This Is How It Happens
These were some of the many rules at Marydale¹ Mental Hospital:
1. Visitors could not bring you outside food, not even on visiting days. Someone had brought in a pizza, hidden pills under the cheese, and the recipient had almost succeeded in committing suicide.
2. No strings. No shoelaces, no drawstrings, etc.
3. No pens. For daily group sessions you were provided a golf pencil.
4. No shampoo, lotion, chapstick, or conditioner—people would use them to smuggle in alcohol and drugs. “Filled all the way up in the bottle, beer looks just like Johnson’s Baby Shampoo,” a supervisor announced. Sure, I thought. Depending on the beer.
5. No hoarding food, not even snacks.
6. No hairbrushes. No hair dryers—if you had long hair you just had to go with cold, wet hair in November.
7. No contact case or contact solution. If you had to use either, you had to go to the nurse desk and check it out every morning and night. If they lost either, you were shit out of luck.
Later, I learned the unspoken rules:
8. If you disagree with anything the staff says, even if it’s wrong and not in your best interest, they will say you are resisting and causing a problem. They will add more days to your stay and maybe more medication.
9. If you complain about anything, even if it’s wrong and not in your best interest, they will say you are resisting and causing a problem. They will add more days to your stay and maybe more medication.
10. There is no difference between disagreeing and complaining. As a patient, you are always complaining.
11. If you agree with anyone that complains or disagrees, they will say you are resisting and causing a problem. They will add more days to your stay and maybe more medication.
12. If you don’t lie, you are screwed.
I followed the rules and I was there for only a week. Actually, even that is a lie: I broke two of the rules. I would sneak cookies into my room from the cafeteria. I hid them in what my sister called my “woodland creature” jacket because, she said, I looked like I belonged in the forest, lying down with sleeping deer, when I wore it. Dinner was served before anyone felt hungry, and the cafeteria shut down soon after. There was an approved, somewhat outdated list of places you could ask to deliver dinner to the hospital, so it was possible to have dinner and pizza later, a pizzeria being one of the few places on the list still in business. Despite this, however, I found myself stealing, eating cookies in the gaps between mealtimes. They weren’t anything special—a generic, somewhat dry chocolate chip likely brought to the hospital kitchen from outside. But to have food that is yours, and the freedom to choose when to eat it, is a great luxury.
My second transgression: I was in possession of pens. The golf pencils were unwieldy and blunt; I considered this a personal slight, as I did their enforced limitations on what we should write (‘Today I am feeling content/rested/anything positive’). The supervisor who pressed me to admit myself cooed to me to “think of it as a vacation, a break from yourself,” but my stay could not be a “vacation” if I was deprived of what I found relaxing. I considered stabbing myself with a golf pencil, to prove that it was no safer than a cheap plastic Bic, but ultimately decided that this was perhaps not the best place to exercise spite. I became feverish and irritable, and one of the other patients noticed.
She was deaf and communicated with an interpreter, but even so I barely interacted with her, as we were not in the same group. On her last day inside she walked by me at lunch and slid a few pens across the table. When I looked up, she slurred “for you” and pointed at me. She put her finger to her lips, winked, and walked off before I could speak.
She was discharged soon after. I never got the opportunity to thank her, to ask how she got the pens in the first place, or what she recognized in me to care.
I wrote with them until a surprise room inspection during lunch one day. While I got a few looks from the nursing staff afterward, they otherwise ignored my infraction. Left to my own devices, I was an easy patient, and they had more serious issues to deal with.
My mom had made the doctor’s appointment for me because I hadn’t been able to get out of bed for a month and a half. I was doing an unpaid internship in New York City, staggering home after work, eating take-out in bed while marathoning Law and Order: SVU. I had a table in front of the TV, but only used it when a friend, worried, flew out to see me, asking me about anything I wanted to do, anything, he would pay for it. One night he tried to kiss me. When I stopped him, he grew horrified and apologized, repeating over and over that he was acting like the kind of man he hated. Afterward, I ignored his calls; I couldn’t be responsible for another failed relationship.
I tried taking dance to get my endorphins up, but only lasted two classes, when I used to dance three times a week. I bought a plant and named it Elliot Stabler, after the strongest, most capable man I could think of. I placed the plant on the windowsill over my bed and whispered to it to please help me. I dragged myself to a few plays, thinking that art could cure me. Finally I told my boss I had a severe medical condition and I had to fly home to treat it. He released me from my internship early.
Later, my mom called to remind me of my appointment.
I can’t do it, I said. I can’t get out of bed.
People who haven’t been depressed don’t understand how someone can’t get out of bed when they aren’t physically sick. The people who have been depressed know exactly what I mean.
The ward next to ours was the geriatric ward. Even with the doors closed, at night we could hear one of the elderly women yelling “Will somebody help me?!” over and over. “I think she’s schizophrenic,” another patient speculated. “I wish they would give her something.”
All the doors in the hospital’s hallways were secured, one after another; you needed permission and a reason to go through.
When you first come in, they take you into a small room. They take all your personal belongings—purse, wallet, money—and record them for inventory. Everything gets sealed into a plastic bag. A nurse holds up a hospital gown before her, like a curtain, and you take off your clothes. The staff checks your clothes for weapons, for drawstrings: anything that might be used to hurt yourself.
(They said they would have to cut the drawstring out of my sweatpants because it was sewn in, not threaded through. I said my pants would fall down. They gave me two hospital gowns instead. Until my family could bring me new clothes, I wore one in the front and one in the back, flapping around as I walked the halls.)
You can place outgoing calls on a single shared phone next to the nurse desk, but if people want to call you they must have your patient number. You bunk two to a room and no one’s allowed to close their doors.
(My first night the hospital didn’t have permission to turn the heat on for winter yet; I received two thin blankets. It was the first week of November and my bed was near a large window. I spent the night shivering, wondering if the pillow would do more good over my body rather than under my head.)
At 4 A.M., they take your blood.
On weekdays we had mandatory group therapy, where we were taught self-help by way of The Secret. Yes, the New York Times best-seller, the book about the law of attraction: that if you send out your vision, the universe will hear you and let it come true. What you put out is what you get.
One of us suffered from bipolar disorder. Another woman had trouble with cutting. Some people were in for stress. A young military member had grown depressed after an injury.
“It works,” said one of the women-people running the group. They were not doctors or nurses, so I was unsure of their credentials or what to call them. The women-people leading the group rotated on different days, and we had a few group sessions each day. “One day I had this visualization that I was in India, with a red scarf. A year later, as I was stepping off the plane in India, I looked down and realized that I was wearing a red scarf, the exact same one that I saw. It took a year for that to happen, but it did. You can’t put a timeline on your visualization, but if you do them regularly they will happen.”
No individual therapy beyond group, only a psychiatrist that saw you Monday through Friday for up to ten minutes at a time in order to prescribe you an array of pills. Sometimes the psychiatrists were late; sometimes they didn’t show up at all. Every morning and night we lined up outside the nurse desk for meds dispensed in a cup. My psychiatrist decided I should be on Seroquel, citalopram, and trazodone. This was supposed to make me, and I quote, “The best Elaine Wang in the galaxy.”
Before each group session, we all had to fill out a form to read and share with everyone. It said:
· Today I feel ______________________
· I am working on _________________
· My self-affirmation for today is __________________
· I would like to ask the group today for ________________
We each got fifteen to twenty minutes. There were eight to ten of us in the group, depending on the day. On the fifth or sixth day, tired of The Secret, I made the mistake of writing Today I feel bored. When it was my turn to read aloud, I passed it off as a mere observation. I thought, perhaps, we would talk about why I was bored, that the group might suggest new exercises for me to work on.
The facilitator’s reaction was swift and unexpected: I would get out of group what I put in.
“Boredom,” she insisted, “is a pre-determined mindset keeping you from learning.” She seemed to take my boredom as a personal affront, as if I were deliberately trying to embarrass her, and I could feel the anger leaking around the edges of her professionalism. The group grew silent. Even the TV on the wall seemed to be looking at me, its blank screen a reflective eye, waiting for an answer.
I didn’t mean that I was trying to not change or learn anything, I explained. I wasn’t bored to be bored. I mean, for the sake of being bored. I mean—it was just a feeling. I just wanted to say how I felt. I wasn’t—I wasn’t saying I was bored to be in a mindset. Maybe I wasn’t bored, just tired. Yes, I was wrong, I wasn’t bored, just tired. I couldn’t tell her that I found The Secret stupid, that it wasn’t helping me.
Another day in group, the leader passed around handouts of various song lyrics. We spent half an hour discussing how we could apply Miley Cyrus’s “The Climb” to our lives. “I had a teacher who told me that I wouldn’t amount to anything and the most I could get was my M.R.S. degree,” said the leader that day. She paused, pulling her lips into a tight smile. She watched us, waiting for us to spell it out in our heads, and nodded, hard. “I want to go in now, put all my degrees on her desk, and say ‘Only a M.R.S. degree, huh?’”
Your teacher was right, I thought. You do not amount to anything, and it has nothing to do with how many degrees you may or may not have. You look down on us. You don’t understand even the beginning of mental illness, and you think that earning degrees will make up for all the things that you do not understand—that they will give you worth.
Though she fed, clothed, and raised me, taking me to the doctor that day felt like the only important thing my mother had ever done for me. I want to say she did everything else out of duty: She refused to buy me bras when I first grew breasts but gave me her old bras from when she was a kid, which hurt and did not fit me. She slept all the time, unplugging all the phones during the day so they wouldn’t bother her. As a kid, whenever I complained about wanting something, she would say the same refrain over and over: “I had to drive you around. You think it was easy, driving you around everywhere, holding up a big pregnant belly?” When I remember her back then, I cannot remember her looking at me with any love in her face; at best it was tolerance.
Now, I can see my mother had been depressed. As a child, I reveled in the peace that came while she slept, but now I see the danger in that; she closed herself off entirely. As an adult, I once asked her if she was happy. “Life isn’t about being happy,” she answered.
My pediatrician, whom I still saw at twenty-three—I hadn’t found another doctor yet—asked me why I was in that day.
I’m really sad, I said, and burst out crying.
He stared back at me. Both of his sons had gone to school with me. I had graduated college summa cum laude, won awards and scholarships. My family went to church.
I must have said more, but I don’t remember what. He left and returned with a pamphlet. We Believe in People, the logo said. His receptionist would call them and set up a consultation for me, today. He told me to go over now, and they would take care of everything.
“I don’t want to go to your funeral,” he said. I must have said something about killing myself.
Who said you’d be invited? I thought.
My psychiatrist at the hospital was Dr. Q. The first time we talked he was doing my entry evaluation: he asked about my medical history, my mood, my background. I was depressed, enough to be doing what they called “suicidal ideation.”
“Did your boyfriend break up with you?” he said.
It’s the question psychiatrists ask to make themselves feel superior to you. Your depression can’t be real if a man left you, that’s garden-variety, women-are-crazy hysteria. Men, even psychiatrists, like to think we can’t live without them. But I had already lived through lots of men leaving me; it wasn’t that. The problem was something I couldn’t live without, but I didn’t yet know what that might be.
“Yes,” I said. He gave me a look.
“But that’s not what’s making me depressed,” I said. He was already writing.
It was true that my on/off boyfriend had broken up with me a month ago, but he had dumped me once before, so it seemed unlikely that the shock would be killing me. Besides, I had moved on: I was seeing a man who lived in San Antonio, and it felt serious enough that he had visited me in New York for my birthday.
I didn’t tell Dr. Q any of this. He didn’t deserve the truth, and he didn’t want it.
Before, I had thought all I needed was a therapist. In college I had felt like killing myself, and had gotten through it with 10mg of citalopram from a general doctor and weekly visits to a volunteer therapist at a low-cost health center. I thought the pediatrician would prescribe me some antidepressants, but maybe he couldn’t—maybe he had to refer me to the hospital and they would do it. My mother and I sat in the hospital lobby, waiting to fill out paperwork.
A nurse ran up to the receptionist. “Have you seen so-and-so?” she asked.
“No,” said the receptionist.
“If you see him,” said the nurse, “bolt the doors.”
After two hours, a woman called us into a separate room. Instinctively I didn’t like her, but everyone always said I judged too quickly, so I tried to be patient. I asked my mother and best friend to come in with me; for some reason I couldn’t discern, I also felt scared of the woman. She asked me the standard questions about my background, my mood, and my mental health history. How old was I? Did I drink? Did I use recreational drugs? How was my mood today? Had I ever experienced physical or emotional abuse? The air cottoned and thickened. After a few seconds, I said, “Yes.”
I snuck a glance at my mother. She stared forward. Maybe she hadn’t heard. Maybe she wasn’t even there.
Neither of my parents had found anything wrong with hitting their children. To them, doing so had been as natural and as normal as breathing. The rules of corporal punishment could always be blurred, and my mother often felt the need to slap or pinch or strike out with any objects at hand. My father was more restrained, but that didn’t stop him from hitting me on the head one night when I had embarrassed him in front of our piano teacher. My family refers to that night as the night I “ran away,” but I only got to the end of our neighborhood before turning back, barefoot and sobbing. I had nowhere to go, and my friends were no help; I probably deserved it, they said, as I was not an “easy child” like my siblings. I confided to my youth pastor, but he said that under God’s law, it was permissible for my parents to beat me—not ideal, but not wrong, either. When I was eighteen, I could leave and do whatever I wanted. I only had to make it until then.
In the interim my father and I would get into more fights. Once, he would kick me up the stairs. Another night at dinner, I would hurl a bowl at him, grabbing it from my mother’s hands as she ate.
Based on what I told her, the woman said, I should be hospitalized immediately.
“Psychiatrists aren’t taking new patients right now,” she said. “You would have to wait at least six months. And even if you did manage to see one of our psychiatrists outside of this facility, they would send you right back there.” This was how it was going to go, the woman told me: If I committed myself voluntarily, when the hospital released me I would be given a psychiatrist and a therapist, whom I could see immediately. But if I released myself—“gave up on the treatment” and left—I would be given neither. And neither felt worse than anything. I would have failed at even a mental hospital, and there was nothing left after that.
What if I do all this and I don’t get better, I asked the woman.
“You will,” the woman said. She took out a stack of forms for admitting me and started filling them out. Halfway through them she said, “See, I’ve even signed them because I already know you’re going to make the right decision.”
One of the hospital patients required a wheelchair and needed routine hip surgeries. In group he made the mistake of being honest about an upcoming operation, his loneliness and fear. His hurt was reasonable—no one in his family seemed to care about him, and he had no friends to visit him in the hospital. He felt scared, he said, and—
“Stop,” said the group leader, the woman who’d visualized visiting India. “You are looking for support where you can’t get it and you need to stop.” He should learn to be there for himself. Make new friends: Google “hunting clubs” or other activities he once enjoyed. “You can always sit and watch,” she said.
The man didn’t like these ideas. It seemed unrealistic for him, between surgeries, to find a close friend by googling meetups.
“All I’m hearing is ‘I can’t,’” she said. She gave him a smug, pointed look.
The patient tried again. Yes, he acknowledged, by looking for support from his family he might be looking for support in the wrong place. “But they are my family,” he said. “I’m never going to stop wishing and hoping they would care.”
I grew close to a few others at the hospital.
In my last few days at Marydale I met a girl with a with a boy’s name. After we both got out we made plans to eat at the one good Indian restaurant in town, but stuff kept coming up for her.
I wrote her an email. If you don’t mind, what were you in for?
Stress, she wrote back. I was involuntary [sic] sent there by a hospital doctor who I went to for stress, and he said that I was suicidal.
Another patient, depressed by a dangerous job situation, lent me comic books to read during my downtime. (In retrospect, perhaps I should have given him a pilfered cookie in return). We kept in touch once we were both discharged, but after a while I wasn’t able to keep up with the volume of his phone calls and texts; at the time we were both in difficult situations, and I needed all my energy to focus on mine. The attention he paid to me—the texts, the compliments—had become too much. Once I wore my sister’s discarded cardigan with a large missing button, and he said it looked nice. In response, I said, “It’s missing a button.” I looked down and saw the front was slightly skewed, perhaps in a stylish way, as if I had done it on purpose. “And I misbuttoned it,” I said.
After a few months, he politely texted me to say it was all right if I no longer wanted to be friends. I didn’t know how to respond, and so I didn’t.
The young man in the army had a baby within the next year. He emailed me a photo of the newborn, and I sent him a blue stuffed hippo I had crocheted with my congratulations. It was one of our last interactions.
In the end, it wasn’t indifference that did us in, but time and environment. Now that we had returned to our lives outside, we had the old routines to go back to, the same daily dramas to deal with. How do you introduce someone you’ve met at a mental hospital? How do you integrate them into your community of friends and acquaintances, those who have no idea?
I think that one of my greatest weaknesses is my sensitivity to perceived kindness. If someone shows me an inkling of niceness, I can remember it for years. As a child, I hoarded these moments; if a classmate played with my hair, I would obsessively recall it for months, the tingle in my scalp from being touched, the dim glow of being chosen, the weight of the new braid against my neck (my mother did not brush my hair). I remembered every time a teacher smiled at me, when a parent of a friend joked with me. Later, alone, I would take these memories out and relive them, feeling the exquisite joy of making someone happy by seemingly nothing, by the fact of simply existing.
In Chinese, my name means I am a flower, known for its fragrance, that floats down rivers (or so my dad says, although he has never given me any proof). I have never seen this flower, but I imagine it to be white with waxy cream petals that are easily bruised, like a magnolia.
Perhaps this is how it happened—being predisposed from birth to easy bruising, I lived up to my name: floating down rivers, smashed upon rapids, crushed underfoot when I washed ashore on muddy banks. But in English, my name means “Shining Light.” It is an old French form of Helen, who survived both cruel gods and burning cities.
¹ Name of hospital changed
Elaine Wang has been published in cahoodaloodaling, Zero Ducats, Hot House, Analecta, and Spires. Her photography has been published in The Lantern Review. She currently lives in Texas with a large and glorious orange Maine Coon cat named Hebby.