#1: I’m condemned to insanity
The nurse told me that if I resisted the insertion of my nasogastric tube, she’d restrain me and shove it up my nose. I was 11.
It hadn’t even occurred to me to fight. The doctors and nurses around me just assumed my every breath spread chaos. At that point, my body was no longer my own—the opposite of anorexia’s intent. I’d lost my battle for control.
The situation would drive anyone nuts.
#2: I take up my Cross
When I was admitted to the hospital for anorexia, my shins looked like bruised bananas, blue-blacked from starvation. Nutrition healed them, but I couldn’t forgive that it was forced down my throat.
Armature grew flesh. Every time I stepped on the scale to be weighed like an animal for market, I fantasized I would float away. But levity was past. I was grounded now.
#3: I fall for the first time
I lived among the sane for three years. In the spring of my sophomore year of high school, I became so depressed that I stopped going to school. My mother committed me to an adolescent psych unit for six weeks, until summer vacation started, in part so I could finish the school year there. Before I was discharged, its oracles prophesied I would spend my life in and out of institutions, though they didn’t say why. Mental health practitioners draw power from suggestion.
So far, this forecast hasn’t panned out. I was held for psychiatric observation due to suicide attempts seven times as an adult—cumulatively, for less than a month. That I challenged if not shattered this prediction comforts me. I feel like I won a senseless war.
Still, my six-week stay in that adolescent facility, situated on Florida’s Treasure Coast, was more fun than you’d think. With its endless volleyball, late-night Ouija board games, and dirty-mouthed evening staff, the hospital was a bit like a posh summer camp, albeit one that allowed the possibility of being strapped to a bed for misconduct rather than kinky fun. There was some of the latter, too. One of my fellow patients, a pregnant prom queen who braided her blond hair like Bo Derek and was sweet as hell outside of high school hallways, arranged for a quickie in the bathroom with her boyfriend during a group outing to a bowling alley.
#4: I meet my therapists
After my childhood, I tried to avoid institutionalization at all costs. I could never view my sessions with therapists and psychiatrists, or even a routine checkup with a general practitioner, as anything but a dangerous dance. Think of the scene in It’s a Wonderful Life in which Jimmy Stewart and Donna Reed Charleston across a gym floor that’s opening up to reveal a swimming pool beneath. In my therapy sessions, I imagined that if I danced too close to the edge—if I said too much—I’d plunge into the asylum’s cold waters.
I can identify by face if not name 20 therapists and psychiatrists who ministered to me on an outpatient basis from age 18 to 38. There was even one social worker, a canny Berkeley woman with lips cushioned by a plastic surgeon and keener perception than most. Once, when I was down because of a destructive and absurdly fun relationship, she encouraged me to harness my “inner courtesan” since she knew I’d loved working as a hostess and dinner escort in Tokyo. Apart from that comment, the best piece of advice I received from the whole lot was to watch Buffy the Vampire Slayer and luxuriate in its female empowerment.
These are just the therapists I met more than once. At the end of a half dozen first sessions, I was told, “I’m afraid I don’t have the time required for your complex case.”
Translation: I don’t want the bother. And, given my history of suicide attempts, I don’t want the risk.
#5: Agnes helps me carry my Cross
During a 72-hour psych hold in the East Bay, to which I was consigned when a switch from Cymbalta to Wellbutrin briefly tipped me into mania, I met a woman who made me aware of the comparative privilege of my insanity. Agnes was large-boned and middle-aged, with lank brown hair and a hardened face that belied the great gentleness beneath. She’d spent the recent months homeless, yet she was far calmer than I was, just out of my San Francisco house. She sat by me for hours, listening to my recitation of problems that must have seemed enviable to her—rocky relationships, a stalled career.
Just before I was released the following day, I put on a green “Galaxy” dress by Roland Mouret, which my first husband had brought at my request. I indulged in high style whenever I was an inpatient; while I was denied makeup—it fell into the category of “sharps,” though how you can self-harm with lipstick I’ll never know—I always dressed in my own clothes rather than ward pajamas. I used fashion to insist on my humanity, a behavior akin to that described by my Italian father-in-law, who spent time in a refugee camp after the Communists forced his family out of Istria. In the camp, he ran into a former teacher who took pains to keep his one suit clean, a protest of self-worth and autonomy in an environment that decimated both. I was in a more fortunate situation, but my voguish madhouse clothes pivoted on similar principles.
At least the dress made Agnes happy. “You’re such a doll,” she said, looking at me with pleasure. If I was a doll, it was only with an assist from pricey clothes. My new friend, by contrast, was an angel in hospital blues.
As I was leaving, I gave her my number and urged her to call me. She smiled sadly as she refused. “I need to pull my life together first. You don’t want to let me into yours when I’m like this.”
But this lady had it backward. She had become a beautiful person despite falling through the system’s cracks. I pray she found shelter.
#6: Sarah wipes my face when I cry
When I first saw Sarah, she was talking on the nurses’ station phone in the psych ward of St. Francis Hospital. She said later, in explanation of our gravitating toward each other, “You can smell intelligence.” Her harsh wit contrasted with her chubby cheeks, nestled within a stubborn mass of auburn hair thick enough that she was once able to forego washing it during the entirety of a two-week 5250 psych hold without deleterious effect.
She lived in San Francisco’s Mission and worked as a private chef when her health allowed it. It hadn’t allowed it for a while; she suffered from ulcerative colitis and the opioid addiction it spawned. She loved fish tacos, Barcelona, Persepolis, gardening, dance, her cats, and, for some inexplicable reason, the television series Big Love. We spent five hours howling with laughter that first night. The charge nurse allowed us a room to ourselves in the back of the ward and only checked on us every hour or so, with the discreet eyes of one enabling an affair.
The next day, she was released, and I went home two days later. For once, I’d gained something from my time in a psych ward: a friend.
#7: I fall, over and over again
The suicide attempts happened more often. One time, a Tylenol overdose landed me in the medical wing of the hospital for five days. Fearing for my liver, the doctors bade me drink a sulfurous concoction, which smelled and tasted like the underworld that had just vomited me up. I didn’t even have the power to leave this plane.
#8: I try to help a woman with more troubles than me
Several months after we met in the psych ward, Sarah was institutionalized again. Her mother and brother said they worried about her, yet wanted nothing to do with her care. They kept resorting to involuntary commitment—that is, to dumping her on someone else. I imagine that by dealing with the problem this way, their consciences felt clean. She’s certifiable, see. She needs to be in the hospital, cared for by professionals rather than her family.
It’s true that Sarah was in trouble. She slept for days, dosed with pills of all sorts, and barely left the house. She’d concocted various schemes for coaxing opioids from the ERs of local hospitals, visiting them one by one and altering personal information each time. “I swap my birth month and day, and if I’m caught, I’ll tell them I just got back from living in Europe and forgot the American way of writing dates,” she explained one technique.
However, a certain hospital had caught on to Sarah, her brother claimed. Sarah had told him that she trusted me, so he occasionally called my cell phone to voice his opinion that it might be better if she “dried out in jail” or was confined to a hospital indefinitely. I reminded him that she was only abusing pain meds because she suffered from pain, both physical and mental. I explained that mental hospitals offered only short-term, crisis care. They weren’t geared toward permanent solutions or recoveries. For those, she needed her family.
The next time her mother convinced the police to collect Sarah for an inpatient psych eval, her doctors determined to keep her as long as her insurance would allow. The evidence of her mental disorder were shots of the inside of her house, taken by a friend in collaboration with her mother. Sarah was a hoarder, and the pictures were framed with the solemnity of crime scene photos, each overflowing room as damning as a corpse. Mental patients can be held if they are deemed too disabled to care for themselves at home, and hoarding could satisfy this criterion. My friend panicked and asked me to intercede.
After several days, her doctor finally returned my call. I offered to move in with Sarah once she was discharged, so that he wouldn’t have to worry about her managing on her own. As I was in the process of separating from my first husband, the change would help me out too.
“That wouldn’t be a good idea,” he admonished me, in the tone of an adult correcting a dim-witted child. “Don’t you know she’s in love with you?”
But it wasn’t like that. I don’t think he understood that for those of us who are mentally ill, all we can do is love and love and love, and hope that someone finally grabs hold to break our fall.
#9: I’m felled
An hour or two after I was admitted to the psych unit, I approached the nurses’ station to request a phone to call my husband. While I waited, I turned slightly and brushed the wheelchair of a patient who had materialized to my right. “Excuse me,” I said, just as a nurse handed me the phone with its suicide-proof, foot-long extension cord. I turned to the left.
The rest was hardness and drowned sound.
Later, witnesses helped me piece together what happened. The woman in the wheelchair, who suffered from schizophrenia, had stood up, thrown me to the ground, and kicked me repeatedly with her prosthetic leg. I don’t know what set her off; I assume, as with most sudden violence involving insanity, that provocation was beside the point. She’d already assaulted a nurse earlier that day.
Like any moment of trauma, my memories of it are vivid but fragmented, cleaved like sashimi into fleshy flashed squares. I see the floor. I somehow see my back being pummeled. Out of the corner of my left eye, I spy an orderly hunched forward and pulsing up and down like a football coach on the sidelines, waiting for his buddies to back him up before diving into the fray. Eventually, this man and others joined forces and managed to pull the woman off me. She had been screaming all the while, her words sinkholes in language’s paved roads. In memories, I can’t hear my own screams.
After the beating, in shock, I was wheeled downstairs for a CT scan. While I awaited the results, I lay on my bed, surging on the crests of painful breath and endorphins. Suddenly, two medics burst into my room with a gurney and announced they were taking me to critical care. “You’re bleeding internally.” They assured me I would be given morphine for the pain and I protested, with the born-again tune of the newly clean drug addict, that I couldn’t take it. “You’re going to need it,” one of them laughed, not unkindly.
That laugh signaled my promotion from a person hospitalized for mental illness to one needing care for physical injuries. The first is stubborn perpetrator; the second, a victim. I noticed the stark contrast in the attitudes of my caretakers, especially when a psychiatrist peeked in on me three days later to see if I needed to be returned to the psych ward once I was stabilized. By this time, I had narrowly escaped emergency surgery in lieu of two blood transfusions and passed nights in which agony was synced with breathing. So I told him the truth: The attack had shown me I wanted to live. He smiled and agreed with me that it would be safer to stay away from the psych unit, thus ending my first and last amiable exchange with a hospital shrink.
#10: I am stripped of my garments
If I hadn’t been so scared, I might have protested. My hands shook as I unzipped my dress, a black-and-gold riff on the cheongsam by Derek Lam. I’m no prude. But this wasn’t an artist’s studio, and rather than cameras and reflectors, I was surrounded by medical instruments and hospital charts. These objects are colder observers of the body’s thrills and throes.
Beneath light the tone of a kicked pail, I felt more naked than ever in my life as the nurse eyed my body. At first I thought she was looking for cutting scars or other proof of self-harm, but she chilled me further when she clarified she was cataloging the bruises I brought with me to the ward. The strip search was a rite of protection, just not for me.
Lack of protection harrows more than an overt threat of violence.
Psych wards entail multiple holds—on time, on freedom of choice, on dignity. They imprison people like me to spare us self-harm yet rake new scars across our bodies. Liability is reserved for the insane.
#11: So many are nailed to this Cross
Power is a many-headed hydra. Beyond the psych hospital, other maws can swallow bodies whole, and have.
The mentally ill are crucified by the American criminal-justice system itself. More than half of male inmates and as many as 75% of female inmates in American state prisons suffer from mental illness. Alisa Roth writes in Insane: America’s Criminal Treatment of Mental Illness, “Today, the country’s largest providers of psychiatric care are not hospitals at all, but rather jails.” And the disorders their prisoners enter with are made far worse by hideous practices like long-term solitary confinement.
Many accused of crimes and plagued by mental illness don’t get as far as the jail. Up to one half of police-shooting victims in the U.S. have some kind of mental disorder. In Canada, Black and Indigenous peoples most often end up dead when the police arrive for a wellness check. In May 2020, a Black Indigenous woman named Regis Korchinski-Paquet fell to her death from the balcony of her 24th-floor Toronto apartment while numerous police officers were present. They’d been called to the scene following a domestic dispute between Korchinski-Paquet, who was harried by epilepsy and mental illnesses, and her mother and brother. After her death, her family alleged that a police officer had pushed her. While the police were cleared of wrongdoing, it’s not just a question of whether she was physically pushed. The Law shoves the most vulnerable over a metaphorical edge.
Hospitals can be just as deadly. A few months after Korchinski-Paquet’s fall, a 37-year-old Indigenous woman named Joyce Echaquan filmed nurses verbally abusing her as she died in a Quebec hospital. As a result, leaders of Atikamekw, her First Nations band, drafted Joyce’s Principle, a document aimed at ameliorating systemic biases against Indigenous peoples in medical care.
I could go on, but I could never speak for all of these people, all of these bodies denied their sovereignty. I can, however, continue the story of the woman I knew well.
#12: She dies
My new husband Mark and I lived with Sarah for nearly a year. She witnessed our wedding.
After I left San Francisco, Sarah and I kept in touch via frequent emails and texts. Two years later, I phoned to tell her that we were leaving for Lublin, Poland. It had occurred to me that, apart from the research opportunities it afforded, Eastern Europe might be a good place for me to dry out from my psychotropic medications, most of which weren’t available there. I suggested to Sarah that she visit me, and we could get clean together.
“I would love to see Auschwitz,” she admitted, in the tone of someone saying, “I can’t wait to go to the Dickens Christmas Fair.” But I understood that it wasn’t because she took the Holocaust lightly; more than most, Sarah just couldn’t imagine the evil and cruelty that had produced it.
I didn’t hear from her again. Instead, two days later, I got an email from her brother, brutal in its brevity.
“Sarah died yesterday. We tried.”
#13: I’m taken down from the Cross
After the freshest grief passed, I experienced something just as shocking and nearly as painful: lucidity. From this new vantage point, I saw that I hadn’t been able to help Sarah, but maybe I could help myself, as she would have wanted. I didn’t know how I would accomplish this task. At 38, I had no fixed course, very little money, zero confidence. On the plus side, I had Mark, our cat, a fellowship, a mad love for the written word, and a ferocious desire to live.
So I started to try. First, the withdrawal period from all meds. Mark washed my sheets every morning following my night sweats. Then I started scampering through the inscrutable playground of Ks and Zs that is the Polish language. I read history books and tried to forget my own past, or at least its learned behaviors.
After about six months, the floor no longer pitched beneath me. I traveled to Zakopane, the mythical village at Poland’s southern border curtained by the Tatra Mountains. This was where my distant cousins sailed to midnight mass on skis amidst snowstorms and found their courage during the moral whiteouts of World War II. I reflected on horrible crimes against humanity and the people who tried to stop them. Felt apart and a part of that nation, this world. And at last I seated myself at the desk in our Lublin apartment and began to write again.
I’ve long thought that my mother doesn’t understand me, yet she once said, when I told her in my 20s that there was never a time when I didn’t wish myself dead, “I don’t believe that’s true. I think that when you’re writing, you’re happy.” In Poland, I relished the full truth of that statement.
I then remembered that when I was in the summer-camp psych ward as a teenager, my mother wrote me a letter promising that just as she had carried me home from the hospital as a baby, she would carry me home from this one too. Such sentiments weren’t typical of her, and I’d grown to distrust this one over the years. Now I hugged it to my heart.
I also understood that I was finally able to carry myself.
I returned to university teaching. I realized I could use the pain I’d experienced to teach my beautiful young students to write and to trust, and that they could not do the first well without the second.
I brushed against joy, that thing in the dark that holds still, for decades or even a whole life, and waits for us to notice it.
#14: Via Lucis
After all the darkness, I’m sometimes frightened by the way of light. By what I thought I’d wanted during those years of diagnoses and treatments, doctors and hospitals. There’s often not much to choose between our heart’s desire and worst fear.
When I was attacked in the psych ward, my assailant pulverized my liver. But it’s the one internal organ that regenerates. Even the myth of Prometheus evokes this miracle: As punishment for stealing fire, an eagle devoured his liver every night, and he grew it back the next day.
Regeneration is a principle of both nature and religion. Japan’s Ise shrine, its most sacred, may have existed on its site for two thousand years, but it is rebuilt every two decades. No nails join its walls. I feel a consonance with this shrine now that I’ve yanked out all my nails and reconstructed my life. The Sacred Mirror in its inner sanctum reflects a cycle of renewal, the bedecked pilgrimage of the seasons, over and over again. I see my health in it.
Yet if I ever need to seek help for mental illness in the future, I know I’ll hesitate. I’ll worry about the power imbalances and condemnations, the crosses and punishments. I wish I could have more faith, but the mirror of medical care exhibits the defects of institutions and discourses.
After my attack in the psych ward, I started a lawsuit to cover my medical bills. The hospital’s lawyers told mine that they intended to drag it out as long as possible. “They think you’ll kill yourself in the meantime and save them trouble,” my lawyer helpfully explained.
But I’m still here. Not the same—none of us is the same after we bear our crosses. But I’m here, and I’m among the lucky.
STORY IMAGE CREDIT: Charles Clegg/Flickr Creative Commons