The door through which you enter matters. It is one of those benign things that can change the cadence of your life. It is like the chair you sit in next to your future spouse. The door is like that. But not at all like that.
If you carry yourself up that concrete mountain and walk through the front door—that is, if you willingly admit yourself—then you are, by definition—admitting to your crazy and are thinking, at least right now, that you’d like to do something about it.
This will work with you and against you.
If you are dragged through the back doors—which can be accessed only by EMTs and the fuzz—someone else has brought you in. Which is an entirely different ballgame altogether. You haven’t quite recognized, let alone admitted to, your own state of being.
This will work with you and against you.
You are pulled, fast-pass, into a smaller, more volatile subset of people that are the very definition of acute. You are, statistically, more likely to be taken upstairs to be hospitalized for, at the very least, seventy two hours. It is a kind of disappearance—you have been picked up off the street and have suddenly vanished.
There is a door separating the front and back room. It locks automatically—the only sound you start to pay attention to is the jangling of keys. The keys are an indication of movement. The sound is a promise—you may not die in Western Psychiatrics’ diagnostic evaluation center after all.
First they’ll bring you a clipboard with a piece of paper on it, the white contrasting bleakly with the fine black print. Somewhere within the jumble of words that you can’t quite read at this point because the place is so damn sedating, is the confirmation that you will not be falsifying your identity or your insurance information. Just sign whatever they hand you.
They will leave you alone for an honest to God indefinite amount of time. This is natural. You are supposed to turn your head and watch Cars 3 or HGTV (it’s always Cars 3, or HGTV).
But first survey the area. It’s always good to know where you are. I mean, they’ll ask you if you know where you are a lot, so have a good answer. Or at the very least, a fun one.
The floor, a speckled blue-green and the wall, a different shade of blue. A shade that—while intended to be calming—will irritate you into a slowly revolving madness, the scope of which will increase every time you notice the difference. The bathrooms are locked. So if someone has to go, expect to hear a sheepish request or a screaming declaration of the need to pee. The chairs are nailed down so that no one can throw them at anyone. You will think, wow, they’ve thought of everything.
But then they will call your name, like a question, like they didn’t take your picture just moments before and brand you with a plastic band that literally has your name on it. Like a question. Like, “Do you remember your own name?” They will lead you into an interview room, except someone has scratched or ripped the v off the sign, so now it’s just an “inter iew room”. You will think this quite impressive, considering they have already taken away anything sharp you could use to kill yourself with, the entire place soft then, by nature. You will realize that if you were more creative, and more up to it, you could probably find a way to end it all.
It’s always the same person. I mean, it’s always a different person, but they all amount to the same tired face, leaning in, clipboard in hand. So many clipboards. Everyone wears scrubs, everyone you meet, which is odd because they’re not reaching inside you.
They’ll take your vitals, to make sure you’re not actively dying. Just passively. Which is much more terrifying.
It slipped my mind—bring a book. Paperback, so that it won’t disappear into some back office because you could “bash someone’s head in with it.” You usually get it back when you leave. Usually. Guards are forgetful.
If you’ve been cornered by the police or rushed there in an ambulance, you have obviously been blindsided by timing, as we often are. There are two options at this point—make friends or avoid eye contact entirely.
Again, read the room.
They will bring another clipboard, and—this is what separates the temporarily and chronically ill—they will ask for your information, or they will ask for an update. The second implies that you are fucked, again. That you are already on their radar, that there is probably no moving off of it, that you frequent here about as often as your primary doctor’s office. You are crackerjack, my friend, and you already know what it’s like.
After you’ve watched the clock spin around like some intricate ballet that you couldn’t find your way out of, after you can’t even recall why you’re there in the first place, they will ask your name, a philosophical question at this point, Am I myself? Will I ever be again? You will be brought back into the interviewing room and asked to tell your story. Which is unfair because you won’t actually say what you mean to. Stories are in the details anyway.
There are three (consistently cold) chairs to a room, which is odd because they have only ever asked you in by yourself, there is only one person who interviews you. This is a big decision—sit closer to the small window that isn’t really a window because you can’t see out of it; or sit closer to the therapist, which implies a trust that has in no way been established yet.
I don’t have an answer for this.
And, almost as naturally as saying their own name (is it a question?) they will say ask, ridiculously, like you’re in a department store:
“What brings you in today?”
I dig my fingers into my kneecaps and smash my kneecaps into each other and this chair just sits under me hearing me think my whole thoughts and then I take a big breath and then I let it go.
“Well, my psychiatrist decided I was manic and she called the cops which I think is unfair because all I did was dance on her desk and then run out screaming and then I hid two floors underground from the cops which I think is impressive because I made it four hours and they went to my house and my work and everything but then they cornered me and handcuffed me and now I guess I’m here.”
“Why do you think they brought you here?”
“Oh I don’t know. What I do know is that they handcuffed me, the cheeky bastards! It’s a cop kink, I’m sure of it. They locked the handcuffs onto the back seat of the van—a whole van, just for me!—but they didn’t know that I’m a magician so I just said, ‘And for my next trick!’ and pulled on the cuffs. It didn’t work. Magic is weird like that.”
“If you could just stop pacing…”
“It’s absolutely freezing in here its March this is bullshit and I have a thermodynamics final in two days but really all I want to do is dance until I literally die which isn’t even a problem because the ending is inevitable. I’m just writing the script. I’m like God in that sense. Do you remember the story of Abraham when he was just going to set Isaac on fire and then God was like, ‘Woah, bro, I was just kidding,’ and then Abraham was fucking wrecked. Kierkegaard was wild about this story, one of the pioneers of existentialism, it’s my philosophy, it’s my religion. You’re standing at the edge. Jump. Don’t. But tell me about you, what brings you in today!”
He’s popped his collar because he thinks it makes him look cool. He thinks he’s cool because he’s not wearing scrubs. He’s got shit red shoes that have no arch support and he won’t understand this at all. Still.
“Have you ever had that moment—it’s fleeting, but it’s there—where you just think, ‘I really want to kill myself?’ And then you do and everyone is like, ‘Wow, we never saw it coming,’ but of course they saw it coming, they just already let go and they realize it all at once. While they’re walking. It just hits them all at once. They already said goodbye. They fucking knew. In every word they ever said to you—it was laced like the wedding dress on a cheating bride. ‘Goodbye.’”
And then I just smile and wave. And he just picks up his hand from his fucking clipboard and waves back with the oddest look in the world in his eyes. Just past his hipster glasses. The glare won’t hide it. It’s fleeting. But it’s there.
“It’s sort of a fantastic story, actually.”
And then I sigh, the weight of these past three weeks releasing itself in this arbitrary fashion. She is the same person—well, not literally, but functionally, and essentially, she is the same as all the others. She is sitting with her legs crossed, her flower scrubs wrinkling, her clipboard on her lap. It’s the same as last time, except this time the weather’s better.
With the last shred of energy I have I gather myself for a momentous performance, as this has been, and will be, the most extraordinary thing to happen to me in my entire life.
I am twenty one years old.
“I’m a physics major, which implies that I’m already mental. I was accepted into an international research program, and I was shipped off, alone, to France. It was supposed to be for ten weeks. I thought I was going to be living with other people from the program—we had been accepted from colleges all over the world—but I was the only one to choose the project that was being carried out in Toulouse.
“Everyone else went to Grenoble. I think this would have turned out much differently if I had gone there too. But I digress.
“So I’m in Toulouse living in a shoebox all by myself. There is not a whisper of a soul in this apartment complex. And everyone in the lab, although perfectly capable of speaking English, decided to speak French around me. I want to say that I’d like to think that they just hadn’t realized I was there, but that’s even more depressing. So I am sold on the idea that they were assholes.
“The point of this is that I was lonely and I missed my family. My depression was gaining momentum and the only thing I knew to turn to was running. So I ran. I listened to Foster the People and Marianas Trench and I ran. And then I stopped eating. And I had already smuggled some diet pills on the flight—I’m an anorexic, I was just here for treatment in May, but it says that on the form, you know that.
“I thought, ‘If nothing else, I will use these ten unsupervised weeks to lose all the weight and come back a specter, a wisp of a whisper of a girl that nobody actually knew. And then everyone will see.’”
“See what?” she asks.
I’m quiet, for a while. The room fills up with all those forgotten sounds. The radiator, her foot tapping on the floor, my own unerring breath. A song of silence. Pervading vibrations.
“I don’t know.”
This question doesn’t quite floor me. It almost does. It does not. It’s the sort of thing a stranger would ask. It’s something so obvious about me it’s painful that someone else notices it first.
“But then I start stockpiling my depression meds and my diet pills and one night I just laid them all out next to a jank knife that I bought at the French version of Walmart and I think, ‘I’m going to do it. I’m really going to do it.’
“I had developed a super close relationship with one of my customers—I work at a grocery store—and she was begging me to come home. She was this tiny voice in my bones. Not my head. But my bones. ‘Could you even imagine life without you?’
“So I came home. It was a painfully impressive feat. My girlfriend booked me a flight for four in the morning and I had to pack up my entire apartment in six hours. I just threw an entire apartment away—the pots and pans, the food, the clothes that shrank in the wash. French laundry is different than American laundry, I swear to God. I looked like I was covering up a crime scene.
“The fun part was that I was supposed to be getting on a plane with my—I guess he’s the French equivalent to a research professor, at six a.m. that very same day. We were supposed to go to Grenoble.”
“I was going to give a presentation. I was going to be different than I am.”
And here, for a moment, a devastation like a natural disaster, a waiting for a response, a heartless president in a neighboring country. Except the president is me and the disaster zone is me and there’s such a dissonance that the two seem far, far away.
“And the flight was just wild, I’m telling you. I hid in the airport afraid that my boss would see me. I wore a white shirt and crazy leggings and a black pair of short overalls tied it all together. I looked like a child. I always look like a child.”
I am wearing a pretty striped dress and black strappy sandals and a ribbon in my hair that I know will be taken away upstairs. Noose hazard. But it’s weird because no matter what they take away I will still look like a child.
“I had to go from Toulouse to Frankfurt to Canada to Pittsburgh and let me tell you, Frankfurters—Frankfurtians?—are insane. Well.”
And I gesture around the interview room.
“Maybe not this insane. But they were eating hot dogs, in the airport, at nine in the morning! There was a fucking line for the hot dog stand! I had a cappuccino. Like, a real one, an Italian one. I’m never doing that again. And the plane from Frankfurt to Canada was eight hours long—I hate planes. You have to decide whether to sit clenched into a ball so as not to touch your neighbors the whole time or just play uncomfortable footsies with them until you land but then not exchange numbers, like a one foot stand, you know? The steward brought white wine and I said, ‘Leave the bottle,’ because I honestly didn’t expect to make it this far.”
I want someone to clap.
“I really didn’t. Also I don’t have a drinking problem, don’t send me to the drugs and alcohol unit. Which floor is that again?”
“Ten,” she says, frantically writing things down. What things? I’m just telling a fun story at this point. What have I said that could possibly be entered as notes?
“So I came home yesterday and there was a giant inflatable duck taking up the entire living room. I don’t know what goes on there anymore. But my therapist here, Erin Thompson, maybe you know her? She made me promise to come here as soon as possible. I just needed to get my bearings, pack a bag. She said she’d call down here to try and expedite the process, getting me upstairs. Eighth floor. But I had to come through here first.”
She blinks wildly.
“I’ll check to see if there’s a bed upstairs for you.”
I get the feeling—it settles down into me like a chilly Sunday morning—that all the therapists in the evaluation center think eating disorders are disgusting.
Someone comes to draw blood and take an echocardiogram to make sure my heart hasn’t shrunken irreversibly. I want to tell them that it has, that everything has shrunken inside, but I don’t know how.
The girl doing my echo is a student. She’s not exactly sure where the wires go. I stick them on for her.
“I don’t think it’s really that bad. I had a momentary lapse of judgment, but I’m fine as a fiddle now.”
He peers up and out of his glasses. It’s the same guy. Literally the same one. I recognize his shoes. They’re red. They have no arch support. It’s something that I feel like he should know? But he doesn’t. Now I’m wondering if he’s even qualified to be a doctor.
“You took seven diet pills. Tell me again why.”
I can feel myself resisting. I also cannot help it.
“I just wanted to see.”
I’m a proper idiot.
“To see what?”
I haven’t eaten in hours. I’m still shaking. The cacophony in my heart won’t stop. I think it’s going to explode. I just learned how to pronounce cacophony.
“Exactly how many it would take.”
Really it was a panic response to my entire family going out to a Chinese restaurant last night. Oil. The oil settling in on my face. The grease sticking to my thighs. The caloric waste in the sauce. But what I’m telling him is also true. I don’t realize it until I’m saying it.
“But that was just a fantasy. It wouldn’t play out well.”
“And what do you want to do now?”
This is the critical part: the convincing. Because God do I not want to be tucked away in here for weeks again. I don’t think I can do this again. It was a fucking nightmare. He strokes his little goatee. Is this guy seriously a psychiatrist? He looks about twelve.
“I want to go home. I don’t feel suicidal. I will be safe. I have a safety plan made, and I’ll be with my girlfriend all night. The urge has passed. I promise.”
A smile. My eyes climbing from the sinkhole of death and into an ethereal light, if only for the moment. But it will only take this moment.
“I think you need to stay here, just for a little while. You landed yourself in the emergency room. I would just feel better if you were here.”
He’s speaking softly. Like I’m a fire that he’s trying to talk into putting itself out.
“So, eighth floor?” I say.
My eyes slip back into the sinkhole. Some part of me has already gone to sleep upstairs, in my tiny room on the threadbare hospital sheets. Some part of me has, after all this time, given up.
“I think it’s important to focus on your suicidality first. Then you can focus on eating again. There’s space on the thirteenth floor. It’s the VIP floor. They just renovated.”
He sounds like the real estate agent talking on the TV. I just stare at the screen.
“I won’t eat if I’m not forced to.”
He gives me some semblance of a pep talk and walks away.
Words will bubble at your lips. You will reach out gasping for brevity like you are drowning in an ocean of hyperbole. Ground yourself—the things which you are about to say matter. You have never so thoroughly understood that language is all that we have on hand for our desperate attempts to transmit reality. Or whatever version of it you’re living in when admitted.
“What meds have you been on?”
“Lithium. But I was paranoid about it making me fat so I flushed them.”
"A Prozac-Zyprexa cocktail, crowd favorite. But the Zyprexa made me into a zombie and the Prozac made me cry, violently. So I started hiding them in the vents in the air conditioner at the residential facility I was at.”
“Lamitcal—no weird rash.”
“Abilify, Visteral, Traxidone.”
"Seroquel, Xanax, Adderall on the weekends but I’m not supposed to tell you my party tricks, am I?”
At first people wear their crazy like badges of honor, their logo being whatever’s in the bottle that they open every morning, if they are of the diligent sort. This will get tiring as the exact number of medications you’ve been on begins to blur, and then you wear nothing but the side effects like memories you’d rather leave at home. You will tick them off on your fingers—until you run out of fingers. The unused pills will lie in your nightstand drawer like corpses, only to be recalled in moments of desperation. Only when out of the side of your eye you catch yourself like a specter. You’ve been absentmindedly stockpiling them for an overdose someday.
Just in case.
“What do you think you need right now?”
“To get the fuck out of here.”
“To be understood. But the essence of connection is one of misunderstanding. We recognize our realities glaringly, we see it so clearly as to describe it exactly as it is, and yet—such a sensation cannot be relayed. When, at last, inevitably, we begin to understand that such a thing is impossible, we become vacant, our mouths closing—like skies with stars that begin to burn out in the blare of the street lamps. We’ll never know each other. Not really.”
You will come to a point at which you realize that no one is going to save you.