiatric admissions.

Course of Hospitalization

Zha was admitted to the partial hospitalization program and continued on Buspar 30 mg b.i.d. [twice daily], Celexa 40 mg daily, clonidine 0.1 mg one or two daily as needed for anxiety or agitation, Lamictal 200 mg at h.s. [Latin Hora Somni—at bedtime], Risperdal 3 mg at bedtime, and trazodone 50 mg at h.s. p.r.n. for sleep [from Latin Pro Re Nata—as needed], with a repeat in 1 hour if necessary. Matthew had difficulty adjusting to the partial hospitalization program. On one prior occasion he was close to meeting the inpatient level of care, but we maintained him on an outpatient basis. However, on November 3rd, he was seen by this author and by Ms. Irwin, the program nurse, as a consequence of increasing confusion, muscle tremors, and maladies. At that time his blood pressure was elevated in the range of 140/108, and his pulse was 100 or more. He had brisk reflexes, 2 or 3+ bilaterally. His speech was slightly pressured. He reported his thoughts to be racing and confused. His ability to distinguish between a dream and reality was diminished, in his opinion. In view of these changes, it was felt that this might well represent a serotonin syndrome, and we discontinued his Buspar, Celexa, and trazodone. He was instructed to take only half his usual dose of Risperdal at night. He reported this morning, November 4th, for admission to inpatient for observation for serotonin syndrome.

Final Diagnoses

Bipolar Affective Disorder, Most Recent Episode Depressed. Alcohol Dependence. Serotonin Syndrome. History of Cocaine Abuse. [Everyone following this? This is not how your life is supposed to go.] Renal Lithiasis [yet another name for kidney stones]. Severe (Health Issues [Serotonin Syndrome], Financial, Alcohol Issues, Living Arrangements).

GAF on Discharge: 28 [In other words, after all this inpatient psychiatric care, outpatient programs, and medication, my GAF is the same now as when I first entered the hospital two months ago.]

Condition on Discharge

Unstable, to be admitted to the inpatient level of care.

Prognosis: Grave.

So they sent me back to Tyler 2, and I went through the same admitting process as I had been through on three previous questions. Interview from the physician's assistant and his nubile trainee. Same guy I saw every time I went through that gauntlet except this time with a fucking cherub (but a skinny cherub) at his side. Questions about hallucinations, delusions, diet, bowel movements. Questions about drug use. Alcohol. Cigarettes. Orientation questions, like What year is it? and Who is the President? Where are you right now?

"The Brattleboro Refuge."

"What town are we in?"

"It's a borough, and it's Brattleboro. Did you know that in the late eighteen-hundreds the Postmaster General declared that all location names ending in "borough" would be changed to "boro"—b-o-r-o—to save ink?!"

The physician's assistant said, "Is that true?"

"Well, it wasn't just to save ink, but yes, it was to save time and money in general and yes it's true."

"So did Brattleboro used to be spelled Brattleboro-u-g-h?"

"I don't know," I laugh.

The physician's assistant says, "I'm gonna give you three words to remember—"

"Cat ball string," I say. "I'll remember 'em in ten minutes when you ask me and I remember 'em from the last time you asked me. They're always the same—cat ball string. Why don't you give me a string of numbers and letters—upper and lowercase—about nine or ten digits long, and ask me that next time I see you."

"How do you know there's going to be a next time?"

I shrug and make an Obviously there's going to be a next time face. (It looks exactly like my Am I a fucking idiot? face.)

"Can you really do that?" the young PA asks.

"Letters and numbers—upper and lowercase—" the older PA begins.

"For about a week, up to about ten characters, yes, but it'll probably be more than a week before I see you again—"

"Only if your luck changes," says my normal PA.

I love this fucking guy. If I was Joe Pesci from Goodfellas I'd shoot him in his fucking face.

"Matthew, why are you here today?"

"Well. Ostensibly, I'm here because Dr. Sbarro says I have serotonin syndrome. But you know and I know that I don't have serotonin syndrome."

"I don't know that," the physician's assistant says.

"Well I do know that."

"How do you know that?"

"Because I've read the diagnostic criteria for serotonin syndrome and based on the physical tests Dr. Sbarro and Nurse Irwin just administered to me fifteen minutes ago I don't meet the diagnostic criteria for serotonin syndrome."

"You're saying Dr. Sbarro is wrong?"

"I'm saying this is a you see what you want to see-type situation. My pulse ranges and twitch measurements were high, but they weren't within the range needed to diagnose serotonin syndrome. And he flubbed some of the numbers."

The physician's assistant leans back in his chair, folds his arms behind his head.

"Are you seriously saying Dr. Sbarro flubbed the numbers on your pulse, your twitch count? Are you recommending that I write that down in my interview notes."

"No, my friend, I am not suggesting you write that down."

"But is it true?"

"Absolutely. He fiddled the numbers a little bit to fit me into the criteria for serotonin syndrome."

"I'm under a moral oath to write down the entirety of what you say."

"Then write it down. I'm not going to lose my job over this."

"But you know I could. Are you playing a game with me?"

"No. I'm telling you the verbatim truth as my senses report it. Take that with a grain of salt."

"I do."

"I do find it kind of suspicious that Birches keeps switching their psychiatrists."

"What do they do?"

"Every week you go up there, the program psychiatrist is a different doc. It's a rotating position for some reason."

"And you find that suspicious?"

"Well what's the utility? What's the positive reason they're doing it for?"

"To give many psychiatrists a taste of the position? I don't know."

"Let me tell you a story. Cat ball string. I'll make it quick. See if you can remember those words for me because at the end of this story I'm gonna ask you what they were. So. Five years ago. First time I was diagnosed bipolar. I stayed up for a week, drank potato vodka, programmed the shit out of some kick-ass cellular automata systems. Learning systems. AI. Artificial intelligence. Finds patterns in seemingly meaningless data."

"You do."

"I find patterns in seemingly meaningless data. Haha. Very funny. How come you're only a physician's assistant anyway—why are there two of you, both physician's assistants, but not a physician to be found? You're not assisting a physician. You work autonomously—"

"Can we get back to your story?"

"You think it's easy being psychotic around you people? Well it's not. Now go home and get your fuckin' shine box."

"Goodfellas, good flick."

"It's not a good flick, it's one of the greatest movies of all time. So I have this manic experience—or what I later come to believe is a manic experience. No sleep. Watching The Truman Show on a loop."

The young PA is typing furiously.

"I call a suicide hotline. They tell me to call 911. Then two cops—at least we're all meant to think they're cops—"

"Why don't you think they were real cops?"

"Because I forgot to tell you the most important part of the story. Before I call the suicide hotline, I call the NSA."

"The National Security Agency?"

"Yeah. I gave a talk there a long time ago and I knew a guy who worked there and I thought he might be interested in this new technology—"

"This cellular automata stuff?"

"This CA-like stuff, yeah."

"To do what?"

"To do what everyone wants to do, post-911—to catch terrorists, naturally."

"Naturally."

"You better go and get your fuckin' shine box."

"So, what, you think these cops were really NSA agents dressed as cops and..what?..they put you in a psych hospital, give you a fake diagnosis of bipolar disorder, and use National Security Letters to keep you committed long enough for the NSA tech guys to sneak into your apartment and steal whatever's on your computer?"

Now I lean back in my chair.

"That's sounds like a paranoid theory spawned from the mind a truly delusional psychotic. I would not advise writing down in your notes that you came up with that."

"You came up with it!" the PA says.

"No, I didn't say any of that shit. But given a few details, that shit is—I won't say a logical conclusion, because that would make it seem like I was crazy—"

"We'd hate to leave anyone with that impression."

"I'm not saying that's what happened. I'm saying if you don't ask the question: Is that what happened? then you're not thinking enough in the big picture."

"What were those three words?"

"Cat. Ball. String. I'm not psychotic. I'm just inventive. People used to pay me good money to be inventive."

"What happened?"

"I guess I got too inventive. Can I go now?"

"No. I have to check your tattoos—or, she does. We have to do the physical exam."

"You know my tattoos, baby!"

"Yeah but I always forget the English translation."

"He conquers, who conquers himself."

"You doing that right now?"

"No, I'm pretty far afield from that one lately. But I did stop drinking."

"Congratulations," the PA smiles.

"Thanks, yeah. That's a tough one for me."

"Are you hiding anything up your ass?"

"Whoah, my man, major party foul. One, it's a complete non-sequitur. Two, it's like saying to your wife: Have you thought about shooting me in the face with the shotgun while I sleep? The bitch ain't never thought of that before. But she's thinking it now, I can guarantee you."

Then the nubile PA completed my physical exam and it was like being touched by an angel. At first I was afraid of being aroused but this wasn't like that. It was elevated. I swear—it was like two holy beings communing in the most respectful way. Did I say holy already because this shit was fucking holy. We were actually emanating white light and there were some other things too but if I tell you you'll just classify it as a hallucination..so..I'll just keep that stuff to myself.

86

"I don't think you have serotonin syndrome."

"Nor do I."

"Uh—what is your diagnosis based on?"

"I've read the literature."

"What do you mean, 'You've read the literature?' "

"I've read the diagnostic criteria for serotonin syndrome. I mean who hasn't—"

"Since when did you become the psychiatrist in this relationship?"

"Hey, anyone can become a psychiatrist these days. It's all on YouTube. iTunes. Princeton has their classes online now. You can piece together degree-level knowledge in three, four weeks internet time. There's eight-year-old kids know this stuff now. Not as well as you," I say.

"Thank you. Now let me be the doctor, please?"

"Ok. I'm sorry."

"No, it's ok. I think you're right. I don't think you have serotonin syndrome but I am discontinuing all serotonergic medicines as suggested by the referring psychiatrist."

"Even my antidepressant?"

"Yes," she said gravely. "I—"

"No, I understand. You have to based on Dr. Sbarro's diagnosis."

"Don't worry, ok. You'll be here. You'll be safe. I'll be here with you."

"Ok, I trust you."

Dr. Meggs looks over her shoulder.

"I wish I could say that trust was justified," she says.

That's all she says. Then she leaves.

---

The weekend comes and goes. I feel the effects of losing my antidepressant. Within a day I'm teary, defenses down psychologically. A week later, the next Monday, Dr. Meggs have the closest thing to a fight that we'll ever have.

We sit opposite each other in the sunroom.

"This was supposed to be just for the weekend but I've been up here..I don't know..five or seven days..or no..maybe nine days. Dr. Meggs, please when agreed to this, Dr. Sbarro said this was supposed to be just a med change—weekend trip—that's what was said when Dr. Sbarro put me here."

"No," she stops me. "He put you here under my care and it is my job to make sure you are ok before I let you go."

I'm crying when I say, "Yeah, that makes sense. It's just frustrating when one doctor says I have serotonin syndrome and it was supposed to be just for the weekend but I ended up back here for I don't even know how long..a week? It just seems like there's—if I may suggest a process improvement—there's a lack of continuity of care between Birches and here, I mean do you guys even communicate with each other?"

"I read your discharge report from Birches. That's how we communicate."

"Ok, ok, I respect that. When Dr. Sbarro put me here, he put me under your care and it's your job to make sure I'm ok before you let me go. I mean, yeah, that makes sense."

I was happy to see Dr. Meggs as always. But for the first time, the sheen of going inpatient had worn off and I was irritated to be there.

"I checked in for a medicine change. Dr. Sbarro told me it was going to be over the weekend. Now I'm on another Tyler 2 odyssey."

"We have to do what we do regardless of Dr. Sbarro's intentions. We have a responsibility to do that."

"I understand. I understand. It's just hard."

The doctor put her hand on my knee.

"I'm going to put you back on a low dose of Celexa."

I sniffle and look at her, as she has stood up by now.

"Thank you," I cry.

---

We had some sensible conversations later.

"One day I got out of the Refuge on a Friday. My bank account had two-thousand dollars in it. By Monday, when you and I spoke, my bank account was empty. I didn't even remember what I had spent it on!"

"Yeah, well that's a bipolar trait."

"Fantastic! What do I do about my two-thousand dollars?"

"When was this?"

"Weeks ago, but I just mean in general, how do I address this problem?"

Skip ahead.

"Now what's this thing about the spoons?"

"Spoons?"

"It's listed in your admissions report..thinks NSA is poisoning spoons—"

"No it's the CIA that's poisoning spoons. Why would the NSA be poisoning spoons?"

"Ok, tell me about what you think the CIA is doing."

"I don't think they're doing anything! Not necessarily. But the possibility exists that they have created a model of the parts of my brain necessary to predict which spoon I will pick out of a drawer of spoons—like the drawer of spoons in the snack room—so that they can poison me in plain sight! Poison just that one spoon and then I pick it up and die and no one would ever think it's possible that it could have been a targeted crime because how could they have known which spoon I was going to pick? So I have so pick an unusual spoon every time I pick a spoon so I can surprise their algorithm. I have to determine which one they thought I was most likely to pick, then out-think them and pick a spoon they never would have guessed that I would pick."

Dr. Meggs says, "Ok, that's a psychotic thought. What else comes to mind, along these lines?"

"Just this childhood memory of Dad correcting me on how to fold the towels. I had gone out of my way to fold and put away the clean laundry, and instead of accepting the way I did it and thanking me, he took me to the towel closet and said this is almost right..but not quite. Then he proceeded to instruct me on how to tri-fold the towels instead of bi-fold them so that they would fit better in the shelf at the bottom of the stairs to the third-floor bedroom. They fit just fine my way. You could select any towel you wanted, take it, and go. The towels weren't bunched together. They weren't spread apart. But there was no way that was good enough to fold the goddamn bath towels unless it was my dad's way."

"That's ridiculous," Dr. Meggs says.

"My dad used to scold me for leaving a little orange juice in the pitcher after what I had done was pour exactly the amount I needed for my glass, then left the pitcher the way it was. In my mind, then, that was the proper thing to do. If the next person needed more than what was left, they could get a frozen orange juice container from the freezer and make more. To my dad's way of seeing it, leaving a little bit of orange juice in the pitcher wasn't forward-thinking enough—it was the job of the person who would otherwise have left less than a glass worth of OJ in the pitcher to make the next pitcher of juice. It's like the lint filter on a clothes dryer—"

"How is it like that?"

"Is it the job of the next person who uses it to clean out the lint caught by the last person's load of clothes, or is it the job of the person who just washed clothes to empty their own lint so that it's clean for the next person before they use the dryer? At this point in my life, I do some of those procedures differently than I did as a child. And we can debate and talk and improve on those processes all day long. But that's not the point. The point is I grew up with a dad who, for everything I did, he always had a correction. Nothing I did was good enough for him to simply say, 'Thank you,' or, 'Good job.' And I have learned that I can infer, from his behavior, that his mind has a drill sergeant in it, telling him he's not good enough..a constant voice in his head, learned from childhood, that tortures him with the idea that he will never be ok, that he can never let things go, that he can never be done working. My dad has a list, and he runs his life and the lives of everyone around him by that list. He is driven by tasks, and not in a fun way. In a way like slavery. The list is his master; he is the slave. He would say he just likes 'to keep busy.' I would call that never facing reality, always distracting yourself from what's really important. One time my sister Leona and I were at Dad's house for Thanksgiving—the year he didn't even invite my other sister Joanne. Leona and I really wanted to have an important conversation with our dad, and we asked him if he could spare ten minutes to talk some stuff over with us. He declined—he was too busy preparing the Thanksgiving feast with his new wife Eva, so that all the food would be ready for the guests they had invited over. He turned down an opportunity to talk with his kids so that the goddamn buffet could be ready for his and Eva's random friends. Leona and I had asked repeatedly what we could do to help with the dinner preparations—nothing, my dad said, everything was under control. Exactly. He was in control, he didn't want the chaos of letting his kids help prepare the meal, and he certainly didn't want the chaos of us having a serious conversation with him about how we all related since childhood. So Dad never talked with me and Leona about what we wanted to talk about, that day or any day. The food was ready for his friends. He and Eva 'entertained' their guests successfully. But let me tell you buddy—let me tell you, Dad—that ten minutes you could have spent with your son and daughter, talking about stuff that mattered to us, maybe having a group hug afterward..that was your life. And you missed it."

I lean back.

"Maybe you didn't come here for a medication adjustment. Maybe you came here to get that off your chest. What else bothers you?"

"You wanna know what bothers me?"

"Yeah."

"When people misread the situation with me."

"How do they misread it?"

"They think they can push me, when actually, when it comes to the real power balance, I am the one who can push them—though I don't ever want to."

The doctor listened.

---

I don't like to be pushed, and I'm not scared of anyone. Nothing embarrasses me, and I don't respond to psychological threats. In high school, the year after I played Mr Frank in The Diary of Anne Frank, I played Uncle Arvide in the musical Guys and Dolls. I was slated to sing a song, but the director (the theatre teacher) neglected to schedule me for a single rehearsal with the vocal coach, neglected to give me sheet music or a recording of the song, and I kept waiting and waiting for the director to come to me to help prepare me for the singing part of this role. I learned my lines, and in a rehearsal when we got to my song the director asked why I wasn't singing. I told him I had never been rehearsed. He said What?? Have you ever seen the movie? No, I said. He scheduled me for an hour with the singing coach and it was clear that there wasn't enough time to prepare me to sing the song. The singing coach was disappointed. I reported back to the director and he seemed satisfied that I had been properly rehearsed. I told him I was not properly rehearsed after one hour of coaching and that I wouldn't sing the song during the performance so I suggested he instruct the orchestra not to play the music and we just skip to the scene that happened after the song.

The director was so pissed that he threw his six-inch Subway sandwich into a metal trashcan with such force that the trashcan fell over. The veins in his head were popping out, he was pointing at me, yelling:

"You will sing that song!!"

I calmly reminded him that I had already told him what I would and would not be doing and the choices left to him had nothing to do with me, but with whether he would tell the orchestra to play the music or skip to the next scene. He was so fucking pissed that the co-star of his last year's success, The Diary of Anne Frank, was telling him that I wouldn't sing the song because he never scheduled me for rehearsals, that he left the room.

He called my bluff (a terrible, terrible thing to do).

The scene ran.

The conductor lifted her baton.

The music for my song played. The orchestra did a beautiful job.

And during that song's music, I strolled around the stage of Colonel White High School for the Creative and Performing Arts, under hot white lights, in front of a packed house, and I thought about things that interested me, I accepted the possible consequence that my friends who were also in this musical might not be my friends anymore, I tried to imagine what my family (parents and sisters), who had come to watch the play that night, might be thinking, and I laughed—to myself—and I replayed that theatre teacher throwing his uneaten Subway sandwich into the trash can, storming out of the theatre classroom so pissed that I was telling him how it was going down, and I imagined him standing somewhere in the back of the theatre watching me stroll around the stage to that beautiful music, not singing a note, and I unemotionally hoped that the reality of who was in control was sinking into his stunted brain.

In subsequent performances, the orchestra skipped the song and the show (as shows do) went on.

Some fellow students hated me for what I did. My best friend, especially, hated me for what I did—but he got to know me better. And some people, a little vampire girl a grade younger than me, especially, respected my conscience, understood the situation, and invited me to her house when her parents weren't home and rewarded me for my stoicism with her affections.

When my parents drove me and my sisters home that night, they talked about the music, the acting, the show in general. When they asked me what was supposed to happen during my orchestral stroll around the stage, I told them there was supposed to be a song there but the director never scheduled me for rehearsals, so I was unable to sing the song. There was no further questioning. No one argued with me—I think by that point they had learned not to.

---

I had a boss once, Bruce McLaughlin. His lackey, Ray, liked to insult me. Ray thought it was funny to make jokes at my expense, laughing that anything that went wrong with our software was my fault, even when I hadn't even touched that piece of software. I was the youngest employee—I was eighteen or nineteen. Ray pushed me and pushed me and pushed me.

I told Jim about these jokes. I said I understood that they were meant as friendly ribbing but that I thought they were in bad taste, inappropriate in a work environment, and that I would stop working with his company if the jokes continued.

Two years later, after Ray continued to poke me and prod me and push me with his ignorance, his idiocy, his lack of a realistic grasp on the situation that existed between him and I..and after periodic phone calls made by me to the owner of the company saying: Jim, if Ray continues this juvenile and disrespectful behavior, I will eventually quit working with your company..one day Ray made one of his super funny, incredibly clever jokes blaming some failed release of our software on me, I went to the front desk where our secretary, Tina, sat, and I said:

"Tina, it's been nice knowing you."

And she was like: "Really?!?!?!?!?!"

(She knew this day was coming.)

And I said, "Yes," shook her hand, and walked out the door of that piddly little company.

Jim calls me later that day, super calm, super executive, professional as hell.

"So I hear some trouble happened between you and Ray today."

"I've been telling you for two years, Jim, that if Ray didn't stop with the stupid jokes that I would quit. Today he made another one of his stupid jokes. I quit. End of story."

Jim acted surprised—he was like, "I just didn't see this coming."

And I said, "Jim, I've been telling you since week two that this was a problem. I told you it was a show-stopper. You allowed the problem to continue. And now we're done."

He tried to get me to stay. He said that Ray didn't mean it, that being an asshole was just part of Ray's personality. I was his star programmer—I could program rings around Ray or anybody else who worked there. But I don't abide being treated disrespectfully. And I don't abide working for a boss who doesn't heed my warnings. And that was the end of my providing services to Softronics, Inc.

Like I said: Don't call my bluff.

"Why don't you want people to call your bluff?"

"Because I'm not bluffing."

87

This admission there was a schizophrenic woman named Sarah who I thought I had met before around town—she looked incredibly familiar and I had déjà vu about a conversation with her—but she insisted it must have been her twin sister (I never knew if she had a twin sister or if that was one of her delusions).

Sitting in a group with her everyone was saying all these normal things and then suddenly she says to me:

"You like to hurt people, don't you?"

Or maybe something even worse—I don't remember the exact wording. It disturbed me and everyone in the group and I got up and left the circle, and she kept saying things like that to others, and to me when I'd pass by, really disturbing me psychologically. I asked a staff member if they could keep her away from me. They put her in ALSA for a night and the next day we ate breakfast with each other and she said,

"I'm really sorry if I said anything that made you uncomfortable. I was off my medication and was in danger of losing my personality."

I didn't trouble her with what she had said. I moved on. We became friends and I liked her when she was on her medication. But schizophrenics can be very hard to deal with when they're in a reality that is highly different than your own. She would say things like, "What did you just say?" when I hadn't said anything, then she'd tell me what she thought I said and it was some horrible cruel offensive thing.

"You like to hurt people, don't you?"

When she said that, it was so out of place in the conversation we were having that everyone was shocked. But she had her finger halfway on the pulse of a truth about me. What allowed us to be such fast friends after this was that she was on her antipsychotics (which I was also taking). And I know now that I am the same way, that I publicize semi-private truths about people in an impolite, antisocial way. Why do you think I have so few friends and family who are still willing to talk to me? It seems funny to me, but the truth from their point of view is probably something like I am too dangerous psychologically for them to be around. Though I doubt many of them could admit to that aloud.

In the morning when she apologized and told me she went off her medicine and that's why she was back in the Refuge and that she was in danger of losing her personality, I didn't understand what she meant about the last part and still it was a scary idea.

I had yet another schizophrenic friend from Tyler 2 who I always made laugh—she was large with blond hair and her name was Karen—she says she's gonna miss me because I always cracked her up. It surprises me that anyone would be laughing at what I do, but since she did, it made me glad. She said she missed her kids and I said yeah, and she says do you have any kids and I joke about not having any because I don't want to change their diapers.

"Oh, you wouldn't mind if they were yours," she says.

And I say, "No, you don't understand, I hate shit. I hate it."

"Why do you hate..shit..so much?"

"I don't know."

"Are you kidding with me," says my schizophrenic friend.

"Sadly, no."

"You really wouldn't have kids just because you wouldn't want to change their diapers?"

"Well I have no way to support them, I guess that's the larger issue. I've always known I couldn't reliably keep a job. But, yes, cleaning up after other people's shit isn't something I'd relish."

"What if your wife did it?"

"I wouldn't want her to have to do it, either."

"You're really not kidding, are you?"

"No, Karen, I'm not kidding."

Sometimes after I take a shit I wipe my butt so many times it's raw. You know when you keep getting that tiny brown spot and no amount of wiping will get you a clean tissue? I hate that. I keep going. I can't stop until I get a completely clean tissue. I'm crazy for clean tissue.

---

On that admission, too, I saw the security guard who I told about the pills—who I handed my suicide pill bottle to—on the inside of the Refuge..he works as a mental health worker now.

I managed to check my iPad out of the contraband closet from some tech who didn't know the rules. This security guard-cum-mental health tech walks by my room like an eagle—one of these paramilitary types.

"Does that have a camera on it?"

I take out one of my earbuds. I'm listening to glorious Mozart, and it is transforming the psych ward into pure freedom, pure lightness.

The guy is right next to me, touching my iPad camera with his grody finger.

"I have to take that away. No electronics with a camera are allowed on the ward."

I wanted to tell him off but I make a point not to argue with people who have saved my life, so I just handed it to him and he said:

"I'm sorry."

And I didn't say anything or give him any foul looks about it.

When I saw him at the nurses' station he said, "I'm sorry, man."

And I just said, "It's ok. It's ok. Please don't worry about it."

What worse could I say to the man who had called 911 when I overdosed on pills? Even though he had robbed me of the freedom of music which transformed my consciousness from bleak psych ward to glorious Mozart—a serious crime—I could not bring down any hammer on this man. I can't even say I like him, but I thank him, and I will give him any leeway in the world.

I just said, "May I please have a sound machine?"

And that particular guy leapt at the opportunity to get it for me. From that point on I was always soothing myself with the sound machine which I carried everywhere. I checked one out every morning and checked the same one in the next morning, checking out a new, charged one for the new day. I learned from the Refuge that music is my "coping skill"—actually it's the most powerful drug I can imagine and I use it all the time now like the sickest addict in the barest abandoned building—I mainline it to alter my state and without it I would die in this stale, stale world.

88

I'm doing laundry and I think of Schizophrenic Mike—who I incited the fight with?

I'm flashing back.

I'm saying all these reality-bending things about not touching my laundry and You touched my laundry and Don't touch the dryer and I saw you touch the dryer and I'm gonna kill you if you touch my laundry..just shit like that. Poor fucking schizophrenic, prob'ly has no idea what's going on anyway and I'm fucking with him saying all this contradictory shit like I love you but I'll stop loving you if you touch my laundry and talking about his mother and how she used to do the laundry and asking him Where is your mother now? I don't see her. She must have left you here, you fucktard, and she's never coming back. Why do you think she left you in a psycho ward? Do you think your mother knows you're psycho? Do you think your mother made you psycho? I hear if a mother doesn't breastfeed her baby he can turn out to be a lifelong fucking schizophrenic like you, Mike. Did your mother feed you with her tits? Just simple, evil, fucked-up shit like that designed to rile the motherfucker up, to make him attack me. And it worked. I pushed and pushed and pushed. I never looked away. I kept my eyes on his eyes so that if he looked away, when he looked back, I would be there. He was stuck in that laundry room and I set up the paradigm for him: he was the prisoner, I was the guard, and he had to take me down to escape the cell.

What I did was evil. I mean, yes, it was manipulative, it was tormenting, taunting..it was provoking as the nurses wrote in my chart ("patient has a history of provoking other patients")..but it was evil. I mean let's call a spade a spade, even if that spade is me. To intentionally fuck with a mentally ill person, to make him attack me so that he would end up in ALSA and I would be viewed as the victim (my psychiatrist soothed me later and told me Mike had a history of attacking other patients, that it wasn't my fault, that I shouldn't blame myself, and I wondered for a second if I didn't really know what happened, if I hadn't, in my own ill mind, done anything to provoke him at all, and this really was just something Mike would have done to me anyway)..but then I knew that even if Mike did have a history of attacking other patients, that he never would have attacked me if I hadn't provoked him. It was a sick thing to do, especially if I had more presence of mind than him—which was probably the case, as psychotic as I may be. It was a horrible thing to do, and to this day, I feel no remorse about it, because Mike, whether he was doing it on purpose or not, was making the women in the unit feel uncomfortable by standing over them, staring at them. He was creating disorder, none of the mental health techs or nurses were responding to the female patients' complaints, and in a vacuum of power, I take over. I might not have run the ward, but I could run Mike, and I ran him out of the unit, into ALSA, for a week—a week during which no man was making all the women around me uncomfortable, a week during which no creepy schizophrenic was gonna fuck up the calm of my psych unit!! (Hear the irony, please.) Hear the irony of a drug-addicted suicidal alcoholic bipolar obsessive-compulsive disordered mental patient committed by the state to a locked psychiatric ward (that's me) who thinks it's his job to bring order to the unit. They say controlling people—people who attempt to overly exert control over their external environments, to bring order to that which is outside—are people whose internal environments (their minds) are chaos.

All I have to say to that is that I've tried to control a lot of people who aren't me. And it hasn't done me a lick of good.

---

I am best friends with chaos, but I think in some situations there needs to be order. And while my stepping in to fill a void of order, and imposing my order uninvited, is part of my illness..in some contexts it works.

My sets in film school, for example. Now, there's an arena in which I was the designated leader—the director—so it wasn't like I was stepping in to fill a void. But my sets were quiet, my sets were orderly, organized, efficient, safe. And that safety came from establishing rules and enforcing them. No one but me was allowed to talk to the actors—this helped them establish the illusion that they were still doing exactly what we did in rehearsal, rather than have to face the fact that they were now in a soundstage surrounded by sets and lights and the camera and thirty strangers doing various jobs.

One of the grips was found sleeping behind the set instead of doing his job. I asked my producer to wake him and escort him off the set—one strike and you're out—that's how I roll. We weren't mean about it, but the producer and I set a tone that everyone else paid notice to: we're here to excellently, respectfully, and quietly do our job. If you fail to do your job, you will not be on this set.

The obvious result is that it sets an example that others learn not to repeat. The more subtle effect is that it creates safety in the form of expectation—we calmly set a pattern for how things would go on this set. That creates safety because people are operating in an environment where they know what to expect, not an environment that is or could become chaotic. So, as always, my weakness is my strength—they always are. Whether it's a gift or a liability largely depends on context.

And—call me a narcissist if you like—but usually when I suggest an idea to someone, they hate it, then they eventually try it, then they come to me and tell me how great it is. I'm not saying I have all the good ideas or a psychological need to—I don't. I'm quite impersonal and cooperative in group settings. It doesn't offend me when people don't use my ideas (unless over a period of years my ideas are never used). It doesn't hurt me when someone comes up with a better idea than mine—it excites me.

But on a film set, if I tell my cinematographer—who was usually Mike—to loosen the screws on the head of the tripod and let the camera drift a little for every shot in the film, his first reaction will be to think I'm crazy and resist like hell. But then he'll do it anyway, because every time I told him to do something before, it always worked out. And months later we'll be sitting in the theater in the Los Angeles Film School, and our directing teacher, Salvador Carasco, will say,

"Wow, I love that fluid shaky movement you used. It works with the split screen and gives your film an edgy feel that works with the script."

And Mike and I will look at each other and smile. And even though everyone will assume that was the cinematographer's decision, Mike will speak up and say,

"Yeah, that was actually Matthew's idea. When he first suggested it, I was like, 'Whaaat?'—I honestly didn't think it was going to work. But it works really well. He's a good director."

And I'll compliment him in front of the whole class, and all will be well.

And years will pass, and I will become a further irony—my sister Joanne says I have Midas' touch, that every project I touch turns to gold—and yet, I am thirty-eight, living with my mother, lying on the floor writing something like my thirteenth book, never having directed a film, my software career very likely over. When I was twenty-three, my cousin said I was the most employable person he knew. It was true at the time. He couldn't find a job as a baker and I was making amazing money for my age, programming computers for Mead Research. Now my cousin is a professor at Columbia University and I am an unemployed writer, disabled to the point that I can't live on my own, am banned by my psychiatrist from driving, can hardly pour a cup of coffee without spilling—and, after some pretty amazing years that came before, this has been hands down the greatest year of my life—because I am writing.

---

Walking, on a trip outside the ward, I took pictures in my mind of that one tree with the circular bench around it and yellow leaves all around the base of the tree in a circle..wanting to never forget it, it's so beautiful. I stood there and burned it into my mind. And I never have forgotten it, to this day.

And I was trapped, by a loop, something someone said twice, and thrown into a well of memory that made me think perhaps I did belong on Tyler 2, and not just for the weekend.

It was this social worker who was on her last day of work at the Refuge before she moved to Austin and I guess she felt like doing her job because she pulled me aside and sat me in the sunroom and gave me a really nice and piercing speech on "emotional honesty" and I felt so good that she had spent some of her time talking to me, saying something specifically designed to help me, based on her observation of me and reading of my charts. I thanked her warmly, wished her well in Austin, and she left the sunroom. Five minutes later I hear her saying, to some other patient,

"I think if you'll just be bold enough to have some emotional honesty around why you're here.." Giving the exact same speech using the same exact phrases to some other patient who had completely different issues and was in a completely different situation than me.

And I was back talking to Daniel.

And nothing made sense 'cause Spots was there, too.

Then a miracle happened. Well, it was a miracle within the context of Tyler 2. The autistic man, Daniel, opened up to me after all he ever did was yell at his doctor unintelligibly about the patients' bill of rights and ignored everyone else. I was sitting across from him doing a crossword puzzle, in a dream. Daniel, the severe autistic man, who only talked with me..he decided I was safe..after a long while..and one day around a square table we talked up a storm.

When I told Spots about it she said, "He trusts you."

Then there was a picture of a girl I met on the internet with a tarantula on her back. Which is weird because I didn't meet her till five years later.

But weird things can happen in the psych ward.

Sometimes it's the medicine.

Sometimes it's your mind.

And sometimes, if you have psychosis, you just never know.

I'm gonna restore you to peace now.

When I count to three, you'll wake up and all will be normal.

Are you ready?

Ok.

One.. two.. three.

89

You're gonna love this next one.

Brattleboro Refuge Discharge Summary (5)

Patient Admitted November 4, 2011—Discharged November 10, 2011

Identifying Data

This was the third Brattleboro Refuge and fourth lifetime admission for this 33-year-old, single white male [I think it's my fifth Brattleboro Refuge admission and sixth lifetime admission—but whatever—I mean you all do know that these records are used in courts and stuff, right?] The patient's occupation is an unemployed computer software engineer, he was fired in August [Whoever wrote this clearly has some logic and writing problems.] The patient is also a writer. The patient lives alone in Brattleboro Vermont. His mother lives close by [If you consider Allentown, Pennsylvania to be close to Brattleboro Vermont, then yes, she lives very close.]

Chief Complaint

"Dr. Sbarro says I have serotonin syndrome, unless they have other motivations for wanting to hospitalize me." Lol—this is not the type of thing you want to say to the admitting nurse in a psychiatric hospital. Hahahahaha—oh shit.]

History of Present Illness

This 33-year-old, single, white male presents on discharge from Birches Program for increasingly disorganized thinking. He also is having physical symptoms of muscle twitching, sweats, diarrhea, elevated blood pressure, restlessness and agitation. He reports that he went to a local Emergency Room a day or two ago for extreme anger and had his blood drawn but was medically cleared, although he does not recall specifically why. Symptoms started in Tyler 2 but then got better and then worsened a day or two ago. Current symptoms include chaotic thought process, increased paranoia, and increased anxiety but patient denies suicidal or homicidal ideation. The patient is having paranoid thoughts about the CIA poisoning milk and spoons, obsessing about being less predictable so that the CIA cannot poison him. He will not eat red or green Skittles together [I would not eat red] and green Skittles together because they reminded me of Christmas, a time of screaming and tension and pain—actually I still will not eat red and green Skittles together and I do not think this indicates any mental illness at all. If color is there, and you do not pay attention to it, then you are the one who is missing part of life—if it is healthy to view color as meaningless, then why is it there at all?]. The computer programming he was doing has been transferred to his brain. A lot of thoughts about the NSA profiling him. He reports having been there and working for them [I said I went there and made a] presentation to them, not that I worked there]. He feels like this is all a chess game and he wants to review his chart to see what others are saying. Reports that the NSA is messing up his life [they very well might be—prove to me, in the age of National Security Letters, that any of us know if our interactions with a potential employer, for example, have not been tampered with by the NSA or an organization like them—you can't]. Prior to admission to Tyler 2, the patient's trazodone and Celexa and Buspar were discontinued. His Risperdal was decreased, all of this in response to the notion that the patient was suffering from serotonin syndrome [Read: I disagree with the referring psychiatrist's diagnosis of serotonin syndrome and taking this patient off half his meds was highly irresponsible.]

Course of Hospitalization

The patient was put back on the Risperdal although we continued to keep him from using the trazodone, Celexa, and Buspar. The patient reports that he was also continuing to have some visual disturbance until the Sunday prior to admission. Throughout the course of his admission this time, he denied any visual disturbances. He also denied any symptoms of diarrhea, hallucinations, increased body temperature, loss of coordination, nausea, overactive reflexes, changes in blood pressure, vomiting [Read: Referring psychiatrist, you fucking idiot, my patient does not now nor did he ever have serotonin syndrome.] He did note some agitation and he was involved with an altercation with another patient which was not physical. The patient had accosted another patient about how loudly he was speaking and complained that the patient had awakened him [This sentence hardly captures the essence of what went down. I wake up at four or five in the morning because some thick-neck, football-jersey-wearing, protein-shake-drinking, backwards-cap-sporting] a-hole is posted up by the nurses' station TALKING AT THE TOP OF HIS LUNGS. Nurses present—no one doing shit. I walked up the hallway in my PJs and looked around as if to say, Are any of you fatherfucking motherfuckers aware that it's five in the goddamn morning??!! Finally this jersey-wearing asshole catches on that I'm standing there, looking straight at him, and he says, "What's your problem?" The nurses behind the desk stand up, on guard. I say, "No, it's your problem. It's five in the goddamn morning and if you don't lower your voice or better yet shut your football-jersey-wearing mouth completely, you're gonna find out that we have a hierarchy of crazy around here and since you just got here, you're on the bottom rung."—"Is this guy threatening me?"—"Call it what you want, just shut your fucking mouth." The guy stands up. The nurses tell me to go back to my room. I go back to my room, every step hoping that big motherfucker comes after me—I'm so keyed up I'd go straight for his eyes. He doesn't follow me, though. I stand in the hallway facing the nurses' station, my room light illuminating me. Come after me, fucker—come, after, me. One of the nurses suggests that I go back inside my room and close the door, as my waiting in the hallway waiting for that thick-neck loud-talking motherfucker is me being extremely aggressive. We want to diffuse the situation, the nurse says, not escalate it. But I'm thinking: Do we? Just now I looked up "altercation" in the Oxford American Writer's Thesaurus. One of the synonyms was "shitstorm." Now all I can think is: Matthew Temple, turning altercations into shitstorms since 1978. If you've been paying attention reading this book—and I've certainly been paying attention writing it—you'll notice a theme: I don't like to exist in a power vacuum. When control is absent, when the adults, the people who are supposed to be in charge, are doing nothing, I tend to step in to fill that void. So far the results of that strategy have been a dangerous and costly mix]. Notes from staff suggest that the patient has a history of provoking other patients. The patient, himself, reported to me that he felt very threatened by the other patient and upset by him. In the afternoon following the incident the patient was able to acknowledge he had overreacted and he did ultimately apologize to the other patient [Again, this hardly summarizes what went down: me and that thick-neck asshole were crying in each other's arms saying, "I love you man," and admitting our sicknesses to each other, fucking giving each other our favorite shirts as a sign of our new-found friendship, etc.]—We didn't just "apologize."—That fucker and I were like five steps away from a formula for world peace—fuck]. The patient reports he has spent a considerable amount of time meditating and this has helped him to put the episode in perspective [And let me say something else about this. At some point where I was causing or loving chaos, maybe when I provoked that schizo guy into a fight..or maybe later when I was standing in the hall outside my room looking to pick a fight with that dude who was yelling and cursing at like 5am..I remember a time in an AA meeting in Tucson, years ago, when I shared my realization that I wasn't addicted to the drugs—I was addicted to chaos. I wouldn't know what to do inside a normal life. Some of that's my actions, some of it's having bipolar disorder, some of it's the way I was raised]. The patient noted that his OCD symptoms were returning, especially with respect to oddities in his writing and worrying about the number 178 now that he is no longer on the clomipramine. The patient also reported having vivid, intense dreams but was sleeping ok.

There's really more I need to say about my tendency to taunt other patients..it's a thing I do in my family with my non-functional uncle as well..when there's no parental order, I instill it. Like this time we're gonna get to in a class at the Refuge where that young kid was being disruptive and the teacher just let him keep disrupting the class for all of us..I instilled order. I told the kid to get the fuck out. Same with the schizo kid who was disturbing all the girls..I'm not going to sit by and let someone make all the girls uncomfortable, so I did something about the situation. Same with the guy acting like he was the boss of the place, talking loud at night insinuating that dominating the sound environment of the ward was his right. I let that motherfucker know he was not in charge of this rathole.

It reminds me of the bridge scene in Apocalypse Now. Climbing through piss and shit..muddy bunker with bombs exploding in the background..Martin Sheen finds a living soldier and asks:

"Who's the commanding officer here?"

Panicked, the guy says: "Ain't you?"

Moments later, meeting a sure-shot zen motherfucking killing machine named Roach who's blowing up gooks with a grenade launcher, Sheen again asks:

"Hey soldier, do you know who's in command here?"

And this zen motherfucker says, "Yeah," and then walks off without saying anything—which I always interpreted to mean that there was no one in command, that Chaos, the Enemy, that Nothing was in command.

Eventually Sydney Poitier asks Sheen, "Did you find the CO, Captain?"

And Sheen says, "There's no fucking CO here."

That bridge scene, with one soldier on LSD, the Americans building up the bridge every night and Charlie blowing it up every morning—with no commanding officer present—something about that reminded me of the ward. There was never any lasting peace, just a revolving door of psychopaths like me, each one of us primed to use this otherwise neutral space as a stage where we would act out our sicknesses, masquerading them as powers, reigning them on other patients' heads, on staff heads, in an idiotic display of something we thought was strength but was just foolishness—no real power there, no real manhood or womanhood, just faces with the skin half torn off.

And that last guy, he was big, he could have killed me with his bare hands, but I remembered when I got beat up in the tenth grade by four guys..and I remembered sometime later when someone had suggested to someone else (and I overheard) the idea that if someone is going to kick your ass, you start acting like a crazy person, saying insane shit and say you have AIDS and you'll bite them and you've got shit in your pants already waiting and you'll shove it in their mouth and eyes, just start flailing around wildly spitting and shit..and I used some of that tactic with big boy who thought he was mob boss of the psych ward.

I remember this movie I watched when I was in Africa, between the fourth grade and fifth grade, and I've never been able to find it since. I was in Liberia between civil wars and I sat in this missionary kid's living room and watched a movie where these four American hunters cross over the line into Russia to chase a deer and they end up in a Russian prison for years..and one of them turns into kind of the leader of the prisoners, he's insane, he can beat anyone at chess, he can win physical competitions because he's crazy enough to do things other people won't—like bite your fucking ears off. I always related to that prison guy. His life was wasted but he found some sort of meaning for himself in being the most insane prisoner of all the insane prisoners. Even in the fourth grade, that archetype appealed to me. It resonated with me. If I had been wiser, I would have known at the time that I resonated with him because he was like me.

During the course of the hospitalization, the Risperdal was increased as the patient continued to have some overtly psychotic ideation and presented me with many notes which confirmed his psychotic thought process. However, once the Risperdal was increased, the patient began to again have what he called "solid" mood but did note that his depression had increased slightly since having began taken off the Celexa and he requested a restart of that antidepressant. In the event, we agreed to a trial of Lexapro secondary to complaints of hyperhidrosis [excessive sweating] on citalopram [actually I can't cum on Celexa but I can on Lexapro]—I have no idea whether I told my doctor this]. The patient denied suicidal or homicidal ideation, denied auditory or visual hallucinations and was not deemed an imminent threat to self or others. There were no symptoms of serotonin syndrome on discharge.

Final Diagnoses

Bipolar Disorder Not Otherwise Specified with psychotic features. Alcohol Dependence. Cocaine Abuse. Recurring Kidney Stones. Unemployed. Chronic Suicidality.

GAF on Discharge: 35 [This falls in the same range as the 40 I had before: impairment in reality testing (that's psychosis)..impairment in communication..speech is illogical, obscure, irrelevant..major impairment in work, school, family relations, judgment, thinking, or mood..avoids friends, neglects family, is unable to work—true, all true.]

Condition on Discharge

The patient was well groomed, in casual clothing with good hygiene. Cooperative with interview, making good contact. No psychomotor agitation or retardation noted. Affect was constricted. Mood was described as "comfortable with this discharge plan." Thought process, quality and quantity of speech were within normal limits. Speech was not pressured. There was no evidence of poverty of speech, no thought blocking, no flight of ideas, no loosening of associations. No tangentiality. No circumstantiality, no echolalia, no neologisms, no clanging, no perseveration, and at this time he was denying ideas of reference [Did you get all that? I didn't. Times likes these are when I'm glad my psychiatrist knows more than me. Ok. Pressured speech is a symptom of mania]—it's when you can't stop talking even when you want to! But it's more than that, it's rapid and frenzied speech, urgent for some unknown reason. You can't interrupt the person. You can't understand what they're talking about. Next: poverty of speech. In a normal conversation, when you say something and I respond, I address what you said and add additional, unprompted content. Poverty of speech is when a person doesn't add this additional, unprompted content. It's a blankness. It's like they're talking, but there's nothing there. So I didn't have that—that's good. Poverty of speech is common in people with schizophrenia. The fact that my doctor includes this in my discharge notes indicates to me that the "psychotic thought process" and "increasingly disorganized thinking" she has observed in me led her to consider a diagnosis of schizophrenia but that she is ruling this out. Same for the next one: thought blocking. Thought blocking is where you stop speaking in the middle of a sentence. It's a sign of schizophrenia. I don't have it—that's good. Next: flight of ideas. A symptom of mania. Rapid thought flow, accelerated speech, abrupt changes from topic to topic that are difficult or impossible to follow. Didn't have that. Loosening of associations is when your thoughts (and therefore your speech) consists of unrelated or only remotely related ideas. It's a sign of mania or schizophrenia. Tangentiality, as you can probably guess, is when you digress from the topic under discussion to another topic which is suggested by associations you have to the original topic. I may not have been doing that then but I certainly do it now—frequently my mom asks me, "What does this have to do with what we were talking about?" It's a symptom of bipolar disorder and schizophrenia. Circumstantiality is discourse based on a non-linear thought pattern. The person includes a lot of unnecessary detail but eventually gets back to the original point. It's what I speculate Mamet might call "taking the long way home." Echolalia is repeating someone else's words. Neologisms are made-up words. In clanging, what you say isn't based on concepts, it's based on sounds—compulsive rhyming or alliteration with no discernible logical connection between words. Perseveration is when you can't stop doing or saying the same thing over and over. Ideas of reference are when you find deep personal significance in events that have nothing to do with you. You attribute meaning to things that are meaningless. You think everything you experience is part of a master plan designed specifically around you. It's a symptom of schizophrenia and also occurs during bipolar mania. Let's move on]. Denied auditory or visual hallucinations. There was no evidence of delusions. Paranoia was significantly diminished from intake. He was alert and oriented by 3 [I know who I am, where I am, the date and time, but not necessarily the events that have occurred recently.] Insight was fair and judgment was considered fair.

Prognosis

Fair, depending on patient's ability to maintain his medications and refrain from use of drugs or alcohol.

Patient Strengths

The patient has a supportive sister and supportive mother. Also is able to make use of therapeutic interventions [I've often wondered what Dr. Meggs meant by this—did she mean that she knew that there was a highly conscious way in which I was] using the hospital, even to the level of causing myself to be admitted? I'll never know].

Arrangements for Aftercare Services

The patient is discharged back to Birches Program [like a fucking tennis ball—every time I go to Birches, they admit me to Tyler 2; every time I'm discharged from Tyler 2, they send me back to Birches.]

Recommendations for Discharge

Resume regular diet and activity and follow up with outpatient providers as arranged by social work. It is recommended that the patient have an appointment with an optometrist to evaluate his eyesight. It is recommended that the patient have a head CT to rule out any space-occupying lesions or other abnormalities that could lend themselves to psychotic processes and/or visual changes.

I may not have had serotonin syndrome, but I was definitely angry. While I was in there, I reprimanded this redhead crackhead so hard that he requested a transfer to another floor.

I sat there in the low rocking chair which was the coveted chair but was specifically given to me this class by my fellow patients because I was obviously on edge. I sat through listening to that asshole interrupt and contradict every share by everyone in the group, saying the stupidest things (including the interchange about how he always says that he'll smoke crack today and quit tomorrow and I say that will never work because if you say that every day then you'll be smoking crack every day..you've got to stop today, because every day is like today..your whole life is made up of days like today, not days like tomorrow, because there's no such thing as tomorrow, you're always living in today) but most of all what I couldn't stand is him being mean to my friends, the other patients.

And then I said to myself, the next time that redhead crackhead says a word, I'm going to interrupt him and give him a talking to like he hasn't heard since he was a little kid. And I did. And the spineless substance abuse counsellor and the senile old guest he had invited in to tell us some dumb-ass inspirational story (about some trivial business he started..like he used to be an addict and then he started reading a book a day and now he has a Lamborghini..shit like that).

So this crackhead finally says one too many words—he finally speaks after the point at which I'd decided to shred him. He interrupts someone in the class while they're speaking and from the coveted low-rider rocking chair I say, and look, and point at this guy:

"SHUT. THE FUCK. UP."

Matt the spineless substance abuse counsellor looks at me.

And I say to him: "Where is your moral compass for thinking this was a speaker who would be valuable for us to hear?"

And then I say to this invited speaker: "How is it that you read five-thousand books and the biggest it stretched your mind is that you wanted to buy a Lamborghini? Were they all self-help books from the 1950s or did you read anything by Eckhart Tolle or Pema Chödrön, for example—because if you had, then I don't think you would be deriving a major part of your self-worth from bragging to a bunch of mental patients about owning a two-hundred thousand dollar car. That's just my opinion." This guy was a cheat, abusing his power with a government office—he's the guy who bought up a bunch of solar panel patents before himself serving on the board who voted to offer Vermonters huge solar panel subsidies and he made millions..and he calls this spiritual success, somehow, just because he used to have a drinking problem. This is his definition of turning his life around, or healing substance problems? I'm thinking What class am I in?

And the whole time I'm telling this faggot to shut up, everyone in the room is dead silent, the crackhead, the spineless substance abuse counselor, Faith, everyone. When I'm done the guest speaker continues his story. Faith whispers, Are you ok? and I shake my head and rock furiously in the chair, trying to control my breathing.

I should have grabbed that old man by the shoulders and dragged him to the elevator. Motherfucker.

When this no-morals, no-storytelling ability storyteller is done exhaling all the wind in his old-ass bag, Matt, the spineless substance abuse counsellor, suggests that we talk about my outburst.

I inform him I've already said all I have to say, but that I'll listen if anyone else has something to say.

Basically the whole group, person after person, says,

Maybe Matthew shouldn't have reacted the way he did, but redhead crackhead has been disrespectful and disruptive in every group and I agree with what Matthew said—though not necessarily in the way he said it—and I think one of you, the teachers, the leaders, the nurses, the doctors..somebody should have said something to redhead crackhead so that we didn't have to handle the situation ourselves.

"Good job, Matthew," Olivia says.

"Yeah, I don't like his dumb ass either."

"Faith, let's try to be constructive."

"I am being constructive. I'm calling a dumb ass a dumb ass—that's highly constructive where I come from."

And the dude—the redhead crackhead—leaves. He sees that everyone is against him, and he walks out, goes straight to the nurses' station, and requests a transfer downstairs to Tyler 1. Good for him. Good for us. Fuck that uppity redhead crackhead.

Earlier, in response to my shut the fuck up, he was like:

"Excuse me, I get to talk here—"

"No you don't. You get to shut your fucking mouth."

"But—"

"Just SHUT IT. I'm done listening to you, so you're done talking. Do you understand what I just said to you?"

"All I was saying was—"

"All you need to do is stop talking. Am I a problem for you?"

"I think you're a problem for everyone."

"Am I a problem to you?"

"Given that you won't let me share my opinions—"

"Then all you have to do..is shut..the fuck..up. Then I will cease to be a problem for you. Ok?"

Redhead crackhead is quiet. He gets up and walks out.

Problem solved.

But Matt the spineless substance abuse counsellor insists on reminding us (me) that:

"We have a have a set of group guidelines for this ward. And one of those guidelines is a non-violence policy. And the way you speak to people is sometimes violent, Matthew. The way you spoke to redhead crackhead certainly was. I don't know if you can hear, but he's out there requesting a transfer downstairs, to Tyler 1."

"He belongs in Tyler 1," Olivia says. "Not up here with a bunch of people who have legitimate psychiatric disorders."

"Well the Brattleboro Refuge considers addiction to be a psychiatric disorder."

"But what I'm saying," Olivia says, "is that redhead crackhead needs to detox off of crack and then maybe he can come up here if he has depression or schizophrenia—which I don't think he has. Matthew—ok, Matthew, I'm not defending what you said or how you said it just now—but Matthew obviously has emotional problems separate from addiction..which, I don't even know if you're an addict—"

"I am."

"And no offense, but I don't think anyone should ever be spoken to that way—"

"No offense taken."

"But you, Matt," she says to our teacher, "need to handle things like redhead crackhead before they get to the point that a patient feels the need to speak out against it."

"Olivia, that's just not how we do things here. We believe that patients learn more when they work things out among themselves."

Olivia huffs, shakes her head, stands up. She walks right next to me and says, "I'm glad you said something. I don't blame you, ok."

"Ok," I say. "And I'm sorry I said it the way I did. That guy just names me mad."

"I know," she says, and she pats me on the knee.

Then she walks out.

And that pretty much ends Mr Bob Dobalina's inspirational speech. There is no formal closure to the class. Everyone just walks out in twos and threes and by themselves and someone turns the TV on and I get up and walk out the door and even though our spineless substance counsellor starts calling, "Matthew! Matthew!" I just ignore him.

I go to the nurses' desk where Michelle is checking out redhead crackhead to transfer to Tyler 1 immediately. Michelle looks at me—I'm sure she heard the whole incident—and she rolls her eyes. She doesn't smile at me—that would be inappropriate—but she doesn't give me a dirty look, either. It's like, in her mind, this was an inevitability—like she's seen this so many times between different versions of me and different versions of redhead crackhead, that it doesn't even make the headlines anymore.

I stand a few feet away from redhead crackhead, filling out my preferences for the next meal. I don't look at him at all. I fill in for an extra hamburger. I'm done with redhead crackhead. I put in for chocolate milk instead of regular milk. Redhead crackhead has gone through my meat-grinding facility, and come out soggy and wet and dripping dead blood. There's nothing more that I can do with him—he requested a transfer off the ward!! I am happy. Not because I "won." No. Fuck winning. I'm happy because he'll be gone..and I won't have to listen to his voice anymore. I don't wish any ill on him—I hope things work out great on Tyler 1, he stops smoking crack, and has a wonderful life. It's just that he was disturbing my environment, so that fucker had to go.

90

See, there's something that happens to you when a psychiatrist looks at your notebooks and your notes to her and she determines that they indicate a "psychotic process"—when those notebooks make perfect sense. Now you might say, who am I to know whether I'm psychotic or not (because if I'm psychotic I might not be able to know that). Well, excellent point. But hear this: When I went home, I used some of those notes to write a program which I think simulates one theory (of mine) about what I call manic, sleeping, awake, or depressed states (those don't mean exactly what you might think they mean based on general usage). So my notes were coherent in the sense that they corresponded to a computer program I wrote using them as a guide. The program has been run by me and at least one other person on two different computers. Its output shows the neural state of a simple organism that goes through these various states, which I think correspond to states in bipolar mentality.

How is that psychotic?

Just because you don't understand it doesn't make it psychotic. My psychiatrists' handwriting is psychotic—so much so that the pharmacy fills the wrong drugs and I have to correct them and say, no, I need Flexeril, not fluoxetine. I already take Lexapro, if I take fluoxetine on top of that, it could induce mania, I could end up in the hospital. Is my doctor psychotic just because the pharmacy can't make sense of her handwriting? Or does she just have messy handwriting?

You know what I'm saying. It's one of my classic arguments, and almost no one agrees with me.

But let's say you're a teacher giving a test, and a student gives you a Scantron that works out as an F. And let's say you look at the answers the student put down, and they just don't make sense—in fact they look random. You might conclude that this student was bored or discouraged or despondent and instead of taking the test, just filled in a random circle for each of the questions. You could conclude that. But, my argument (which no one ever agrees with) is this: that student might be doing something extremely ordered, which only appears random to you—for instance, the student might have used the Scantron to write an encoded message which, when decoded, says, "This test is boring," over and over. Encoded in the digital form, it would look like the student was just fucking around, when in fact they were doing something completely sensible, non-psychotic, albeit unexpected. The warning in this is that when someone does something you don't understand, it doesn't mean it's senseless, it just means it's senseless to you.

Ok, so most students taking tests and people in psych ward interviews are not doing things like this. They are not intentionally coding meaningful behavior into random-looking activity for their own entertainment. Most people aren't that on top of a conversation that they're talking (as Prince would say) "in, around, through." They're not even aware of what they're saying—just as most of us are not hyper-aware of what we're saying in a conversation. It's like skiing or skating or walking or driving—you're not thinking about every little move you make, it happens automatically.

But while my psychiatrist probably has correctly diagnosed me as psychotic, I disagree with her using my notes as evidence for this "psychotic process." My notes are highly unusual, irregular, sometimes written in a language my psychiatrist can't read because I made it up and no one can read it but me—but that doesn't mean I'm psychotic. That just makes me weird. Psychosis is delusions and hallucinations. What part of a beyond-creatively written note indicates a delusion or a hallucination? It certainly doesn't indicate a hallucination—how does me doing something you didn't expect conclude in me hallucinating? It doesn't—it just doesn't. Where, then, is the delusion—the false belief that even when a person is shown contradictory evidence, they continue to believe? Where in my strange note is an indicator that I am deluded in any way? There is no indication—there just isn't.

And like I was saying before, there is something that happens to me when someone—well, when my doctor—looks at my wildly creative behavior and slaps the label "psychotic" on it. And what it is that happens is that I start not to care if people understand me. Why not talk in nonsense all the time? Why not express myself exactly how I feel, ignoring social rules, knowing it will turn off most people..but why would I care, if I am psychotic, if I am medically determined not to make complete sense anyway, to be clouded by delusions and hallucinations (which I am), then why even try to behave normally—why even fit into the box?

Do you hear my anger? You're right, it's there. Maybe if I was of average intelligence or below average intelligence I could care less about being branded psychotic. But now I find myself in a position where I can think circles around my psychiatrist—she sometimes suggests things I've never thought of, but I can keep tabs on and categorize and analyze and remember everything she says and I can ask her questions she never thought of and doesn't have the answers to. I'm not actually angry with my psychiatrist, so that's a bad example.

But there have been bosses, coworkers, friends, and my dad, who at some point decided that I was crazy—and they were right—but they never were able to see the full me (as, even though I was the crazy one, their view of me was narrower than my view of them) so they dismissed all of me when only part of me was functioning less lucidly than them, and most of me (even though I was crazy) was functioning more lucidly than them. So in business situations, even though I was "Crazy Matt," I consistently came up with totally unorthodox, totally appropriate, mindstompingly simple solutions to problems that teams of programmers hadn't solved in years. In the large corporations, my solutions were implemented, they solved long-standing problems and ultimately saved money, which was the whole point. I have a maddening way of solving problems by not solving them—by reframing them as something else and then solving that. I'm a superlative problem solver—I am, it's no brag, it's just the truth—but often, especially in the small corporations, people don't really want suggestions that work from people "under them" on the org chart. Consistently coming up with ideas that show up your boss is your ticket to hell in a small company, because small companies haven't figured out that ego isn't an asset—that's why they're still small companies..and why they always will be. Any suggestion you make that might help them to become a medium-sized or someday a large company, is met with resistance from the boss, from everyone who works there. They're scared of change, they're scared of growth. Deep down, they want to be a small company (forever).

Anyway, fuck small companies—I'm off track.

All I really have to say is it's a weird and strangely fun position to be in, to be branded disabled partially due to psychosis when, from my perspective, I make a lot more sense (or at least have a a lot more capability) than my abled, non-psychotic human friends.

---

When I was in film school, I called my sister Joanne one day, from outside the building, in front of the school. And I said:

"Everyone is cutting me off, Joanne. My friends here are dropping like flies. At the beginning everybody was buddy buddy and we were all dumb film students trying to learn something together about how to make a movie. Now I'm making films that consistently the teachers compliment and nobody wants to work with me!! They won't even talk with me!"

I exhaled. My head was leaned against the stone of the front of the building.

And Joanne said: "Well, bro, I'm sure you're familiar with this dynamic from other schools before. Once you start to stand out, people feel threatened. Their only recourse is the recourse of the pack—the pack mentality. They have to stick together against you to survive. But you survive on your own, my bro. You always have. And, if you'll allow me to say one more thing.."

"Yes, Joanne, this is just what I need."

"Ok, well, I'm not sure I'm using this phase right, but I think you'll know the sense in which I mean it, even though this isn't the sense..it's not the way it's normally defined."

"What is it?"

I can hear Joanne chewing on the other end of the phone—an apple, or granola.

And my sister, my loving, genius sister, said, "Well, this is a little coarse, and I don't mean to insult your fellow classmates."

"No, go ahead, insult them."

"Bro," she chews, "the proof is in the pudding. You know. They can gossip, they can shut you out socially—that's their skill. But you can make films that your professors like. And that's why you went there, right?—to make films. And you're doing that. And not everyone can do that. So I say, ignore those mofos and get back to making films."

And that's what I did—of course that's what I did.

And that's the sense in which I use that phrase when I say it (which is usually to myself): The proof is in the pudding. Meaning: you can call me crazy, you can diagnose me psychotic, you can dismiss me because sometimes bipolar people are delusional, but the proof is in the pudding, bro. You can talk crap. Or you can diagnose. But I can write books (I've written twelve—I think). I can program computers like somebody who's been programming computers since he was a kid (because I have been programming computers since I was a kid—I learned to program before I learned long division). I've invented some artificial intelligence algorithms—I presented one of them to the NSA when I was like nineteen years old. I've discovered many new types of one-dimensional cellular automata (a type of logic system). I've sold paintings for thousands of dollars. I'm a prodigy at group leadership—like in a camp counsellor role—I can create trust among a group and inspire that group when at the beginning they were all disruptive and ho-hum and not interested. I get down on myself about my relationships but Joanne reminds me that I'm excellent at relationships (when I want to be).

---

I was talking to one of my bosses one time—basically about how I didn't fit into the company—and he said:

"You're one of the smartest people I've ever met."

(This guy graduated at the top of his class at MIT.)

And I said, "I'm good at one or two things."

And he said, "No, you're really good at a lot of things."

I said, "Ok, five."

He said, "No, ten."

And we laughed together about how my broadness and my depth of knowledge was what was making me not fit in well in his company. Smh. So basically if I was dumber I would fit in better, be a better employee?

Basically, yes.

I've had two company owners say almost this exact same thing to me, which was: "I'm not sure what type of environment you'd fit well in [but it's not this one.]"

I'm telling you, corporate America, even though they say they do, do not want to hire the smartest people they can find. The smartest people they can find will cause them extreme pain every day and that is not who they want to hire. They want to hire consistent, dumb, recent college graduates who program at a level I would plainly call incompetent and who will never get better over the course of their careers.

I know I'm smart. I know that corporate America will never hire me again, after calling my references. And now I know that I wasn't just weird from birth onward—I have, through genetics and experience, been given obsessive-compulsive disorder, bipolar disorder, and (as a permanent side effect of a bipolar medication) tardive dyskinesia. I am constantly in pain (and do not take pain medication because I'm an addict); cannot take care of myself independently; spend twenty-three hours a day lying down (to lessen the clenching); have suicidal and expansive swings of mood, speed, capability, and energy; and am, yes, psychotic. I recognize my delusions after the fact (sometimes, that I know of). I have a constant visual hallucination of a moving pattern on the walls and other hallucinations when I'm manic. So, yeah, I'm crazy.

But when my doctor says I'm psychotic, I think: why even play by the rules anymore? I can do more than than most people who aren't psychotic—the proof is in the pudding. I can bake my pudding—can you? The proof is in the pudding, bro—can you bake a pudding? I have no way to ever succeed at the job, the career, the house, the wife—and I've always known I never would. I just never imagined that for myself—some basic intuition knew that would never be my life. And it's freeing, being on the outside. Oh, it has its downsides—mainly the lack of funds. I won't be buying a BMW anytime soon. But the upside is exactly that I am psychotic. I'm psychotic?—I can say whatever I want! No one's going to take me seriously anyway—I'm psychotic! Might as well say what I really feel, Tweet what I really want, retweet things that if they were ever seen on my desk at work they would get me fired. I've been doing this to some degree all along—and all along it's been a problem. The more I blogged, the harder it became to survive a job interview. People were spending more and more time asking me about my poetry than my programming skills. Once I had written books that were readable online, it was almost impossible to get a job. Now that I have a six-year gap in employment, a major mental illness, and 11 inpatient psychiatric stays, I'm unhirable. But you know what? I was never really having fun in those jobs. I never felt alive then in the way that I do now. Now, I can write whatever I want. Now, I can program whatever I want. No one can ever fire me. And with the little disability I get, I can pay half the rent and split the grocery bill with my mom. The rest goes to health insurance.

And this might sound mean, but along with the no one can ever fire me part, goes the I don't have to work with idiots part. I looked unfavorably on most of the people I've ever worked with (some more than others, of course). And really the nicest way I can put this is: I never have to work with you motherfuckers ever again. You treated me unfairly, you paid me less than I was worth, you generally played the fool, and worst of all, you wasted my time. I actually wanted to do something; you were content to go nowhere. And—look!—we both got what we wanted.

91

On the outside, seeing Spots on the sidewalk and being like:

"You lookin' fine, woman!"

Some kind of animal-print pants, tight as fuck, mini jacket, smoking a cigarette.

She says I look good too.

"Nice to see you on the outside!"

"Likewise!"

We're on Elliot Street. It's the first time I've seen her since I saw her on the inside. She's smoking her brand and I'm smoking Kamel Reds. We're both in street clothes and she is looking fine. I mean I like her dressed in her Refuge clothes, no doubt, but a tight pair of leopard skin pants and us saying what's up like real live human being.

"I've been meaning to ask you something, not sure I had the guts on the inside," she says.

"What is it?"

"Tell me about your love history."

I give her a brief breakdown.

She says, "Sounds like a lot of heartbreak."

And I have to admit she's right, and I fear that my lack of ability at relationships makes me less attractive to her. But I gotta tell the truth.

---

We talk outside her bar at a cigarette break.

She asks me for one of mine.

I give it to her, light it, and she says:

"Are you suicidal."

And I say, "Yes."

And she says, "You have to go back. Promise me. You have to promise me you will go back."

"Ok, I promise," I say, my tears freezing on my face.

"Good. Good. Go team. I might have to go back too. I want them to detox me off my pain meds. I'm addicted to them now."

I nod.

Then a snowball hits me in the chest.

Then one hits Spots in the back!

Drinkers at Whit's are attacking drinkers at the hippie bar on our smoke break! There is only one recourse!!

I run the little distance down the hill and I'm throwing snowballs at the guy who work at the bike, at Thomas, at Justine's boyfriend.

Then Justine tackles me, throws me down in the snow right next to a fire hydrant. She's wearing a snowsuit and we're rolling in the snow—the night before Thanksgiving and her hot breath in my face—feeling her whole body press against mine, her on top, and the two of us looking at each other, our faces so close and she said,

"I like you,"

And I said, "I like you too. You should come over to my house sometime."

"Why? Are you gonna make me dinner?"

"No. I'm gonna make you scream."

Our eyes were darting back and forth. My cock was getting hard and I knew Justine could feel it through the snowsuit she was wearing 'cause she pressed back, her pubic mound absorbing me.

"I'm gonna take you up on that," she said.

And the moment was over, reeled back like a fishing lure, gone. Justine got up and the snowball fight had never stopped around us, and we went back to throwing snow in each other's faces and smoking and going back inside.

After that I developed a fetish for women in snowsuits, imagining that all they had on underneath were some kinky panties or maybe nothing. For a while there I wanted to fuck every girl I saw in a snowsuit.

And for a while there everything was wonderful..was that the high moment of the second act? With Justine's hot breath in my ear and Spots asking for one of my cigarettes to smoke—I think it was. I think it rose to that point, peaked for about three minutes, and then I think from there, for me, it was the way down.

---

Vermont in general is losing young people. Young people tend to move out of Vermont because it's full of podunk towns and icy mountains and these young people prefer to live in neighborhoods with hot nightclubs and Lamborghinis and better drugs and better jobs and the ability to "have a life."

So they move to the most expensive part of New York or LA they can afford—which is like Harlem or Koreatown, which are dangerous neighborhoods to live in, even by my standards. And anyway, "having a life" is something that means one thing when you're young..but as you age it sort of isn't a thing..because anything you do, well, that's your life =)

Opposite the trend of youth draining from Vermont into cities with more of a scene, there are young people staying in Vermont, moving to Vermont, and making themselves a hell of a scene in Vermont. Specifically in Brattleboro. There may be only fifty really cool twenty- and thirty-somethings in B-boro, but those are some of the coolest people in all the world—according to me.

Everyone's a character.

Everyone's an artist.

Everyone's a pro.

I mean Spots—one of the best chefs in New York—lives in Brattleboro. Or me, a premier programmer who helped build one of the internet's first large databases at Mead Research, inventor of many new types of 1-dimensional cellular automata (a math/computer thing), and author of a couple handfuls of novels—Brattleboro. My point is there are a lot of little boroughs across the US, and to find one as cool as Brattleboro, in terms of the people who live there..well..the only place you could find anything close would be in Arizona.

Let's dwell on Justine, her perfect Brattleboro-ness, and the high-point of that snowy moment, full of spirits from two bars, playing in the snow with a bunch of young adults..just as free and wild and innocent and pure and fun as snow play as a kid except, with these kids, if you found a partner, you could unzip their snow suit..pulling Justine out of her plush full-body cover and running my finger underneath her panties where the lips of her vagina took my touch and salivated, their moisture wetting her panties, and us both taking them off together, Justine's hand gripping my hard cock and me laying her silently back on the bed in the attic apartment, both of us knowing what was coming next. Nothing would be more Brattleboro than her snug little twenty-one-year-old pussy and my hard cock inside it.

92

But that was all fantasy.

I left the bar soon after rolling around in the snow pressing genitals with Justine and staring into her eyes and her face being so close. When she said what she said to me, she quickly stood up and her boyfriend was watching her and she went with him back into Whit's and—as much as I would love to fuck Justine—all was right with in jungle, with Justine and her man sitting at the bar, him flirting with Jill and Justine sitting next to him, drinking shots along with helping him out with his pitchers and pitchers of beer.

That night I didn't share a drink, as was customary, at the Whitman's bar with Justine and her boyfriend. I liked the guy genuinely but it would have been even more awkward than usual after Justine and I had spoken and pressed ourselves to each other in the snow.

All was right in the jungle with me walking up the winding streets to my apartment, jerking off, going to sleep, and waking up to the internet being off.

(Months of non-payment will result in termination of services.)

Early in the morning, Thanksgiving, no one out, I take my iPad right down in front of Whit's and use their internet to make a call to my mom.

I say, "I might be suicidal."

She says, "Do you need to the hospital?"

I say, "I don't know but I think I'm just going to go to some AA meetings and Thanksgiving celebrations and take it slow and see what happens."

She says, "I'll call you back."

And I say my phone is out of minutes, internets off at the house, so I'll call you.

She says, "You call me."

"I will."

There were early AA meetings on Thanksgiving for people like me with no family in the area and I went down to the Methodists' getting there in the middle of a meeting. I drank maybe five cups of coffee because I had discovered that on Risperdal caffeine didn't have it's usual effect of wigging me out. Some people theorize that caffeine is supposed to be not good for bipolar people, which spawns a theory in me that Risperdal is a good drug for me since on Risperdal I seem to be able to drink coffee like a normal person. This backwards-ass AA group says the Lord's Prayer at the conclusion of their meeting and I don't even care. I seeing Sadie at this early group and am impressed because every AA meeting I go to, Sadie is there. But I never a chance to talk with her.

During the sectarian prayer I did not speak or listen, but thought instead about how, the day before, in light of the flood, the town had come together to fundraise for one of its richest citizens, the owner of a bar that flooded. They raised untold tens of thousands of dollars for a rich business owner while I'm begging for food at churches—they were doing welfare for the millionaire business owners instead of the penniless hungry—typical America.

For thine is the kingdom, and the power, and the glory, for ever and ever. Amen.

It reminded me of what my dad said when, after film school, jobless, I was unable to pay the first installment on the school loan my dad had cosigned with me. He said, very concerned, "This is going to affect my credit." I don't know what I said in response, but what I was thinking was: That's a luxury problem, dude. You're going to take a hit on your credit?? I'm about to be homeless!! He never took a hit on his credit—he used money he inherited from his dad to pay the $80,000 loan in full. No real trouble befell him. But I did become homeless, and my dad did not help me, did not want to talk to me, did not support me emotionally, and does not support me emotionally to this day. That's the world he lives in: a world where problem is defined as a potential drop in your credit score. This is the world I live in: problem is defined as being homeless and possibly dying.

When I talk to those two guys who are homeless, camping on this little green triangle in town under the pretense that they are part of the Occupy movement, they tell me a long story about how that land isn't owned by the city, it's owned by the Methodist church, so the city can't kick them off.

"And the Methodists, they serve food on Thursdays, so they're not going to kick us off their land."

I tell them I've been to those Thursday meals at the Methodist church.

Dagny Taggart's spirit is with them.

See, Atlas Shrugged has become a sign that people who are still deluding themselves about capitalism use to recognize each other. I used to believe in capitalism. I had a copy of Atlas Shrugged on my desk at SXG and my office mate said, "Oh, you've read Atlas Shrugged!" and then we had some meaningless conversation about how most people don't believe in hard work and it's amazing how people like us understand that everyone could be rich if they wanted to, if they really wanted to, ignoring the obvious fact that working at SXG would never make either of us rich—we'd always be the underlings, working for a handful of millionaires, paid just enough to make it hard to quit the job, which is what every last person in that company wanted to do.

We believed we were sound monitored at work, so at work everyone spoke as if working at SXG was the greatest job in the world, working with the smartest group of people ever assembled. But get three or four of those same guys in a cab after a holiday party, and the only topic of conversation there ever was, was whether the three of four of us could get together enough technology and capital and bravado to start our own hedge fund. The subtext to all this was that any five people who worked in that company could have started that company—we just didn't.

The owners spent their time on yachts and in helicopters and playing with their kids in huge backyards. And at company parties, the owners were the ones drinking straight vodka, warm, while the rest of us were content with beer or wine—those motherfuckers had something to drink about. If your company is responsible for eighty percent of the options trading volume in the market, does that sound like a jubilee of firms and individuals going head-to-head in an open marketplace where everyone has a chance at a piece of the pie?—Or does it sound more like anyone who isn't SXG is walking into an ambush. Dagny Taggart would have hated SXG—but Dagny Taggart didn't know a thing about US capitalism.

Dagny thought the government would take power away from the corporations, pass laws to control them, steal their innovations in the name of eminent domain. But what she learned hanging around me is that it was actually the other way around: the corporations of billionaires bought every decision made by every representative and every senator and every President, stripping the government of its ability to protect the rights of the People as provided by the Constitution. Dagny was worried about takeover of innovators by the ignorant voting masses..in reality a handful of people took away the money and rights of three-hundred million Citizens—economically, everyone was a slave.

I'll tell you one thing: I hate this system. I used to believe in Ayn Rand and building companies and all that bullshit—just because that's what they teach you when you're little. But when one thing goes wrong, when you're unable to work, especially with a mental illness (since fewer people understand that yet), well suddenly the system doesn't work for you anymore because it has no need for you anymore. I've worked for companies that provided long-term disability, fifty percent of your pay or whatever..but with a mental illness, what are the chances they won't have already fired you first? They're gonna fire me for my bipolar symptoms long before either of us knows I have bipolar disorder—it's not like they have a doctor on hand who says: "This man is mentally disabled, you owe him his long-term disability." No. I'll behave erratically, no one will understand why, and I'll get fucking fired. I've heard of a golden age, when my grandparents lived, when you could work for the same company your whole life, when your work for the company meant they took care of you. But I've never seen it in my lifetime.

---

I was making phone calls from in front of Whit's and some AA guy drove by in a truck and saw me in the cold and invited me to the atrium for a free public Thanksgiving:

"Are you gonna be there with us?"

And I just said, "Yeah!" to get him off my shoulders because he looked like a do-gooder who was going to try to rescue me from the cold and the supposed temptation of taking a drink on one of these dangerous holidays.

I went to Gretchen and Tom's place for Thanksgiving even though this felt like defeat and me giving in Gretchen's and my (and Tom's) sick relationship but they were friendly and the three of us ate Gretchen's food and I cuddled with Gretchen, watching a movie while Tom slept in the chair. Gretchen put her head on my shoulder and our arms and fingers autonomously flirted with each other.

When the movie ends, I leave, and when that happens, my sanity fails. I'm not inside on the Thanksgiving track. I'm outside in limbo.

I'm still hungry after Gretchen's vegan Thanksgiving delights and I'm overcome with thoughts of the Bowmanstown diner..of living there with Mom and their burgers..and how I want another one or two of those someday.

If I visit Mom there, it's a must.

They were those east coast burgers with the right beef-to-bread ratio, coming out of this tiny boxcar diner, the servers the realest motherfuckers on this planet, and my routine of eating burgers and a Coke as the ultimate dalliance while I was getting sober one of the many times I got sober back then.

One of the calls I make standing in the Whit's doorway using their internet is to Mom.

"I'm suicidal again..or maybe still, I don't know."

She says, "Call the ER."

And I say, "I have a mental health crisis line."

So I call them and the woman is like,

"Are you really suicidal or are you just having a bad day?"

I say, "I don't know but I think I'm suicidal because I've felt this way before and I tried to kill myself."

This total idiot of a crisis line worker tries to talk me out of going to a psych ward, saying, "You sound like you're well spoken, probably come from money, right? What do you have to be suicidal about? Give me three reasons."

I hang up on the bitch, call my mom back, tell her what happened.

She says, "I'm this close to coming up there and wringing someone's neck. Don't they understand? Did you tell them about your previous attempt?"

"Yes."

"And she said what?"

Etc.

I tell my mom I'll walk to the ER. I promise her this, so she won't worry, and I feel terrible for bothering my mom about my petty issues but I'm broken down and I felt I at least needed to talk to someone.

She says, "You did the right thing in calling me—you can call me any time, ok?"

I'm about to go to the ER or maybe just secretly go home but Spots calls me right then.

"You didn't go to the hospital did you?"

"No," I say.

"Well you're coming with me to breakfast tomorrow."

I accept, spirit raised, and go home to an apartment with no internet. I connect to Tooler's internet, downstairs, which isn't password protected, feeling bad because I had password protected mine after they were already using it and Tooler and I had a big talk about where she said I was being underhanded by quietly cutting off their access to my internet—which I was, selfish and underhanded and mean-spirited: I would have never even noticed their usage on my internet account if I had let them continue to use it. I was just mad and acting irrationally. I was hurt, really, and trying to tell them that.

---

I woke up and Googled, "what to do if you're about to become homeless."

I meet Spots for breakfast. She pays, luckily, since it was her invitation and also I have no money. She ate a fruit plate, I ate a meal.

"So what are you gonna do now that you lost your job?"

"I don't know. Probably sink and die."

After breakfast, Spots and I ran across Sadie outside the Backside Cafe. I introduced the two of them, thinking about which girl I was more appropriately with, wishing I could be with both, but thinking Spots was more appropriate for me.

Afterward she buys us both coffees and she reminds me we live like a block from each other.

"You want to come over and draw?" I say.

"Yeah," she says, nodding like she was just waiting for me to ask the question.

We go upstairs and the best I can do is set us up a place on the floor of my bare apartment and get us paper and pastels and pencils. We draw and drink coffee and smoke cigarettes in the apartment and I draw all over her drawing, adding even more detail to her detailed strokes..it's the best I can do as I can't muster the courage to kiss or fuck her. It's hard, when you're worried you might be homeless tomorrow, and also you want to kill yourself, to flirt with a girl or fuck her. But that's what I should have done—I know it.

Spots goes to my laptop to put some music on and sees the page on the browser, search results and tabs titled What to do if you're about to become homeless. She politely opens a new tab and plays her music there—never saying a word about the search results I had up.

"I have to go set up the bar soon."

"Can I hang out with you and write?"

"Yeah, I was hoping you would."

We were like little kids—helping each other—but what we're helping each other not do is act out suicide.

I hung out with Spots at her work..me writing, playing darts. Really it was just me pathetically hanging around Spots for her entire shift while she worked and I played darts and wrote.

Gretchen shows up and I tell her to leave. She totally cock blocks me with Spots, so fucking needy she must have searched every bar on Elliot Street to find me in this one. Cock blocked me so much that Spots said,

"Are you and Gretchen together?"

"No! I have a stalker situation going on here!"

Psychologically, Gretchen was driving me crazy by being too close, too up in my business, never giving me time alone even when I said, "I need time alone and I'm going now." She fucking sniffed me out at the hippie bar, came in, stood close like lovers stand, hugged me tight like lovers do, and totally fucked up the idea in Spots' mind that I might actually be single.

"You know, if you want to be with her," Spots says, "that's fine."

And I'm like, "We're not together. She just follows me everywhere I go!"

And truly, even though I spent my last night in Brattleboro in Gretchen's bed, Gretchen is one of the main reasons I left Brattleboro—the town is just too small, and I didn't know how to communicate with Gretchen that I need time alone. You can't just show up next to me on every bar stool on Elliot Street. I need to be with other people, I need to be home, writing, without your needy calls and this stupid half-affair, half-friendship where I got the worst part of each. If I had been my strong self, I would have told her not to follow me, not to be around me anymore at all. But I was in a weak position. I was in and out of hospitals. I wanted to kill myself! Gretchen offered codependence, and I was weak enough to accept it. I wasn't healthy enough to have a reasonable relationship. I had had them in the past, numerous times, but at that time I was so sick that the person I attracted, more than any other, was the second-sickest person in town.

---

While Spots and I are smoking on one of her breaks, some dude walks up the hill carrying an AK-47 right in from of the hippie bar.

I said, "Nice gun."

Spots says, "Does that freak you out?"

"Yeah."

"You get used to it," she says. "Gimme another Red."

I offer her the cigarette.

"I took all my pain medicine last night," she says. "All of it. At once. And I'm gonna be coming down from it soon. I'm going to the ER when my shift is done. Are you still suicidal?"

"Yes."

"That's no good, you can't live like that, you have to go back to the hospital, get your meds straight. Promise me you'll go to the hospital tonight or first thing tomorrow morning."

"Ok. You promise too."

She nods. "I promise. I'm going to tell my boyfriend right after my shift ends. I'm probably going to cab it to the hospital—things aren't right between him and me and I don't want him driving me."

She didn't need to tell me for me to know that there was a similarity between her boyfriend for her and Gretchen for me. Totally different relationships, but similar in the sense that sometimes what makes your world intolerable, as a crazy person, are some of the sane people around you. Why do you think they call it a Refuge?

Her boyfriend got there and the three us finally had a drink together (OJ for me), the three of us with Spots in the middle, all sorts of tension, but we're civilized, it's 2011, polyamory is old news.

Spots looks at my juice and says, "I don't know how to take this whole no-drinking thing of yours, so I'm just going to sort of roll with it and you let me know if you're ever uncomfortable or I do anything wrong."

"You're doing everything right, Spots."

We all have a cigarette, then the two of them go off together to fuck while I am left with nothing. Spots turning around and making the sign for call but but it wasn't call me it was call the hospital.

As the two of them walked up the hill and out of sight while I stood there and smoked, I had the distinct feeling that Spots wasn't going to the hospital that night, that she'd lose her nerve and never tell her boyfriend and maybe I was the sick one and she was the well one and they were going to have a nice life together rubbing genitals while I would be the only one of us three to actually kill themselves or return to a psych ward. But that was just my sick mind thinking.

Earlier I wrote:

Both these recent days I have looked at that #90 Rx of 0.2mg clonidines and wondered if taking the whole bottle would kill me. Maybe if I place that bottle on my doctor's desk and say I'm not safe with these, that would be a decent transformation into what would happen next. I don't want to get into the psych ward game, where I'm going there because I want to, exactly, but—as I was telling myself the other day in my manic Birches treatment journal—You can't imagine it away..and you can't imagine it there, either. Thoughts of suicide aren't pretend.

I almost puked over the fence when Spots and her boyfriend walked off together.

Then I ran into one of the mental health workers from the Refuge who was drinking and smoking at the bar.

"What are you up to, tonight?" I say.

He says, "Do you recognize me?"

I say, "Yeah, Brett, you're a mental health tech. I know who you are."

"Ok, cool. 'Cause we're not supposed to act like we recognize you if we see you outside the Refuge."

"It's cool. I don't care. What you doing tonight?"

"I'm supposed to be meeting my friend to go hook up with some hookers."

"Awesome."

"What about you?"

"Was just hanging out with a friend and I'm about to go home."

"Cool."

Then his friend gets there and they're slapping each other and breathing steam from their mouths and saying shit like:

"I wanna find me a goth hooker who's like twelve years old."

And then the other one, my mental health tech, says, "These hookers won't disappoint, man—you're gonna bust in like three seconds with these little girls."

"Ok, but the lowest I'll go is twelve. I have standards."

"Ok," says the tech, "but you might have to go eleven if the goth thing is still a requirement!"

"Oh, it is, bro! It is!!!"

And they head off down the hill.

93

The next day, extremely depressed, extremely lonely, I decided I wanted to talk to my dad. I had unemployment money I used to put minutes on my pre-paid phone. I called him.

"Hi, this is Van."

"Hi, this is your son."

Then he just hung up. Didn't say a word. Just fucking hung up.

I thought maybe it was an accident, like he doesn't know how to use his phone 'cause he's old.

I called back.

"Hello, this is Van."

"Hi, it's Matthew. You just hung up on me. Was that an accident, or..what happened there?"

Silence.

"Dad, I need help. I'm in trouble..mentally."

"Well, Matt, I can't talk right now. I'm looking at homes and I'm waiting for a call back from my real estate agent."

Then he hung up again.

My whole body turned cold. My stomach had shivers like I was standing in the middle of a frozen lake in just a t-shirt.

It is difficult for me to live knowing that my dad has such priorities, and that I am so low on the list.

I was even more ready to kill myself than ever before.

I don't like living, knowing that I am a piece of shit to my own father. I don't see why he went about the trouble of having children. When I was homeless, he never comforted me, he never encouraged me. I didn't want money—I wanted a kind word. I want a father who is emotionally there.

I opened my email and drafted a simple note to my immediate family:

From: Matthew

To: Sharon, Joanne, Leona

Bcc: Van

Subject: I just called Dad and he hung up on me

It is colossally difficult to live knowing that my own father doesn't have the time of day for me.

Just fyi.

And this is before I even said anything to the guy..this was at the "hi this is your son" part of the conversation. Wow, Dad; wow.

I pressed send.

But, really, that note was a bit too subtle and not immediate enough to reflect the situation going on inside my head. So I wrote another one:

From: Matthew

To: Sharon, Joanne, Leona

Bcc: Van

Subject: Fyi

I can't deal with this. This is not a family, it's a collection of individuals.

I need my dad to love me. Otherwise, what was the point of him having me?

I am going to kill myself.

Goodbye. And Dad: fuck you.

To be fair, I stole that idea about our family being a collection of individuals from my sister Joanne. How fucked up is that—I plagiarized my own sister in my suicide note.

I pressed send.

I ran a bath and took my one cooking knife with me. It wasn't serrated but it was really sharp. I sat in the hot water and tried to understand all the angles on this thing—what it meant, who it would affect, whether I had another option.

I shaved first—I like the feel of a clean face.

I felt something like a pressure on my brain, like how heavy my head was.

The electricity was off in my apartment—the only light was what was coming through the windows. The bathroom was in shadows.

I thought that probably no one would care if I died. I didn't feel to close to anyone. None of us talked that much so in my mind we didn't really have real relationships anymore. Even further down that path, I thought that I was more an inconvenience than a benefit to anyone I knew, even my family. I failed to see what value I was providing to them—they didn't need me.

I basically feel like I'm an inconvenience to everyone I know. I feel like my family would be better off without me. It's not true, but when you're suicidal, you believe these types of things. They seem true, and there's no way to think your way around them. Your mind is telling you to kill yourself, and giving you the very good reason that you will be doing a favor for the people you love the most.

I was just way out here in Vermont with no friends, no girlfriend, no job, soon I would be homeless and it gets cold in Vermont, really cold. I had written five books at that point—publishers had no interest. I had no car. When the snow came, that cut down my job options to zero. And I didn't want to go back to the Refuge. I preferred the privacy of dying alone, and I'd planned this for ten years—when I was twenty-three I knew that the way I wanted to go was in a bathtub..because I love baths.

I pretty much knew that I was going to kill myself since I was twenty-three—since Rebecca died. Her mother asked me at the time if I was suicidal, and I said, yes, I was. I think Rebecca's mother was, too. She's an alcoholic, like me.

In fact I might have known even sooner that I was going to kill myself..right around the tenth grade, when life turned horrible.

---

And that note, included above—that's the exact note I sent to my family. I pulled it from my email account which I was using from before I moved to Vermont to now.

Mom and I argue, to this day, over whether that was a threat. I say it wasn't—it was a notification. A threat would be if I said, Give me one-million dollars or I'll kill myself. I wasn't threatening anything. I was notifying them about what was about to happen. Mom says I'm going to kill myself is the same as I'm threatening to kill myself. I say I guess you could consider it a threat if you think something valuable is about to be lost—but I didn't consider myself that way, as something valuable that I would be taking away from them. I hardly thought of their reactions at all, and the only thought I did have about them was that they would be better off without me. I hated myself so much and valued myself so little that I actually thought my family would be happy if I died, as a person is happy when a heavy and useless burden is lifted. I imagined them forgetting about me instantly, moving on with their lives, and being all the better for me not being there.

Depression is insidious. You think you'll be ending your own pain, yes, but you also hold the unshakable belief that killing yourself will be doing your family a favor.

---

Somewhere in there—and this was before I ever drank, before I ever did drugs—the world became intolerable to me, so heavy that I would break down in class crying and when my classmates asked me what I was sad about, I didn't know. I just knew that I felt the world, and I felt its hurt, and it was so much pressure that I had to escape.

But I couldn't escape. Nothing I tried worked.

I had the knife in my hand. I was ready for the pain. I thought back to the time I had cut off my own wart from my right-hand finger, and I was pretty sure this pain would be comparable. I planned to cut with the wrist, not across it, so the tendons wouldn't keep me from cutting deeply enough.

This was a for real suicide.

And then I thought: Well, it's a nice enough day. Why don't I take a bike ride—a really long one—and get the endorphins flowing, you know, try to make myself feel better. Then, after the bike ride, if I still feel like killing myself, I'll kill myself. If not, I'll live another day.

It was a simple thought, a lucky thought, really a coin toss of probability within my brain is all that kept me from slicing myself up right then.

I got out of the tub.

Then I went for a bike ride to clear my head. I want down the hill, all the way through town, past the Refuge, along this empty highway with hills on both sides and a shallow river with the most striking rocks. I got off my bike and went down to the river, seeing how beautiful this stretch of Earth was, with its wet/dry stones and its patches of grass and the sound of water running. I said, well, at least this bike ride is making my body feel better. I went as far as I thought I could go and still have energy for the way back home, then I turned around, crossing the highway, and everything was uphill from there to my apartment.

---

When I got home there was a cop talking with someone in the car repair place parking garage and it only took me a split second to know that he was there for me. He looked away from my neighbor and said,

"Are you Matthew Temple?"

"Yes."

"I got a call from your sister, Matthew."

"Oh yeah, what did she say?"

"She said she got a disturbing email."

"I suppose, if you consider that disturbing.

"Well I'm just here to check on things, make sure you're doing alright. Mind if we talk in private?" he said mostly for the neighbor's sake.

The officer stood close to me.

"Your sister is worried about you..that you might..do something to hurt yourself. I see you took a bike ride."

"Yeah, I was trying to see if a bike ride would make me feel better."

"Physical exercise—great idea! I work out, myself."

Then he shows me a picture of his home gym with him flexing his biceps or triceps or whatever—I don't know bodybuilder shit.

"I just want you to know that I care about you, Matthew. This isn't just a job for me. And I was about to break down your door to see if you were in there. And if you weren't there, I was prepared to stay here all night and all day tomorrow to meet up with you. So I have to ask you something. Are you still feeling like hurting yourself?"

I look at this guy. Genuine guy like this really should have picked a different job.

"Well, I'm not going to lie to you. And I'm not exactly jazzed about what the consequences will be of answering your question honestly. But I'm not gonna lie—that's just not how I do business. So I have to say that yes I am still feeling like hurting myself."

"Well, Matthew, I appreciate your honesty. And it sounds like you've been through this before so you prob'ly know that I have to ask you to come with me to the hospital."

"Yeah, I know that. Do you mind if I lock my bike up?"

"Go right ahead."

"Ok, thanks. I'll be right here. I'm just going right inside the front door and I'll be right back. Do you want to come with me?"

"No, I trust you. I'll meet you back here."

So I lock my bike up.

A second patrol car shows up—it's this guy's boss.

The cop gave me his card and went up to his superior officer and said, "Do you mind if I let him sit up front with me?"

And the superior officer said, "If you're comfortable with it, it's fine with me."

Only in fucking Brattleboro.

So I sat in the front with this police officer on the way to the ER of Brattleboro Memorial.

I'm stuck in the ER all afternoon. The cop says he'll stay with me until the ambulance comes to pick me up—and he does. I feel terrible for inconveniencing him but he assures me it's his job. I still have his card. I kept it because one day I was going to send him a thank you note but this paragraph is going to have to do. That man was David Cerreto, Patrol Officer for the Brattleboro Police Department. These days police are most famous for murdering unarmed civilians, but Officer Cerreto will always be famous to me for responding to the worried call he got from my sister Leona, and saying he would have broken down my door or waited there all night at my apartment or done anything to find me. He did a good thing for me, he treated me with respect, he did his job, and I will always remember him for that.

---

Late afternoon, early evening, I'm finally in an ambulance taking me to the Windham Center, whatever the fuck that is, when the EMT who was taking care of me in the back of the ambulance was like, "Do you remember me?"

And I'm like, Jesus fuck this is a small motherfucking town!

But what came out was, "Uh..yeah?"

"We were drinking at the Metropolis like six weeks ago!"

Oh. Now his face does form into something I know and I remember the position we were in at the bar.

"I don't remember much of our conversation," I said.

"Neither do I," he says. "But I remember you're a writer and you were telling me about your books."

"I must have been really drunk, then."

"You were! Don't worry, we all were. You had that girl Gretchen, and she was telling everyone how great your book is."

"Well she's lying. She has no taste anyway. How would she know what a good book is."

"She seemed really excited about you."

I wince.

"Like you were gonna be famous someday."

"I doubt it, man. I think.." (I indicate the captive body in the stretcher.) "..you're lookin' at it."

"Nah, you'd be surprised, who you see on this job."

"Isn't there something you can give me, back here, that will kill me?"

"Nope, can't do that."

"Can't you just put a bubble in a syringe..won't that kill me?"

"You won't always feel this way," he says—and I hate it when people say that to me because I know (just, logically) that they're probably right.

94

I didn't have much at the Windham Center but at least I had my ChapStick comfort object—checking to see if it was still in my pocket is probably something I developed after to the move to Philadelphia, as a kid. That move, that culture shock, was anxiety inducing. Sometimes, at the Refuge, they would let me keep my ChapStick. Sometimes they'd put it in contraband because it was "medicated"—it said that on the side of the package and we weren't allowed to bring medicine onto the ward. What was bullshit to me is sometimes I was allowed to keep it, sometimes I wasn't. The inconsistency with which the rule was applied be bothered me more than the rule itself.

Other than that, the Windham Center sucked. They sent me there and I assumed Spots went to the Refuge or didn't go at all. Winds had a sub-par admissions process—nothing like the Refuge. I sat in the hallway and wrote:

At the Windham Center—some guy is playing ESPN on the TV at 7 in the morning—moral of the storydon't ever tell anyone what you're doing, and have as much and the best sex possible before you dieI had a dream last night about fucking some tight-pussy girlI am so missing sexfix my teeth, get my body in shape, make a ton of money, and generally become someone women will drop their panties forit would take me getting this depressed, this disenfranchised, to set this as a goal—but I'm sick of going without company of all kindsI should be the one having fun, enjoying the basic pleasures of life before I dieinstead of suffering and lonely being forced to listen to mindless TV in some mental wardAnd don't feel guilty about anythingmy wants are kingif I want to fuck, or to marry, say, Faith, then do it (if she's willing)forget, forget completely, what the fuck I think anyone else thinks

And in this dream this girl was so tight, but she loved me so much, and she wanted me inside her so bad, that she was encouraging me, telling me to keep going, pulling me a little deeper and a little deeper, until tightly I was all the way in, until tightly we were all the way together, and then rubbing along the little bit of movement we could get given how tight we fit togetherAnd it was a kind of love*dream of red walls, a bathroom opening to a shared hall, picking out a subset of clothing whose colors perfectly matched the last twelve months' covers of Omni magazineand the sexiness of getting the magazine together to do it under the steam and the hot water with the door open to the shower in the stairwell hallwayAnd the hot dog shop outside with the pretty girl I used to work withwith Beautifuland who I want to hide fromAnd when it's all set up inside and she comes in just when I was starting doing it(short story)

Dreams of giant treeand once you climb up a ways, there's a plateau, a field in the sky, with other treesHearing the general news about how effed-up the country is, how falling-apart we all are politically, makes me feel better about being down right nowmaybe it's a good time to be out of the worldat least it's a pointer that I'm not the only person having trouble—which makes me feel better about being messed up myselfjust go inward, in lifego into my thoughts, which are a vast place and a comfortable place and a deep place of programs and fonts, environments and systems, stories and characters and worlds11-15-11I don't know if it's the meds or if I'm actually learning how to live, but today I managed to choose a moderate responseG. bringing me clothes, called to ask if she could copy my key for future such eventsI said noand I didn't flip out, or majorly reactand I don't think I'm going toI can choose a rational, moderate response and simply leave it at that

The other ten or so patients are in the TV room chitting and chatting and there's nothing shy about me—I am an extrovert—but I don't feel like meeting a new set of people at a new hospital I'm likely never coming back to, so I write more.

Breathing of a neck, broadlyof a neck and a draintry to out-shift a grave-diggery..try to out-shift a molesheets tiny aching mole of a sleevethat's one tiny aching mole of a sleeveok todaytry to out-sit an owlyou'll die of fidgetingfingerprints don't ever play games with a game player, dearI should have hiked and when I won't let you;;you'll only do the same to another idea of a road mousedeathtrap of a cowboysilence gameof some kind of brilliant handwritingalternating black and reda glassicy glass aching of a penpatience is the only monitormetronome

I finally fucking allowed someone to visit me in the hospital for the first time in my life. Gretchen brought me Skittles and Kamel Reds. As usual we were both just using each other. I didn't want her there. She didn't want to buy me cigarettes. But she wanted to feel important and needed and so she did what she had to do to be that for me. She sat all close and interleaved our knees.

When she left, all the other patients were like Wow, that's your wife? I always think I'm about five years old so I thought the question was ludicrous. They thought Gretchen was sexy—I thought she was a too-skinny waif skeleton. I was like No, she's not my wife. They said That's your girlfriend? I was like No! They were like Damn, boy, that girl likes you.

Gretchen visited me every single day. I told her it was a waste of time but she came anyway.

I sat in bed listening to my flamboyantly gay roommate describing his future after Windham..some long-term rehab facility where he was basically going to live for years. We both had mixed feelings about that, but I felt for him, and he was kind to me about my snoring, which I always appreciate in someone who's sleeping near me.

Really the only thing of note about the Windham Center is they had homemade food and it was good. Every other aspect of that psych ward sucked camel testicles. They just didn't know what they were doing.

I bummed a ride home with Gretchen. I would have rather ridden the bus. We were quiet the whole way home. She had assumed she would drive me. I thought that sort of thing had to be specifically arranged—not assumed—and I could feel the tight lips of rejection on that girl's face. This experience hadn't brought us closer, and looking back, I wish I had never invited her to visit me, so I could have kept my clean record of never having had anyone visit me at a psych ward. I felt marred.

As we're driving down the highway through the hills back to B-boro, I'm not thinking of the married woman driving me home..no..right here a tiny flashback to the night that had come about a week before with me and Spots standing in front of her bar and this, at the end of this chapter, in between the words of these sentences, is where I remember the last moments I spent with one of the coolest people I've ever met..and here and only here is where I reveal that that night was the last time I ever saw Spots (outside of my imagination). We talked about going to the hospital.

"So I'll see you in there," she said.

And I said, "You will."

But that was the last time I ever saw that girl.

95

I'm sitting out front of the Food Co-op eating food stamp purchases in the freezing cold, remembering the looks some cashiers and shoppers gave me when I bought salmon cuttings and beet juice. Like if you're on food stamps you're supposed to be holed up in your kitchen stirring a giant cauldron of rice, you know? Just 'cause I'm poor doesn't mean I know how to cook.

I got there early for the 7am meeting at its new location after we got kicked out of community center whose building got sold to get made into a Chinese restaurant. By this time they had moved the community center to a strip mall up the hallway..most of the people who use the community center can't drive or don't have cars, so I imagined its classrooms empty of all but the most high-functioning drunks and drug addicts..the ones driving Mercedes-Benz's and Range Rovers. But the drunks and drug addicts in the house across from the old community center will have a Chinese restaurant two steps away for late-night munching—score!

I had some large drawing notebooks with me and everyone at the morning meeting wanted to peek inside them—I said after the meeting! I wanted to respect the purpose we were there for.

I made three shares that meeting—yeah, I triple-dipped—just to show up my pussy-mongering former sponsor and demonstrate that I could reach Sadie on a level that he never could, that had nothing to do with sex, that had nothing to do with vulturism, that had nothing to do with using AA seniority to get in bed with a twenty-five year old. I showed everybody in there that the most fucked-up person in the room can also be the person with the most wisdom in the room. All you have to do is pay attention to your fucked-up life, and spend your life contemplating it, then automatically you'll have the most wisdom in the room. Wisdom is not a thing of pretense—it's what you learn from getting fucked, and fucked, and fucked, and learning from the experience.

And after the meeting I showed my drawings to those who wanted to see them.

My ex-sponsor Mark was all about the pussy, b-lining for Sadie after the meeting, making sure he was in position to hold her hand during our final prayer—the guy was a maniac for fucking sober pussy. Some people from the Refuge sober house showed up at that meeting and Mark spoke only with the female members, touching their hands, shoulders, heads—whatever he could get away with. I honestly wanted to shout: YO, OLD TIMERS, IS THIS AN AA MEETING OR AN ORGY TO YOU, YOU DUMB MOTHERFUCKERS, but (as with 90% of my thought) I kept it to myself and endured the obvious snobbishness of virtually everyone around me. My sponsor was the R. Kelly of addiction..see where everybody else is in it at least partially for the recovery, my sponsor was always only in it so he could piss on some little girl's face. You could just tell by everything he did that my sponsor was only there for the pussy—always had been—the fucker prob'ly wasn't even an alcoholic. He's hitting on Sadie obviously during and after the meeting, mentioning her in his share, sitting real close to her in the circle. The whole thing disgusted me and that's the last AA meeting I went to for three or four years.

Here's how fake this motherfucker was: he offered to bring me food at the Refuge—I was going inpatient that morning. I said great. Told him when the visiting hours were. He asked me what kind of food I wanted—made a big show out of it so Sadie could hear how nice he was being to me. I told him my favorite carry-outs. He said great, then—making sure Sadie heard him—I'll see you on Sunday. Never heard from his ass again. Never saw him again. He was just doing all that to impress this 25-year-old woman, who was in early recovery, so he could make this bitch his wife. I told you, the guy isn't in AA for the recovery—he's in it for the pussy.

---

Like a responsible bipolar drug addict, I overdosed on BuSpar in a Refuge bathroom to amp up my mania to help me get admitted to the hospital. (BuSpar is an anti-anxiety med but for some reason it makes me physically shake and talk like I'm a stutterer on crack.)

I was completely crazy on it in our morning check in. It was someone's birthday and I was wearing a birthday hat and the medicine was making my dick hard. I managed to make a few notes in spite of all this:

?? November 2011 [at least I got the year right]

Call SSI[phone number]

Ask Dad to come for family meeting (?) LOL

Ask social worker to call Dad

That LOL is my favorite part. My social worker is asking me to get my dad to come to Vermont for a family meeting? See they understand that I'm in a really serious situation—a life-threatening situation—but they don't understand there's no way my dad would take off a few days' work to come to Vermont to visit with me and my care team for a family meeting! The logical result of that would be my dad helping me in some way—perhaps just psychologically. But something I've learned about Van Temple, over the years, is that he is either incapable or unwilling to function as my dad. The thought of him showing up at a family meeting to support me is truly laughable, even though this Refuge understands family support to be essential to patient success.

"So. Matthew. What I'd like you to do is see if you can get your dad—since he's the closest family nearby—to come to the Refuge for a family meeting with you and I and the rest of your care team."

Long pause.

Then I let out a laugh roughly on the level of Robert de Niro in Cape Fear, when he's smoking a cigar in the movie theater?—yeah, that's me.

My dad coming to a family meeting?!? There's a better chance of Stephen Hawking winning the Olympic high jump and I am working with Stephen Hawking every day to improve his chances of achieving this goal.

Totally high on BuSpar and life, I beginning a counseling session with my social worker's multi-PhD intern. She says she thinks we'll be particularly well matched. But we only had a partial session because I was routed back to inpatient, whisked away to Tyler 2, shoo shoo shoo. Some therapy like that could have helped me, but I could never take advantage of it because I didn't have my basic needs taken care of (a place to live in Brattleboro, where I wasn't getting kicked out, money to live on, any employer who would hire me). Without that basic continuity, counseling with the multi-PhD counselor was never going to be possible.

My social yanked me out of counseling, took me back to group, and then walked me down the hall to talk to the Birches psychiatrist who had one of the RNs take me down to be admitted.

In my brief moment in the social work group, someone says something like, "The same thing happened to my friend, only it was an overdose of lithium, and she felt all embarrassed after all these people in her therapy group saw her acting all weird on meds," and this woman comforted me. "Don't feel embarrassed."

I told her straight out, "I'm not embarrassed." Never crossed my mind to be embarrassed. To feel insecure because of what others were thinking about me? It just never occurred to me to frame the situation in that way.

I get called out of group.

Talked to psychiatrist Dr. Le with my notecards which I had brought with me because my mind was like glitterbox, essentially, and I was having trouble maintaining continuity without an index of references.

I was twitching and flinching and flipping from card to card to help me assemble a coherent conversation and Dr. Le said:

"Are you manic?"

And I said, "Manic is such a slippery term. I mean, it's kind of like asking someone if they're 'cool.' It's really best to ask other people the question and not the person themself, don't you think?"

"Can you maintain safety outside of the Refuge?"

"No," I said. "I think I have to answer that one 'no.' "

"He's going in," she says to my social worker.

And that was the end of that discussion.

Brattleboro Refuge Discharge Summary (6)

Patient Admitted November 21, 2011—Discharged November 28, 2011

Identifying Data

Patient is a 33-year-old Caucasian male who has had multiple inpatient hospitalizations here at the Refuge and recently was just readmitted to the partial [hospitalization] program after an inpatient admission at Windham Center for four days. He is single, unemployed, and lives in Brattleboro Vermont by himself.

Chief Complaint

"I want to finish the program. I think the structure is helpful for me. It's good for me to be around other people, to be watched."

History of Present Illness

Patient was in Partial Hospitalization Program but then hospitalized at Windham Center for four days, secondary to suicidal ideation with a plan. He reportedly had had an argument with his father on the phone and emailed his family, indicating he was going to kill himself by cutting himself in the bathtub. While inpatient, his medications were kept the same. After he was felt to be stable, he was discharged and readmitted to the Partial Hospitalization Program.

When psychiatrist Dr. Le interviewed me upon readmittance to the Birches PHP, she said:

"You went to Windham Center for suicidal ideation with a plan and they let you go after only four days?"

I looked across the desk at this Asian woman—petite—it was a different psychiatrist every time I came to Birches. There are dumb psychiatrists, but none of them work at the Brattleboro Refuge.

I said to Dr. Le, "The Windham Center is not equipped to help me at this time."

"What does that mean?"

"Well, that means that the Windham Center is distasteful to me in every way. They're a rinky-dink setup and I didn't want to be there so I talked my way out."

"Didn't you see a psychiatrist there?"

"Yes, I saw one every day."

"Was he aware that you were suicidal with a plan?"

"Yes."

Dr. Le leans forward and looks straight into my eyes.

"Then how did you get out of there in four days?"

I looked right back into Dr. Le's eyes. She was exciting, intense, and talking to her made me feel alive.

I said, "Their head psychiatrist—"

"Yes I know him," she interrupts.

"He has a weak mind," I say.

"And?" she says.

"And I made him release me."

And right then Dr. Le made up her mind double-damn sure to admit me back to Tyler 2. But I knew she was going to do that—that's why I brought my drawing notebooks with me that day. I had them at the AA meeting—remember? I knew Tyler 2 only had copy paper and crayons, so I brought my own art supplies with me. I wasn't manipulating Dr. Le into admitting me—she's a fucking psychiatrist, I'm a psychotic miscreant, I can't convince her of shit—but at the same time, just like in fifth grade, I could mark my own test. I knew every time I would get an answer right, and every time I would get an answer wrong. I had done Dr. Le's diagnosis for her, before she did, and I knew what it was going to be.

Course of Hospitalization

Patient was resumed on Lamictal 200 mg at bedtime and Risperdal 1 mg q.a.m. [every morning] and 3 mg q.h.s. [every night at bedtime]. Patient was also continued on the prazosin 2 mg at bedtime, clonidine 0.1 mg daily at 6pm, 0.2 mg three times a day as needed, and citalopram 20 mg once daily. However, a couple of days later, he was noted to be a bit manic. He reported racing thoughts, some visual and auditory hallucinations. At that time it was recommended that his Risperdal be increased to 1 mg in the morning and 4 mg at bedtime and for him to discontinue the Celexa. This was prior to the Thanksgiving holiday. After the long holiday weekend, he did not appear to be doing very well. He reported not having slept for three days, with racing thoughts and visual hallucinations. He did not feel that he could maintain safety at home. It was felt that it would be best for him to be admitted inpatient for medication adjustment in a safe and contained environment. Patient was agreeable to this.

Final Diagnoses

Bipolar I Disorder, Most Recent Episode Manic. Alcohol Dependence in Early Remission. Cocaine Abuse in Remission. History of Kidney Stones. Possible History of Serotonin Syndrome.

GAF on Discharge: 25 [my lowest GAF yet]

Condition on Discharge

Patient appeared to be manic, with racing thoughts and visual hallucinations. He denied any suicidal or homicidal ideations, plan, or intent. He was agreeable to inpatient admission.

Prognosis: Poor without inpatient hospitalization.

Patient Strengths

Patient is pleasant, cooperative, able to have some insight. Access to resources [What resources are you talking about? Is there a Swiss account number I'm supposed to decode by finding patterns in the newspapers lying around Tyler 2? Sorry—schizophrenia joke—not funny. Especially since some of my cohorts in Tyler 2 were actually trying to do this.]

Arrangements for Aftercare Services: Patient was admitted to inpatient.

96

At the time of this discharge from Birches to Tyler 2, I was down to only four psych meds. I think at one point I was on ten. Even when I did street drugs, my friends and I held the general concept that you don't do that to your body. You do one drug—maybe two—at a time. Any more than that and you're asking for trouble.

---

Let's skip all the psycho mumbo jumbo, meditation, meal plans, Chad, Rainbow, and everyone else and let's just talk about this one kid I met this admission. We will call him The Kid Disrupting Substance Abuse Class and keep in mind that I had been inpatient enough times and the substance abuse class was held often enough that I had been to this same exact class many, many times but even though I had memorized the curricular materials and even though I had a low opinion of the Matt (the spineless substance abuse teacher), I still believed that if one goes to a class, should sit quietly and listen to the teacher teach. That is a belief I do have. And this flew in the face of Keith, this little teenager who should have been in the children's ward. Keith's objective was to talk when the teacher talked (and at a louder volume), to run and jump onto the couches and tables in the classroom, and to straight-up cuss at our spineless teacher.

I found this teacher spineless and generally a useless human being but strangely I found myself defending him against Keith, asking Keith to:

"Please be quiet until class is through."

Keith took this firm but polite request as an invitation to up his antics, which I took as an invitation to tell him off in grand style, then I complained at Matt the spineless substance abuse counsellor for not acting as an authority figure and making the class accessible to those of us who were not disrupting it, to which he had some spineless Christian answer, to which I told him off.

Then, to my total surprise, something opened up within me and left the room and sat against a wall in the short hallway, crying endlessly with multiple techs leaning over me, sitting next to me, giving me advice about making a tissue box of things to give up to god and I thought of how someday I would put Gretchen in there and then I gave her the keys to my apartment when I was inpatient and I imagined her fishing through the tissue box that said "I give this problem to god"—or something like that—and finding her name in it.

Somehow, by the design of the devil herself, I ended up in my bedroom with Matt, the spineless substance abuse counsellor, sitting with me in my room as I wailed my anger and said I wanted to kick doors and he said,

"I really hope you won't do that,"

And I said, "Well what about punching a pillow?"

And even that he thought might injure me and put the Refuge in an insurance liability situation. Fuck. All insurance has ever done for me is take my money and then refuse me not only the treatment the doctor recommends but my right to punch a goddamn pillow.

When the doctor says, "If Matthew doesn't take four of these a day, he might end up back in the hospital," the insurance company says, "We'll pay for three."

Fuck. You.

I'm required to pay you money so you can sit in your mansion and watch the Surgery Channel while I'm lying on my floor, writhing in pain because you refuse to use some of the money that went into your mansion to buy me that extra one pill per day that I need to be well. I want to go that person's door, ring the doorbell, and when the CEO of BlueCross BlueShield opens the door, I want to say:

"You wouldn't cover my medicine."

And then blow my head off.

---

Anyway I'm having a freak out crying spell after asking some young kid to be quiet during group when the teacher was just letting him disrupt the class. Sitting in the hallway just around the corner from the main room, wailing, bawling my eyes and my soul out of my body, three staff members standing over me giving me advice (and comfort?) while I just fall..the fuck..apart.

And saying, "I realize it has nothing to do with that kid it's just the dad power vacuum thing and the Mom's dad power vacuum thing."

I was so angry and they had the spineless (but caring) substance abuse counsellor stay with me in my room and he sat in a chair while I told him I wanted to hit things even my pillow and he asked me not to because I might hurt myself. Idiot.

Looking back I guess they had me on one-on-ones after my accosting of that young kid and Matt said he would listen if I wanted to talk but I politely told him no—which just bottled it up even more inside of me—and I realized in that moment that all the incredible anger and sadness that I had shown that day was just the tip of the iceberg. I didn't just have to work through a few things and leave the Refuge, recovered. I was standing on top of a mountain of rage, trying to excavate it with a shovel.

The next day that kid, Keith, who was disrupting the fuck out of substance abuse class, was eating breakfast near me and I said I was sorry.

He said, "No, that was my fault."

And I was like, "No, my freak out had nothing to do with you. That's just my own issues coming out and you don't deserve to have them vented on you."

But he said, "No, that's why I'm in here. What I was doing in that class. I do that everywhere."

And his admission touched him deep, because Keith started crying right then, and his cry turned into a wail, and he cried—no lie—for two days, until they could transfer him to the youth ward, and nothing I or anyone else did would console him.

I felt bad. I just think of my own problems, figuring everyone else has it together. The Reverend John Watson suggested to Be kind, for everyone you meet is fighting a hard battle Things can be especially touchy in a psych ward: one who plays the antagonist is often a house of cards—I present myself as an example. Me and Keith are more alike than we are different, even though that might be especially hard for him or me to see. That's why they train Refuge staff to only intervene in patient conflicts when absolutely necessary. Keith and I fit together perfectly: his disruption catalyzed my release of anger about chaos permitted by nonparticipating or irresponsible adults from my past. My oversensitivity and overreaction and general meltdown showed him that his disruption affects people's emotions, hurts them, and when he saw that in me, it touched a nerve in him that none of us, staff or patient, had guessed was there.

97

When I got home from the Refuge, sometimes I didn't feel like Indian food or Whit's. I wanted to stay under the radar, you know, not make a big deal of going to Whit's—and going to Whit's was always a big deal for me. I mean I couldn't make a five-minute trip into Whitman's. I'd order food to go and pretty soon Thomas and I would be buying Billy Joel songs on the jukebox, he'd be telling me New York stories, Walsh would show up and I'd be buying her drinks trying to get inside her pants again—even though she had no intention of letting me do that and was just using me for the drinks..and I liked being used by her, at least it was some form of relationship!

But eventually I got tired of all that.

I even got tired of alcohol—yeah. Even this alcoholic, for whom alcohol was such a big part of my life almost every day for the last decade, got tired of alcohol. I think it was part of my depression—you know how depression makes you lose interest in activities you used to enjoy? Well, I was too depressed to drink. That's pretty fucking depressed for me.

So instead of making a social outing to Whitman's, I just went on the Domino's website and ordered the most ridiculous pizza possible. I added so many toppings that the site told me I couldn't add anymore—I had reached an internal limit set by some committee at Domino's Corporate, implemented by a web programmer who still had a job.

But I didn't let that stop me. I just ordered two pizzas, spread the out-of-bounds topping across the second pizza, and scraped them all onto one pizza once I got it back inside my apartment. I ordered Cokes, chips, sides of sour cream—if it was on the menu, I ordered at least one. When the delivery guy came, he had three, four bags of crap in addition to the two extra-large pizzas, and my poorly-thought-out attempt to stay below the radar was undermined by my inescapable character—as everywhere, at Domino's I acted so extravagantly and charismatically that the delivery drivers fought to deliver my goods. Not just to collect my twenty-dollar tips, but to meet the guy who would order such a smorgasbord—did I just use that word? Yes I did—such a smorgasbord.

"So are you having a party?" this teenage kid is asking me.

"No."

"All of this is for you?"

"Yep."

I offer him a cigarette. We're on the porch.

"So..what—if you don't mind my asking—what do you do?"

"Most of the time?—I spend inpatient at the Refuge."

"Oh. Why?"

I exhale some Kamel cigarette smoke. For the next three minutes I'm a celebrity.

"I have bipolar disorder with psychotic features so it's like..suicidal and homicidal impulses."

"Homicidal?"

"Yeah. I'd like to kill my former boss. Well, all of them, plus my father. Basically all of the shitty male role models in my life."

"You're not gonna kill me, are you?" he jokes.

"What's your name again?"

"Brent."

"Brent, you've never done anything to make me angry, so why would I kill you?"

I smile.

"But like if your pizza was late, would you get angry then?"

I ash.

"No. I only get angry about psychological neglect and abuse. Fortunately, you and I don't have that complicated a relationship, so I would never have any reason to get mad at you."

The kid is like starstruck—my pizza delivery man standing on the steps talking to me in the headlights of his car, which is parked half on the sidewalk, half on the street.

"Do you have a job?"

"No. I write."

"Are you published?"

"Yeah, I'm self-published and I make about five dollars a year selling books."

"How many books have you written?"

"I think..five? Mostly I live off my unemployment, Brent."

"Seriously?"

"Yep."

"Are you looking for a job?"

"No! Why would I want to do that? Every job I've had has been a disaster. Did you know that the Domino's website will only let you put a certain number of toppings on a single pizza?"

"Yeah, that's because with too many toppings the pizza doesn't cook right."

I scratch my forehead.

"I hope you know I'm not saying this is your fault, Brett."

"Brent."

"Brent, I'm fully aware that you had nothing to do with this decision. But—here's an extra twenty."

"For what?"

"For extra tip."

"Th-thank you."

"No problem. All I'm saying is—are you sure you don't want a cigarette? Kamels—the best!"

"No, I don't smoke."

"That's prob'ly good because I hear it causes cancer, which increases death by like a thousand percent. That's not an actual figure but it's something like that. Anyway I know the topping limit isn't your fault but you have a manager, yes?"

"Yes."

"And he has a manager, yes?"

"She. But yes."

"Well maybe you can like run it up the flagpole and let the Committee on Topping Limits know that there is no theoretical limit to the number of toppings you can put on a pizza."

"But with too many toppings, it's too heavy for the crust."

"Then fortify the crust."

"What?"

"Fortify the crust."

"How?"

"I don't want to get into hows right now, Brent. I'm just saying, if a customer wants to put ten, twenty, fifty toppings on an extra-large Brooklyn-style crust, then they should be able to do that."

"I'll talk to my manager."

"That's all I'm asking. I just want to be represented in your customer profile. Crazy people order pizza, too, and we don't want just two toppings. We want no limits on the pizza app. Tell them that, please, as one former web programmer to another former web programmer, you know, you're limiting the whole country on kind of a key issue."

Brent laughs.

"You want a Coke?"

"No thanks, I don't drink caffeine."

"What, are you on the track team or something?"

"No."

"Do you have to get back and deliver more pizzas?"

"We're dead tonight."

"Well I gotta eat this while it's hot, I don't have a microwave. Tell your boss she rocks and from now on only you are to deliver to this address. Here's another twenty."

"I can't—"

"Take the fucking money, Brent. Don't make me angry."

That was basically my life. Overeating while watching Girl, Interrupted on repeat—I especially related to Angelina Jolie's sociopath character. AA people say you're trying to fill a God-sized hole with alcohol. Yeah, well I'll try to fill that fucker with a Domino's pizza with like twenty-five toppings on it, just as well. And just like alcohol, it's great in the moment but the next morning you feel like shit. I hate fucking pizza leftovers—all dry and stale, like a dead animal. But yeah, fuck, maybe I do have a God-sized hole. Then again, fuck God—I'm an atheist. I gotta go eat this pizza.

98

Traveling on foot through intense rain with no umbrella and just a hood to an NA meeting at the Refuge. It was the one with cute heroin addict so I didn't want to miss it. I had a crush on that girl since I first saw her at this very NA meeting. She sat too close and she touched my hand and she gave me Skittles and I was attracted to the fact that she was a heroin addict. I saw her later at the Refuge when she was detoxing. She just made me want to be a girl who did heroin..it was so much cooler than a guy doing it. Her last name is hard to guess so I will tell you her real first name was Grace. God, I wanted to be or be with this girl heroin addict I kept seeing at meetings who always sat next to me held my hand too hard and too tight with her hot little fingers.

But as I tromped through the rain, a car made a u-turn and pulled up beside me. Walsh. She picked me up and I had no complaint because it was raining, hard, so hard I was thinking of turning around but Walsh rescued me. We went to some convenience store in New Hampshire where cigarettes were cheaper and then we went by her place of work to visit the children. She works at a school if you don't remember. I got the chance to see Walsh in a new environment—one that wasn't a bar.

She picks up some kid.

"Yeah, he's too adorable to get upset with."

Then another kid.

"He's just so happy to be awake and alive."

"Yeah," I say, "it's a nice reminder of the good parts of life."

Back in her car, both of us smoking, Walsh said:

"I'm sorry I let the whole sex thing drop. I mean I wasn't intending that to be a one-time thing but then I got raped and things got weird and it felt weird to have you over right after that."

"It's ok, Walsh. I'm sorry you got raped."

"Where were you going in the rain anyway?"

"I have bipolar disorder and I have to go to the Refuge sometimes."

A little pause.

"My dad is like a big-time doctor there."

"Oh yeah?"

"Yeah, it's like a big deal. Do you want to go to the Refuge now, I'll take you."

"Nah, I missed that meeting by now. Hanging out with you is better than going to an NA meeting anyway."

"I'm sorry about..I'm not usually that passive and boring in bed—"

"You weren't boring."

"I wasn't boring by virtue of having a vagina—"

"I'm not looking for a performance," I say.

"I'm just apologizing, ok? Let me apologize?"

I let it drop.

"You know I'm inviting you to have sex with me again? You hear that in what I'm saying, right?"

"I hear what you're saying, Walsh. I'm too fucked up to think about sex right now."

"Wouldn't it help? Don't you want to cum in me again?"

"I never came in you the first time. The only time."

"I thought you did."

"No, I couldn't."

"What was wrong? Was I bad?"

"Walsh, you were fine. I think it was just.."

"Are you too crazy to fuck?"

I laugh.

"No. I fuck more when I'm crazy. I think it was just that you were too slippery with your period blood so I couldn't get enough traction to get off inside you but believe me, I have every sick desire to fuck you in every hole imaginable and use you to make me cum."

"Ok, that's a little TMI."

"I like you, Walsh. I think you're a cool girl. As friend. As a lover or a fuck buddy or even something more. But—look I'm a mental patient so I'm not going to hold back—"

"Please don't."

"You don't seem all that interested in me. Remember that day we walked around the street fair. You had all these people you had to talk to—everyone except me. In relationships I've been in—and I'm not saying this is a relationship—but that could have been a, you know, like a romantic walk around the street fair, for us, with us talking to each other about things that matter to us, or making fun of people, or you telling me you had some coke you wanted to do together and inviting me over to your house all mysterious and making me wonder if we were gonna just do drugs or if you were gonna let me take your clothes off again. You know what the best part of our sex was for me?"

"What?"

"It was right after I took off your pants and it was me in my boxers and your in your panties and we knew for certain that we were gonna fuck—that a new dick was going to be in your pussy and my dick was going to be inside a pussy it had never been inside before. Just..knowing..that you're about to have that feeling of going inside..or I guess in your case of something going inside."

"I liked that, too."

"Then let's fuck again sometime."

"Maybe," she says.

And I say, "Then it's no, if it's maybe. If it's maybe it's no. I don't think you even really like me."

"What does that have to do with anything."

"I guess I at least like to be friends with someone I'm fucking. But for you it's just the free drinks and the occasional cocaine and..I don't even think we ever would have fucked if I hadn't dyed my hair orange."

"I have to let you off up here."

"That's fine."

"Are you mad?"

"Absolutely not, Walsh. I'm not trying to force you into anything. It's just..I like you. Like genuinely like you. I'm not about to start buying you flowers or anything but I have some genuine feelings for you."

"That scares me."

"I know it does."

"Can we still be friends?"

"Of course!"

"Is it gonna be awkward?"

"It's not gonna be awkward for me!"

"What about the free drink deal—does that still stand?"

"Walsh, a promise is a promise. As long as you and me are drinking in the same bar, the drinks are on me."

Walsh smiles.

We hug.

"Day drinkers for lyfe," she says.

We bump fists.

"Do you even drink anymore?" she asks.

"No," I say.

And I get out of the car.

---

My sick Tooler fantasies. You would think they would have died off after things went south with Tooler once I moved to the third floor, but no. We made up with a hug as she's off to a party she invites me to. She's getting beer and then walking to some house. We hug and she hopes I'll be ok [with my mental illness, implied] with everything. She walks up High Street and out of the light of a streetlamp and that's the last time I ever see her.

She invited me to the party.

"I'm waiting for this pizza."

My fantasy was of licking Tooler's pussy on her and Issa's bed and Tooler pulling me up to fuck her. And I didn't want to have sex with her because her genderqueer-ness was kinkified in my mind—I wanted to have sex with her because I liked her from the first day we met, to the night just she and I finished a bottle of wine in the kitchen while Issa stayed in their room. I loved Tooler the day I heard her cum from Issa's mouth and fingers or whatever—I'll never know. But it made me want to love her and specifically love her pussy with my mouth and just be with her anyway she wanted because I thought she was the bomb. She picked me to live with them even though I was a guy..she never made it an issue. That might not seem like a thing, but having a woman treat you, as a man, like you're not a predator is special. To be allowed, after investigation, to be considered safe by a woman, these days, is unheard of. It was so refreshing it affects me to this day—just being treated fairly by a woman.

And five years later I still fantasize about Tooler and I pulling off each other's clothes in her and Issa's bed and her telling me she identifies as genderqueer but she loves pussy and she loves cock too. Then she pulls down my boxers and holds my cock and licks it and sucks it till it's hard. She lies back on the bed and shuffles off her jeans, and she lets me pull down her panties..simple white with a pink bow at the top. When we fuck, we look in each other's eyes and everything that was unspoken is said. We know that the reason we argued and the reasons we hurt each other's feelings are that we liked each other from the beginning.

I just wanted to hear her beautiful voice while she came.

But that was all a fantasy. The last time I saw Tooler I was sitting on the front porch smoking waiting for a pizza. Neither of us had cars. She was walking to pick up beers and then to a party. She invited me but I said no.

She asked if we could hug. We hugged and she walked up the street and that's the last time I ever saw her.

I love Tooler. In fact I love almost everyone.

But Tooler, her pale white skin and her pink features. I love how white and soft she was and when I saw her face I knew what her pussy would look like, its pale outsides and pink insides. She tells me, right before I put myself inside her, that she hasn't been with a boy since high school and that she's very, very tight.

99

I know things are really starting to fall apart when my unemployment check gets cut off. Calling to check on it with Gretchen at the atrium.

"Just stay calm and check the facts."

"Well. The facts are that I'm out of money and I'm scared I won't get any more!"

Gretchen, calm and logical, helped me navigate the maze-like automated voice prompts that seemed so convoluted to me. I wanted to throw my phone across the room. I couldn't think straight.

And things are really falling apart when I'm staying up all night, manic, watching The Matrix over and over and over waiting to get back into the Brattleboro Refuge, remembering watching The Truman Show over and over in Los Angeles, years ago, right before my first admission to a psych hospital. I watched and re-watched Inception the same way, the year before I moved to Vermont. I love Alice in Wonderland to an unnatural degree. Someone lost in a dream world. Trying to wake up. That's me.

It might be all of us.

I stayed up all night manic and texted Gretchen in the morning early said you want to go on a hike. Of course she said yes to anything I wanted to do, it was so rare that I initiated contact with her. At the end of the river trail, we hugged and said, "I love you," then spent time in the coffeehouse together and she was so worried to leave me alone but she eventually went to work.

---

And that Monday, sneaking antidepressant pills into the hospital in my ass so I could manipulate my high..taking a BuSpar overdose to increase my mania and force myself into the hospital.

I woke up, put antidepressants in a condom and pushed the condom up my ass while lying on my back in bed, walking to the Refuge for a day at the Birches program, knowing they would put me in Tyler 2. This was my last hospitalization I think. They put me in Tyler 1 first because there were no beds in Tyler 2. I was unable to shit in Tyler 1. I asked the nurse for a laxative and finally shit out the medicine in Tyler 2. When it came out, dry and clean in its rubber compartment, I had this rush of feeling really smart for getting past the full-body underwear-only search upon entry to the hospital. Just the idea that I was secretly in control of the situation that the staff of the Refuge thought they controlled. I can't relate to that feeling now in a visceral way but I remember thinking I was like "smarter than Hannibal Lecter" and things like that, like I was smarter than everyone—which is prob'ly just mania.

I took the medicine to boost my mania as it had in the past but this time I felt no effect, probably because I was already manic! I told Dr. Meggs I smuggled something contraband onto the unit but that it wasn't dangerous but I wouldn't tell her what. She asked why I did it and I said it was:

"To illustrate that I can manipulate others because I'm operating on a different level than them."

No doubt what she included in her notes included a reference to grandiosity, that typical bipolar symptom of expansiveness and superiority that feels so, so good when you're having it but seems so, so ridiculous from the outside.

---

Let's talk about the hiding antidepressants up my butt thing, getting a laxative from the Tyler 1 nurse because the condom had shifted, hiding the pills in my room, abusing BuSpar prior to entering the hospital—that deserves discussion. Of course it contains an element of attention seeking. I would abuse BuSpar on a schedule that would maximize its effects right at the start of the Birches program day, so that in the group therapy meeting run by my social worker, the symptoms would be visible to all. On at least one occasion, these symptoms contributed to my inpatient hospitalization. When I abused antidepressants in the locked ward, I would take them in my room and then go sit on the floor in front of the nurses station. Inevitably Michelle would look over the desk and see me, then come around and say to me:

"Feeling a little manic, are we?"

And shakingly, hyperactively, I would say, "Y-ee-sseeess."

At the beginning of that last hospitalization, when I managed to shit out the condom containing a baggie containing another condom, all wrapped up neatly and twisted to ensure the medicine inside did not mix with my feces, when I unwrapped that package in my room and separated out the clean Celexa pills from the shit-smelling condoms, and just barely managed to clear the antidepressants from the plastic that had been up my butt, and I saw the medicine was untouched—the operation complete—I felt such a rush of power, an uncontrollable thrill. I thought it somehow reflected on me a great genius. Specifically, I remember identifying with Hannibal Lecter, thinking this little bit of pointless trickery put me on or above the level of Lecter in terms of intelligence. That the staff had no idea what was going on with me (even my psychiatrist) made me giddy—no, euphoric.

I felt I was in control, that my illness wasn't real, that I had been controlling it all this time by manipulating my symptoms with medicine.

But it's way more complex than that.

Most of the time, I hadn't been manipulating my symptoms by attempting to abuse psych meds. The psych meds I was taking aren't manipulable recreationally. In fact, a manic reaction to antidepressants is literally a textbook diagnosis of bipolar disorder—only people with bipolar disorder have a manic reaction to antidepressants, so while I thought I was simulating bipolar mania in myself while thinking that my doctors' diagnoses were wrong—that I didn't have bipolar disorder at all, never had—I was proving all along that my illness was real.

See that's part of my sickness: I think I'm controlling things when I'm not. I think somehow I'm the one making up certain shit, when I'm not. I am not in control; I am not the one telling the story, I am what is being told.

And though I didn't know it as clearly as I do know, even back then, during my last hospitalization, my own realizations combined with Dr. Meggs's suggestion to me that "What we're dealing with here is way beyond bipolar mixed with a little psychosis," started unraveling my own illusions of the context under which I had been making all these inpatient visits to Tyler 2. Somehow, before, I thought I was in control of the doctors, that nothing they said was real. I have never believed I had bipolar disorder. It's difficult for me to believe it now.

I've read that I'm not alone in this, that part of what is broken in the brain of a bipolar person is the same part that would allow me to accept my illness. From within the existing medical paradigms, I am the disordered one, my behavior is unusual and dangerous—but I have never believed those paradigms, and when I have it's only for a second. I grew up inside me, inside this brain and this bipolar mind. To me, I'm normal, and all of you are weird. I don't view bipolar as a disorder, even with all the pain, the suicide it causes its sufferers, even with all the destruction and inconvenience it causes our families and lovers and employers. I don't think I should have to adjust to them—I think they should have to adjust to me. And here's an even stronger point: I can't adjust to them—they can adjust to me. Therefore, who should do the adjusting? Them—the normal people, the healthy people—they should make their world friendlier to me.

But all that is philosophy. What I'm talking about is me, during my final hospitalization at the Brattleboro Refuge, talking with my doctor about depersonalization and finally after months of talking to her and being in this hospital in its various forms, dual suns descended on me: One sun, the sun of humbling realization, informed me through my doctor's words that I was psychotic, that I was unable to one-hundred percent properly do reality testing, that my line between what is real and what is imagined is slightly blurry. That sun is kind of like your morning vitamins, the first pills of the day, without which you won't even get out of bed. It is the word "go." I have to accept and learn to wrangle it like the lion in the cage if I'm to exist at all. I have to learn to doubt the reality of some of my thoughts.

And I'm extremely lucky.

Because some people can't do this at all.

But I have enough "meta," enough parallelism in my brain that sometimes I can recognize a psychotic thought on my own. And for the rest, I have to trust a few people to bounce thoughts off of, and trust that they will tell me the truth—and it is trust of the ultimate kind, truly blind trust, because by definition I will never know if they are telling me the truth or if they are manipulating me. This is a huge vulnerability in me, and maybe it's part of why I have such a reptilian hate for manipulative people.

That's the first sun of two, the morning medicine, the first pill.

The second sun is that this will never be resolved for me. I will live the rest of my life not really knowing if I have bipolar disorder, if I am really psychotic. I live with an untangleable knot where reality and fiction are mixed up in a way that they'll never be unmixed. I have a tentative relationship with reality. But if you want to know my deepest thought, it's this: I think being diagnosed psychotic is an advantage. Because reality for everyone is tenuous. The constructs we use to understand the world—science, medicine, religion, philosophy—are always changing, and changing in a way that what was agreed upon as "truth" yesterday is today discarded as silliness. So no one really has a solid relationship with the truth. It is common for people to say that the more experience they gain, the less they know. The smartest among us are the ones who best understand the importance of doubt. Basically, what I'm saying is that no one knows "the truth." The world is not made up of people who know the truth and people who don't. It's made up of people who incorrectly think they know the truth, and those who correctly know that they don't.

---

"One thing I've noticed about you," Dr. Meggs says, "is that you are preoccupied with status and class, perhaps based on your humiliation experiences with your father when you were very young."

The first time I met her when I told her about the potty-training experience, she said, "I'm so sorry that that happened," and she made the call, right then, that it sounded humiliating, which I never thought of before she suggested it.

She's right about me and class, though.

I'm so pretentious I would never do cocaine off the cover of a laptop unless it was an Apple. Or white wine: even though I'm an alcoholic I would never drink white wine, no matter how desperate I was.

"Why not?"

"I'm way more of a classist than I am a drunk. If it isn't red, it isn't wine. White wine is low class. I guess you're right, I'm fixated on class."

(This thing about not drinking white wine even when I'm desperate is false—I know that now. I didn't know it at the time.)

"I sometimes play the humiliator because I learned to do that from my father. I get that now. The game is humiliator/humiliated. But now that we've started to talk about this, I understand that the counterpart to that game, which I've also learned to play, and play more and more consciously, is the cheerleader/teammate game..I have discovered in life that in addition to being a great humiliator of others, I am also a great cheerer-on of others..as they write their first book..as they go through mental problems. I was talking with my Mom on the phone. She says hers used to be to kill (a victim) and now it's to heal (the broken). But I see both of those in her still, and I know I still play my primary game as well. I see, though, that it's possible to change your game, to change your primary mode of relating to people..that's fucking deep to me."

"It's deep to me too."

"Dr. Meggs, what do you think is the difference between brilliance and greatness?"

"I don't know, but try not to let it consume you all night, ok?"

---

Before I went into the hospital this last time, my landlord Abby got mad at me for leaving all the windows open and the heater on in the winter. I hadn't meant any harm, I just like the fresh air with the heat. Maybe that's a bipolar mania thing—enthusiasm over judgment. Or maybe I just don't think about things sensibly.

And leaving my apartment for the last time, with my bags of stuff I was keeping set on one side of the stairway leading down from the apartment..and an apartment full of stuff I left behind: Playstation, roller skates, books, DVDs, jackets, kitchen utensils and devices.

I walked out of my life.

I couldn't keep it.

And leaving a key for Gretchen on the windowsill outside the door in case I needed Gretchen to pick up my stuff I was keeping (which I did).

And then going into the hospital for the last time.

There were bins of clean clothes that I would never wear again, an exercise bicycle in the bathroom.

And before they forced me into Tyler 2, I sitting on the floor in a Birches facilitator's office asking her to (and she did) print off a several-hundred-page document that at the time I felt I needed to give to my psychiatrist in Tyler 2 so she would understand my hallucination, how it was based on a computer program I wrote right before my first manic trip right before I was first admitted to a psych hospital in California and diagnosed as bipolar. When you have a delusion, it feels real. It doesn't seem crazy to you—it feels crazy to everyone else. To you it feels like you know something everyone else doesn't, like your vision is larger than the common vision and eventually everyone else will come around to your way of thinking.

The weird thing is..sometimes they do.

100

Before I went up to Tyler 2 the last time, the one day I stayed on Tyler 1 with the detoxers, a mental health worker named Jack told me the difference between Tyler 1 and Tyler 2.

We were standing in the main hallway.

He said, "Tyler 1 is people who when they stop using are basically ok."

At the time, we were watching the Tyler 1 patients dance a giant caterpillar-shaped animal made out of their bodies..they were coming down the hall with their art therapist, walking in these huge funny steps, holding onto each other's bodies. And they were all happy and silly.

And I realizing, even before hearing the second half of what Jack was going to say, that I belonged in, and was properly headed for, Tyler 2.

Jack said, "Tyler 2 is people who when they stop using their problems get worse."

My whole soul just dropped about four inches.

Jack said, "You might have noticed that I'm never on the same floor two days in a row. I started working a different floor every day because I was getting too attached to patients. I cared too much for them, and I would develop attachments, so they assigned me to a different floor every day."

Jack speaks confidentially with me.

"I don't worry about you, doing your paintings and reading your Faulkner." He laughs. "I worry about Schizophrenic Mike who is never going to get out of places like this. You're gonna be sitting on the beach reading your Faulkner or climbing your mountain or fucking your girl. But Schizophrenic Mike is never going to get to do any of those things."

Fuck, yeah, the guy I almost strangled after tricking his schizophrenic brain to attack me. I'm a real nice guy.

"How are you sleeping?"

"Until last night I'd been up for three days."

"Then it's good you're going upstairs. In all my years working at the Refuge, the most reliable sign that someone is getting better, and getting ready to leave, is their sleep. Not sleeping well: you're gonna be here for a while. Sleeping well: you're almost ready to go. I can always tell when people are ready to go, because their sleep evens out. In all my years of observing and working with mental patients and addicts, regular sleep is the number one indicator of good mental health. You know Lynne and I and Michelle and Dr. Meggs are always slightly breaking protocol with you because you're easy to like, intelligent, and you help us to feel good while we're helping you not kill yourself."

I smiled, and then I joined that caterpillar romping down the hall—just jumped right in as the first link in the chain and clomped and skipped and danced with them a little way down the hallway. I was totally welcome, and they were all totally nice, and I thought about Jack's theory of Tyler 1 and Tyler 2 and I thought he was right.

---

Jack and I talked all the time.

I told him that Lynne said it was easy to break the rules with me because she knew she could trust me.

But one day Jack tells me something about the mental health tech hiring process after I tell him about the interaction I have with one of their lowlife health techs weeks after this caterpillar day.

It's after I tell him about the mental health tech that I did a righteous smackdown on for his loud discussion of a certain instance of a gun his father had and exactly how many people it had killed in Iraq while I was up in the middle of the night, as always, sitting in the power chair by the nurses' station.

When I told Jack this, he said something I wouldn't have imagined in a thousand years. He said:

"You know those two ladies who do the hiring for the Refuge? They're these two middle-aged women, maybe in their sixties, named Agnes and Kelly. I like people, as I'm sure you've noticed, so one day I get these two ladies talking, and they tell me their hiring strategy for mental health techs—and to some degree doctors and other employees. But the mental health techs are the ones you come in contact with the most. Your doctor might spend half an hour or an hour with you if you're lucky. But we mental health techs, we're a dime a dozen—you have so many idioms in English, it's part of why I like this language. So Agnes and Kelly, what they're looking for is not the perfect mental health tech. They don't even look at your résumé. They hire us to create a mix of personalities, some helpful and caring like I try to be, some smart, some dumb, some articulate, some inarticulate, and also—and you're not going to believe this, but they also hire jackasses like Brent because they want to create a mix of personalities for the patients to interact with inside the Refuge to make it less of an artificial environment because they know that when you get out, you're going to be dealing with a mix of personalities. The outside world, your job, people you meet in shops or on the street, they're not hand picked to love you and listen to you and be considerate of your mental health problems. So these two ladies—I think they're quite brilliant—but they probably picked Brent to work here because he's a jackass, because he doesn't like interacting with patients. When you talk to me, you learn things, I learn things—everything is easy. But you being forced into a confined space with Brent is hard for you. And they want it to be that way."

Now I've been to a lot of shitty mental hospitals, but the Brattleboro Refuge is not one of them. I never met Agnes and Kelly, and I have no idea where whoever hired them managed to find a pair that thought that much outside of the box, but I have to agree with Jack's use of the word brilliant to describe their hiring practices. That is out-of-the-box thinking there.

---

And so correct. I live in a world where my uncle throws around the phrase "nigger pussy" like he's blowing the seeds off a dandelion, with relatives who naively work for fossil fuel companies that are destroying planet Earth—and they know it—just to put food on the table for their families. I live in a country with a bunch of motherfuckers who still hate black people, who think the poor should be made into slaves for the rich, who still shop at Walmart. And I live in the gun capital of the world. So for the rest of my life, I'm going to live in a world where my relatives carry pistols in the glove compartments of their trucks (while their language and actions indicate that they are even angrier and sicker than me—which I understand is hard for some of you to imagine), I am going to live in a world where cops shoot people for reaching in their pocket to pull out their motherfuckin' ChapStick. That's who I live with. And I have to learn to live with those people I consider to be either a) somewhat brain dead or most likely, b) extremely fearful.

I have grown since my time in the Refuge. I've been working on my anger, learning that there is nothing I have to get angry about. It may be good for some people to get angry as a motivator but anger is not good for me. I have to stay as far away from it as possible. Even before I got sober, I deleted my Facebook account for the express reason of making it impossible for me to ever send a drunk message to my "nigger pussy" uncle. It became clear to me that he was drinking when he sent abusive messages to my mom on Facebook and I didn't ever want to do the same to him, even in defending my mom. That's one of the maybe twenty reasons I stopped drinking this last time—I didn't want, for my nephews, to be the uncle, like my uncle, who has since I was born been nothing to me except the drunk uncle that I hate.

I used to fight with him on the internet. We've briefly argued in person. It mortifies the family, because they are all conflict avoiders and my grandmother, my aunt Susan, refuse to stand up for their daughter, their sister, their grandson, their nephew, when their son and brother is being abusive and hateful toward me and my mom. But I no longer view that as my responsibility to correct. People must correct themselves. I avoid contact with uncle Rusty and sincerely wish him the best life possible. I do that thing where you pray for people who have hurt you. If you're skeptical of doing such a thing, let me tell you: that method works and it works fast. It has freed me of my resentment—I know now that my uncle isn't making a conscious choice to hurt me and my mom..he doesn't have a choice. He's doing the best that he can. And with that thinking, I can feel compassion for someone who has been nothing but hateful to me since I was a little kid.

So I don't fight with my uncle on the internet. I care so much about never saying an unkind word to him that I deleted my Facebook just so it could never happen. Deleted his emails too. Removed him from my contacts. Pray every night to a god I don't even believe in that he has the best life possible. I'm praying that right now. And if you're reading this, Rusty, these aren't unkind words, this isn't an attack against you—this is just you looking in the mirror.

And not everyone has the strength to do it.

101

Dr. Meggs pointed out that The Truman Show and The Matrix are both about people living in a world where everything around them is fake. So is Inception, another one I repeat watch.

And Dr. Meggs leveling with me: "We're past bipolar disorder with a little psychosis mixed in. Do you know what psychosis is?"

Hallucinations..delusions..reality testing..a blurry line between reality and imagination..

"How does all that feel to you?"

I tell Dr. Meggs I'm a little scared.

She says, "You have someone with you on this journey. And I will do everything in psychiatry's power to help you."

"Ok."

She brought up this thing I snuck onto the ward.

"Do you feel people don't understand you?"

"Often, not."

"Do you often sneak things past people in conversation to test them or see if they're paying attention?"

"Hah. My whole family does that."

"Why? Why do you do it?"

"Because people are so fucking stupid. I'm trying to keep myself entertained."

"No one else can entertain you?"

"The entire room is empty! Not this room. But, typically, in a room full of people, there's nothing going on. It's all stuffed animals! Only very rarely do I meet someone I can talk to fully, on every level."

"How rarely?"

"About once every ten years."

"And how do you handle the other people you meet?"

"I translate. I warp what I'm presenting to them so that they have something they're capable of interacting with."

"That sounds like a lot of work."

"It is! But if you want to get by in this world that's what you have to do! Do you think I would have ever been able to get a job without doing that?"

"So to get a job you have been translating yourself into some..performance?..that your employers can handle?"

"Of course. They'd never hire the real me."

"And what is that?"

"A wider person."

Dr. Meggs stops writing.

"You think about things that you choose not to share, don't you? Things you think are too weird or taboo that you won't tell anyone, even me, because you're worried about what people would think."

And I tell her yes, I constantly tailor what I reveal to fit inside what other people are ready to hear. I can never share my real self—with anyone—because it's too big for anyone to hear.

"Are you afraid of being judged or punished if you share these thoughts?"

"Yes, I am. I very much am."

Maybe some things are too big to share with the world.

"Aside from The Truman Show and The Matrix, is there anything else you watch on repeat?"

"Well, one time I fell asleep to a YouTube playlist of supposed MKUltra mind-control videos and I felt a little irritated in the morning. But I already watched Se7en on LSD and—I mean—if you can watch Se7en on two hits of very strong LSD and keep your shit, you can handle some probably fake mind-control videos on YouTube."

"How many times have you done LSD?"

"Twice?"

"How many times have you done mushrooms?"

"I was thinking about that last night, since we talked about it, and I counted..eight."

"Oh, Matthew."

"Think I'm pretty much done with that."

"I hope you will be."

"I'm pretty sure I am. I've never done DMT but with LSD and mushrooms it is my experience that you don't need to go back there too many times—it's not like you find fundamentally new insights every time you trip. I've taken some notes while I was on LSD and mushrooms so that I can read them later and examine my mind from both points of view."

"Do you have the notes?"

"Yeah, they're in my notebook."

"You have it with you?"

"Yeah, here we go."

I flip through pages of my infamous Blue Notebook that I keep with me always.

"Ok, here's something. It's very hard to write a complete sentence when you're tripping—to maintain a complete thread of thought from beginning to end—so mostly they're little phrases, but I managed to get some complete sentences. Here's a phrase: the subtleties of color, the smearing intangibility. Or: Thinking is important..and people should do it more."

My psychiatrist laughs.

"Try this: this was in response to the experience of writing the first thing ever written on a particular blank page. This was on mushrooms. It says: oh, fuckbracelet, blank is better. And then I said, again about mushrooms: it's a mirror to how your mind works. And then, on the same page: the verbal detracts from the visual."

"What did you mean by that?"

"Well I was tripping with..people who shall remain nameless..and the three of them were in one bedroom of the suite we had rented to trip in. One of them had a guitar and they were playing it. And that whole experience was amazing—it was perfect for them—but I went into the other room and I realized that the less verbal activity that was going on in my brain, the more visual activity could happen. And I was reveling in this visual experience—looking at the patterns that appear on a blank piece of paper—and knowing that the more I participated in the verbal, the less I participated in the visual. And if I eliminated the verbal altogether..by closing myself into the other bedroom in the suite..by ceasing to write on these otherwise blank pieces of paper, that my visual world flourished. And that's an insight I've carried with me into the non-trip world. Like a novelist versus a photographer, you know?"

"Can I see that notebook for a second?"

"Sure."

I hand it to her.

She flips through the pages. She doesn't look up at me when she asks:

"Could you explain this to me if we had time?"

"Sure."

"And you would be able to explain it to me in a way that it would make sense to me?"

"Yeah."

"Where did these ideas come from?"

"I made them up?"

"What are they about?"

"Things in math."

Dr. Meggs looks up.

"Just things about numbers. Like a five isn't really a five, you know? There's more than one five. Our counting system..one, two three, four, five..it's just a shadow of a more complex system, a network. It's just stuff in logic that I think about."

"How many fives are there?"

"One-thousand twenty-four."

"How many sixes?"

"Thirty-two thousand, seven-hundred sixty-eight."

"Why are there so many sixes?"

"Because each six has different properties. We think of a six as divisible by two and by three, but that's not exactly true. Only some sixes are divisible by both two and three. Some sixes are divisible by two but not by three. Some sixes are divisible by three but not by two. A six isn't just a simple count, it's a network."

"You have several references to d'Anconia throughout here. Is that Francisco d'Anconia from Atlas Shrugged?"

"Yes."

"Do you relate to that character?"

"I relate to the part where he locks himself in a hotel room for years and tries to figure things out."

Dr. Meggs reads out loud from my notebook.

"Is it more useful/interesting/beautiful to repeat or to reverse? The innocence is dying..god is growing bored..and she is coming to destroy us. Do you believe in God?"

"Only as a metaphor."

"What's this?"

"I have no idea. It looks like a design for a search engine."

"What's this?"

"Me trying to solve the factoring problem. Foolishly."

"Ok, Matthew, hold on a second. What is the factoring problem? And why are you working on it if you consider it foolish to work on?"

"The factoring problem is the problem of developing a quick way to factor large numbers that are the product of two large primes. It's the basis of all cryptography, all internet security, and it's considered by everyone to be impossible to solve. If it was ever solved, all cryptography, banks, governments, would no longer be able to operate."

"Do you consider it impossible to solve?"

"Well, everything starts out impossible. Just because everyone in the world thinks something is impossible doesn't mean it is impossible. It just means it's not possible yet."

"In your heart of hearts, though, do you think it's possible?"

"No."

"How long have you been working on this? Matthew, there are hundreds of pages here of you working on a problem that even you consider impossible to solve!"

"Well, solving a problem isn't the only reason to work on it."

"What other reason is there?"

"Well, for one, it exercises your brain. Just because you always fail at solving a problem doesn't mean it's not worthwhile to try. You fail, but you emerge a stronger thinker. In fact, I think there's a reasonable point of view from which you could ask why anyone would ever work on any problem that wasn't considered impossible. And secondly, during the process of failing to solve an impossible problem, one may develop techniques that are useful in other domains. So, failure to solve the stated problem doesn't mean that the work involved in that effort was a failure."

I take the book back from my doctor.

I flip to a page at the end. And I read.

"There is a place beyond wanting—beyond knowing the relationships between—beyond knowing the definitions of—beyond feeling—beyond worry—beyond emotion, actually, in the realm of action, pure action; beyond caring about all the ways that people act and all the things that people do, there is just acting and just doing, just the motion of the body dancing with all of its desires and its circumstance."

There was more that I read her, two more pages of beyond—all the concepts that the tripping me could conceptualize going beyond, and when I read her "beyond goodness in all its forms, beyond the valuation of good and evil," she asked me to stop.

Meggs looks at me.

"Were you on mushrooms when you wrote that?"

I nod.

"Some of it is beautiful."

"Thanks."

Then she gets up to go, and at the door she says:

"Please don't do mushrooms anymore."

"I'm not planning to."

"I'd like to understand the inside of your mind better, ok?"

"Ok."

"So I'd like you to give me a moonwalk—a thought landscape—as though you were a moon rover and you drove around and captured the interesting features of your mind and encapsulated them in a way that you could transmit to me on Earth so that I could understand them. I think this may help me understand what's going on in your mind so I can know how to help you better. Take a few days and then we'll go over it together."

I agree and for days whenever anything passes through my mind that seems like it should make the list for her "moonwalk," I write it down on one of my notecards.

Dr. Meggs also says she's ordering some tests from the Refuge psychologist.

"Don't overthink them or try to figure out what the test is trying to test, just go with your first answer, ok?"

I agreed to do that.

102

These were the results:

Brattleboro Refuge Psychological Services Report

Patient Tested December 1, 2011; December 5, 2011

Referral Source: Mary Alice Meggs, MD

Reason for Referral

Initial personality screening and clarification of diagnoses.

Tests Administered

MMPI-II, Rotter Incomplete Sentences Blank, Draw a Person (DAP), and Millon Clinical Multiaxial Inventory-III (MCMI-III). Also, a clinical interview was conducted with Mr Temple.

Results

This is an initial personality screening. Therefore, the following hypotheses should be considered conservatively, and integrated with other sources of clinical evaluation. This becomes particularly important in that Mr Temple may have tended to magnify his difficulties. This may represent an inclination to draw attention to his plight, and perhaps reflect the degree of vulnerability he is experiencing at the time of hospitalization.

Adults with similar test profiles, as well as comments made by Mr Temple, indicate his experiencing a significant mood disturbance with periods of depression that may often show agitation and erratic qualities, shifting between expressions of self-deprecation and despair, perhaps mixed with a sense of hopelessness and futility. At times this may be punctuated by outbursts of discontent and frustrations with inner tensions, as well as life circumstances. Self-loathing is apt to be present, with Mr Temple demonstrating an intropunitive style, contributing to his depressed state. His grumblings and, at times, provocative responses, may serve as a vehicle for discharging tension for brief periods.

Mr Temple's test results also represent periods of hypomanic episodes that may punctuate his depression. He acknowledged these periods occurring for up to a week in duration. His manic episodes may be expansive and irritable in quality, rather than a more euphoric and cheerful presentation, both according to his test responses and his comments during the interview. Mr Temple also noted that his father had relatives who had been diagnosed as bipolar, as well as a sister who had previously been diagnosed with bipolar disorder.

The test results also raise a question about an anxiety disorder, with obsessive features. He described previously being diagnosed with OCD, and described various ways that he would obsess and show repetitive and checking behaviors as part of compulsive loops in an OCD pattern. The results also raised a question about bizarre thinking and thought distortion, to a point that one might identify delusional content. Mr Temple described what might be paranoid kinds of ideation as recently as the current hospitalization, although, on some level, recognizing that these thoughts were "crazy," he was cautious about expressing them to others. His thoughts may be overlay to fears about contamination as part of an OCD presentation. Mr Temple denied auditory hallucinations, but did describe what seemed to be visual-type hallucinations, or images around texture and layers. There is a question whether this might be a side effect of his medications.

Mr Temple acknowledged a significant prior history of alcohol abuse/dependence. He noted more recent sobriety, his lengthiest period of sobriety being 11 months. Individuals with similar profiles tend to self-medicate, using alcohol as a means to try to blot out their emotional distress for brief periods, and perhaps bolster their fragile sense of self-worth, particularly in interpersonal circumstances, when drinking [This is so cliché and so trite that I can only imagine the Refuge psychologist plagiarizing it from some college textbook—it's also so accurate and so true about me that I find it hard to read, even five years later.]

The test results were in keeping with more enduring personality characteristics representing a depressive personality disorder with some borderline and narcissistic features. These individuals are often chronically depressed and pessimistic in their way. Mr Temple may frequently feel misunderstood and unappreciated, with intense conflict between his need for nurturance and care, and at times asserting himself angrily in a more impulsive manner. He is likely to often feel the victim, overburdened and mistreated, behaving in ways that contribute further to this expectation. These adults have a pessimistic outlook and anticipate being disillusioned, and thus behave, or rationalize, that they can be irritable and reactive to those who have not appreciated their status, or not responded in the supportive manner that they would have expected. Mr Temple may struggle between feelings of suffering, melancholy, and then resentment. He may show a rapid succession of moods with low frustration tolerance. He is apt to show a flux of attitude and contradictory behavior, with limited internal cohesion in coping strategies. Thus, he likely participates in a self-defeating cycle, further complicated if he is drinking at that time, undermining already a fragile capacity for internal response inhibition.

Sincerely

Fuckface, PhD

No but wait, there's more:

Brattleboro Refuge Psychological Services Report

Patient Tested December 1, 2011

Referral Source: Mary Alice Meggs, MD

Reason for Referral: Assessment of Cognitive Functioning

Tests Administered: Wechsler Abbreviated Scale of Intelligence, and Trailmaking Test: Part A and B

Clinical History and Behavioral Observations

Mr Temple is being treated for mood disturbance as well as a history of alcohol abuse/dependence. There are no specific medical problems reported, with the exception of Mr Temple describing negative consequences from the use of serotonin medications, including visual hallucinations.

At the time of the evaluation, Mr Temple was pleasant and cooperative. He seemed to show signs of frustration when having difficulty answering a question. Mr Temple was attentive throughout the evaluation. He seemed to hyperfocus on anything that he might struggle to answer, or to complete.

Results

Mr Temple received the following prorated IQ scores on the Wechsler Abbreviated Scale of Intelligence (WASI):

Verbal IQ Score: 134

Performance IQ Score: 129

Full Scale IQ Score: 136

Based on the Verbal and Full Scale IQ Scores, Mr Temple is performing in the very superior range of cognitive function relative to his age group. His Performance IQ Score falls in the superior range of cognitive adaptability. Subtest scores show above average performance in abstract conceptualization of verbal as well as nonverbal information. Mr Temple also demonstrates a good capacity for the use of verbal language and finding relationships between words. One would anticipate optimal performance up to the very superior range across the areas of verbal comprehension, as well as nonverbal conceptualization.

Mr Temple's results on the Trailmaking Test part A and B show a split in performance regarding efficiency completing each portion of the test, relative to his age group. Mr Temple finished the part A section in 21 seconds with no errors (mean = 30.2, standard deviation = 10.4). This task requires sequencing of numbers only under timed conditions. In contrast, Mr Temple required 97 seconds with six errors to finish the part B portion of the test (mean = 64, standard deviation = 23.4). This task is more complex, in that it requires sequencing and integrating of letter, as well as number series, under timed circumstances. Similar results reflect what may be a far greater challenge for higher-level processing of information, including cognitive flexibility when shifting set. Mr Temple seemed to struggle with the complexity, and showed some confusion when having to respond to fixing errors before moving forward on the task. He then became overwhelmed and frustrated with his efforts, further compounding his inefficiency of performance.

Based on the results, one would anticipate superior performance in overall cognitive capabilities. His difficulties with a more complex task raise questions about executive performance, and the recommendation of a more complete psychological analysis.

Sincerely,

Fuckface, PhD

I wondered for a second if I had hospital addiction syndrome. Was I just making up and exaggerating my experiences so instead of being alone in my apartment I could live among other crazies like me, even if I had to live in a locked ward to do it? Was what I was telling Dr. Meggs true, or was I making up a person I thought she'd like, just for the attention? Even my MMPI said I was likely exaggerating my responses to make my condition seem worse. I wish I could say I was consciously doing that, but I wasn't. Dr. Meggs said to answer those questions with the first thing that came to my mind—not to overthink them—and that's what I did. If I am lying to my doctor, exaggerating my responses to the MMPI, it's happening on a level I am unaware of. That's a scary thought to me, that I might be so out of touch with reality that I don't even consciously know that I'm lying.

But when I read the definitions of Münchausen syndrome, I know that's not me. I'm not a well person pretending to be sick. I am a sick person willing to try anything, and hoping—probably in vain—that someday I'll be well.

---

I met a woman once who was faking auditory hallucinations just so she could stay in the psych ward and stay off the streets. My Yahtzee buddy from my original LA psych ward stay. She confided in me after a while and I was like, ouch, you're willing to take a bunch of crazy psych meds, who knows what they're doing to your brain—just to not be homeless. I had been homeless at that point, and that's a tough choice to make. I would have made the other choice myself, be homeless, but I understood the path she was taking, too.

I told that to my Dr. Meggs and she pulled her chair up close. She said:

"I once had a schizophrenic patient who heard screaming in the walls and she tore through the plaster with her bare hands trying to free the people she thought were trapped inside the walls of her house."

I'm looking at my psychiatrist like are you shitting me.

I knew the patient she was talking about, naturally.

"Of course there was no one there," Meggs continues. "Just empty walls. So you see?—Your hallucinations could be a lot worse!"

Thank you, Dr. Meggs. Thank you for that image =)

---

Sometimes I think the only difference between people who are outside of psych wards, and people who are inside psych wards, is that the people inside psych wards are getting better mental care.

I hope I never have to take another IQ test again. I might just refuse if I'm asked to—or smear my feces all over the walls. I'm sick of solving puzzles and taking tests. I don't even like to play games anymore—there are zero games on my iPhone, iPad, MacBook—every game I've tried in about thirteen years just seems stupid to me.

As for Dr. Fuckface and his analysis, I think it speaks for itself. Anything I did to argue with his conclusions would probably only strengthen them.

There's a really fucked-up thing that we people do with psychiatric diagnoses: we give them character. Like a schizophrenic is widely characterized as someone who is so dangerous and delusional they can't function in the world. A bipolar person is characterized as an artist, some kind of genius with special insight into knowledge and beauty—but impossible to relate to. People with borderline personality disorder are seen as people so manipulative that they're even harder to have in your life than bipolar people—but people with borderline are good in bed if you can keep them from fucking with your head (which you can't). Major depressives are seen as pathetic alcoholics so boring they have nothing to offer society. Narcissists are looked down upon by everyone, due to that pack mentality in which the tall nail is hammered down. I hate that Dr. Fuckface, PhD used the word narcissistic in my Psychological Services Report. I hate narcissists, which suggests I am somewhat like them, otherwise there would be nothing in me which resisted resonating with them—I would ignore them, unbothered. I even have a favorite video on the internet by a doctor who describes the differences between grandiosity in bipolar mania and the grandiosity and other similar traits in narcissism. I use this video to convince myself that I'm not a narcissist (I could never stand it if I had that diagnosis) but, rather, that my grandiosity is always part of mania, putting me squarely in the bipolar camp.

The New Oxford American Dictionary defines narcissism as extreme selfishness, with a grandiose view of one's own talents and a craving for admiration, as characterizing a personality type. Extreme selfishness—no, just the opposite. I'd rather have everyone else taken care of and me dead than the other way around. I'm self-sacrificing to a suicidal level—so far I'm not looking all that hot as a narcissist. Grandiose view of one's own talents—when I'm depressed, I think I have no talents and wonder why I'm alive; when manic, yes, I have an unbelievably grandiose view of my own talents. I believe it completely and it gets me high—higher than techno, higher than a shot of cocaine, higher than ecstasy, higher than crystal meth. Most of the time I'm not manic or depressed and I don't think about talent at all—I just work. A craving for admiration—this is a split for me: I don't crave admiration but I do try to manipulate others into admiring, not me, but my work. My ideal result is for a person to hate me as a person (due to the disgusting, unacceptable broadness of my mind and the amorality implicit in that) but be unable to deny that my work is superior. I don't care if you love or hate me as a person—both please me—but I want my work to be undeniable to you..I want there to be no way for you to ignore it. Once admiration is actually given to me I enjoy it for about fifteen minutes and then I want to kill myself for being the focus of anyone's attention. Actually almost anything can make me want to kill myself.

Before I was ever diagnosed with bipolar disorder, I hardly knew what it was and I didn't have any associations of like or dislike for it—I had no relationship (in my mind) between me and bipolar. But over just about a decade since that diagnosis, I have come to cling to that diagnosis like someone who is about to drown clings to their sinking ship. I may die, but goddammit I'm going to die sinking with the Titanic, not some other ship with a bad reputation. I have gone from denying that I have bipolar disorder to defending my bipolar diagnoses from all other comers—fuck no you're going to diagnose me with narcissism, fuck no you're going to diagnose me with simple depression, fuck no you're going to diagnose me with borderline personality disorder..it isn't even a brain disorder!..my behavior can't be explained by something as rudimentary as borderline personality disorder! I mean, come on, borderline is for manipulative little girls (or my dad) and all they need is some counseling to get through it—I couldn't possibly have something that's solvable through counseling.

Bipolar disorder is the perfect disorder for me (in my sick way of categorizing and judging and worshipping mental disorders). Schizophrenia is too crazy, depression is too boring, narcissism is deplorable (it's for the weak, the insecure), borderline is too easily solvable for me to respect someone who continues to live with it without solving it. I like to fuck girls who are borderline—that's it. But don't you see—as I have, over these years—that I could have never manipulated scores of psychiatrists in various hospitals to conclude or agree that I have bipolar disorder unless I had it. I have a fear, a delusion, that I don't have any sickness at all. I am insecure, and I do contain a touch of narcissism. I do have psychosis independent from a mood episode (one of the criteria for schizophrenia). But just as I once learned that the reason I was attracted to camp counsellors, the reason I like them, is that I am like them..in that same way, the reason my classification of psych disorders favors bipolar disorder as being the most likable—the one I would most like to have if I had to choose—is simply (and nothing more than) that that is what I have.

I like it best because it's what I'm forced to deal with, and for better or for worse, it's become part of my identity.

Finally, my puny analysis of Dr. Fuckface's overuse of commas: I feel you, bro—once a teacher handed me back a two-page paper and she had circled sixty-two unnecessary commas. I took out a few of yours to make it a little easier on my readers but I left in most of them so they can see how a PhD psychologist writes.

103

I've decided I'm taking no more tests. I'm giving no more interviews. I'm sick of diagnosis. I'll chat with Dr. Meggs, but that's it—and I'll only chat with her about off-the-record stuff. I'm going into my mind, and I'm going deep this time. I scribble in the nuclear submarine notebook, writing programs without a computer, theorizing about psychiatric practice, and writing about what is in and how my mind feels.

Mental health worker asks me what I'm writing.

I say a design for a program that simulates manic, depressed, awake, and asleep states.

He said it looks psychotic.

I say what do you mean by that?

He says I have a good buddy who's a programmer..if I showed him your notes would they make sense to him? Would he be able to build the program?

I said probably not but that doesn't mean I'm psychotic! Doctors have terrible handwriting..does that mean their scripts are nonsense, or the product of a psychotic mind? Just because I'm the only person who understands what I wrote doesn't make it psychotic! I can write in codes and special languages, draw thoughts visually using shapes and diagrams..this may be impossible for others to decipher but that doesn't mean it isn't perfectly cogent, lucid, sane, and sensible.

He did make a good point then, by saying that if I spend so much time each day writing in my notebooks, being in my own imagination, that I miss out on possibilities occurring in the real world, the world outside my mind.

I admit I do like the real world, with its geography and food and women's bodies..but between the world outside my head and the world in, I find the one inside to be the realest.

I wrote:

watching Inception

we want to make worlds like this

where people can truly lose themselves

interface pure consciousness

bend and fold

trade

—weave— consciousness

They used to call me Helen Keller at this bar I went to in LA. Because I'd wear headphones and sunglasses while I was in there, and I'd write on napkins or my laptop or my phone. But I didn't want to talk to people. I didn't go to that bar to make new friends. I went there to get drunk. My eyes were covered. My ears were covered—and these weren't earbuds, these were Sennheiser HD 280 Pros..they covered my entire ear and I was in my own world. Somewhere in there—maybe somewhere before—but sometime in my life I stopped believing in the real world and I started believing in my imagination.

"See?" says the health tech. "Where were you just now? You could have been talking with me but instead you were inside your notebook, writing..what? Was it earth-shaking? Is it gonna help you get pussy?"

"I think everyone's hallucinating—just most people don't know it."

"Interesting insight. But how's it gonna help you get pussy?"

"You think a lot about pussy, don't you?"

"I love to think about pussy," says this mental health tech.

And I say, "I have this video I like to watch, it's a a hot girl in bed and she's jerking off and so it's standard porno shit..right?"

"Right."

"But then—then, she picks up this picture from her headboard and looks at it while she masturbates."

"Can you see what's in the picture?"

"No. That's the thing. You can't."

"Hot."

"I know, right? But the thing that really gets me off isn't the hot girl in bed who grabs a picture frame and looks at it while she masturbates..and you never see who she's looking at, so I always imagine she's looking at me, and I'm her boyfriend off on deployment, and she can't want to get me home, you know, I'm off killing civilians in Iraq, shooting 'em in the head with some classified carbon-fiber rifle and torturing them and taking pictures of them with doggy leashes around them, making them eat their own shit, stuff like that..what really gets me off is knowing that my MacBook has a camera and I think about the NSA agents sitting in a bunker somewhere forced to watch a straight man jerk off to some 18 year old because somehow I got on their watch list..but some of them are gay, and their dicks are getting hard watching me masturbate to the girl who is masturbating to the picture that none of us ever get to see..it's those guys in that bunker, their dicks getting hard and the precum seeping out through their uniforms..that's what really gets me off. I don't get off on porn itself. I get off on NSA agents watching me get off on porn."

And this mental health tech says, "Really?"

And I say: "No, I just made all that up."

And the tech gives me the one-eyebrow skeptic look and gets up and leaves me the fuck alone.

Never fuck with crazy people.

---

In fifth grade I took a ten-question test. I don't remember what the subject was. But I got a seven out of ten—seventy percent. My teacher called me up to his desk after he had handed out all the tests. He pointed out three marks I had made, each one to the left of one of the three questions I had gotten wrong.

"What happened?" he said. "You marked your own test. If fifteen years of teaching I've never seen anything like this. You knew that these were wrong answers, so why did you go with them."

"I didn't know that they were wrong. I knew that the other seven were right. These were the ones I was unsure about."

"It's a true-or-false test. If you were unsure of these answers, why didn't you answer the opposite? You would have had a perfect score."

My eyes welled with tears. I looked at my teacher. I shrugged.

"It's ok. Do you need a tissue?"

"No."

My teacher passed the test back to me.

"Go back and reconsider your answers."

He gave me a pass that day. And when I simply switched the answers I didn't trust, I got a perfect score. Was it fair to me? Fair to the other students? That doesn't matter—it's not the most important thing.

I thought a lot about that test and my own thinking in the next four years, the years I spent at the Julia R Masterman Laboratory and Demonstration School for gifted students. And I learned to develop (or maybe always had) what students of education call metacognition—which is the awareness and understanding of one's own thought processes. It's thinking about thinking, knowing about knowing. The root word "meta", means beyond. Because there is thinking, and there is thinking that goes beyond thinking. It involves, not IQ, not some raw machinery that no one has any control over, but rather it is the simple process of stepping back..stepping back and getting a wider view. I learned from that experience of "marking my own test," as my fifth-grade teacher called it.

Some people say that it is important to know things, but much more important to know what you know and know what you don't know. To think you know something, but not know that in reality you do not know it, it a dangerous thing.

I learned to take a step back and think about what I thought, not just to throw knowledge around like having certainty in a first draft, but to perfect my knowledge, to grade my own tests, and I went from being a smart kid with potential to being someone who could score one-hundred questions right out of one-hundred instead of just ninety-nine out of one-hundred. I wasn't the smartest person in that school—Megan Heckert and this kid Blaise probably have higher IQs than mine. But from our elementary school days to our first high school year, I became the one who could not just survive a ninth-grade AP biology test, but dominate it. When the teacher graded on a curve, my perfect score made me the enemy of even the second-highest scorer in the class (usually Megan). On or off a curve, I was getting one-hundreds—every question right—on every test they gave me. The second-highest score was like a thirty-four. It wasn't a matter of brainpower—it was a matter of care.

I'm not trying to convince you of my intelligence—you'll make that decision for yourself. I'm telling you this because I want you to know what things are like inside my mind.

104

Faith got there and it immediately improved my mood. I was eating lunch at a table by myself and then someone was standing very close to me. I looked up. It was Faith.

We smiled. We laughed. We air hugged.

Oh thank god my Faith was back. I mean you never want to wish someone into a mental hospital, but if I had to be there alone, or I got to be there with Faith, I'd definitely pick being there with Faith.

When she got there my entire world changed. I actually had someone to talk to who made sense.

I think I need to be around cool and interesting people. I think I'm a frustrated extrovert who just needs a high caliber of people to hang around. People with spunk. I'm an extrovert who hates people..not because I hate people..but because people are mostly worth hating.

Faith stood at the door of my bedroom and tells me why she's back.

"I was in this classic car. It was like a blue thing with you know those wings things on the back and a leather top and this guy—I won't say his name—he gets me in the back seat and he's like do you wanna fuck and I'm like, 'No! No I don't wanna fuck you.' This was a date in his mind—it wasn't a date in mine. He was just some friend from high school. We got McDonald's—is that worth raping my pussy? Apparently he thought so."

"What the fuck, Faith!"

"I know, it really sucks. And now I don't know if I'm pregnant or not so one of the social workers is gonna come and have me pee on a stick—how embarrassing."

Just then this social worker named Shiloh or Turquoise or something, she comes by and takes Faith by the hand and she's mad at me and Faith just 'cause she's talking to a guy. Excuse me, we're not all rapists and I'm not talking to Faith to get down her pants, she's my friend, asshole. One of those men-hating women, this social worker was. Fuck her.

I showed Faith my orange hat with a "P" on it that I had won in ward bingo and said the "P" stood for psychotic since I had just recently found out from doctor Meggs (who was Faith's doctor, too) that I was psychotic.

It's such a charged word—mostly because nobody knows what it means.

"YOU'RE PSYCHOTIC??" Faith asked.

"Apparently."

"What does that mean?"

"It just means I have a blurry line between reality and imagination—I can't always tell what's real and what my mind is making up."

"Nice," Faith says.

"Yeah, it's pretty insane," I say.

And then Faith says, "I wanna come in your room."

And I say, "I want you to, too."

"I'm gonna come in real quick."

"Ok."

She runs in and we hug each other from top to bottom, everything pressing together, and Faith says:

"I want to F you."

"I want to F you, too, Faith, now get out of my room before we get in trouble."

That was when the social worker came by telling Faith she needs to spend time alone, and she asked me real mean if I know why Faith is here and I said:

"Yes, I do, she told me."

This undercurrent again that Faith shouldn't even be around males because all males are dangerous when they're really pulling apart two sick people in a psych ward who have found someone they can relate to. And what if I did fuck Faith, if she wanted me to? That would be a good experience for her, for me. Crazy people get to have sex, too, you know.

---

Faith tells me this story:

She says her counselor took a sexy letter away from her that some boy wrote Faith.

She jumps in the counselor's car after work and won'r get out. She wants to read that sexy letter.

They're driving all over the road crazy because the counselor only has one hand on the wheel—with the other, she's holding the sexy letter away from Faith. Faith must not read that sexy letter!!

Then the cops start chasing the counselor's car.

Faith reaches over with one foot and puts her foot on the gas! The car speeds up way past the cop.

Now they're in a car chase with a cop who thinks they're some type of fugitive or something. Finally the counselor gets her car under control and pulls to the side of the road.

Faith freaks out—she's sure the cops are going to shoot her or take her to jail just on general principle. Faith runs across a four-lane high way at dusk, cars barely missing her, to try to escape the American Killing Machine.

Somewhere earlier Faith bit the girl who bit the staff of her monitored apartment: a girl bit the staff, and to show her that wasn't the right thing to do, Faith bit that girl!

Then she almost makes the counselor crash her car, etc.

She gets out of the counselor's moving car on the highway and when Faith is three lanes away the counsellor finally says:

"Ok! Faith! I'll let you read the letter!"

Then, one night with Faith pulled up to my door in a desk chair as usual, me telling her about my life, Faith says she heard this saying somewhere that she wants to tell me:

"Failure is the opportunity to begin again."

She gives me that piece of knowledge and I keep it forever.

And I love it.

It is powerful advice, the advice of sages, given to me by this curly-haired bipolar girl in a mental refuge.

And one night..this I'll never forget..the normally spastic Faith singing to Adele's Someone Like You with her head inches from the ward radio, lying her torso down on a table in the main room. It's the calmest I've ever seen her.

Never mind, I'll find someone like you

I wish nothing but the best for you too

Don't forget me, I beg

I'll remember you said,

"Sometimes it lasts in love but sometimes it hurts instead,

Sometimes it lasts in love but sometimes it hurts instead"

I wish I could write the loneliness and connection that seeing Faith do that created in me, how I felt childlike and helpless still, as everyone does deep down, and how seeing Faith deal with her problems by listening to Adele and singing along while she laid her head down on the table—one of the only times I've seen her at rest—I wish I could write how that made me feel. But I can't, and in this point, I have failed my reader more than anywhere else in this book.

---

Meggs said to me, casually, while I'm perched in a chair in the main room eating breakfast—she was helping another patient and she just shoots it off to me—that I was at "the top of human performance," or "the very edge of human achievement" in reference to the psychological services test results she had reviewed. I thought this was funny since IQ doesn't indicate you've achieved anything except taken an IQ test—it was a phrase that I thought didn't make sense in the context of a discussion about IQ—but I knew what she meant. I realized then that I had put Dr. Meggs on a pedestal, built her up into some type of X-Men super-psychiatrist who was smarter and better than me in every way, and her use of the term achievement or performance with respect to IQ showed me that she was either being lazy with the words or she didn't really understand what the test meant.

I had told her I felt smarter than most people I met, and I think that's part of why she gave me the IQ test. Now she was casually and comically telling me it was true (Refuge confirms I'm "super smart"). But an IQ of one-forty or above is required to be considered a genius. So I'm no genius—and I can't tell you what a relief that is.

I sit there in the vitals chair while Dr. Meggs talks quietly with Faith, who is lying on the couch.

I thought of how close Meggs and I had become. I mean I told her that I used to stick my grandmother's maxi pads in my underwear as a kid. It made my penis so hard. The things I told Dr. Meggs in therapy..and to tell her that I feel smarter than other people..and not just people but almost everyone I've ever met. It isn't sexual but it's a very intimate thing to tell someone..it puts you in a very vulnerable position.

So when she IQ tests me and says the results came back and the hospital psychologist said I'm at the edge of human "achievement" (even though IQ has nothing to do with achievement), I wonder if I'm talking to the right person—if I should have been so candid with Dr. Meggs.

And when I finally see the test result it's a fairly unimpressive 136—I wonder if it would be higher if I hadn't done street drugs or if I wasn't on like eight psychiatric medications when I took the test. Anyway I figure if I stay away from crack I can keep that IQ for the rest of my life and I'll at least be able to keep my head above water in most smalltalk situations.

Meggs is saying that I'm off-the-charts smart—but I'm not. I just think she doesn't understand the test. What I remember most, as I'm sitting in the vitals chair and Meggs is dealing with Faith who is lying on the couch is that Meggs speaks to me briefly, professionally, and as an equal.

---

Later Meggs and I talked in my room.

"You had an encumbered morning?"

"Yes, I had an encumbered morning. I was telling Mom some of my recent thoughts and she told me I was being too intense for her—maybe for me too—and I'm sick of that in my family and in most people, this desire to shy away from the intense, as if the intense was something to be feared and avoided and not the juice of life!! I don't even like unintense people! Put 'em on an island—make 'em play Parcheesi for the rest of their lives or watch daytime television or something. I mean, I want to be someone my mom and other people feel comfortable around, but that may never happen. Even though lithium softens mania and depression, they're still there. The thing is I can't tell when I'm being too intense or depressive because they both feel normal to me. And I'm generally attracted to intense things and people. I like painters who couldn't possibly fit anything else on the canvas."

"Like Basquiat or Pollock."

"Exactly! Intense seems normal. Normal seems boring. My mental disorders have conspired to make me have emotional breakdowns many a night. And at times like those I don't plan to say much more than what I can't help getting out because I don't really want help. With a little time passed—and some CRAZY text messages—I get my head above water. When I'm using and I get depressed, I drink or drug. When I'm clean and sober and I get depressed, I make plans to kill myself. So, I'm always Tweeting: No, I'm not suicidal tonight—please don't call the police or report my last Tweet as suicidal. I will let you know if I'm ever suicidal again. In fact if I ever try suicide again, I will live-Tweet it—deal? I actually Tweeted that. What is that? Someone who treats life so crassly, so cavalierly, doesn't deserve to be alive. A lot of people think that "self-medication" by people with major mental disorders is just an excuse to drink and drug. I can easily see why that point of view seems sensible. But walk in my shoes: try to stay alive, with bipolar, even with lithium, without killing yourself.

"The alcohol was helping to numb your more intense emotions."

"Right."

"I don't judge anyone for 'self medicating'—sometimes you do what you gotta do."

"Yeah. Thanks. I'm not planning on doing that, but I mean in the past it has helped me survive, to get to this later point in life."

"Exactly. When it's the difference between getting through the day and not getting through the day, get through the day."

"I'm surprised you can tell me that, since I'm an alcoholic."

"I'm not encouraging you to drink. I think if we can get you on the right medication, you won't need to drink."

"Ok." I sniffle. "That sounds really good to me."

"I'm not a substance abuse counsellor. I'm your psychiatrist. For now I just want you alive, and we can work on the luxury problems later."

"It's fucked up," I say, "but as destructive as it is, for some of us, drinking is an alternative to suicide. Can I switch gears?"

"Go ahead."

"In addition to the humiliator pattern at work and with Dad, I have always had a need to be understood, and felt that I wasn't. I've written five books and no one in my family's read them. I get wildly great reviews on author sites but the people closest to me in my life have no interest in the slightest in learning that part of who I am."

"That's gotta be tough. Let's talk about your moonwalk later, ok?"

"Ok."

I take a sip of orange juice.

"I have a couple of patients to meet with early tomorrow and then I'll find you and we'll talk in your room, alright?"

"Alright."

"You seem cheerful today," she says, smiling.

And I shrug.

"I am."

Dr. Meggs says in the most genuine way:

"I'm so glad, Matthew."

Meggs says she knows she doesn't do outpatient stuff but to call her if I ever need to. (And I did call her from Portland when I was up for three nights and woke up with ecstatic skin sensations after stopping my own Risperdal without telling anyone. That landed me in the psych hospital with my most intense hallucination ever..texture off the charts with music in the distance.)

That night Nancy was right across the hall from me, screaming, and I went to sleep like a rock, covered my eyes and had not a single worry, schizophrenic woman screaming at the people in the walls and I was across the hall from her, in my bed, totally relaxed.

And that night I had a dream I was done with Dad forever—that I locked him out of my mind, my world, and refused to speak of him or listen of him from any of my family.

And it was amazing.

105

This last stay at the Refuge, I just ate, slept, talked with Faith, met with my doctor, and sat in my room making up writing systems. The first times I went to the Refuge I attended every class, went on every walk, attended so much that the teachers had me be their whiteboard note taker.

On this last visit, newcomers to the Refuge, adults older than me, gently encouraged me to attend classes ("You'll get more out of your experience that way.")

I wanted to be like, Bitch, this is my seventh time here..I've memorized all the classes and to be honest I'd rather sleep than attend one more substance abuse class. But have fun.

I loved my sleep, though (depressed).

I loved my quadruple-decker hamburgers (Risperdal).

I loved when Faith came and talked at my doorway (I'd lie down and she'd dance around in the doorway or pull up a chair and sometimes she'd sneak in and we'd give each other sensual full-body-press hugs).

I loved the evenings—I sat at my desk and made up a new writing system and taught myself to read and write it in my journals.

My doctor comes in.

"What is that?"

"A writing system I invented."

(Once my mother saw the genesis of one of my writing and programming languages called dot oh and she said, "You do realize normal people don't do this." And I just thought: Pity that the world is filled with so many normal people.)

Dr. Meggs asked me to use some of my notecards to write down a "moonscape" of my mind—actually I think the word she used was "moonwalk." She said she wanted to know the terrain of the inside of my brain. She said it would help her understand my thoughts, because that's something she couldn't see from the outside, and that having this moonscape would help her treat me.

"Write down anything that you are afraid to share, or that sticks out to you, or that you think might be 'crazy.' "

So I write down a shitload of stuff—way more than she expected—and she sat mostly quietly and took notes as I read her each card and explained it a little. Occasionally she asked a probing question, and she feverishly took notes, asking me to pause from time to time so she could catch up. This took us two full one-hour sessions, over two days.

These are the notecards I read her, along with my elaboration for each one:

I feel like I'm smarter than almost everyone else—I feel like most other people don't make any sense. The things they do seem idiotic to me. They seem like foreign creatures, like one of us is alien. Like I'm humoring people, and I'm funneling and filtering and translating myself down just so that I can communicate with almost everyone. My native language would be completely incomprehensible to them. It makes sense. It just doesn't make sense to them. From this, they make the incorrect conclusion that I am "crazy" or there is something wrong with me. But just because you don't understand something doesn't mean it doesn't make sense—it means you don't understand it, which is entirely different.

I abandon cars—I've thrown away a lot of things, ok? I used to have a normal number of things, kitchenware, chairs, desks, tables, bookshelves, clothes, food—stuff like that. And I used to paint. One time I mailed all my paintings plus the contents of my spice rack to an art dealer in New York who had never heard of me. I thought I was gonna get a show that way—Mary Boone was gonna get my stuff in my mail and see the spice rack and she was gonna get my artistic genius, you know—I mean how many times in the history of the world has an artist mailed an art dealer his entire spice rack?—probably only one. Did she ever respond? No, she never responded. But I had a lot of fun at Kinko's, in the middle of the night, buying packing materials—tubes, bubble wrap, tape, markers—I prob'ly made three trips to Kinko's that night, and the same guy was working the whole night. He'd be like, "Back again?" and I'd be like, "Yep!" happily buying all the tubes they had, all the bubble tape, all the Sharpies—So you were manic?—Well, I guess so, I didn't know what manic was at the time. Did you have artistic genius? I mean I've seen the drawings on your walls, so I know you have talent, but did you think it was realistic that you might get the attention of a New York gallery? Why not? I don't know that I have artistic genius—did I say that? But yeah, I thought I had a chance. I mean, back then I was selling paintings for a thousand dollars—to drug dealers, but still. What else have you thrown away? Gradually I threw away everything. People thought I was suicidal, of course, since they teach everyone that that's one of the signs of suicide—getting rid of all of your things. Was it a sign of that for you? Not consciously, not literally. But I was killing off parts of myself, killing off my options. And then I was running out of money in Los Angeles because I was spending all my student loan money on drugs and eating out in fancy restaurants..so I wasn't paying my rent and I knew I was going to get evicted. My girlfriend had left me at this point—well, that's not exactly true. I kicked her out of the fucking house because that bitch would not shut the fuck up for five minutes. It was like arguing was the only thing that gave her any pleasure with me. She did some crazy things like yelling at me in a restaurant—she was a very angry person, maybe even angrier than me—and I got up and I said, Rishi, don't ever yell at me again, in public, in private, anywhere. So anyway it was just me and the place was a mess so I took my essential things I wanted to save and I put them in a storage unit and I locked my door one last time and walked away. I hadn't paid rent in months. There were computers in there, printed out CAs all over the floor—What's a CA?—It's a cellular automata, one of the logic systems I like to play with and that I've discovered new types of—to me it looked like a reasonable person's workspace but Rishi did come over once and she said, "Wow, I bet this is what god's apartment looks like," because she could see the beauty in the CAs I had invented—it's kind of like looking at a fractal for the first time, you can recognize that there's complexity there that's infinite and fascinating. Except CAs are even more so. Did you two have sex when she came over? I doubt it, I was pretty fed up with her by then, we were past the point of hatefucking. One time she did come over after I had kicked her out—and that was like me yelling and screaming Fuck you! and he yelling and screaming Fuck you too! and then I pushed her—gently—out the door after I made her give me her key and I locked the door and sat there listening to her bang on the door yelling and she finally sat down on the carpet and cried. And she eventually left. I hoped the best for her but I could not live with that woman. Anyway she came over one time after we had broken up and I was about to go somewhere and I was like, Rishi, I have to go somewhere but I let her in anyway and she kissed me and the next thing you know we were bent over some cabinet in the kitchen and I was fucking her pussy so hard and pulling on that girl's hair so hard that my dick came out of her pussy and when it went back in it went into her ass. I was so mad I didn't even know the difference. I wasn't looking. It felt about the same. She was holding onto my hands tight and I came in that girl's ass. Then I saw that I had fucked her in the ass and she was like, That was nice—pulling her pants up—we never tried that before. What was I talking about? You said you abandon cars. Right, so I took everything I wanted to keep to a storage unit two blocks away. Two plastic totes—that's what I was down to. Two plastic totes. Then I got on a plane and visited my dad in Delaware—that was back when I was still welcome around him and his new wife. I edited my film school thesis project on my laptop. I talked to my film school friend Mike on the phone and he said, You wanna try heroin? I just went with my instinct—I said yes. It was always on my "never" list and the minute I agreed to try it, I got butterflies in my stomach as strong as being in love. Went home, went to my old apartment. The locks were changed and there was police tape over the door and an official notice stating the apartment had been reclaimed and all its contents were now the property of whatever gigantoid property management company company owned the Alto Nido. I rented a room in a crack motel, called Mike, and we did heroin. He shot me up for the first time. So I guess that's a story about losing an apartment. But I also lost my car. I stopped paying the parking pass and I would walk through the underground level it was on sometimes and talk to it—just quick affirmations and kind little prayers, saying I was sorry I had to leave you, Puma (which was her name), and I prayed that she would keep me safe on my new journeys. I wasn't really fighting for my life, I guess, back then. And one day when I walked down there, my Puma's parking spot was empty. And I said goodbye and walked on. How many cars have you abandoned? Three. I think. Do you want to talk about them? Not really. It's all pretty much the same story. I ran out of money or my car broke down and I didn't have enough money to fix it—but that's not true. Like, with this one car—it was a BMW, an old-ass BMW but I loved that car—it overheats, and I get off the highway and park it in this parking lot, at the very edge where I figure it won't be noticed for a while. Because I got paid in a few days, and I was planning to tow it and fix it—I had that plan in mind, but I was so scared they'd tow it before I had a chance to fix it. And then, when I got that check, I just gave up, I let it go. It was like this secret type of paralysis in my head—like not in my brain but in my mind. Like those times I get stuck walking and I can't take another step? It's like that, like there was part of my mind that I couldn't overcome, and that part of me kept me from doing anything to fix the problem! So there was that car, and one or two more, I can't remember. Maybe five total. The real question, Matthew, is not a question of cars. You abandon cars. OK. That is weird, wasteful, maybe illegal. It is manic. But what you need to do is translate this idea to how you treat people..and see what the similarities and differences are.

Can't stand the idea of beheading—hate movies that contain beheadings..have read in a couple different sources that you are conscious for some number of seconds..three?..seven?..after your head is cut off..I obsess over the idea that I will be beheaded. Would you ever want to decapitate someone? No, but I would like to strangle someone.

Bit through the skin of my own wrist—called the police and told them I had been bitten by a coyote—went to the hospital and got treated for a coyote bite. That's psychosis, right? Right.

I killed a snake in the woods when I didn't have to—it snuck up on me and I pummeled it with this cinderblock that was behind the cabin. Its guts were coming out of the side of its beautiful black skin and I hated every moment of doing it—but I was compelled, I had to kill it once it scared me. I didn't want it to scare anyone else. I felt horrible, killing that living thing, and seeing the details of how it died, with this ground meat-looking stuff coming out of its scales and its skin and it was writhing and twisting in pain and I finally beat it to death with a branch to put it out of its struggle. I had blood all over my hands and my face and this girl came out of the woods and said, "Are you ok?"

I fed one snake to another—put them in the same cage knowing they were a cannibalistic species. My favorite one died. I felt horrible. It makes me ill now. It's one of the worst things I've ever witnessed, and it was my fault. I don't keep pets anymore because I'm afraid of what I'll do to them and I remember this girl Charisma that I used to like to fuck..she was real violent with her animals and it used to disturb the hell out of me but I never said anything 'cause they were hers and it was her business. She used to have a really nice pussy before she had babies.

Fixated on the idea of electrocution—was shocked plugging in a clock radio when I was a kid and ever since have been terrified of dying by electrocution..have dreams of my mother being struck by lightning..yeah, I think that's the worst dream I ever had, of my mother dying by natural electrocution..she was on a hill, on a cross, and I saw her face at the moment of death and I can still scare myself by bringing up that memory.

Push/pull repulsion/attraction to electrocution murder stories—like that of Gary M. Heidnik—I don't know him—Well he's a sick fuck, don't bother. Unless you want to have bad dreams. I don't see myself doing what he did, but I feel what I think is an unnatural fascination with this man and his actions..and not just a fascination, but I feel an understanding and a sympathetic resonance with him..I'm not actually interested in murder. Partially because I'm a kind, empathetic person (most of the time..or..with most people) and in my experience so far, with people I love, I would never want to cause them pain..but with people I hate, who have crossed the line with me, I'm not sure I'm so kind after all, because with some people, I perceive that the only barriers I would have to killing them would be incarceration, reputation, and the physical dirtiness of it..there is nothing attractive to me about having body parts stowed around my kitchen..So you're saying if murder was less dirty, you would be more likely to do it?..it more depends on the freshness of the body..it's not about blood..I like blood..but where I find it exciting to think of Heidnik electrocuting women in his basement, he also boiled a woman's head in a pot on his stove, which I find pointless. Why is boiling a woman's head pointless but electrocuting her not pointless? Because electrocuting a woman is an emotional activity—there's an emotional connection—where boiling a woman's head would not be an emotional act (at least for me). Would you ever electrocute a man? No, I don't think that would be exciting.

I used to steal notes—in school. Elementary and middle school. My cousin—who now teaches at Columbia—he did it first but I took it to the extreme. He showed me this shoe box where he kept notes written by girls in his classes. This was before cell phones, so girls would write notes about all their super sexy special topics of conversation, social news, gossip. It's a total violation. It's a total violation, Dr. Meggs echoed. I know, I said. That's probably what you enjoyed about it. Maybe, maybe. But I went to Houdini-style lengths to collect notes and know about girls' lives. I went in their desks, their purses, their pockets, hand in stealth mode, stuck my hand in their pockets so slowly they couldn't notice and I didn't just have a box of notes, I had a whole crate. It was a way to be inside girls before I was ever physically inside girls. Hey, I'm the psychiatrist here. Heh. I do think it was a way for you to gain intimacy, but a forced way, and it wasn't really intimacy 'cause it wasn't two way. I nod. Dr. Meggs says, I think you already know that. I nod some more. But it was exciting, wasn't it, to have access to someone else's thoughts. Maybe what was even more exciting to you than knowing their gossip was that you violated them, violated their privacy. Do you think that might be true? I think you're right on, Dr. Meggs, and that's a perfect segue to our next topic.

Compulsively masturbate with girls' panties—I mean girls I like, I ask them for their panties and bras and they give them to me, and I use them to cum..but I also sneak into girls' rooms who aren't my girlfriend and steal or borrow their panties and imagine fucking them and think what their pussies must be like while I rub their panties on my cock and I cum so quick. I'll tell you right now that is how many serial killers get started, by breaking into strangers' houses and masturbating with their clothing. You need to know that. That is a sort of classic first step for serial murderers—serial killers. The behavior ramps because it isn't satisfying so it becomes abduction and rape. I'm just telling you this because I think it might be useful for you to know. I know. I've read about that in true crime books by FBI criminal profilers. See, there again you're marking your own test. You're playing along the edge of right and wrong and you have read the manuals describing each, so you know what you're doing—you know where you fall on a certain spectrum. And yet you're standing at the hole..you have chosen to stand on the edge of a hole where on one side is safety— For me? For you and for everyone who knows you. And on the other side is the Mariana Trench. I assume you've heard of that. Yes. It's the deepest part of the ocean. Let's go to the next card.

Obsessed with virginity—I think I'm growing out of this one, I don't think it's worth mentioning. Before you grew out of it, what was the content? Um..being obsessed with having sex with virgins. Have you ever had sex with a virgin? No. Well that's where the fascination comes from. Yeah, but I'm not as into this as I used to be. I deconstructed the idea of my own virginity before I first had sex and that experience leads me to believe that having sex with another person who is a virgin would be a non-experience..or could be..just that it wouldn't necessarily be a big deal like my mind used to think it would be.

Obsessed with vaginal blood, periods—What can I say? I like pussy blood. What about it? It just seems like such a special experience that women get to have. I honor it. I worship it, even. It's holy to me. In a sexual way. Absolutely. In a sexual way.

I'm obsessed with stories of torture murderers—one story especially about a man/woman couple in the southwest who abducted women and restrained them on a table and kept them alive for months. They used medical instruments to torture them via their genitals and sensitive parts..they would drug them and the women would wake up in this shipping container that had been converted into a sex torture cell and there would be a recording the couple would play..without the victim seeing their captors..and the recording would explain to them that they had been detained for use as a sexual toy and that their body would be used for the sexual gratification of the couple, then the woman would be tortured sexually, and finally killed. The recording actually said: You will die in this room..isn't that fucked up? But I have to admit, I would like to have a woman strapped to a gurney and have complete control over her, for pleasure and pain..I saw this show called Most Evil and they measured brain responses to serial killers versus normal people while showing them various stimuli..it turns out that some people can only be turned on by someone else's pain, by someone else's suffering. That's not the case for me..I'm turned on mostly by seeing a woman cum, especially if I'm helping it to happen. But I can't deny that I'm also turned on by seeing a woman's helplessness, seeing someone completely used up for someone else's pleasure. I don't think I could ever actually rape somebody, I doubt I'd be able to get it up in the presence of someone else's real distress. But I can enjoy watching the violent rape of a young woman by, say, her father..and I know that's transgressive but I can't honestly say I think it's immoral in every case.

Obsessed with choking during sex—I have of course (as safely as possible) choked and been choked by girlfriends to intensify the moment of orgasm..but it's more than that..it's the desire to kill a person at the moment of orgasm. I want to choke a girl to the point of unconsciousness and fuck her and cum in her while she's unconscious. I want to see her lifeless face bob up and down with the pressure of my dick and pretend she's dead and I know she would want me to keep enjoying her body even if she was dead. I'm getting an erection just telling you this.

I would like to be killed by my dad—I told him this once when we went camping together..that was one of the last times we saw each other. I don't think he appreciated the symbolism of this act, but to me it was the most meaningful thing we could do together. He clearly hated me, or didn't know how to love, or just didn't want me around, so I thought we could combine his love of power tools with my dual desires to die and to do something meaningful with my dad, and he could cut my head off with a Skilsaw and we would both be done with each other. He didn't seem to know how to respond to my suggestion—which was genuine—but he's not very smart, so it was unreasonable for me to expect him to converse on that level.

I don't believe everyone is subject to the same morality—Yes, I think I read something about that on your admitting chart. You said, "..there is a different morality for more enlightened people." What did you mean by that? I can see how that would be an idea you'd want to keep to yourself—many people would find that idea frightening. From a bipolar point of view, it may simply be an example of grandiosity, but I'd like to hear more of what it means to you. Um. People who can't or won't even conceptually play with thoughts outside their moral and cultural safety zones bore the hell out of me. I'm not sure I can say it more clearly than that.

Omitted—I told Dr. Meggs that I had never told anyone this, and I told her my absolute darkest secret, something that I had kept to myself my whole life since it happened (until this moment), and which, if told in public, could send me to jail for decades..it is criminal..it was unintentional..but it was deadly for at least one person (probably two) and I somehow escaped alive..this action of mine has given me guilt enough to last until I, too, someday die.

At the end, I placed the last notecard in my done pile and said:

"That's it."

I was expecting her to tell me what it all meant, to tell me that I could never leave the Refuge, that I had the signs of a killer written all over me, but all she said was:

"Is this making you feel better, to tell me these things?"

106

I was surprised.

I said, "Yes."

And Dr. Meggs said, "Some of the things you've told me, I'm recording in my personal notes, but I'm not going to include those things in your Refuge chart..because..I don't want the other staff to see them and..they aren't of any use in terms of your treatment for bipolar or the psychosis, ok?"

I nod, worried eyebrows.

Dr. Meggs puts her hand on my knee briefly, then retracts it. She cocks her head to the side.

"What are you worried about?"

My eyes are tearing up. I shrug, wipe one eye on my shirt.

"Matthew, I think you're scared of your own thoughts. I'm going to be very unprofessional with you and tell you that some of what you've said scares me. I'm trusting you not to tell anyone that I told you that."

"I won't."

"I know. I trust you. You're a very sincere and gentle person. I'm supposed to keep a certain distance from you but you're such a gracious person and, without crossing the line yourself, you're very inviting. So it's hard to maintain that distance with you, because I can trust you, too, not to abuse me if I cross that line with you—and by that I mean if I let down my defenses by being more honest with you than I would with a normal patient. It's not a psychiatrist's job to say the truth as she sees it, to a patient—it's her job to say what's helpful to the patient to help them get well. Do you understand the distinction?"

"Yes."

"Of course you do. This is what I have to tell you about your scary thoughts: thoughts and dreams are almost the same thing. We all have bizarre thoughts from time to time—I have them, everyone does. But where I might have a bizarre thought when I'm watching TV, my thought just comes and goes. I don't live in it. But because of that psychosis—that blurry line you have between what is real and what is imagined—you stay with those thoughts more than a normal person. And you seem to have more of those bizarre thoughts and more variety in those thoughts. Your mind is a busy place."

"You can tell?" I laugh.

"It's obvious, yes. And..for now I'd like to have a talk that stays between you and me."

"Ok."

"But I promise you, if I see any signs that you are a danger to anyone—including yourself—I will keep you safe. Do you trust me?"

"I do."

"Good. Now, some of the thoughts you told me are very disturbing. But just because you have a dream you raped someone doesn't make you a rapist."

"Why is my mind focused on such horrible things?"

"I don't know. I suspect your relationship with your dad plays a major role. And the loss of your girlfriend—that is very sad, I'm sorry. And that has to have been a very traumatic event for you."

I nod, my eyes tearing up again.

"You're not a violent person, Matthew. I think you have the potential to be. I think at times you have been, like with the killing of the snake in the woods and the other snakes. That combined with your love of fire as a child and the fact that you were a late bedwetter—although neither of us knows how late..we'll have to ask your mother for that. But there is something called the Macdonald triad or the sociopathy triad—"

"You think I'm a sociopath?"

"No, actually, I don't. If I did and I felt you were dangerous I wouldn't let you leave. But you may have a very complex mind in which part of you could be a sociopath if you let it—but that part of you is not in control. I think it haunts you in the form of these bizarre thoughts you've been telling me about. However the controlling part of you, the major or more powerful part of you—and I have had many weeks now, several months?, to observe you—that major, controlling part of you is very kind, Matthew. I wish you could see yourself through my eyes, or the eyes of any of the staff here. You maintain decency with Faith when she flirts with you—but you don't cut her off. She needs you and you need her. You are the only truly bipolar patients on the ward. There's an example of a relationship where you have more power and could easily abuse that power—and others have abused their power with her before."

"She told me."

"What did she tell you?"

"That she was raped. By—"

"Let's not talk about who. I'm already overextended with you in terms of patient privacy and a couple other areas. But, look, do you ever touch Faith inappropriately?"

"We hug secretly—intimately—sometimes..but I don't touch her inappropriately. I respect the abuse she's experienced and I maintain an awareness of that when I relate to her. But we do touch sometimes outside the bounds of Refuge rules—though not in an aggressive sexual way..on either of our parts, by the way."

"See? Even a normal (psychologically healthy) heterosexual male would take advantage of Faith if given the chance..and she opens herself up to those chances. But—and now I'm going to tell you something that if you told anyone else I would kill you—Faith needs those secret hugs with a person who is responsible with her..that's part of her healing. You two are very good for each other, and that wouldn't be possible without your maturity with her. I see you set boundaries with her. They may not be the boundaries the Refuge has set for you, but you set just the right boundaries, in my opinion. So don't scare yourself so much. There's a lot going on in that mind of yours. But from what I can see you govern your own behavior remarkably well. I think we have your mom to thank for that. If your dad had been your only parent—" Dr. Meggs shakes her head. "—you might have turned into someone more ruled by your psychoses in terms of internal domination by these thoughts and in terms of external action based on those thoughts. Do you know what I'm saying?"

"I believe I do."

"Yes, I'm sure you do."

"Well, yeah, it's just like from Girl, Interrupted when they're talking about ambivalence."

"I've seen that movie but I don't know what you're referring to."

"Winona Ryder says her favorite word is ambivalence and the head honcho psychiatrist says The word suggests that you are torn..between two opposing courses of action. And Winona says, Will I stay or will I go? And the psychiatrist says, Am I sane or am I crazy? And Winona says, Those aren't courses of action. And the psychiatrist says, They can be, dear, for some."

Dr. Meggs looks at me like she's fascinated by this simple recitation from pop culture.

"Exactly," she says. "There is some control in your case. And you are very lucky to have your mom. So thank her when you see her, ok? And remember, having a crazy thought doesn't make you crazy. You have enough meta, a dual process going on alongside your psychotic process, that you can sometimes tell whether a thought is real or not. Remember that movie, A Beautiful Mind, where he notices that the little girl never ages, and that's how he is finally able to do reality testing and know that the little girl isn't real?"

I laugh/sob. "Yeah, I love that movie."

"You're lucky—you can do that type of reality testing sometimes. Some people can't do it at all."

I start to cry full on.

"Thank you, Dr. Meggs."

She gets up and moves the box of tissues to beside me on the bed.

She puts her hand on my shoulder and I start to cry harder.

"We're gonna get you out of here, ok, Matthew? You're a kind, gentle, brilliant person and I think you've come to the end of Tyler 2's usefulness to you—don't you think so?"

I nod and look at her through blurry eyes.

She says, "Just like you find Sarah's thoughts disturbing, others may find some of your thoughts disturbing."

"But what is disturbing?" I say. "Imagine a glass of water with a spoon in it. The water is still. You start stirring the water with the spoon. That's disturbing the water. There's no moralistic or judgmental way to think about stirring a glass of water being disturbing the water. But that's all disturbing is. It's not a moral concept. And I'll tell you this," I say, sniffling.

"What?" my doctor says.

I say, "If what you're doing is not disturbing, then what you're doing is nothing. We have a misleading set of connotations of the word 'disturbing' that makes this non-obvious. Think again of the glass of water. If you stir the water, you are disturbing it. If the water is not disturbed, then what are you doing? Disturbing is not a moral issue. It is an issue of content. Art or action that is not disturbing is art or action that is without content. Cries of 'crazy,' cries of 'weird,' are cries who come from people who are avoiding self-discovery (out of fear). That's ok, but let's call a spade a spade."

I am choked up as hell at this point.

Meggs says, "I get what you're saying. I do. I just want you to know that you have nothing to be afraid of. Even inside yourself. Those weird thoughts, they don't control you. They do control some people who have them—but in your case, probably because of your intelligence, along with a dose of your mother's influence, you control them. Nothing's going to take you over—you just have to live with a wilder mind than most of us. Put it in your books."

"I do."

"Ok. This conversation never happened, as far as I'm concerned."

"Same here. Thanks for crossing the line."

"Well, Matthew, you kind of deserved it."

"Thank you Dr. Meggs."

"And none of this will go in my report to the Refuge, alright?"

I nod, hugging myself and rocking back in forth.

"Get yourself a cup of water, get some sleep, and wake up in the morning ready to work on your discharge plan, ok?"

She stands in the doorway. I can see her facial expression now. Compassion. Love. We've gotten too close, she's helped me all she can, and it is time for me to stop learning on her and leave the hospital.

I give my doctor the thumbs up and a teary smile.

And she leaves.

"Oh yes," she leans back in the door. "I suggest you do not apply for disability because I fear companies will have a way to research that you've had it in the past and they will discriminate against you for having taken it, even though that's illegal."

She leans back out.

---

I think my doctor did not understand that with all my skills and my intelligence, I was not much more capable of taking care of myself than Faith. That rating system they have, 0 to 100 points, that says how capable you are of being independent or how necessary it is that you stay in a hospital..I think I got higher ratings than Faith because I was more intelligent. But intelligence doesn't mean capability in the world. I mean just because I can talk intelligently doesn't mean I can live.

After the doctor left, as I thought about those two minds of mine, one who was dominating the other, I remembered thinking at a very early age (third grade or before) that the measure of a person I valued most was the distance between the two concepts they could hold in their mind that were that farthest away from each other.

I wonder if this is a scary definition for most people, even a psychotic one. Because that great distance between those two far-apart concepts held by one person appear as inconsistency. Can I post a picture of a woman with no arms and no legs being fucked by a machine, a twist of hair falling over her forehead, her body beautiful, her breasts perfect, perfect face, and then post a quote by a feminist saying that men trying to bring levity to rape by making jokes about it is unwanted since rape has already come to the level of levity by our treatment of it in actual fact, when I have written a book from the point of view of a rapist, in a ridiculous dark comedy style, a satire? I have..I have done all those things.

What will my young cousin think of me if she sees these distant stars held in a single constellation? Will she know that a person can be so broad? Or will she be so narrow that she will be forced to judge me in order to not think more deeply about herself?

There is no such thing as contradiction—there is only such a thing as small-mindedness.

And it is a mistake to think that someone else's way of looking at a thing is the same as yours—a very big mistake. When you judge me for looking at a sick painting, a taboo or transgressive piece of art, you are really only revealing that your way of viewing that painting is sick, that you view it as taboo or transgressive. You might think I'm looking at a piece of child pornography, when what I'm looking at is a picture of my joyful younger self in the bath, and by looking at that picture, I am gaining a sense of enlightenment at the reminder of how happy I have been in this life.

If you say that's sick—that only indicates that you are sick.

107

I'm at the nurses' station ranting at Michelle.

"If American companies would work with differently abled people, then maybe the government wouldn't need a disability program. Right? See?? What if the attitude in the country was: Everyone can do something. There's room for all kinds. Let's find a way to work together! But no, no, that's not how we think. For instance, I have a mind that still works fairly well at some things..I could potentially work as a programmer for four hours a day or less. I'd need to lie down for ten minutes out of each hour—"

"Matthew. Matthew. I think you need to calm down."

"I don't need to calm down. I'm calm. See?"

"I think you need to slow down then."

"I'm slow."

I pound on the nurses' station countertop.

"The thing is—"

"Tell me."

"I am. Lynne told me that even this—this psych ward—is too high stimulation for me. That there's too much going on inside my brain."

"I know. I'm lookin' at it right now."

"But companies aren't motivated to include everyone—they're motivated to make profit. Different is bad, cookie cutter is good. People are down on the government for providing disability money to people companies won't hire. Well, what's the other option: We allow companies to decide who lives and dies, based on who they will and won't hire? It's easy to consider it a waste of money to help the needy until you become the needy—and that can happen to anyone, at any time, regardless of their work ethic or their effort or their quote unquote net worth. Americans are over-focused on the idea that they're individuals—the individual innovation of Larry Ellison, hard work and dedication—"

"Who's Larry Ellison?"

"He's one of the top American billionaires, consistently, according to the Forbes list. Larry Ellison—right—created the Oracle database and made him a long-running member of the top ten quote unquote wealthiest people in the world? Simple as that, yes? Well, no. His work was based on the work of others, developed with funding from the CIA, and then he started his own company based on that work paid for by the CIA, and then became one of the richest people in the world. Then Oracle was sued by the US Justice Department for defrauding the federal government for about a billion dollars. So, Ellison's story is one of innovation and hard work, yes, but also one of stolen innovation and massive fraud."

"Matt. Slow down."

"The point is—"

"Slow."

"The point is Ellison didn't get rich by himself any more than Howard Hughes or the Koch Brothers. They all inherited or stole ideas and money that we credit them with on Forbes' ridiculous lists equating mere money and mere property to the esoteric concept of wealth. My point is they don't exist in a vacuum, and neither do the homeless and mentally ill. The poor. You think those people are personally responsible for not fitting in with society—for not having a job, which is almost universally considered the mark of success in this country. Get a good job, make your momma proud. It's ridiculous. I've been in psych hospitals with schizophrenic people who cannot just get a job. They never will be able to. And I've been in psych hospitals with bipolar people who will never get a job—they can't, no company would hire them!! But does that mean they should die, should have nowhere to live, be poor? Why does having a mental disability that makes you unattractive to profit-motivated corporations mean that you shouldn't have a curved-screen TV and a nice apartment and the ability to live as independently as possible and have friends and loves and close ties to family? Because they didn't earn it? They can't earn it."

"I'm asking you to slow down or else I'm putting you in ALSA."

"I'll slow. I'll slow."

And I do.

"I'm asking you to hear my story, which is this: I used to be able to earn it. I had bipolar then. It stood out to everyone but me. But I made good money writing software for health insurers who later wouldn't cover me because of my mental illness. Think about that: I helped write the software so an insurance company could exist and then when I needed help from them—insurance coverage—they refused to sell it to me. How does that honor the web of interconnectedness we all find ourselves in? And now I can't work at all. I live with my mom. My various mental disorders may shorten my life by decades—statistically they will. Does Larry Ellison deserve a better life than me—more rights than me because of his billions? The CIA funded the initial development of Oracle and then Ellison took that work and formed his own company. What if I had gotten that kind of help from the government? Might my life be different now?

"People who are against food stamps and welfare and disability say: It's not fair. Well, wake the fuck up because corporate subsidies and special treatment for the rich and pardons for politicians aren't fair either. But these middle-class dupes don't bother yourself with all unfairness—they believe the system works for them. It doesn't. It keeps them working—at a fragile surface tension—with just enough material distractions that they remain immobile politically, but continue to pay taxes. They're angry when a homeless person gets a free cup of coffee, but they don't give a shit that an upstanding-sounding company like Oracle takes a billion dollars from American taxpayers and is allowed to continue to operate. Or when ExxonMobil deceives the entire planet about climate change, intentionally fucking up this delicate ball of blue and green that we're living on in the middle of a bunch of empty space!! Or when the US Government knowingly allows people to continue to drink alcohol and smoke cigarettes when science has known for a long time that certain of our illegal drugs are less dangerous than our legal ones!! What kind of fucked-up morality do these people have?"

"Matthew, see that couch over there? Go lie down for fifteen minutes. I'm timing you..starting now."

---

That night, after telling Dr. Meggs my moonwalk, I had a dream I cleared all the biting dogs (a recurring dream symbol) out of my house and they thanked me for my mercy of not killing them. And not only did I get them out; I changed the lock on the door—replaced it with a fresh, secure one—and locked it for good.

108

This time I was inpatient in Tyler 2, we could all feel a shift. My doctor and I knew we had to do something to break the cycle of me going to Birches, them releasing me to Tyler 2, Tyler 2 releasing me to Birches, etc.

As David the RN said, "You've learned all you have to learn from Tyler 2."

Dr. Meggs spoke about it from a different angle:

"Some people," she said, "develop a dependency on the hospital. They become unable to live outside the structure of these walls."

Then she made a pouty face.

"We don't want that to happen to you."

I nod.

This is part of what made me willing to go live with Leona, my sister in Portland, and part of why my doctor liked that plan. I develop the plan over several days and several conversations with my sister. She says they are willing and excited to see me. Portland is a long way from Brattleboro Vermont, but I believe I can get a job there doing software work and neither of my parents are offering me a place to stay so it seems like a good (and really my only) option with family.

I'll always sting from the fact that neither my mom or my dad offered me their place as a transitional living space after I had spent three months in psychiatric hospitals. I mean, if there's a time for a parent to step in and help, it would see to be this.

My little sister Leona offered to help, even when she and her husband probably didn't have the resources to follow through with their offer, and I will never forget that.

I began to detach, psychologically, from the crew of patients currently in Tyler 2. My life would be in Portland now, and it was time to build those relationships, not the ones here in the Refuge.

I remember one day all of us being in the lunchroom seeing Sue through grated windows as she left with her girlfriend, who was going to let her come live in Massachusetts with her, give Sue's addiction and their relationship one more chance. Sue relapsed by shooting cocaine and when I saw her in Tyler 2 this last time we were so happy to see each other! She was doing some sort of art project and had paint all over her face and sweatshirt. She relapsed with that girl Winehouse me and Sue were in Tyler 2 with. Seeing Sue go was a melancholy mix of feelings: hope for her, sadness she was going, and a realistic prediction that things wouldn't work out in Massachusetts with her girlfriend any better than they had worked out here, over and over, in Brattleboro. But I hoped I was wrong.

---

Since I knew this would be my last time at the Refuge, and my last time seeing Dr. Meggs—my best psychiatrist yet—I asked her if she would write down for me some key thoughts she thought would be helpful for me to remember in the future, based on her psychiatric analysis of me. She agreed, and in one of our last meetings she whipped this little beauty out of her brain, improv style. I will explain it to you, as she explained it to me.

Ok, I'm going to draw you a skeleton upon which I'm going to hang some ideas about your mentality. This isn't a complete picture of you—there are of course the tendons and the muscles and the eyes, and those things are just as much a part of you as this skeleton, but for now we're just talking about your mind.

Ok.

First you have an organic layer. This is your OCD, your depression, and a weak tendency toward psychotic thinking. Those are features of your brain—you can't think your way out of them. Is this all making sense so far?

Yes, perfectly. Thank you for doing this.

You're welcome. You don't have to thank me so much. It's not that you can't deal with OCD in therapy, but it's a brain thing, it's well understood, it has to do with too much communication between the Leonagdala and your frontal lobe via the neurotransmitter serotonin, which is why we had such good results treating you with the clomipramine..except the clomipramine caused you to hallucinate, so..you have been marked as having an allergy to it in this hospital. But it was so effective that I am recommending that you—at some point in the future—you might try it again at a small dose. Small dose.

For your depression, Lexapro seems to work fine. Are you having any side effects?

No.

Good. So stay on a small dose. Ten milligrams. More could make you manic, then you'll end up back in here..and we don't want that. Don't take that the wrong way.

Oh no. It's fine. I'm ready to leave.

I feel you are too, Matthew. Now your psychosis—you remember, is an inability to draw a focused line between what is real outside your mind and what your mind makes up. Based on your reports, Risperdal has sharpened your thinking, you said you feel solid and normal—more than usual at least—on the Risperdal?

Yes, it's my best drug yet.

Ok, good.

She smiles.

That's the organic stuff. Then there's a psychodynamic or therapeutic layer. This is your moonwalk. It has mostly to do with your relationship with your dad. Listen to me, because how you handle this layer—and this is something you can change in therapy and your own thinking, thought behavior, outward behavior, and so on—how you choose to handle this layer could make a great difference in your life, if you choose to handle it differently than you have been up to this point in your life.

No pressure.

No, there is no pressure. There are only choices.

Then her face gets real serious and she looks me in the eyes.

Your first relationships learned from your dad have given you a fixation on status versus humiliation. You remember me talking to you about this before? Your language, your concepts, are crawling with ideas of status. You are a classifier among classifiers—I have never met anyone as focused on and aware of status as you are. For you a thing can't just be a thing, it's a thing in a category..or, really, for you, it's a thing in all sorts of categories.

Yep, that seems like me.

Honestly, I don't see how you can do it all. I mean I'm a doctor and I'm trained to diagnose—which is a type of categorical thinking, dividing symptoms into diagnostic categories—and you're running circles around me.

Yeah, but when I run in circles I just fall down.

Well, that may be true, and I'm trying to help you fall down less, but Matthew, you've diagnosed things about yourself quicker and better than I can.

I marked my own test.

What does that mean?

I took this test..in the fifth grade..I marked every answer I got wrong with a little symbol beside the question.

So you had the option to score perfectly, but there were questions that for you could go either way.

Right! No one's ever understood that before. You're the first person to get that. See, because as I've gotten older—but it's always been the case for me since at least the fifth grade..like..the designers of multiple choice tests think that there's only one correct answer to each question. But there's not! Maybe to the simple minded there is! But don't you see: the only thing you're testing in these classic types of tests like multiple choice, fill in the blank, or matching one set upon another..the only thing you're testing is whether the test taker knows what the test maker thinks is the right answer. That's wholly different than testing what the best answer might be. And, in truth, the more you think about a question, the less likely it is to have a single answer. So tests have become increasingly hard for me, because they are, in effect, useless.

There's a lot there and I really can't express how much I would like to discuss these issues and dynamics you're touching upon, but I have to get to my next patient at the end of this hour so I am going to have to let you know that I have heard what you've said and tell you that—honestly, as your doctor, I'm not sure if what you just told me is an indication of your high intelligence or your psychosis..or both. I'm sorry, Matthew, I don't mean to treat you badly but unfortunately in the context of Tyler 2 I don't have time to discuss that further with you right now.

You're not treating me badly.

Well, treating you curtly.

It's fine. It's not a problem.

Ok, back to your moonwalk. I believe you are quite focused on status—that of yourself mostly, but also that of others—and you think of much of the world in terms of a competitive interplay between status and humiliation—one or the other. You learned to be humiliated at a young age by your father. Some of your moonwalk shows that for you, sexuality may need to involve humiliation. All this is just my theory, ok, and it's not set in stone—these are things about yourself that you can change. Ok? Matthew. How are you doing over there?

Yeah, I'm here, it's just hard to hear some of these things.

Do you want me to stop?

No, please keep going.

Do you want a tissue?

No thank you.

You prefer your sleeve?

Highly.

Are you comfortable with this discharge plan?

My mom already bought the plane ticket—or somebody bought it, but—the strings are being pulled and I'll fuck everybody else up if I change the plan. Plus I don't want to be here anymore, myself.

I understand that. You've been through a lot here. Can I give you a piece of advice?

Yes, feel free.

Don't think about anybody else. Think about you.

Ok, I'll take it under advisement.

Good, she says genuinely.

I'm sorry, I shouldn't have said that that way. You deserve better treatment from me—you've done nothing but help me.

Matthew. Go easy on yourself. People are imperfect and you're one of us, too, ok?

I laugh.

Ok.

There may be an element of shame or guilt in your sexuality because of the early humiliation with your father, but I don't know, we haven't talked much about your real sexual relationships—mainly you've told me fantasies about what you'd like to do to women and I'm not sure if they're fantastical play for you or more realistic things you actually want to do or have done.

I don't know either.

It's ok. Let's move on. Staying in the psychodynamic/therapeutic layer, you display a consistent pattern of questioning what is genuine versus what is artificial. Remember the day you told me that you weren't sure that I was a real doctor and that you thought everyone was just playing a role—you're not really a patient in a psychiatric hospital, you're just playing one.

I still feel that way.

Do you feel a sense of depersonalization?

Yes. Why?

It's just a theory I'm working on. But I'm not sure yet. Do you remember the earliest time you felt that way?

Honestly I feel compelled to tell you about a time when I was preschool or kindergarten aged and I was at church and no one was looking and I pulled a booger out of my nose. I thought it was a booger. But it wasn't. It was two blood vessels—one red, one blue—and they were twisted around each other. It was this very large for something that had come out of my nose. And I was convinced I had pulled out part of my brain through my nose—like the Egyptians—and ever since then I've been convinced that I'm missing part of my brain because I digested it.

Have you ever told that to anyone before?

I have never told that to anyone, but I wrote it in one of my books. But I'm pretty sure no one ever read the book, so in actuality I'm pretty sure that you're the first person to ever hear that story. Why do you ask?

Because I'm trying to determine of the story is real.

Tough, isn't it?

I think one of the saving graces on your psychodynamic/therapeutic level is that you have a tenderness and a generosity within you whose etiology is most certainly your sisters and your mom.

What is etiology?

It means the cause. I think you are very lucky to have had them.

Yeah, I know, I'd be fucked without my mom—my sisters too.

Now there's an existential level.

Thank you for doing these notes.

You're very welcome, Matthew. You're fascinated with life versus death, what it means to die. Your experimentation with feeding one snake to the other—the cannibalistic snakes?

The California king snakes.

Yes I really think your experimentation there is a part of your fascination with life and death and that it's not—at least I don't think so at this time—I don't think that's a sign of sociopathy in your case. I'm pretty sure of that, actually.

My favorite one died.

What?

When I put them in the cage together, my favorite one is the one who lost. My favorite one died.

I sniffle.

You remember the Macdonald triad we discussed?

Setting fires, bedwetting, killing animals?

It's obsession with setting fires, late bedwetting, and cruelty to animals, but yes. The fact that you're crying because your favorite snake was the one who lost the contest between what are—if I recall correctly—cannibalistic snakes?

Yes, they're cannibalistic.

But they would have done that to each other naturally in the wild.

But they didn't do it naturally to each other in the wild. I did it to them.

Well maybe it was a mean thing to do. Maybe it was a horrible thing to do. Maybe it was a tad bit cruel. But let's use Ted Bundy as an example. At eight years old he was killing animals, dissecting them, and setting them on fire. I don't think he was crying about it after he did it, either. You have a fascination with death—and with life, I believe!—and make no mistake, you push the boundaries, sometimes very hard. But how long ago was this snake thing?

Six years.

Six years ago and you're you're crying about a snake dying! Most kids forget about a goldfish in a week!

I let out a humongous sob.

Dr. Meggs holds a tissue out for me but I decline, stick with my shirt instead. You can never be sure where those tissues have been.

I'm sorry, Dr. Meggs says. It's ok—you can cry about that snake all you want. But the fact that you even had a favorite snake in the first place, and that you're crying about is six years later..you're not a serial killer, ok? You very well may have chosen not to be one. You have some bizarre thoughts. You have very bizarre thoughts. But you do something creative with them—you write. You do safe things with them—you go to the hospital when you need help. So your responses and coping mechanisms are healthy, so far. Just keep doing what you're doing, take care of yourself, stay sober, stay away from drugs that are bad for you, and the only other thing that's key to you on the existential level is that you're lonely and depressed. You need to be around people—they will check your psychotic reality against the real reality just by the nature of social interaction. You know, we can all drift into la-la land, but most people have social structures like a spouse and kids and a job. You don't have that structure to create responsibilities that keep you grounded—it's just you, and you alone, floating around in space, or the sky, or the sea, or whatever. So don't let yourself get too lonely—be with family or friends. Take your meds. You need to be in therapy—for the rest of your life. And you're probably going to be taking meds for the rest of your life, too, but don't look on it as a bad thing—it's just you doing what you have to do to keep yourself stable. Keep meditating—that seems to help. And on this question of SSDI. I wouldn't pursue it in your case. I know that by law employers aren't supposed to discriminate based on disability..but I wouldn't trust that. I don't know what all they can see when they do their background checks, but if you've received disability in the past, it could make it impossible for you to find a job. Is all that clear? I'm sorry, I have to run.

It's clear. I appreciate your explaining this to me.

Dr. Meggs nods and gets up to leave. She picks up the paper she's been scribbling on from the bedside table of my hospital room.

I say: Can I keep that?

You want to keep this?

If I can.

You're welcome to, it's just..if I had known you were going to keep it I would have typed it up or something.

This is fine.

You can read my handwriting?

Oh yes, it's very clear. You have have very clear handwriting for a doctor.

Meggs laughs and shakes her head. She folds the page in half and gives it to me.

This way I won't forget.

Well, if you think it will be helpful.

I think it will. You've been a great psychiatrist. I—well it's my nature to say this in a formal and convoluted way..but I'll just say: Thank you.

You're very welcome, Matthew. You've been a joy to work with.

---

Michelle had suggested at one point that Dr. Meggs was "keeping me around for another week."

"Oh, yeah, does she think it's unsafe to release me into the wild?"

"No, I think she likes you."

"What do you mean?"

"I mean I think she likes your company and she's keeping you around for another week because you make Tyler 2 a better place for her to work. She likes to see you. She likes to talk to you. We just got out of team meeting. She's not ready to let you go."

I smile.

"Well I like her, too. She's a good psychiatrist."

"But it's more than that. You two click."

"That's true. We keep it professional but, yes, I like her as well. She's smart, she's really smart. And she cares."

"You need somebody like that to talk to, don't you—somebody who's smart and who cares."

"I guess I do."

"Well she thinks you're smart. You impress her. She's impressed as hell that you diagnosed your own allergy to clomipramine."

I keep it to myself that I have since come to the conclusion that my clomipramine diagnosis was incorrect.

"We're a team," I say.

"The other thing," Michelle says, "is I think she likes to see things go well for a patient once in a while."

"Is this going well?"

"Compared to most people?—Yeah!"

109

I wrote this on December 8, 2011:

When I'm sitting, I'm

imagining a fantastical event

thinking how I would phrase a description of it in a book

That's highly un-present.

———

more fast-moving

white clouds on blue

Liliana read this after asking to see my book. (Remember, she's the PTSD dissociator who was brought in in handcuffs that that stupid kid Ross likes to imitate?)

Liliana read my book. We talked for a moment.

Then she had a seizure.

She stood up, started to seize, then fell to the floor right at my feet.

Chad grabbed my pen to stab himself in the wrist—he was poised with my Pilot Precise Rolling Ball V5, which has a very long needle-like protrusion at its tip..he was poised with that above his wrist, where all those little veins are. I reached out and firmly took it from him in one motion.

"Give it to me!" That from Chad.

He needed to self-harm to have some control in a scary situation.

We all yelled for help and Dr. Meggs was on the spot, asking us questions, taking metrics on Liliana's body and clearing the space.

Meggs asked, "Did she start to seize before the hit the ground, or did she hit the ground and start to seize?"

I answered. "She seized first and that made her fall."

Then I left the room because I didn't want to be in the way.

The health tech who I wasn't a big fan of for calling me a pedophile (or likening me to Lewis Carrol or whatever) said I saved the day by preventing Chad from stabbing himself in the wrist—suddenly I was a hero. Bullshit. I'll never let Chad stab himself in the wrist. That's not heroism. In a psych ward, that's just doing your job.

---

And on December 9, Full moon:

Thinking of the stars, and moon, and earth, and sun, and how few revolutions, up there, it takes to spell out my life down hereMaybe there's nothing to worry about, about being inside a psychiatric hospital—and not much to celebrate in staying out of oneAnd maybe I can be at ease about the particularities of my life, knowing how many of us there are and how small we seem to the sky

---

Hearing patients speculate how much it costs the Refuge to keep a patient in the hospital for a single day. People guess two-thousand dollars, one-thousand, other guesses. One of the mental health techs overhears this and says it's something more like ten-thousand a day per patient. None of us can believe this, but he says just look at all the staff..there's maybe three staff people per patient..so there's all their payroll..and there's the janitorial staff, the kitchen, security, building maintenance.

"Don't forget we generate our own power here—we have our own power plant so if the town's power goes out we never lose power. Plus, the Refuge has to pay insurance out..on each of you."

"Why?" a patient says.

"So if you kill yourself," another patient says, "and your family sues the Refuge because they were supposed to be keeping you safe."

"Is that true?" the original patient asks.

"Yep," the mental tech says. "A lot of what we do around here is for the insurance companies."

And as they went on about everything the Refuge has to do to get insurance against any of us killing ourselves, I thought of how stupid and wasteful this all was. Ultimately I would spend three months in the Refuge. If this mental health tech's figure of ten-thousand a day was twice whatever the actual figure was, I could live for a year outside the hospital on what it cost to keep me here for a week.

I mean I know I have psychological problems and I'm psychotic and suicidal and shit, but half the reason I was suicidal was I couldn't find a suitable job and I was running out of money and was about to be homeless. Since I'm so abhorrent to society due to the fact that I refuse to break the law when my employer asks me to, maybe instead of spending whatever mountainous sum it must cost to keep a bipolar person like myself locked in a psych ward for three months out of the year, might society instead spend a small fraction of that to buy meager shelter, food, clothing, outpatient psychiatric care, and pharmaceuticals that make me less dangerous to myself and others? I think all that would be roughly equivalent to a couple of weeks in the joint—nothing compared to what Vermont Medicaid must have spent on me the year I tried to kill myself.

110

I saved my perfect wrist badge I had the front desk make me on the last night of my stay just so I'd have some nice quality memorabilia from my journey in Tyler 2. I didn't feel bad at all about getting a new bracelet made if someone was paying ten-thousand dollars a day to keep me here.

I don't know exactly when, but somewhere in my series of inpatient psych hospital visits, I developed a sense of pride for my wrist bracelets—maybe not pride, maybe more like love. I kept them after I left the hospital, though after a few days or weeks outside, in the normal world, I would come to view old hospital identification bracelets as junk and throw them away. But at my last stay in the Refuge, knowing I was probably never going back there again..on my last night I went to the nurses' station and asked for a fresh one.

I started to apologize to the nurse on duty, but he stopped me.

"I get it," he said, and he printed me another one and put it in the plastic sleeve.

I was planning on keeping that one forever as a souvenir. I thought I took it to Portland. But it's mysteriously gone. I probably decided, at some point (as I always do) to let go of my identity as a locked-ward psych patient, and threw it away. Or maybe the CIA stole it. (Just kidding—I think.) Thoughts like that I'm never really sure if they're true or if they're false. But there's nothing in me now that wishes I still had that bracelet.

---

On my last night in Tyler 2 I was feeling generous so I decided to go to one of the always optional AA meetings led by Matt the spineless substance abuse counselor. There were only like five people in the whole meeting, including Matt, and I knew each of their history and knew that I had been to way more 12-step meetings than anyone there, so I decided to share first. And I shared kind of long—line ten, twelve minutes. I went into some past history. I used generic language—didn't mention drugs by name or anything.

Then this psycho woman on a couch perpendicular to mine apparently has been holding it in and she turns to me and says:

"You're glorifying!"

And here was my thought process:

This bitch can shut the fuck up 'cause I'm in the middle of my share. She'll get her share. And for now she can STFU and listen to whatever the hell I goddamn want to say. And I thought about telling her that, right in the meeting, in about those words.

Then I thought: Why am I even in this meeting? I came in here to do Matt the spineless substance abuse counselor a favor. My share is a) a generosity, b) appropriate for an AA meeting. I don't need to expose myself to people who don't know what the fuck happens in an AA meeting who want to criticize my share.

So I walked out. I just stopped speaking, stood up, and walked right out of that motherfucking room. And I didn't need to vent my anger, I didn't need to let everyone know how slighted I felt, I just needed to stop—for me—so I stopped.

I could have argued with that bitch, I could have put her in her place and destroyed the sanctity of that entire so-called AA meeting. But instead of venting my anger on that..woman..for interrupting me, for incorrectly categorizing what I was doing as glorifying, I just got up and walked out of the meeting.

Brilliant—a new choice for me.

At the nurses' station, Michelle asked me if I was alright. Her face showed genuine concern. And I peacefully told her:

"I don't like being interrupted when I am speaking in an AA meeting and a woman interrupted me while I was speaking so I decided not to participate anymore in that group."

"Was it Kelly?"

"I don't know—who is Kelly?"

"Brown hair, red sweater."

"Frizzy-hair bitch?"

Michelle nodded.

"She's carrying around a lot of repressed feelings. Of course I can't talk to you about another patient but I think if you get to know her you'll find out she's had a hard life."

I tapped on the nurses' desk with the ball of my hand.

"Well," I said, "I don't feel like getting to know someone who interrupts me while I'm sharing in an AA meeting."

"What did you do?"

"I didn't do anything. I just got up and walked out."

"Good for you," Michelle says. "And you didn't get angry!"

"Oh I'm angry. I'm angry."

"But you didn't act on it. I see you making major progress. You're totally different than when you got here."

That seemed like a bit of a stretch to me, but I don't argue with people paying me compliments.

"Thanks Michelle. I think I'm gonna get a chocolate milk."

"That sounds like an excellent coping mechanism," Michelle says.

See, in the real world you just act on your cravings, or follow your schedule, or generally do what you like. But in here, in the psych ward, you learn that all of those behaviors are not as innocent as we think—they are coping mechanisms with which we constantly assuage ourselves in a world so hostile and so chaotic and truly so evil that if we didn't have chocolate ice cream and back rubs and junk food—not just the crazy people, but everyone—would flip the fuck out.

---

That night I played Scattergories with a group of four, and we're all having fun and we are keeping score and I am just dominating the game which surprises me because I suck at trivia, crossword puzzles, and chess, and I don't even play games anymore. Someone comes by and says I have a telephone call..it's my sister. I tell them to keep playing without me.

I go to the short hallway.

There, Joanne and I have a half an hour conversation.

Then I go back to the game table and I'm surprised to see they're still playing. And they all laugh, telling me that even after all those rounds they played without me, my score is still in the lead. Lol. I just laugh, because that seems impossible. And they all still want to keep playing, so I sit down and we play some more!

111

Michelle brings over my crisis plan.

"I need you to fill this out sometime tonight and return it to the nurses' station."

"Ok."

"I don't want to interrupt your game. You all seem like you're having fun."

"It's ok. I can do this at the same time."

And I did.

Tyler 2 Discharge and Crisis Plan

Name: Matthew Temple

Date: December 14, 2011

What are your early warning signs that you need to ask for help and/or practice skills you have learned.

Anger at self or others—this is not a yellow flag..it's red.

Stress in unwanted relationships; participation in such. [Obviously this refers to Gretchen. She didn't respect boundaries when I set them, I sent her mixed signals, and I didn't know how to get her out of my life—which is exactly what was needed, nothing less. This is especially hard in a small town.]

Stopping taking or modifying doses of any medication.

Missing, avoiding, or holding back in therapy.

Not hiking regularly and/or not exercising regularly.

Getting very very lonely.

Feeling bad or guilty about doing reasonable, nice things for myself.

Allowing my bank account to be dangerously low.

Who are the people who will help you and how can they help.

Sister Joanne

Sister Leona

Mom Sharon

David (NA)

Spots

1.800.RETREAT

911

I need support, listening, substance abuse talks, and medical help including psych and/or emergencies.

List positive ways you have dealt with stressful situations in the past.

Write about it. Talk with someone I can trust. Let it go. Call for help.

List the special coping skills you will use in a crisis situation.

Breathing meditation. Calling loved ones for help. Calling the Refuge or 911.

List places you feel peaceful, content, or safe.

My apartment [which I knew I was getting evicted from so I don't know why I listed this].

The Refuge (grounds or inside).

Mt. Wantastiquet and Indian Pond.

As a backup, my Mom or Leona's house.

What are some affirmations you can use to feel better about yourself and the world.

It's important that I'm alive. It's meaningful that I'm alive. I deserve goodness in my life. I deserve a place to live. I deserve to live easily. I deserve to live peacefully. I deserve meaningful work. I deserve to love and be loved. My consciousness, my experience, is valuable and meaningful for its own sake.

I am amazing.

What did you learn in treatment that you can take with you and apply to your recovery.

Breathing meditation is a way to practice living in the moment, to slow down and calm down, and something I will benefit from practicing regularly.

I must take my suicidal thoughts seriously; they are not minor, they are not minimizable; they are real, and they are dangerous—dangerous enough to justify hospitalization, as a pre-emptive measure to avoid suicidal action.

My anger must be handled in an equivalent manner to suicidal thoughts in (2); my homicidal thoughts must be taken seriously and handled similarly.

This is the only crisis plan I kept from the Refuge. It is filled out in handwriting neater than I ever remember my handwriting being. It fills the space exactly—if there are five lines for an answer, my answer is five lines long. It is written in some type of art pen with a very fine tip. I can't tell exactly what pen it was but it writes at less than half a millimeter—I would guess it's around 0.3 mm, one of the art pens I bought at the art store in Brattleboro at Spots' suggestion that I buy myself something nice, some art supplies and Indian food, once I got out of the Refuge. I don't know why I only kept this particular crisis plan, but my guess is that I thought it was the one that would be most useful to me. I filled one out every time I left the Refuge, so perhaps I thought I had finally perfected the art of creating a psychiatric crisis plan.

---

Also that night, I filled out the client review form, as always—a three-page form asking about your experience at Tyler 2, asking for any suggestions or improvements you might have to suggest, asking you to rate the food, staff, restrooms, classes, and other aspects of the experience. It also asked if there were any staff members who did their job exceptionally well. I always nominated Lynne, but there were too many to name.

Anyway, on the night of my last discharge from that ward, I filled out my review form in art-ified, barely legible script, then decorated the blank space with chaotic, reverberating lines in colored pencil. My intention was to say: I really appreciate the work you've done. You're exceptional, so I'm giving you an exceptional-looking review form, something truly a work of art. But that's not how it came across. In fact it almost cost me more time on the ward. A few minutes after I handed it in, head nurse Michelle gestured at me with her finger to come to the nurse's station.

"How are we doing right now, Matthew?"

"We are doing fine."

She holds up the form.

For like one-tenth of a second, I see it from her point of view. It's crazy (for lack of a better word), it's chaotic, it's disorganized, it's antimatter, it's a black hole, it's insane.

"What is this supposed to mean?"

"Oh I was just doing some decorations."

She leans in close to me.

"Do you think you're ready to go tomorrow?"

I take the review form from Michelle's hands. I look at the first page. I flip it over and look at the second and third pages. I'm kinda shocked at how full it is with color and pen and lines and complicated lettering.

"I can hardly read what you wrote," Michelle says.

"I can see that."

I nod.

"Yes," I say. "This is hard to read. It's the combination of everything, combined, it's—there's a lot going on here—they say that when you try to over-control your external world, it's a sign of an out-of-control mind. So maybe this is a sign that my mind is clear and organized."

"Nice try," Michelle says. "So do you think you're ready to go tomorrow?"

I think about that. I'm basically always ready to go, when I'm in Tyler 2. And I've been here most of the fall, now into winter. I can't stay in the psych ward forever. I already have an Amtrak ticket from Brattleboro to New York, then a plane to Portland to live with my sister Leona. If I stay here it'll fuck up my transportation. But like Lisa said, without your life all that other stuff is useless. But I don't think I'm going to kill myself. Tyler 2 is home now, but it's a sad home with a revolving door—all the patients are temporary, you can never make any lasting friends, and I don't want to live my life in a hospital.

"Yeah," I say. "I'm ready to go."

Michelle looks at me skeptically and puts the review form in my chart.

The next morning, Dr. Meggs finds me in the main room eating breakfast. She kneels beside my chair.

"They showed me your review form," she says.

"Yeah?"

"Yeah. And I'm a little bit worried."

"Why? It's just aesthetics. I'm just trying to keep myself entertained. I didn't mean it any particular way except to dress it up a little and make it look pretty. It's kind of like a thank you to everyone here for doing such a good job."

My doctor looks at me for a long time.

"Ok," she says. "But that's not what it looks like."

"I know. I got sent here from Birches for decorating one of my daily journal forms."

"I've seen it."

"Is that in my chart, too?"

"Yes. That is in your chart."

"Well, I like to fill spaces with words, lines, shapes sometimes. One time I took down my shower curtain liner and wrote random poetry covering the entire thing with Sharpie script this big. It just looks good to me. It looks crazy to you. But to me, that's just beautiful. Lots and lots of words."

My psychiatrist frowns. She speaks quietly in this room bustling with patients eating, people getting their vitals taken, staff setting up new clients with crappy toothbrushes and sandals and shampoo and lotion which I assume is meant to aid in masturbation.

"With this drawing..your review form..the risk goes up for me. If it's just beauty to you, that's one thing. But when you fill out a review form like this, it sends a message to me and all the staff."

"What message did it send you?"

"That maybe your thoughts aren't as organized as we'd like."

I look at Dr. Leona Meggs, MD. My eyes tear up.

"They're not as organized as I'd like, either. Ok? But I'm doing the best I can."

"I know you are."

"I'm not going to bullshit you, I'm not in tip-top form. I haven't been for years. And it's been hard to spend the last three months in Tyler 2. My life has fallen apart. My whole life has been a series of events in which my life falls apart. That's what I'm used to now. I used to have girlfriends, jobs, cars, apartments, I ate at restaurants. I had fun. I made art. I sold art. I went on camping trips. I had a relationship with my dad. It was a fake relationship, but it was a relationship! But..I grew up..or something..my mind became more complex..I became more of who I am—"

"You have bipolar disorder. It was there all along. It got worse when your girlfriend died. You're never going to have a normal life again. You operate at a high level in some ways, Matthew, but all your problems at work, some of that is because—"

"Because I don't make logical sense anymore?"

"Sometimes you don't. Sometimes you do. But it's never going to be like when you were twenty-two again. That culture, software development, whether it's a hedge fund or a search engine, that's a young man's game. It's caffeine culture, ripping and running. I have a nephew who does that and I know how it is. I'm not saying you can't get back into it. I'm hoping you will! Move to Portland—if you're ready..if not, stay here as long as you need—but if you can get back into some sort of job, try to re-develop your independence..I think you can do that. Look around. Schizophrenic Mike? He's never going to leave. He'll always be in this place or some place just like it. He's a rock that you drop into a pond and it sinks straight to the bottom. You're in the same pond, but you're like a rock that's skipping along the surface. Part of this is biological. Part of it is managed with medicine. But part of it is managed by you. You're not doomed because of your illness. But look at me. Matthew, you have one of the worst mental illnesses that you can have. It's debilitating. It might get worse for you. You have to be very careful. You cannot drink."

"It lowers my inhibitions," I say, voice wobbly.

"Right. And if you feel suicidal, you go to the hospital. You have to treat suicidal thoughts like a heart patient treats chest pains."

I'm silent. I'm looking at her, tears streaming from my eyes.

"Which is how?" she says.

"Go to the hospital," I say.

"Right. Do you have your little card?"

My Brattleboro Refuge Emergency Card. A card filled with phone numbers and strategies and advice.

"Yes."

"If you feel suicidal," she says. "Take out that card and call one of your supports. And if you can't get one of your supports—"

"Call 911," I say.

"That's right. And you better take it seriously. You call 911, you go to the hospital, you get to a safe place. There's nothing wrong with you, there's nothing wrong with your spirit. But you have a brain disorder which makes people twenty times more likely to kill themselves. Ok? If you need help you call Tyler 2 and you have them page me. Whatever I am doing, I will come talk with you on the phone, and if you need to come back here, that's ok. Ok? We're always happy to see you go, but you're always welcome to come back. That's how this works."

"Ok."

"Ok?"

I wipe my face.

"Your coming here is not failure. Are you listening to me?"

I nod.

"What you did was the action of someone who wanted to survive. You did what you had to do to get the help you needed. That's a good sign."

"It is?"

"Yes, it's good because you're alive. Some people who try to kill themselves—regardless of their level of ambiguity about life and death—some people succeed. And that's it. They're no longer with us. But you are. And—if you want—you're going to go on to Portland and live with your sister and find a job and move on and you're going to live a wonderful life, Matthew. You're very capable and heaven knows you're more capable than some of the people who work here."

She smiles.

"You're just a little nuts, that's all."

I laugh. Cry/laugh/snort—the whole fucking thing.

"You know I'm kidding."

I nod, smiling, laughing, closing my eyes.

Dr. Meggs stands up.

"Alright. I'm going to tell these nurses to forget about your review form and let you go, ok?"

"Sounds good."

"Find David and have him get your things out of contraband. I'll see you in your room for our final checkout."

I nod.

"You know," I say. "Something doesn't have to be true..to be true."

Dr. Meggs hesitates for just half a second, like she was going to say something else, but whatever it was, she decided not to say.

112

The night before. Me sitting at 3am reading Pema Chödrön and making notes, sitting in the blood pressure chair by the nurses' desk.

I think about some specifics.

December 15, 2011

Probably my last night at the Refuge ever, as I'm going to NYC and on to Portland, Oregon after that. I am unsure of this plan, and as usual confusing my mythic internal story with the actual external story. In short I don't know what I'm doing. I hope that life gets better, for me, clearer and maybe easier and more happy.

Dream I was having trouble keeping my car on the rollercoaster track. Over the hills and bumps it would come off, fall afar the tracks and leave the coaster. But then with help from a guide, on a different train on a different track, and in a different final car with two other riders, I was able to keep up with the train, just barely (or have the hope to), running behind the car to speed it up, manually coupling it back to the track and to the train ahead.

Interpretation: With Meggs's guidance, and Leona and James' help, becoming able to weather some of my life's ups and downs.

Dream that I discovered ghost friends and occult books and had an unnatural affinity in reading and communicating with them.

Change address.

Register clownfysh.com another 1-2 years.

Thank you cards to Mom, Joanne, Leona.

Buy Neuromancer eBook.

Get daily pillbox.

Friday 12:31pm, Amtrak, Reservation 04A91D, Boarding #2Y1XZC, $69.

Also I think of all this has conspired to place the knowledge that I have, the genetics, the experience, inside my head..the value there is considerable..a blessing..and my job to use in the best way I see fit. I am a blessing, a benefit, a gift, a wonderful package or a package of wonderful..not something to be wasted, not something to disrespect..but something of extreme value, which must be played strong, not underplayed.

I really do think, even as fleeting as it might be (or might not), that I have found something in this moment, today, some happiness, some self, something that had been worth fighting for, but which is elusive to even the best sleuths. May I never cease to find that self, that health, that wonderfulness in life. May I do whatever is necessary, use every means available, to keep along this path.

When I look at this picture—a selfie I took in the woods—it's like: that's the me I should be seeing..that's the me I deserve to be able to feel..I deserve my own satisfaction, I deserve to be happy, to be on my path.

I am worthy to pursue my dreams.

I think that's the basic idea I'm getting at, that I haven't always, haven't often felt:

That I am worthy to pursue my dreams.

That I'm ok enough, worth enough, to try for happiness.

That I don't automatically deserve to suffer and die..that I am worth working for, worth living for.

---

And while I'm sitting there, having these holy revelations, this one male nurse is talking about how many Iraqis were killed with this gun his buddy gave him, about how accurate the gun was, the perfect deadly weapon.

I'm sitting in the power chair, the vitals chair—night nurse John had told a story of the girl who sat there and controlled the whole room with her spaceship helmet, how she was their most memorable patient ever—and I just stewed and stewed at this guy's endless speech until I finally gave him an ass-ripping that would have made my sister proud. Of all my righteous smackdowns, this one was notable in that after I scolded him for the inappropriateness of discussing weapons in a psych ward because a) you're around unstable, suicidal, homicidal people, and b) we have a contract on the ward that we read every morning that you—male nurse—may not ever have been to, but this contract states that we will not behave violently toward each other, and glorifying the number of Iraqis killed by your father's gun is flagrantly in violation of this non-violence policy.

Also, I told him directly that if he was so interested in murdering people that perhaps the job of mental health technician in a psychiatric hospital, surrounded by suicidal people, was not the best job for him.

"Your job is to help people who are so depressed and have so much self-hatred, to heal so that they can feel good about living, and live for a long time instead of a short time—yet your hobby, and your avid interest according to my hearing of the stories you've just told, is in murder, is in killing people, is in war. Do you really think, that with all that focus on killing and the weapons that do it, that you can function effectively in, say, a one-on-one with a suicidal—or probably in your case, worse—a homicidal patient? Do you think you're in the right headspace to do that?"

And then, after all that, while he and John sat there silent, listening to me talk, I informed them that this behavior was so inappropriate that I was considering writing a letter to the clinic director describing the event and asking her to respond however she felt appropriate. Then I reminded them both that the clinic director and I were on a first name basis, had spoken many times, and that she liked me very much.

"And Mr Dude—Mr. Gun Freak Mental Health Tech Dude—this isn't the first time I've heard you brag about your buddy's gun and I've come this close to talking to the clinic director about you before—you should know that. All these nights you're in here bragging about killing Iraqis we're listening—patients are listening—and some of us—ok—just 'cause we're mentally ill, we happen to be a lot fucking smarter than you and we're the kind of people who can deal with organizations and raise a stink and get people fired because they potentially make the boss look bad in, say, a local newspaper story that features your name prominently?"

Then I stopped, and though that mental health tech gave me dirty looks for the rest of the night and into the next morning, I never said anything more to him—not once I got up from the chair. I wanted to. I wanted to wheedle that weak-minded pro-violence pencil-peen motherfucker into a puddle on the floor. But I didn't. I just kept silent, let it go, and didn't say a word.

Finding a job that fits it hard. I know that from experience. There is the pressure of what your parents want you to do, there are ideas you have from childhood about the first roles you imagined you might play in society. There's what you're good at. There's what you love. And there's what you can actually get someone to hire you to do.

If you're this guy, Asshole Mental Health Tech, living in Brattleboro Vermont, the best job you can get is working at the Refuge. He's obviously not a nurse, so he doesn't have any mental health schooling..he's a mental health tech, which means he has a bachelor's degree in something—prob'ly blowing up Iraqis and shit—and as a mental health tech he gets the shittiest jobs, just slightly less shitty than the custodians.

But you've got to follow your love.

I have never seen that guy talking with a patient, helping a patient. If he was my nightly check-in I'd instantly request someone else. If you're so interested in guns and blowing people's skulls apart and you have the type of conscience that allows you to talk about "popping that sand nigger in the eye" then grow a pair and join the fucking Army. Go over to Iraq. Actually risk your own life—'cause over here you're just talking..over there the "bad guys" have guns, too. They wanna pop you in the eye, and there's a good chance they'll do it. I'm not a career counsellor. All I'm saying is, Asshole Mental Health Tech, if you're reading this, maybe you should find a new job.

But that asshole kept talking.

And I was like, "Would you please shut up? Don't you see the irony of this? You're supposed to be a mental health worker, helping sick people, and yet you're a person fascinated by and honoring Americans killing people from another country, acting like its some sort of game. If you don't respect Iraqi lives, how can I trust you with my life, in here."

His boss, John, the one with the lip movements and bald head and the Rugby shirts, told his subordinate to change the conversation after that oakie gun collector just looked at me and continued to talk about dead Iraqis—what balls. And of course I steered clear of him the rest of the night—though it angered me to see him and to know that he existed. But he didn't say anything to me.

And I thought of that line from Apocalypse Now, where the French woman says,

"There are two of you, don't you see, one that kills, and one that loves."

And her husband says to her, "I don't know whether I'm an animal or a god."

And she says, "But you are both."

And sitting in the vitals chair in the Brattleboro Refuge on my very last night, I thought clearly: You might have to see yourself from several points of view to really know yourself. And I believe that to this day.

113

Some last day memories:

All the conversation is inane.

I resent it

I resent people intruding on perfectly good silence with their idiotic words

I miss a little conversation with Sadie or a lot with Spots

god, I thought Spots was beautiful when she was at the pottery wheel in an art apron, especially, I fell a little bit in love

And Daniel's refrain, every time I left the Refuge—every time I left the room:

"Good luck to you, sir. Good luck to you."

Good luck to you, sir.

Air hugs with Faith throughout, then a real hug on my leaving day, in front of everyone, before she took the elevator down to arts and crafts. She finally gets on yellow level and can leave the ward. The staff sees our hug and allows it because they know I'm leaving and they know Faith and I love each other.

The elevator closes. We never see each other again.

Last morning. Yoga/meditation. Lynne asking me after the millionth class I took with her what I had to say about my meditation experience just then.

I said, "I really have nothing to say right now."

Lynne said, "After as many times as you've taken this class, I'm glad that you have nothing to say."

(That is, perhaps, the point of meditation.)

Lynne talking to me in my room on my last day there and us talking friendly and lovingly and tearfully and her saying:

"It's easy to cross the line with you, to be more personal than professional."

I told her, "Spots and I were talking on the outside and we both agreed—well—we both agreed we were in love with you."

Brattleboro Refuge Discharge Summary (7)

Patient Admitted November 28, 2011—Discharged December 15, 2011

Identifying Data

This is the fourth Brattleboro Refuge fifth lifetime admission for this 33-year-old single white male. Patient is an unemployed computer software engineer and also a writer. Patient lives alone in Brattleboro Vermont.

Chief Complaint

"Because I'm a little manic. I decided to talk to the doctor at Birches."

History of Present Illness

Patient was discharged from the Brattleboro Refuge on November 15, 2011 and is currently attending the Birches IOP Program. He has not been able to sleep since this past Thursday. However he did report that on Saturday night he had a couple hours of sleep and a half hour yesterday. He reports "I really want to go to sleep." He watched The Matrix multiple times last night in order to fall asleep [Never fell asleep, watched the Matrix like five or six times in a row.] He has been having difficulty completing tasks and needed to make note cards in order to remember what to ask his doctor. He has also been writing down his thoughts which include "sounds are intense," "colors are extremely bright," "texture hallucinations." On admission he denied auditory hallucinations and paranoid thoughts. He also had fleeting thoughts of suicide and he does have a concrete plan. The plan is to cut himself deeply in the bathtub but "it doesn't have to be a bathtub." He also thought about taking a whole bottle of clonidine. His last thought of harming himself was on Thursday. He denies homicidal ideation. He has not been showering because he does not want to touch water; cool water feels too cold on his hands. He does not want to be in hot water because it may be too hot [Before my suicide attempt and inpatient hospitalizations, I bathed every morning—I couldn't feel awake, like my day had started, before my shower or bath. After this point, I stopped bathing, dropped down to once a week, once a month. Only now, five years later, am I once again comfortable bathing every day]. Denies drugs or alcohol since he was last discharged [Of course not—the Refuge is my new addiction.] Says he feels anxious about going to the floor and being behind doors.

This shower thing might seem trivial to you or weird, but showering at the Refuge is fucking disgusting. It's also complicated. I went from needing a bath or shower at the beginning of every day, to the Refuge, to not bathing for a week at a time, to not bathing for a month at a time, to slowly, slowly getting back into bathing and hygiene until now, five years after my attempt, I not only bathe normally but I've become a deodorant junkie—I wear it three times a day—just because I like the way it smells to me =)

I'm a person of habit, though, of obsessions. Remember that period I went through where I would make enchiladas every night, drink a bottle of wine, and watch a movie? And at a certain time each night I'd call T-Mobile and change my telephone number? I was concerned/paranoid/angry/whatever that my phone was contained in the company directory and I didn't want there to be any greater than a zero chance that anyone who worked at that loser-ass company would call me. That's more about habit than anything—about obsession and compulsion.

Course of Hospitalization

Patient was initially admitted to Tyler 1 as there were no beds available on Tyler 2. When first seen on Tyler 2 patient reported having "slept fantastically" and he denied auditory or visual hallucinations. He denied suicidal and homicidal ideation. He reported however "I've lost my ability to think clearly, I can't finish a thought. My thoughts are really an endless box of glitter [Actually I said: My mind is like a glitterbox.] I feel that you're just pretending to be a doctor and that I'm pretending to be a patient. I feel that the cellular automata program has infected my brain." He also reported some grandiose thoughts: "I'm smarter than most people and there is a different morality for more enlightened people." We elected not to change any medications until a neuropsychological exam could be conducted to help us diagnose and clarify as the patient has had multiple admissions at this point in time. Patient has a history of reconstituting very quickly on the unit, discharging and then decompensating over weekends ending up in A&E [Accident & Emergency, same as Emergency Room] at the Brattleboro Refuge and after one admission went to Windham Center. Patient was emotionally labile on the second day on Tyler 2. A minor slight set him crying and tearful. Patient reported "I know it was out of proportion to what was said." Patient was very downcast but was able to contract for safety and had a neurological exam and completed the neuropsychological testing. The patient reported that he was very depressed since he came off the Lexapro the last time and requested a restart of his Lexapro. Although the neuropsychological exam did not result in any focal findings and was basically within normal limits they did recommend a head MRI given what appears to be an increasing psychosis as well as some visual disturbances reported by the patient. Patient continued to be despondent about his situation: "I'm unsure that there are reasons for hope in my case." In the event, the head MRI was essentially within normal limits with the exception of small cysts viewed at the base of the left maxillary sinus. There was no evidence of any space-occupying lesion. As patient continued on Lexapro his mood improved. He began to evolve a plan for discharge this time that would be essentially different from the previous two which had resulted in a rapid decompensation. Patient reported that he felt that it would be better to live with a family member for the time being in order to supply structure to his days. He evolved a plan to move to Portland, Oregon where his sister Leona and her husband agreed that he could live there and help in the care of their young child. In addition the patient had a plan to begin to look for work again in order to get his life back on track. Ultimately receipt of the neuropsychological testing suggested that patient did fit the criteria for bipolar disorder and in addition there was some evidence for psychotic process. After the patient was feeling well again and having ruled out any organic causes for his psychosis we agreed that patient would discharge and move to Oregon to live with his sister which is in fact what he has done. Our plan for outpatient treatment would include medication, psychodynamic psychotherapy, continued work with mindfulness techniques, living with a family in a structured day and refraining from alcohol and drugs.

Final Diagnoses

Bipolar Disorder. Psychosis NOS. OCD. Ethanol Abuse. Street Drug Abuse. Recurrent Kidney Stones. Questionable History of Serotonin Syndrome. He has good support in his family, has an increasing history of mental instability including a psychotic process that threatens to undermine his ability to engage as his past work as a computer programmer.

GAF on Discharge: 40.

Condition on Discharge

Patient was well groomed, cooperative, good eye contact, no psychomotor agitation nor retardation, mode of speech was within normal limits and mood was "Solid. I feel good with this discharge plan." Affect was constricted, cognition was intact. Patient was alert and oriented x 3. Thought process was logical and non-psychotic. Patient denied auditory or visual hallucinations and there were no overt signs and symptoms of psychosis. Patient denied suicidal ideation. Denied homicidal ideation. Denied craving and denied pain. Insight was good. Judgment can be considered fair. Patient was not deemed an immediate risk to self or others at time of discharge.

Prognosis: Fair.

Patient Strengths

Patient is extremely intelligent and has relatively good insight into his mental health issues and has a supportive family which will help in maintaining his stability.

Arrangement for Aftercare Services

Patient was referred to Cascadia Behavioral Healthcare where he could be assigned a therapist and psychiatric prescriber. Cascadia Health is in Portland, Oregon—[phone number]. Patient was encouraged to seek a primary care provider. We are under the impression that the patient will be eligible for Oregon Healthcare within 24 hours of moving to Oregon. Patient is advised to resume a low-calorie diet and increase his physical activity.

Well, as they say, The best laid plans of mice and men often go awry. Oregon's implementation of Medicare, which they call Oregon Healthcare, only supports a certain number of people, and it was full. There was a lottery for spots that opened up when people died or got different health insurance. I entered the lottery, but lost—no health insurance. I entered again and lost again. With no money and no health insurance, I couldn't get a primary care provider.

Dr. Meggs agreed to continue to prescribe my medication for a while—I would call her in Vermont and she'd phone the orders in to our pharmacy in Portland. Then my sister and her husband would pay hundreds of dollars so I could get my psych meds—money I only recently paid back, five years later. I had better healthcare in Vermont—I wonder sometimes if I would have been better off with health insurance and a good mental hospital in Brattleboro, even if I became homeless, than living in Portland.

114

Remember when I was in Tyler 1 for one day before they transferred me up to Tyler 2 for my last admission? I saw that girl again—the cool one with the Skittles who I always saw at AA meetings. Her name was Grace. I guess she hadn't gotten clean yet before she started going to meetings, or else she relapsed, 'cause now she was in detox.

She was always friendly to me in meetings, but now, in Tyler 1, I was the only person she knew at all from the outside, so we were instantly best friends. She asked me what I was detoxing off of.

I said, "Nothing."

"Oh right," she said. "I heard them say they were moving you upstairs. What's wrong with you?"

"Bipolar disorder."

She has a genuine look of sympathy—even though she has one of the prettiest faces I've ever seen, Grace is not just another pretty face.

"My sister has that."

"I'm sorry."

"No, yeah, no. I know it's really hard. My littlest sister has it. She's only nine. They say the average age of onset is getting lower and lower. Either that or we're detecting it earlier because there's better psychiatric support in schools."

"I think the latter."

Grace puts her hand on my thigh and I can feel my dick immediately get hard.

"That's fucking sexy."

"What? My pajamas?"

"No, the fact that you said latter. There aren't a lot of smart people in Brattleboro," she says.

I say, "There aren't a lot of smart people anywhere."

I take her hand off my thigh.

"Why'd you do that for?"

" 'Cause if you keep your hand there ten more seconds you're gonna be giving me a hand job in the utility closet. No touching!"

"Just a hand job?" she says, and squeezes my thigh again.

"You are a naughty bitch," I say. "Now I'm not gonna be able to stand up for ten minutes."

"You seem like you would be fun to do drugs with," she says.

"Yeah, that's what people tell me."

Grace puts her leg over mine. My cock gets harder.

"I'm detoxing off heroin," she says sweetly.

"I know, I've been in meetings with you, remember?"

"Oh. I didn't think I ever shared."

"You did once. At a meeting here."

"And I said I was hooked on heroin?"

"Those weren't your exact words."

"Fuck I must have been high. Now prob'ly the whole town knows."

"In this town, probably, yes."

"Grace!" one of the nurses shouts. "No touching!"

"I have his permission. I have your permission, right?"

"It doesn't matter!"

Grace gets this sullen look on her face but she unties our legs.

"I have your permission, right?" she whispers, walking two fingers across my leg and giving my dick a little shank.

I turn my head, look her in the eyes.

This girl is movie-star gorgeous—more than that, actually, because she looks that way without makeup—she's smart, she's got a hot body ten years younger than mine, and she doesn't treat me like an untouchable, the way most girls with that amount of coin would treat every guy except the ones they want to have sex with.

She doesn't blink.

"I have your permission, right?" she mouths the words.

I smile.

The nurse says, "Grace, he's not detoxing. I'm just warning you, you and Matthew may not be in nearly the same state of mind. You might want to give him his space."

"Basically you're trying to tell me he's crazy and I might get hurt if I talk to him."

"I'm just saying that you can't assume that everyone on the ward is here for the same reason."

"I know he's bipolar. He already told me. So you don't have to maintain his secrecy for him. I know people with bipolar. I mean I have an affinity for them."

"Ok, just have your affinity without your hand on his leg."

"I have his permission."

"There's no touching on any of the wards. We respect each other's physical space here."

Grace takes her walking fingers off my leg and crosses her arms.

"You seem worked up," the nurse says. "Do you want to spend a few minutes in your room?"

"This is how they talk to you," Grace tells me, as if the nurse is a painting on the wall, not a person with ears and a brain and feelings. "Do you hear what she's telling me? She's saying Grace, go jill off in your room and stop venting your sexuality on this poor bipolar kid because if you push him too far he's gonna snap, as bipolar people do, but I'm telling you, I have experience with bipolar people and I'm not even sure this cat has bipolar. He seems perfectly fine to me. I've never seen him snap—I bet he only snaps when people act up around him, isn't that right?—well guess what, we need people to fuckin' snap on fools who act up or else—"

"Calm down, Grace."

"—or else the world would be pure chaos. Am I right? Tell her I'm right. Honestly, tell me, Matthew, tell me if I'm right."

"You are right. But you'll never be right in here," I say. "Detox and never look back, Grace, never come back here."

"Fuck," she says. "I am getting a little worked up. I mean like I don't care about the rules of Tyler 1, the world, the country, the county, city, state—not necessarily in that order—are you with me?"

I nod.

"I might need to spend some time on Tyler 2!" she says.

She stands, walks up to the nurses station. She points at me.

"That guy is not fucking crazy. Take me. Take me instead."

"Grace, please go lie down in your room."

"You know what," she says. "I have learned something here."

"What," says the nurse.

"You got the wrong people in this hospital. Tell 'er, Matt. He's not bipolar! Or if he is then what's wrong with being bipolar."

"So you're a nurse now."

Grace busts out laughing. She's laughing so hard she's hitting herself in the stomach.

"Actually, I am a fucking nurse, you dimwit bitch. Didn't you read my chart? Marlboro College, two-thousand nine. Fucking. Nurse's degree. Right there. Boom. And I'm telling you there's nothing wrong with my man here."

"Matthew."

"Matthew, right."

"Grace T., will you please go to that water fountain and put some cold water on your face or sit in the vitals chair and I will bring you a cold washcloth because you are ramping and you're upsetting everyone in the room. Maybe your friend can help you calm down."

Both Grace and this nurse—who I had every respect for—look over at me.

"I don't really feel like helping her calm down."

The nurse shakes her head.

Grace does a victory dance.

"Grace, get some water."

"No, I'm not getting some water. You know why?"

"Why."

"Because I have one more thing to say."

"Well you have everyone's attention! Go ahead and say it!"

That was a mistake on the nurse's part—she let Grace get under her skin. Usually there's not this type of excitement on Tyler 1. Observing Grace, I am reminded that those with bipolar siblings are eight times more likely than average to have bipolar disorder themselves. I think of how I started in detox as well, in Tyler 1, having forgotten my previous bipolar diagnosis, and it was my drug use which was the obvious symptom that brought me to the hospital, but it was my bipolar, my psychosis, that were visible once I stopped drinking. I hoped Grace's path would follow a simpler course: detox, get released, get a job, find non-using friends, fall in love, live a happy life. But that was extremely unlikely.

"Your basic fundamental problem with mental hospitals," Grace said to us all, "is you have mentally healthy, perfectly fine, perfectly normal dudes like that dude over there. Do you think he would be in here if the world made more sense? Do you think I would be in here if the world made more sense? If I wasn't raped at eleven?"

"Grace—"

"No I don't care! This is exactly the point! Why am I supposed to feel ashamed about being raped..by my brother..when I was eleven? Where is the part in that where I am supposed to feel ashamed. Where is my brother now, while I'm in here trying to fucking survive? He owns a bar in Trenton. He's doing fine! He's probably still raping eleven-year-olds! But do you think that motherfucker'll ever end up in a detox, in a psych ward like Matthew's going up to in a few minutes? Maybe if people weren't allowed to vent their sicknesses on people like us then there wouldn't be so many crazy people in the world! Because what is a crazy person? All people are crazy—we certainly know that by now. But crazy people—the ones who end up in institutions—all we are is the weight-bearers. We're just the sensitive ones. We're not the sickness—we're just the ones who take the blame for the sickness. You know why we're in here, right? Do you know? Do you know? We're in here..to get a break..from what's out there. Because what's out there is so bad that if you feel too much, or think too much, what's out there can destroy you. But who does that make sick? The people who are part of the oppression—the mental fucking oppression—or the people who are in here taking refuge from it??"

I realized—as I always have—that often the urge to have sex with someone, if you scratch the surface, is really a surge of affinity with them. It's the recognition that you've found someone like you. After that, sex is arbitrary. What really matters is that you're not alone.

---

I left the Refuge. It was weird, being free, outside, in all that snow. I checked my voicemail and got a message from my old friend Ashley saying her dad had been hit by a car. When I finally got ahold of her it quickly became clear that it was her dog, not her dad. Still sad though.

The Refuge called me saying housekeeping had found a folder in my room containing my passport, Social Security card, name change documents, Arizona photo ID. I had just gone through the whole ritual of leaving the Refuge for the last time, now I had to go back to get these essential papers. Fortunately when I got there one of the mental health techs brought them to me in the lobby. My OCD was tickled by the fear that I would lose these documents and end up in one of the many societal voids that are difficult or impossible to get out of. I checked and double-checked and triple-checked and quadruple-checked and more, making sure I had each one of those special little pieces of paper or plastic. Finally I put them all in a folder and somehow convinced myself that after I had put them there, they were still there. At some point I had to let go my doubts and leave the Refuge lobby for the last time.

I walked down Main Street. Checked my PO box.

I took care of a little piece last-night B-boro business: going to Whit's, eating with Thomas, not drinking, not telling him I'm leaving Brattleboro forever but making this our one-sided goodbye.

I went to Gretchen's house. She had gotten the duffel bag from my apartment. We hug, tightly—too tightly, as always, like lovers which we were not.

I kept having to make multiple trips to the post office and bank once I opened my mail, to get unemployment money deposited in the bank and another two weeks applied for. I ended up with a net balance of $9.61—this was below the minimum balance and in Portland I closed that bank account to avoid being charged a fee greater than my balance. I don't think they understood—that bank account wasn't about the $9.61 for me—it was about maintaining the illusion that I was connected to the world. But I had to close it, and for about five years I didn't even have a bank account.

Gretchen saw me organizing my pills on the carpet in her living room and we went to the Hotel Pharmacy and picked out a pill box. This was a step for me: I was now someone who took so much medicine that he needed a pill box to organize it. By phone, I made an Amtrak reservation for the next day's Vermonter from Brattleboro to New York. I wasn't about to make the same mistake I made during my first trip to Brattleboro. I needed a clean break—I needed to get out of here.

Once all my business was settled, Gretchen and I sat on the floor in front of her couch and showed me pictures of her in high school and she looks younger and cuter, yes, but mostly she looks happier, and I wonder if she was as psychotic then as she is now—my guess is not—she used to have cute round cheeks, now her cheeks are sunken in—too few calories under the guise of veganism. She would look better if she gained a little weight.

Gretchen's husband Tom talked about this sleep apnea study he was doing that night and showing me his old sleep apnea mask—he and Gretchen call it Darth Vader. We talked a long time before Tom awkwardly left me alone with his wife while he went to spend the night having people studying him breathing—and periodically not breathing—while he slept.

I left a duffel bag with Gretchen that contained some clothes and drawings and my vibrator..days later she's emailing me telling me how she's wearing my clothes because they smell like me. I hope she used the vibrator and made herself cum, too, thinking of me—she said when I met her than she and Tom hadn't had sex in seven years. Our relationship was already unhealthy, I wish she and I had fucked..it would have made up for some of the stress of our whole ordeal, made it worth it. My mom says she had an emotional affair at the end of our parents' relationship—is that what this was? Not really, more of a stalker situation and I was too lonely (as usual) that I took whatever friend I could find, even when doing so got in the way of me and Spots, because of Gretchen showing up like a lost puppy at Spots' bar, creating the distinct impression for Spots that Gretchen and I were together. Then there was that time at Metro when I left Gretchen at the bar to speak with a woman whose husband has bipolar. Gretchen came over and gave me the meanest look. I tried to shake Gretchen, telling her she can't treat me like that, but she was sick enough and I was sick enough that it just never stopped.

Gretchen drank wine on our last night together. She asked me if it was ok and I said sure, what am I, just a mentally ill dude trying to stay sober, go ahead, drink in front of me, get loose, invite me to sleep in you and Tom's bed together while you're tipsy.

We slept in their bed together under a huge white comforter—my favorite kind. I couldn't breathe and I was sweating but Gretchen and I held each other under the covers. Gretchen reminded me that on the first day I met her I was so sexual with her, even trying to get her to come home with me that night..and she notes that now things have changed, that I'm standoffish with her sexually/physically.

"What happened," she says.

"What happened is that I got to know Tom, and I now consider him a friend, and as such I would never do anything to hurt him."

I touch Gretchen on her nose and speak with our lips so, so close together.

"Like sleep with his wife."

Gretchen reminds me she and Tom haven't had sex in seven years. I don't know if that's supposed to be an invitation, a tease, a what.

Gretchen and my relationship was always inappropriate and it continues that night to be inappropriate, leading up to one final kiss. We kissed, yes, very delicately and gently, like a first kiss among teenagers, holding each other's faces and touching only slightly with our tongues. We slept in the same bed all night, holding but not fucking in her and her husband's bed on my last night in Brattleboro. I felt it was a colossal moral failure on my part.

So I never slept with Gretchen, leaving me with the irksome fact that the last person I fucked was the fat girl. This will bother me for years, whereas if the last girl had been Walsh, especially if we had better sex and she had cum and I had cum inside her, I would have felt proud and affirmed, sexually, through the following years.

It's like this one time a long, long time ago when I saw Charisma at this punk show and I wanted the attention of Chrissy or one of the skinny girls but fat Charisma was the sure thing and I took her home and her post-childbirth pussy was loose and she said it was the best sex we ever had. I felt so tainted that I invited my problematic ex, Rishi, to come back to Dayton when she'd been asking and I'd said no. Even though I knew it wouldn't help me and Rishi's relationship, I just wanted the last person I had sex with to be sexy, and a prize, someone who indicated I was worthy of a decent sex partner. To me, the fact that I fucked fat Charisma, and later that I fucked petite Rishi, were acts that reflected on me and that helped to determine my status, even just in my own head.

115

Awkward goodbyes the next morning with Gretchen at the parking garage.

Many hugs.

One hug that was finally the final hug.

She went to her car.

I went down the hill.

I got my usual sushi train food from the one sushi place in Brattleboro. It was the same cashier—the dancer—I had spoken to on my first trip here. I wondered if she recognized me. We just talked business, I got my sushi, I left.

I had a moment in the waiting room and in the train on the way to New York accepting my comings and goings to and from the town. I was leaving almost exactly one year from when I arrived and in a way leaving was failure..but it was unavoidable.

I talked to this kid in the train station who was sitting across from me.

He said he just graduated from college and I ask him what he wants to do, what he's interested in, but that's not the world he lives in.

"I just want to get a job."

"Doing what?"

"Anything, man, I just want to make it."

I lamented his whole generation. I'm jobless now but at least for a good twelve years I was able to work and find jobs (without a degree). Now, college graduates don't even have faith that they'll be able to work..at all..at any job.

I pulled out my laptop and wrote.

December 16, 2011

Sitting in the Brattleboro Amtrak station. This will be the first time I've left since I moved here, just about one year ago. The town has changed significantly in that time, with fires and floods, and the closing of the Walmart.

I think I might be done here. If I ever have money, I might like to come back to Vermont to hike, or to live, in a remote house. I could probably "make it" here if I wanted, but I might be a little less of a small-town person than this place requires..or maybe I'm just in a hard spot at the moment. This has been a decent transition from living with Mom. Though now I'm going to live with Leona. Maybe I can find a real job in Portland. Maybe I'll publish a book. Maybe I'll live off unemployment and disability and write another book or two, continuing making work I can be proud of. I made a friend here (G) and I'm leaving a friend, which is hard. I'd like to be closer to people, more people and in a few cases in deeper ways, than I have been in recent years. Maybe in Portland some love with women, maybe I'll find some friends I can really connect with. We'll see. The Refuge has been good here. Today I feel quiet as I listen to the breeze. Mind is at peace. And in terms of getting down to a few possessions, I'm about as Zen as I'd ever want to be. A backpack and a satchel. With more money [available at all times] I could get it down further. I'd love to have a house but what I really want is to make art—great art if possible—in words. Maybe I can do both.

Doing pretty well, these days, at enjoying the good in what I'm doing, in where and when I am, and not pretending there are other realities.

In the train station I held on to the memory of seeing those Florida postmarks on the letters from my dad as a way to know that I'm not delusional. Knowing I have those secret scans of a couple of the choice Florida letters. I don't read them. But I keep them, in my digital files, as proof that it's more the case that my dad is lying than it is that I am crazy..or..unfortunately..more likely..that my dad has been lying to me and my sisters and my mom this whole time and it's pushed us all over the line and made each one of us crazy—some of us more than others.

One thing I learned is I wasn't technically suicidal..I never have been. I love life. I'm even afraid of death sometimes. But on no occasion have I gotten myself into the position where I did not know how to take the next step in life, and where I was hurting so badly that I equated not knowing the path with death and unbearable pain with a desire to die. Close, but not quite.

And I met a girl with a back brace, who once asked to smoke one of my Kamels, who I saw sitting at a potter's wheel in the Brattleboro Refuge, and for the first time in a decade I felt my heart move. Like, truly move. Like, would do anything for you and live with you as long as you would have me. Her mother committed suicide. Spots had attempted it many times. She's the kind of person who is full enough to feel enough pain to really end her life. I hope she's not ashes at the bottom of the ocean right now or decomposing bones in some terrible box underneath the ground. I hope her blood runs hot and her mind is firing and she's lying in bed and I hope that someone's licking her pussy, and fucking her—maybe not as well as I would—but well enough.

And that she's reading this right now.

And that she has a smile on her face.

I wish luck to the recent graduate in the Amtrak waiting room, then board the train. I take a window seat. Dagny Taggart sits next to me. Yeah, when I left Brattleboro I took Miss Taggart with me. I even bought her a ticket. Sitting next to me in the two-seater she wears her ripped and tattered jacket, buttoned up to look as smart as possible. Like me, her hopes and ethics and romances and tendencies are real and realistic, but she lives in a world of fiction. Our train could crash at any time—all those moving parts—rails and gears and the engine all produced by indigent hands. Even Dagny Taggart couldn't have prevented it. And we end here, on the train with unbelievable light coming through the bare trees, blinding me, speeding on the rails in a contraption that at any moment, through some small mistake, could derail and kill us all. But we ride anyway, as far and as fast as we can.

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