The Mind Reels will be published on October 7th. Preorder it wherever books are sold.
She was pissing in the utilitarian bathroom attached to her room when it first really occurred to her that she was in a mental hospital. The little room stunk of disinfectant, which annoyed her, but she reflected for a moment that it was better than the alternative, and for whatever reason this little insight pulled her into her body sufficiently for her to really consider that she had spent the past six days in a psychiatric facility.
It was a disquieting feeling, and yet “better than the alternative” was her overall impression of her current station in life. They had taken her cell phone, which was merciful; she could not bear to consider who might have sent her words of sympathy, and who might not. Her room was a double but the other bed had sat empty ever since her arrival. Ronnie, her favorite wardie—the only wardie who she had talked to at all, really—had told her every day at bed check that she would surely have a roommate the next day, but it kept not happening. The whole ward seemed strangely empty in general, and the therapist who led group had said that they were meant to have ten instead of five. Somewhere in the back of her mind Alice wondered at the efficiency of the system, poked at questions of access, but such thinking was burdensome and she did not have the means to really engage with it, so she let it go.
She was taking meds daily, in the morning and before bed check. She was somewhat surprised, and even a little disappointed, that they did not force her to open her mouth to make sure she had taken her pills. But such a contrivance would have been unnecessary. Inpatient life agreed with Alice. She had taken to it immediately and without complaint. She was dedicated not to getting well but to being a good patient, which was not the same thing. When she had been there a few days and the Seroquel and lithium were slowly building up in her bloodstream she had suddenly felt confronted with the fact that she had committed to nothing, really, in the past year. She had been going to college only in the most technical sense; she had been a friend to Sadie and her rapidly shrinking social network in the most minimal sense; she had gotten fucked by sweaty men she didn’t really desire and acted cold and distant toward the ones she did. Now, she would be the best patient this ward had yet seen.
It was early still but the pills were wending their way through her body, building up in her brain. The shot of Haldol had shaken her and her environment was destabilizing and felt unreal, but she was fairly certain that it had worn off after a day or two. The trouble was that she could not remember what normal felt like, and anyway the Seroquel and the lithium were busily working in the background to the point that she now seemed to view the world through glass, through a pane of warped and thin glass that bent everything she saw at a slight angle, and the effect was macabre and disturbing. In time this too would pass, and she was left with a dark question: Had the pills settled in, and she went back to thinking and seeing as normal? Or had she merely gotten used to the warped and bent angle, so that she now could not tell what normal even was?
Still: She excelled at being a patient as she had excelled at few other things in her unexceptional life. In the mornings that meant rising early to use the bathroom, which the addition of 1,500 milligrams of lithium salts in her diet made a bit of an adventure; waiting for morning checks, then following the crowd to the cafeteria along with the inhabitants of other wards; charbroiling stale bagels until they were somewhat palatable and brutishly cutting chunks of frozen cream cheese onto them; going to group and performing for the therapist, her peers, and herself; continuing to read the copy of Angels & Demons she had taken from the ward’s sad library, which proceeded at a snail’s pace due to her sudden and extreme memory and focus issues; lunch, sat alone like every meal, staring into her plate so that no one would attempt to talk to her, which no one ever did; one-on-ones with the psychiatrist, which were now every other day; physical activity in the rec room, like Zumba or yoga, which she enjoyed more than she would ever admit; “quiet time,” in which she would read a few agonized pages at a time, or try to jot her feelings down in her journal, which had amounted to perhaps a half page in her stay there; dinner in the cafeteria, perhaps sticky and delicious spaghetti with tomato sauce and a “salad” of a few forlorn pieces of iceberg lettuce, a single cherry tomato, some slices of onion, and gloopy thick ranch dressing that reminded Alice of her mother; then evening hours, where she would sit and watch the other patients watching Jeopardy! or one of the judge shows or a bad TV movie. Then pills again, then lights out, then staring at the ceiling feeling the fuzz around her thoughts, then unconsciousness, deep untroubled sleep brought to her by Seroquel and by a body that had given up on fighting.
It was all terribly boring. She knew that was the point—her group therapist had said as much explicitly—and she didn’t mind boring, so much. The trouble was that all of that free time inevitably left her to think about what came next, and what she had to look forward to. She was both desperate to read her outgoing texts from the past several weeks and terrified at the thought of doing so. What had been said? Who had she insulted, threatened? Did Sadie know she was in the hospital? Her parents knew, and so Sadie must. It hurt to ponder how few people were left in her life who would have been brought into this confidence. There were no longer very many who would bother to ask after her.
Her parents had driven over an hour to the facility on her first night, but they had been informed of her condition and then turned away, and for that Alice was glad. But she could not keep them at bay forever, and now the day of their first official visit had arrived. She could not imagine what she would possibly say to them.
First, though, morning check—a nurse robotically checking her pulse, blood pressure, and temperature, then meds. She had thought she would receive them from someone behind a desk, waiting in a large scrum of patients, like in the movies. She asked the nurse to give them to her so she could swallow them all at once, but she shook her head no and handed Alice her three prescriptions one at a time. The nurse asked, as she always did, if Alice was suffering from diarrhea, so Alice lied and said no. After she had left, Alice took a shower, which was operated only by a button that ran lukewarm water for exactly two minutes before needing to be pressed again; there was no temperature control. She dried herself off with four hand towels not much bigger than an unfolded napkin. Then Alice ambled down the hall to the cafeteria, again struck by the half-empty halls, and today chose a mushy but sweet fruit cup, unable to deal with the effort of applying frozen cream cheese without destroying the bagel. She finished quickly and clutched her book up to her face, simply to hide from social interaction. It was probably an unnecessary defense. Then it was time for group.
Group therapy was . . . well, it was group, comforting and alienating all at once. And strange. Alice could not, for the life of her, develop a clear or simple attitude toward it; she did not look forward to group, and did not dread it, but dreaded trying to decide if she enjoyed it. Her general commitment to being the perfect patient stood, and she would participate as asked in all things. But group . . . in years to come Alice would decide that group was a lot like travel: In hindsight, things look fulfilling and rosy that were in the actual commission of doing them rather tedious. She got little out of group in the act of going but pulled much more from it when accessing those times as fuzzy and indistinct memories. Someday she would understand the therapeutic power of hindsight.
She was, as usual, the first to arrive in the windowless room. The therapist, a young woman who was clearly trying to appear older than she was, sat in her usual spot, her hair pulled into what looked like a painfully tight bun. She gave her usual half-smiling half-nod.
Soon the other four usual patients walked in. They had made their introductions every day, and Alice had tried willfully to refuse to learn their names; there was something terrifying about the prospect, about knowing them and them knowing her. But of course day after day of hearing them introduce themselves and complain about their own problems, she could not help but feel that she knew them now, at least a little. She had been told that patients would forever be cycling into and out of her group and to prepare for it, but as with her hypothetical roommate, no such turnover had yet occurred. They sat quietly for a moment in their chairs, waiting a good two minutes after their session had officially started, which was one of the therapist’s little contrivances.
At last she welcomed them and said that she had hoped they were having a good day. Group was an everyday thing, at least in that ward at that hospital, at least for those patients. She was unclear on why she had been put into this particular group with these particular people, and she would never learn. If she had interpreted correctly, there were two schizophrenics, one schizoaffective, one who suffered from depression and had a history of amphetamine-induced psychosis, and one Alice.
The therapist started, as she always did, with Daryl, and as always he could not be moved to introduce himself beyond correcting her—“D,” he would say, “D, say D.” And the therapist would immediately acquiesce and ask D to say more about himself and his day, which he would fail to do, only making soft grunting noises and occasionally stammering out a limited sentence about being hungry or cold. Always the same ritual, and every day it annoyed Alice more and more that the therapist would not simply recognize that D’s name was D. D was, Ronnie had told her, a schizophrenic with negative symptoms—he was withdrawn, barely verbal, moved very little, seemed constantly to be right on the verge of falling asleep. His belly hung with meds weight, which made Alice anxious; she had not had access to a scale since they first processed her through. She saw many of the other patients were overweight, their bodies battered by the insatiable hunger their drugs infused them with. And this was in a context where they could not control their own food intake. But she was still skinny, at this point, her ribs a record of her recent velocity. In any event, D always said very little and mostly rocked back and forth in his chair, and the therapist rarely compelled him to speak given his difficulties.
“Try a papaya,” she once heard him speak-singing to himself in the common room. “Try a papaya,” he said, rocking gently. “Try a papaya.”
He was a resident of a psychiatric hospital, seemingly a fairly long-term one, and he suffered from diabetes and hypertension thanks to his weight, but he seemed to be the closest to happy of any of them.
Jessie was not fat. Jessie was frighteningly thin. She was the depressed druggie, the one with a history of selling her body for meth and then smoking so much that she became psychotic. Alice was surprised to find that she still looked good, that she looked youthful, that her skin was not pocked with sores and her teeth were firmly implanted in her mouth. But Jessie was full of surprises. It turned out that her parents were quite wealthy and that she had attended expensive boarding schools, and it was there, not in some shady rural meth house, where she had developed her drug habit. Much of Jessie appeared on the surface to be cool, and Alice often fantasized of a life where they were tight friends. Certainly her tattoos and her profanity and her just-enough resistance to the group therapy project were attractive qualities. But there was a desperate quality to Jessie, a neediness, that kept her from ever seeming really cool. The distance between the detachment she affected and the need she clearly felt made her seem small and sad, and her petty acts of insubordination mostly just wasted time.
Today Jessie played according to the script. She said again that she felt “clinically depressed,” which Alice would discover was a knee-jerk tendency within such institutions; “depressed,” after all, was just a feeling. She turned over dim memories in her head of lying motionless on her dorm room floor, but found she could connect with none of it, could not make it relevant to what she was doing that day. The therapist asked Jessie if she had worked on her mood board.
“You know I have,” said Jessie sullenly. “You saw me do it.”
“But what did you feel, when you were doing it?”
“I felt like it was a fucking waste of time,” said Jessie. She said it a little too loudly, a little too insistently, and it created the air of theatricality that attended Jessie’s self-presentation as a mental patient. This was something Alice learned quickly: M ental patients were competitive, and in group therapy, they would compete. Jessie clutched a pen in her hand with a grip designed to mimic holding the cigarettes she was not allowed to have. It was overplayed, undergraduate. She looked small and sick.
“Well, then, you’re feeling something now, aren’t you?” said the therapist, looking pleased with herself. “I hope you shared that frustration on the mood board.”
Jessie’s little body twitched with annoyance. It was clear she would have liked to fight. But fight who, and for what? In this stay and those to come Alice would find that the psychiatric hospital was a space that inspired the urge to resist but contained no solid object to resist against. It was an antagonist but not a target, a big dumb ape that moved clumsily and hurt only due to indifference and was impossible to hurt in turn, its skin too thick, its hair to shaggy, and anyway it was only a vacuous animal stumbling brutishly according to its instinct and thus impossible to hate. Jessie swallowed, loudly.
“I want out of this fucking place.”
“You can leave at any time, Jessie,” said the therapist, cocking her head to the side. “We’ve discussed this.”
She clicked the plunger on her pen, in and out.
“As soon as you feel you’re ready to be released to the care of your parents.”
Jessie crumpled her wax paper water cup in her hand, another gesture of unconvincing theatricality.
“I’m an adult!” she shouted. “I’m fucking old enough to go on my own.”
“And that’s what the court order is for,” said the therapist smoothly. For a moment Alice thought Jessie might break completely, but the therapist started speaking in softer tones.
“Come on, Jessie,” she said. “Let’s talk about food. You’ve been doing so well.”
And so she did, and quickly the tension left the room. She talked about having a second banana yesterday to go along with her dry English muffin and black coffee, and soon enough this turned to her standard tale about the pressure her parents put on her and how getting high became her only release. As usual, by the end she was crying, as was the schizoaffective patient, Cynthia, and as usual Alice wondered why she could not cry herself. The therapist once again thanked Jessie for her emotional honesty.
Cynthia went next and, as always, she told a pleasant tale about taking it one day at a time and putting one foot in front of the other. She was bright and articulate, even though she spoke only toward the ground, and she was ever-ready to acknowledge that she had a psychotic disorder. There’s a certain species of mental patient, Alice would learn in time, that sees little space between recovering from addiction and managing their illnesses, and as is true in the twelve-step space, they take solace in constant self-identification. Ronnie the wardie had told Alice that Cynthia was a regular presence in the hospital; she would relapse into psychosis, arrive at the facility in hysteria, be brought down with meds in a couple days, then spend the rest of the week being as compliant and receptive as she could be. She would leave all smiles and in three or four or five months return with her delusions and her conspiracy theories in thickest bloom.
Alice had sympathy for Cynthia but disliked sharing group with her because of her utter dedication to repeating self-care clichés she had found in Instagram memes. On the other hand, her introductions were usually short. The same could not be said of Gerard.
Gerard was in his mid-fifties but had a certain boyish quality to him, and had that strange feature some aging men have where his graying temples actually made him appear younger. He had schizophrenia, which produced some negative behaviors that remained permanently vague to Alice—he was paranoid about money, was the sum extent of her understanding, but she knew it must have gone beyond that for him to be here. To be here again, that is. Gerard was the type of mental patient who refused to ever drop his affected sagacious attitude, making free with a homespun folk wisdom that combined “eat pray love” aphorisms with a little bit of non-denominational Jesus and a lot of big opinions about other people’s diagnoses. He had already pigeonholed Alice and chewed her ear about all of her problems, days earlier. His introduction was its usual mix of self-aggrandizement and shameless sloganeering, and the therapist’s barely hidden distaste for Gerard was one of the only things Alice liked about her.
Eventually Gerard ran out of clichés and staggered to a close. “Check-ins” had once again taken half of their therapy time. With considerable ceremony the therapist rotated a whiteboard on one of those freestanding easels; it contained a word cloud, sans words. And in short order she explained that they were to share words and find connections so that they could better understand what united them. The activity went as planned, which is to say that each participant playacted their role—Jessie rolled her eyes but was eventually compelled to participate, D made soft vague noises until the therapist wrote down a word she pretended he had said, Gerard talked over everyone, Cynthia named only positive qualities in an exercise about debilitating mental illness, and Alice quietly fulfilled the requirements of the assignment, adding “scared” and “fast” and “alone” to the word cloud.
As they always did, the group ran out of steam, suppressed as they were by powerfully sedating medications and having exhausted their opportunities to talk about themselves. And so the therapist spoke soothingly and vaguely about what they had learned, running out the clock as each member of the group gradually withdrew further into their sedation and their sadness. And then group was over.
As she left to go, Alice found herself intercepted by a wardie, and she felt dull cold fear inside of her. It was time. Her parents were waiting in the visiting area.
The tables and chairs for visitors were stooped and little and her parents looked vaguely ridiculous as they waited. She walked toward them robotically until they noticed her and rose. Her father looked haggard and like he had not slept; her mother appeared beatific and calm, possessed of the maternal benevolence of one whose child was reaching out for the last branch. Alice hugged them both awkwardly; she had never shared a non-awkward hug with her father, even when she was little, but it stung to feel her mother’s body pressed against her and yet so distant. They sat back down at the little table, her chair so low that her knees rose up comically high against her body.
They simply sat together, and Alice nurtured a little hope that they might just sit silently with one another for the first time in her life—exactly what she needed. But her mother soon began the expected babbling, talking about women at church, local politics, and how everyone had been asking after Alice without ever coalescing around why they might have been asking after Alice, why she had become someone that people asked after in concern. Alice’s father studied the floor, as expected. Alice was only tired; her thoughts had to burrow their way through mud to get out, so she lagged behind the conversation in a way that her parents couldn’t have missed. Finally her mother said something that referred to the present situation.
“They told us what you got.”
Alice could only nod robotically.
“Yeah.”
“They talked to you about it, right?”
The question irritated Alice to no end. What did she think she was doing all day?
“Yes,” she said.
“They gave me a brochure,” she said, reaching into her purse. “I got you one, too, so you could read it when you get out.”
Alice looked at the two brochures, stamped with smiling faces on their covers, and found she could bear no ill will toward her parents. As it had periodically in recent days, the fact of the burden she was imposing on her parents sent a shiver of shame down her spinal column. She thanked her mother; she could think of nothing else. Her father stirred.
“No credits, this whole past semester,” he said. “I called ‘em. You didn’t get a single credit.”
“I’m sorry,” said Alice.
“They don’t give you the money back,” he said, then shook his head. “Goddammit, Alice.”
She had not expected this—she could count the number of times her father had spoken to her in anger on one hand—but it felt good. She wanted to be castigated, needed it. She immediately regretted her reflexive apology; had she reacted angrily she might get as much as she deserved.
“I’m thousands and thousands in debt to that school,” he said, shaking his head and refusing to look at her. “Thousands and thousands and no credits for an entire semester.”
“I’m sorry,” she said again, and felt certain she would be crying if not for the hundreds of busy little milligrams working their magic in her brain.
“We gotta, we gotta, we gotta talk,” he said, now tapping his toe along with shaking his head. “When you get right.”
“Talk about what?” she said, suddenly annoyed.
“You might have to go to State around the corner so you can live at home,” he said. “I’m breaking my back for a dorm you don’t get any sleep in.”
“That’s not what we’re here for today,” said Alice’s mother. Her tone had the predictable effect, and he backed off.
“Honey, we just want you to rest and get well and we’ll be there for you when you get out.”
“When do I get out?” asked Alice.
“Well, you’re free to go whenever you’re ready,” she said carefully, repeating a line that Alice had heard a lot lately. “But the doctors think you need more time, and so do we.”
She was not entirely unaware of the scenario—she was a legal adult, her current stretch of hospitalization was voluntary, and she could force her way out if she wanted to. She wasn’t sure if she wanted to. But now her mother had let her know that they wanted her to stay, and she was sure she did not want to disobey them. Not again, and not like this.
And with that she moved back to small talk, to Alice’s relief. At times her father even participated. This was a kind of ball Alice knew how to play. As she did, she turned the question of whether to stay or go over in her head again. The institution was sterile, lonely, and cold, and she was prone to feeling shame for being there. But nothing was expected of her, here, and she wanted for nothing, and she felt no particular desire to go. She felt that she was balanced on a wire between staying and going and thought that the slightest breeze could push her over onto either side and she knew if it did she would feel no remorse no matter what the direction. And here was her mother, telling her to stay awhile longer, and so that was fine by her, by her illness, and by the world.
In time they ran out of small talk and her parents rose. She clutched her mother and grasped her father’s forearm in affection to ensure his own comfort. Her mother cried as she walked them to the ward door and showed them out. Alice’s mouth tasted like chalk and in her head impulses rose up but could not sustain their momentum, thoughts smothered under the blanket of therapy and medication.
She wandered back to her room. She had taken to sprawling out in the empty bed during the day but Ronnie had softly told her it was unfair to the staff to force them to make another bed for no reason. Her visiting hours had gone long and she was missing origami, the only craft therapy day she had been interested in, but it didn’t seem sensible to go halfway through. She picked up the Dan Brown novel and thumbed through it. She tried again to carry the thread of the conspiracy it described; shadowy figures worked tirelessly and in silence to impose the whims of ancient powers, distant and inscrutable and unseen. The words passed as easily as writing ever could, and Alice made her most aggressive advance yet, but in time she surrendered. The cognitive effects of her drugs were just too persistent. She would concentrate, and concentrate, and concentrate, and then suddenly she would be realizing that she had drifted off again. This feeling was pure hindsight—she lost time. She was reading her book and then she was realizing that time had passed in which she had not been reading her book. She read a sentence and forgot it and reread the sentence and remembered it then finished the paragraph and forgot it. So she stopped. It was a shame. This was the perfect time to read. But her brain wanted one thing only, to rest, to reconstitute itself like vapor into a cloud or a cloud into rain. Perhaps, someday, rain into a placid lake. Somewhere deeper in the recesses of the institution someone was screaming, but the sound was dim and distant, and then Alice was tired in the way of high-dose antipsychotics, the wandering exhaustion that will pad into your body and settle in for a nice long stay, and so she closed her eyes, and though it was early afternoon, she sank into a black and empty sleep.