Kitabı oku: «The Blind»

For the misunderstood

“Oh, you can’t help that,” said the Cat: “We’re all mad here.

I’m mad. You’re mad.”

“How do you know I’m mad?” said Alice.

“You must be,” said the Cat, “or you wouldn’t have come here.”

—LEWIS CARROLL,

ALICE’S ADVENTURES IN WONDERLAND

CONTENTS

Cover

About the Author

Title Page

Copyright

Dedication

PART ONE

OCTOBER 18TH, 9:40 A.M.

OCTOBER 19TH, 11:12 A.M.

OCTOBER 19TH, 1:15 P.M.

OCTOBER 20TH, 7:44 P.M.

OCTOBER 21ST, 8:55 A.M.

OCTOBER 23RD, 11:37 P.M.

OCTOBER 26TH, 3:35 P.M.

OCTOBER 28TH, 9:12 A.M.

OCTOBER 28TH, 11:00 A.M.

OCTOBER 28TH, 10:01 P.M.

OCTOBER 31ST, 10:25 A.M.

NOVEMBER 1ST, 11:11 A.M.

NOVEMBER 2ND, 10:53 P.M.

NOVEMBER 3RD, 8:31 A.M.

NOVEMBER 6TH, 6:14 P.M.

NOVEMBER 8TH, 11:03 A.M.

NOVEMBER 9TH, 10:00 A.M.

NOVEMBER 9TH, 4:46 P.M.

NOVEMBER 11TH, 8:36 A.M.

NOVEMBER 14TH, 12:34 P.M.

NOVEMBER 14TH, 9:21 P.M.

NOVEMBER 16TH, 9:14 P.M.

NOVEMBER 18TH, 12:03 P.M.

NOVEMBER 22ND, 11:06 A.M.

NOVEMBER 23RD, 2:14 P.M.

NOVEMBER 26TH, 12:45 A.M.

NOVEMBER 29TH, 9:11 A.M.

DECEMBER 1ST, 5:30 P.M.

DECEMBER 1ST, 7:06 P.M.

DECEMBER 1ST, 8:23 P.M.

DECEMBER 5TH, 9:21 A.M.

DECEMBER 5TH, 2:49 P.M.

DECEMBER 6TH, 11:13 A.M.

DECEMBER 7TH, 7:22 A.M.

DECEMBER 7TH, 12:27 P.M.

DECEMBER 8TH, 4:17 P.M.

DECEMBER 8TH, 11:28 P.M.

DECEMBER 9TH, 12:14 P.M.

DECEMBER 10TH, 10:24 P.M.

DECEMBER 12TH, 3:23 P.M.

DECEMBER 14TH, 7:11 P.M.

DECEMBER 15TH, 4:33 A.M.

DECEMBER 15TH, 6:16 A.M.

DECEMBER 16TH, 2:12 P.M.

DECEMBER 19TH, 1:19 P.M.

DECEMBER 20TH, 3:46 P.M.

DECEMBER 21ST, 9:46 P.M.

DECEMBER 22ND, 11:34 A.M.

PART TWO

DECEMBER 27TH, 8:37 A.M.

DECEMBER 27TH, 11:22 A.M.

DECEMBER 28TH, 3:20 P.M.

DECEMBER 29TH, 12:47 P.M.

DECEMBER 29TH, 5:11 P.M.

DECEMBER 31ST, 11:47 P.M.

JANUARY 3RD, 11:40 A.M.

JANUARY 3RD, 2:00 P.M.

JANUARY 4TH, 10:56 P.M.

JANUARY 5TH, 1:17 P.M.

JANUARY 5TH, 5:34 P.M.

JANUARY 10TH, 11:00 A.M.

JANUARY 12TH, 3:09 P.M.

JANUARY 13TH, 9:50 A.M.

JANUARY 17TH, 11:08 A.M.

JANUARY 18TH, 10:47 P.M.

JANUARY 19TH, 10:19 A.M.

JANUARY 20TH, 11:14 A.M.

JANUARY 20TH, 2:23 P.M.

JANUARY 20TH, 3:15 P.M.

JANUARY 24TH, 10:44 A.M.

JANUARY 31ST, 11:02 A.M.

JANUARY 31ST, 12:01 P.M.

FEBRUARY 2ND, 9:37 P.M.

FEBRUARY 7TH, 11:22 A.M.

FEBRUARY 9TH, 7:21 P.M.

FEBRUARY 10TH, 9:13 A.M.

FEBRUARY 14TH, 11:01 A.M.

FEBRUARY 14TH, 12:11 P.M.

PART THREE

FEBRUARY 21ST, 10:57 A.M.

FEBRUARY 21ST, 2:37 P.M.

FEBRUARY 24TH, 5:41 P.M.

FEBRUARY 28TH, 10:32 A.M.

MARCH 1ST, 4:46 P.M.

MARCH 2ND, 3:20 P.M.

MARCH 3RD, 1:14 P.M.

MARCH 7TH, 1:57 P.M.

MARCH 11TH, 1:41 P.M.

MARCH 11TH, 7:11 P.M.

MARCH 12TH, 2:39 P.M.

MARCH 13TH, 9:22 A.M.

MARCH 13TH, 10:04 A.M.

MARCH 21ST, 7:44 A.M.

Acknowledgements

PART ONE

OCTOBER 18TH, 9:40 A.M.

I’m kneeling on the floor in my office, tying the top of the garbage bag into a knot and squeezing out the excess air as I do it. The maintenance guys always leave extra bags at the bottom of the garbage can, so I can replace this one with a fresh one and just dump the tied-off bag into the bin. I find this is the most discreet way of hiding the rank stench of alcohol when I throw up into my garbage can. I want to believe that my tolerance is high enough that I never throw up, but the truth is, more often than not, I find myself on my knees in my office the morning after.

My name is Sam. I’m a psychologist, and I work in a mental institution. It’s not like the ones you see in Rain Man or Girl, Interrupted. It’s in Manhattan. It doesn’t have sprawling grassy lawns and manicured hedges. It doesn’t have wide hallways and eleven-foot doors like in One Flew Over the Cuckoo’s Nest. It smells like a combination of antiseptic and bubble gum because they added bubblegum scent to the antiseptic. The lights are fluorescent and the toilets are always broken. The elevator is the size of an airplane hangar and it’s always full. I’ve been working here for six years and I’ve never been in the elevator alone. Someone pushes the alarm button every day.

The ceiling tiles in the unit have leak stains in the corners. All the doors are painted gray and have oval windows with chicken wire in the glass. Except the office doors. There are no windows on the office doors, and they’re painted pale yellow. They all have paper signs on them saying things like Lunch and In Session and Do Not Disturb. We have to make new ones pretty regularly because patients write stuff on the signs.

It always feels like once you walk through the front doors, the world gets smaller. It’s impossible to hear outside sounds and, even though I’m in the loudest city on Earth, I can’t hear it in here. There’s only one group room that faces the sun and that’s where the plants are, but it’s always dusty and no one likes to go in there.

We have a lot of different kinds of patients here, 106 of them. The youngest is sixteen and the oldest is ninety-three. The oldest used to be ninety-five, but he died a few months ago. There’s one wing where the men live and another wing where the women live, and pretty much everybody has a roommate. If a patient is violent or something, they can get a single room. Once patients find this out, they almost always become violent. What they don’t realize is that a single room is just a double room with an accordion divider running through the middle, and when the room splits, someone loses a window. The institution is called the Typhlos Psychiatric Center and I’ve never asked why.

It feels fraudulent and silly and sometimes even comical, but I’m not any different from anyone else here. The clinicians are supposed to instill hope. We’re supposed to take our talents and patience and hard-earned degrees and apply our education to the betterment of others. We pride ourselves on having it all together. We fancy ourselves the shepherds. We are told that this is noble and upstanding work, and a benefit to society. But it’s all a pile of shit. We’re no different from them. There’s no line in the sand. In the end, we don’t have canyons that divide us. We barely have a fissure. I have a key and an office and they don’t. I came here to save them; they can’t save me. But sometimes, the lines get blurred. People say “If you can’t do, teach.” Well, if you can’t save yourself, save someone else.

OCTOBER 19TH, 11:12 A.M.

There is a new patient starting this week. No one wants to work with him. His file is nearly empty, and the rumors churning among the staff have been filling in the blanks with horror stories and nonsense. (He murdered his last counselor; he refuses to do paperwork; he’ll be a nightmare patient.) Even I don’t want to work with him, and I’m the one who takes all the patients no one wants. No one really knows what he’s all about; what’s true, what’s a rumor. He has one of those charts where nothing is clear. He obviously hadn’t answered the questions during the psychosocial evaluations. Most of what was written was garnered from his physical appearance and intake materials. He was definitely in prison; those records are clear. For twenty-some years, although somehow the charges aren’t written in his file. Then halfway houses for years after prison. And now he’s mandated to treatment as a condition of his probation.

We take so much of our power for granted; it only really exists because our patients aren’t aware of their ability to fight against it. And then this guy comes in and starts unsettling everything. I guess I respect him, in a way. I had been napping in my office hoping that something would change, and I guess this guy may be the one to change it.

OCTOBER 19TH, 1:15 P.M.

“Okay, guys, what does hereditary mean?” I’m running a group counseling session. This is a psychoeducational group, so I’m supposed to be helping my patients understand their diagnoses. So often psychiatrists will tell a patient that he or she has something and then never explain in plain English what it means.

“It means it runs in your family, right?” This is Tashawndra. She had eleven children. Every single one of them has been removed from her custody by social services. She isn’t sure of the whereabouts of most of them, and she believes that two of them are dead, but isn’t positive. This is her reality.

“That’s exactly right—it means there is a genetic component. So which mental illnesses have a genetic component?” I’m up on top of the desk, where I usually sit.

“Cancer. My mom had breast cancer and I had to go get checked for it because she had it, but I didn’t have it.” Lucy.

“That’s right. Cancer has a big genetic component to it, so it’s important to get checked out if someone in your family has it. But what about mental illnesses? What about the kinds of things we treat here?”

“All of ’em, right? I know that if your parents or your brother is addicted to drugs that you will probably get addicted to drugs, too. And people here are getting treated for that. You treat drug addicts here. And sometimes, if your family is depressed, you could get depressed, too.” Tashawndra.

“Yeah, that’s a big one,” I say, wagging my finger in her direction. “Depression has a genetic component. So does schizophrenia, bipolar disorder and many of the other problems we treat here.”

“So you’re fucked, huh? If your mom is schizophrenic, then you can’t stop it from happening to you, huh? It’s like you’re born fucked over. You’re born to be crazy, right? Ha, like ‘Born to Be Bad,’ that song? Born to be crazy.” Tyler. Tyler has schizophrenia. At twenty-two years old, he’s very advanced for his age. He seems to have a greater understanding of the world that the rest of us missed somehow. He’s at peace with things that the rest of us struggle with. Tyler has forgiven.

“Well, no, not always. And watch your language. When you have a genetic predisposition, which means when someone in your family has a disorder, then sometimes you will get it and sometimes you won’t. It depends on what else happens in your life. It depends on whether or not you are exposed to things that will help you stay well, or things that will make you get sick.” I’m bouncing my heels off the front of the desk.

“What kind of stuff makes you sick? Like drugs and stuff?” Tyler. “Because I know my brother did drugs in school with his friend, and then he was crazy after that. He got locked up but he was crazy, man. He never acted like that before he did those drugs.”

“Drugs, sure. That’s a significant one, actually.” I’m nodding and explaining, bright-eyed. “Also, poverty, abuse, growing up without both parents, not being able to get enough food or go to school. They are kind of like strikes against you. So, if you have the gene in you to get depression or schizophrenia, and then you have these strikes in your life, too, you could end up with the diagnosis.”

“Like three strikes, you’re out, right?” Tyler. He and I talk baseball in the hallways. I’m afraid of running into him one day at Yankee Stadium.

OCTOBER 20TH, 7:44 P.M.

When it’s almost time to go home, I start to look at all the things I’ve been avoiding all day. I don’t have a drink or a cigarette with me to help me look at these things, but I start to peer into the abyss anyway.

I know when I get home and I am alone, and my phone isn’t ringing, I’ll be looking at this, so I may as well get it started now. Maybe it will ease the burden. Maybe I won’t cry so hard when I’m at home. Inevitably, the only thing that happens is I am going to be forced to wear sunglasses on the train home because my face will be swollen with misery and my eyes will be brimming with tears that somehow, every single day, manage to cling to my eyelids until the very second my apartment door swings open.

It didn’t always feel like this. Sometimes things made sense. Back when I felt like I understood what was going on, and I wasn’t just going through the motions.

The subway is down. There is a fire on the tracks on the A/C Line, and I have to get off the train a hundred blocks from my apartment. For whatever reason, I am walking now. I tend to think when I walk, which is probably not a good thing, because I don’t have any cash and I can’t stop somewhere for a drink to help me stop thinking.

It’s cold out. The kind of cold that makes your knees hurt and your lips get solid, so it’s hard to talk. My eyes are watering, but I’m not crying. I’m smoking back-to-back cigarettes, and I don’t have gloves, so I have to keep switching hands.

Even though it’s freezing, there are families out in the street. I’ve seen them since I got off the train. There is a mother pushing a stroller on the other side of the street, and we have been pacing each other for blocks. She looks like me. Well, she looks like my mom, and I guess I look like my mom, too. We’re blonde, and I’m guessing the woman has blue eyes like we do, even though I can’t see that far. She’s small, like my mother is. I’m much taller than they both are; I always thought my dad must have been a pretty big guy. Now I’m stuck thinking about my own family as I walk south in this bitter city.

It was just me and my mom growing up. My dad is somewhere, but I don’t know where. I’ve never met him, but it doesn’t really make a difference because Mom was almost too much to manage on her own. Sometimes she sang his praises—Your father is a wonderful man. And sometimes she shit all over him—He’s just some mick fuck who doesn’t deserve me. I wonder if that baby in the stroller knows her dad.

My name is Samantha because my mom’s name was Samantha. I think that’s why I go by Sam. Our last name is James. So I have two first names. I always told people never to trust someone with two first names.

I can see my apartment now. It’s the only one on the floor with no lights on. It’s in an old limestone walk-up building in the middle of the block. I’ve been living in New York City for a few years. I bounced around different studios and tiny one-bedrooms in Brooklyn and Manhattan after I came here for graduate school. My current apartment has three closets, which is practically unheard-of, and a bathtub. I have a desk and a coffee table and it could pass for a grown-up apartment if I could just buy food to put in the fridge. My couch is brown and I have different pillow covers for different seasons. Now it’s the dark blue ones. I have a carpet that’s mostly sun bleached because my windows face south, so the summer sun is in here for the whole day, and I used to like the colors but now I think it looks like a little girl’s carpet. My kitchen is very clean and has a window above the sink, so I can look out while I’m washing wineglasses and see what everyone else is doing. The radiator makes noise, which is comforting because if it didn’t, there would be no sound in here. I never turn on the TV because it makes me feel small.

The front door to my building has a tricky lock, and it always seems to get stuck right when the wind picks up and starts to make my ears hurt. The dark green tile floors in the lobby always look dusty and I’m afraid I’ll slip on them and crack my skull. The stairs are wide and rounded, from a New York era long forgotten, and as I wind up them to my apartment, I peel off my outside layers.

I’m opening a bottle of wine that I bought at the liquor store across the street last night. I always make sure to be delicate and grown-up about my drinking. I drink every night, but that’s okay because it’s expensive wine that I drink out of expensive wineglasses that I always remember to wash before I go to bed. I also always clean my ashtrays, because even I think it’s gross to have stale butts around the house. I quit smoking a few times, but then I gave up quitting because something else is going to get me first anyway. Desperation makes you hold on to funny things.

OCTOBER 21ST, 8:55 A.M.

I’m sipping the acrid, burned coffee from the lounge, waiting for my boss, Rachel, to start the clinical-staff meeting. My nails are grimy and dirty, and the nail polish is mostly peeled off. I look up to catch my colleague Gary staring at me. He immediately looks away when our eyes meet, but then he quickly turns his head back to me.

“Yes?” I ask him, eyes wide.

He brushes the side of his temple with the back of his left hand and juts his chin in my direction.

“What?”

He does it again.

I put down my red pen and coffee cup and wipe the sides of my face. I pull back my left hand to see a streak of unblended cakey makeup across my pinkie. Crispy little bits of scab are dotting the makeup.

Rachel begins the meeting.

“Good morning, team. Nice to see everyone bright-eyed and bushy-tailed this morning.”

Muffled laugher and sarcastic snorts.

“I know it’s been getting a little overwhelming with all the new patients starting, but as you know, there are seasons and cycles that are at play with mental health, and with winter almost here, even though it’s only October—” she shakes her fists at the windows “—with the shorter and colder days come more depression, seasonal affective disorder, hopelessness and the like. I’m not telling you anything you don’t already know. That being said, as you’re already aware, we have another new patient, and he is starting today.”

The staff begins to look around nervously; people start adjusting their shirts, looking down at notepads, trying to disappear into the noise.

“I’ve heard a lot of chatter in the hallways. I understand that it’s natural to speculate, but it’s very difficult to maintain unconditional positive regard, an unbiased attitude and an open mind when rumors are being spread in this manner. You all know what I’m talking about.” She glares at us like we should know better.

“Well, can you give us a little more insight into the story with this guy?” Gary.

“I’m not really privy to any more information than you are, so we’re in the same boat. But I am urging you to put your preconceived notions away, set down these ideas you have about him and focus on the little information that we do have. He is coming here for treatment, for help, and your job is to provide that treatment without making the man into a monster.”

“Look, I’m all for positive regard and unbiased treatment, but isn’t it important to ensure the safety of the staff?” Gary again. “I mean, I heard his file is incomplete because he attacked his last counselor. I heard he refuses to answer intake questions, and won’t discuss his history, and if you pry, he goes ballistic. I mean, he’s forensic, and I’m not sure I’m comfortable treating a patient who is known for attacking his counselor.”

“Well, we are not in the business of turning away problematic patients.” Rachel lowers her head and shuffles out the file. “And there’s nothing in here that indicates he has been violent with staff in the past.”

“That’s because there’s nothing in there at all! The file is nearly empty. It says he is a big dude and wears a hat and doesn’t talk. It says he’s been in jail half his life. But, somehow, it doesn’t say on what charge? Hmm? That’s insane! You can’t have a forensic patient with no history, and no psychosocial, and no diagnosis, and nothing in his file, just waltz in here, and we’re supposed to figure this all out from nothing!” Gary is exasperated. Gary used to be a social worker in the finance world. He worked for a firm that did corporate layoffs, and Gary’s services were offered to those individuals who lost their jobs. He always ended up feeling like the messenger and he couldn’t hack it anymore, so he ventured into something he thought would be cushier, less dramatic, more sustainable on a daily basis. He went from the frying pan into the fire, and he is still looking around, bewildered, wondering how he got here.

“Then what exactly do you think we should do, Gary?” This is David, who usually stays above the fray in these meetings.

“Send him somewhere else!”

“That’s ridiculous. We are the ‘somewhere else.’ This is the last stop. Would you rather he was out on the street? With no treatment? No chance?” Me, wiping coffee stains from the conference table.

“Look, I mean, I just don’t want him on my caseload. I don’t have a lot of extra time on my hands, and being tasked with completing an entire file of pre-intake data in addition to everything else needed for him, for a guy who will probably stab me and doesn’t even talk? No. I’m sorry, but no, thank you.” Gary folds his arms across his chest and leans back in a huff.

“Then why are you working here?” Shirley immediately regrets these words, and she cowers back into her seat, hoping this comment didn’t open her up to the possibility of being the new guy’s counselor.

Rachel jumps in, taking control of the discussion. “It’s important for all of us to have a forum in which we can discuss the concerns we have with the patients, and to bring everything out in the open. These meetings are exactly that forum. We are not here to attack each other. I want you all to talk to me and each other about what you’ve heard and what makes you so nervous about our new patient Richard. But I will continue to caution you—rumors are usually unfounded, and we need to be careful how we color this man.”

Gary slumps farther down in his chair and disengages from the discussion. Julie, the bubbly princess, pipes up that she is fearful for her safety, and she worries that she’s too physically weak and defenseless to effectively treat someone who intimidates her. Other female staff members coo in agreement. Julie has wormed her way out of taking anyone else onto her caseload for weeks.

“Why was he in jail?” Shirley.

“I honestly don’t know.” Rachel. “As I said, I have access to the same records as you, and I don’t have that information.”

“But isn’t that weird? Shouldn’t we know?” Julie.

“What difference does it make?” Me. “If he were in jail for racketeering or armed robbery or whatever. It doesn’t make a difference. It could be drugs. It could be the third offense for something small, and with the ‘three strikes, you’re out’ law, he could have been in jail forever. It’s not a sex offense, because he isn’t registered—I looked it up. It really shouldn’t matter what he was in jail for. But it’s important to know that he was in jail. His perspective is obviously altered, and he has probably been subjected to some pretty horrific stuff in there.” As I say all of this, it occurs to me that I am completely uncomfortable with not knowing why he was in prison for so long.

“I heard he doesn’t talk, at all, and that he is very aggressive. He refuses to follow protocol, he doesn’t get along with other patients, he doesn’t do paperwork.” Shirley.

“Well, I think it’s clear that he’s not cooperative with doing paperwork, but beyond that, I am going to ask everyone to chalk this all up to speculation and the tendency to fill in blanks with drama when we don’t have sufficient information. The fact of the matter is he is here, and he is going to be working with us.” Rachel is no longer looking at anyone and getting ready to drop the bomb. She’s stalling. Everyone starts to shift uncomfortably.

“Sam—” she looks up and tightly smiles in my direction “—and Gary.” He slumps back into his chair, defeated. “I’m going to put Richard with you, Gary, and Sam will be your backup. You can learn a lot from this patient, and I think you’re up for the challenge. And, Sam, you have the best success rate with difficult patients, and you’re a ranking member of the clinical staff. I prefer to start Richard with a male counselor and see how that goes. We will all be here for extra support should you need it, but I’m sure you’ll be able to handle this.”

Shirley and Julie give each other exaggerated looks of relief, and everyone breathes a sigh. David gives me a conciliatory squeeze on my shoulder. Gary huffs up to Rachel and lolls his head to the side as she hands him a copy of Richard’s intake materials. He says nothing, and instead looks to me with wide eyes and an impatient bend in his leg.

“No problem, Rachel. I’m on it.” I gather my papers and coffee, and as we all bleed into the hallway, Rachel hands me my own copy of Richard’s file.

Gary assures me that he has no problem taking Richard’s case, and I will not need to participate in his supervision. Gary is an idiot.

“Well, that’s all well and good, Gary, but I’d like you to come to my office so we can discuss a plan of action. Not because I don’t believe you can manage this, just because I want to stay in the loop if I’m going to be your backup.”

“I really don’t have time right now, and I’d like to get an initial meeting with this guy done today.” He stands at the door to the conference room with his whole body and one outstretched finger pointed toward his office.

“Come on. It’ll only take ten minutes.” He expels a giant, frustrated moan and follows me down the hallway to my door. “Sit down,” I say, waving my hand at my patient chair. He flops down dramatically and lets his Gatorade slosh onto the carpet in front of him.

“I’m going to find him on the unit and bring him to my office for a meeting this morning. I’m going to talk to him like a man, and I’m going to treat him like he’s not scary and no big deal. I’m sure all this crap about him being scary is just because he was incarcerated and prisoners scare people. Well, not me; I’m not scared.” He rubs his Gatorade spill further into my carpet with his shoe.

“This is the extent of your plan? You’re going to talk to him like a man?” I’m not even bothering to write this down.

“Yeah. It’s not rocket science, Sam. He’s a patient and I’m a counselor. So, he has to answer me. I don’t see why everyone had so much trouble before.”

I shake my fragile, hungover head to try to clear the stupidity of Gary’s response. “Can you please give me something a little bit more specific? How do you plan on getting through to him when clearly no one has been able to until now?”

“Like I said, by talking to him like a man.” He slowly enunciates the last three words.

“What does ‘like a man’ mean?” I hover my pen over my notebook and avert my eyes. I can’t look at him for fear of his response.

“You wouldn’t understand because you’re not a man.” He stands up to leave my office and pats me condescendingly on the shoulder as he leans down to add, “I’ll make another meeting with you after I’ve gotten some answers out of him, okay?” And he’s out the door.

OCTOBER 23RD, 11:37 P.M.

I have been avoiding garbage day for about a week now, and the recycling bin is overflowing. There isn’t much space under the sink in my kitchen, and since I drink more than I cook, I have the big recycling bin between the front door and the fridge. It looks more like a hamper.

The blue see-through bag has been pulled under with the weight of the bottles, and I need to yank it up by the red strings to get it out of the can. The clattering sound it makes is absolutely insufferable. There is a leak at the bottom, and the putrid stench of week-old wine and booze, mixed with the acidic smell of the Tropicana bottle from this morning’s screwdrivers, is making me gag. There’s a reason I always put this chore off until the last possible minute.

The noise the bottles make as I pull it along the carpeted hallway is not as bad as it would be if I were to pick it up and haul it over my shoulder, Santa Claus–style. I will have to carry it that way when I walk down the old marble steps to the basement.

I push open the refuse-room door, and I see skittering bugs as I turn on the lights. They’ve come inside to hunker down for the winter, and this room is a veritable buffet of gnarly shit for them to feast on. I flip over my huge sack of booze bottles into an awaiting plastic can, and it sounds like several of them smash. I feel the ooze that has spilled down the back of my pajama pants, and I try to dry it off with a rag that was hanging on a hook by the door.

I get back up to my apartment and clean up the smears on the floor. I put the two forgotten bottles of beer into a fresh blue recycling bag and line the can with it. I have two bottles of scotch on my bookcase shelf that I never finish. There’s always at least four fingers left in each bottle so if I have company, it looks classy and sophisticated. I usually have a bottle or two of wine in the fridge, too. Not because I’m saving it, but because I buy in bulk.

OCTOBER 26TH, 3:35 P.M.

Gary is loitering in front of my office door as I return from running a women’s group.

“Hey, Gary. Did you need something?” I can see the desperation in his eyes, and I know what he came here to discuss with me.

“Yeah, I need to talk to you. Do you have a minute?”

“I sure do, come on in.”

Gary slumps low in my patient chair and rakes his sweaty fingers through his hair. “This is making me crazy. I can’t get a word out of this guy, and I’ve had meetings with him every day since Friday.”

“You mean Richard McHugh?” I know exactly who he means.

“Yeah. I brought him in on Friday, like I said, and I tried to start the evaluations and assessments for his patient file, right?” He’s leaning on my desk and waving a meaty paw in my face. “And he doesn’t say a word. Not a word. He just sits there, and I thought he must be deaf or something, because he just didn’t say anything. He didn’t get mad or anything; he just sat there. I kept asking him the same questions, and he just looked at me or looked out my window. So, then I figured maybe he wasn’t ready. I told him about me, tried to relate to the guy, said I would treat him like a man if he treated me like a man, and still nothing.” Gary is genuinely surprised that his presumptuous macho plan didn’t work. Half of me wants to laugh in his face, and the other half wants to be professional and help him develop as a counselor.

“Okay. So, the original plan didn’t work. You said you met with him every day since then. Did you change your approach?”

“Yeah. I mean, I did everything I know how to do. First, I was just trying the ‘talk to him like a man’ thing, and that didn’t work. Monday, I asked him to come back to my office, and he didn’t put up a fight or anything. So, I figured this time I would just be all business and make him answer the evaluation and assessment questions. But he didn’t answer a single question! He started reading the newspaper. He brought this huge stack of newspapers with him to read and wouldn’t even look at me when I asked him questions.”

“Okay, and I imagine the sessions yesterday and today were more of the same?” I’m already tired of hearing this.

“Yeah, total silence. He doesn’t even say hello.” Gary leans back, satisfied that this is my problem now.

“Gary, you’ve made four attempts to talk to a man who apparently doesn’t like to talk much. So, you shouldn’t be surprised or disappointed that conventional methods aren’t working.”

“I don’t think it’s my methods, I think it’s me. I think he just doesn’t like me.” Gary is saying this to appeal to my ego, so that I offer to take over for him and he doesn’t have to ask me.

“How would you like to proceed?” I’m not letting him off that easy.

“I think you should take him. I don’t have this kind of time to waste on someone who doesn’t talk, doesn’t want to be helped.” He is crossing his arms and shaking his head in fast, erratic twitches that make him look like a frightened woodland creature.

“I can’t make that call. You’re going to have to speak with Rachel.”

“Oh, come on, Sam, can’t you just take this one for me?”

“I’ve already taken Shawn for you.” I sigh. “But if Rachel signs off on it, I will take him. Until then, he’s yours.” I close my notebook for effect and open my door, allowing Gary to go find Rachel and deal with this.

OCTOBER 28TH, 9:12 A.M.

We have a 9:00 a.m. staff meeting most mornings to discuss our patients and any administrative nonsense that needs to be addressed. Everyone usually drags ass in the meeting except for me and my boss, Rachel.

Rachel is a linebacker. She is a formidable presence, and her booming voice and sharp intellect scare the shit out of everyone. She was born to run an institution, and her lack of a private life really helps her excel at her job. Her stringy, mousy brown hair is pulled back with a velvet scrunchie and she is always wearing a sweater set and chinos that are too tight in the hips and it makes the slash pockets stick out like little ears.

Rachel likes me because she needs to believe that I really am always energetic and positive and a barrel of sunshine. Whenever I am out on the unit, I am a superhero. I am a troubleshooter, and a problem solver, and the go-to gal to get stuff done. My coworkers hate this about me. Until I cover their groups, or take their patients to the ER, or finish their case reviews/progress reports/treatment plans; then they love this about me. I make self-deprecating jokes as a defense mechanism. I always ask people about their weekend and how they’re doing because people are narcissistic and won’t ask me how I’m doing in response. This way I don’t have to lie to anyone.

“Frankie’s back in the hospital.” Shirley begins her report. “Apparently he was standing in the middle of the street trying to direct traffic. This was an intersection on Broadway, and it’s amazing that he isn’t dead. Supposedly, when the police tried to stop him and arrest him or whatever, he started running away from them, bouncing off of cars, running in between them… It was a mess. Eventually they tackled him, I’m not sure, and they brought him to the psych unit at Columbia University Medical Center. He is on suicide watch right now, and I keep getting calls from the docs telling me that he’s not cooperating. I’m not sure what I’m supposed to do about this.” Shirley is both disengaged and disenchanted and ran out of empathy years ago.

“You go to CUMC, Shirley,” Rachel responds, irritable, frustrated, possibly menopausal. “You talk to the doctors. You make sure they know you’re the point person in his continuing care. Eventually, Frankie is going to be coming back here for inpatient services once he is cleared to go, and he needs to be aware that he wasn’t abandoned in the psych unit at CUMC.

“Remember, all of you.” She is looking at us like bad kids who ate all the cookies. “We are the only resource for many of our patients here. We are their mothers and fathers, their caretakers and confidants…”

I didn’t sign up to work on this unit to be anyone’s mother or father and I resent her for saying this as she drones on with the lecture she has delivered so many times. I sip my coffee and stare out the only window in the conference room. There is construction going on across the street; I can hear it a little bit, but mostly I just watch the men in jeans and reflective vests glide up and down this building as they work the planks and rods of the scaffold, and I wonder what would happen if someone jumped off.

“In other news,” Rachel continues, “I’m announcing a caseload change this morning, as well. Gary has been working hard to reach our newest patient, Richard McHugh, but unfortunately, he hasn’t gotten anywhere. I met with Richard yesterday to discuss a change in his counselor, and he asked for you, Sam, by name. So, tag—you’re it. Good luck.” Rachel told me about this before the end of my shift yesterday, so this is nothing more than a performance for the rest of the staff.

Rachel pulls me aside and thanks me for playing along. I rejoice in being her golden girl, and whenever she has faith in me, it helps me to have faith in myself. She reminds me again that Richard specifically said he wanted to work with me, Samantha James.

Julie is waiting for me outside the conference-room doors. “No wonder Gary couldn’t handle that guy, I’m sure you’re going to do a much better job. I can’t believe Rachel even wasted our time assigning him to someone so incompetent.” Julie, always looking for someone to tell her she isn’t incompetent. She is huddling next to me like we’re girlfriends of twenty years, holding my arm and whispering her hot-coffee whisper into my hair.

“I just think it’s stupid to have these meetings at the ass crack of dawn when everyone is still hungover and can’t even read yet,” I say, trying to lose her.

“You’re hungover?”

“It’s a figure of speech, Julie. I am not literally hungover.” Lies. Lies. Lies. I would be much better off wrapped around a toilet right now, but Julie will offer me no solace.

“Oh—I know—I guess I just thought maybe you went out last night again. When are we going to go out together? Are you doing anything tonight?”

Julie likes me and wants to be my friend, but I find it impossible to like her. As much as I appreciate her for being an idiot who can’t get over high school, I still can’t tolerate listening to her inane musings and cotton-candy problems with her debutante friends and country-club life. David walks past us and gives me a knowing smile and chuckle.

“I never make plans this early in the day. I will let you know, though; we should definitely grab a drink sometime.” I smile broadly and disengage from her grasp as we are getting close to my office. I juggle my coffee and my case files to try to get the keys out of my pocket when I see that my door was left open anyway.

Nothing is amiss. I must have just left it unlocked. Maybe I’m still drunk. My iPod is still sitting tangled in the headphones on top of a stack of books on my desk. That wouldn’t be there if anyone had come into my office. My sneakers are in the corner where I leave them every morning. A couple of months ago, Shirley left her door open during one of her group sessions and the batteries got stolen out of all her electronics.

OCTOBER 28TH, 11:00 A.M.

My initial meeting with Richard is already happening today, and I have been fixing my desk and my hair and my face and my office for the past hour to prepare for it. I am afraid of him, and I haven’t had this feeling since I started on my first psych unit nearly fifteen years ago. I was barely twenty-two. I never feel like this anymore. I’ve sat across from lunatics and psychopaths, diplomats and dignitaries; it’s all the same to me now. I haven’t been scared like this in ages.

My office is configured the way it’s supposed to be, with the desk chair closer to the front door than the patient’s chair. This is done just in case the patient gets violent and the therapist needs to escape, but we say it’s done so the clinician can obtain emergency services more quickly should the patient need it. I’ve never had a patient get violent in my office; it usually happens out in common areas. I realize I have the scissors closer to the patient’s chair and I move them to the drawer. Sometimes I sit on my desk so I can gaze out the window and pretend I have a different life.

The door knock is so loud and jarring that my already frazzled nerves just explode and lodge themselves in my throat, making it hard to speak. I have to appear calm no matter how scared I am.

“Hi, Richard. Come on in, have a seat.” I remain standing, holding the door open for him. I’m waiting for him to sit, then I close the door and begin to get dizzy. He sits in my patient chair and places a large stack of newspapers at the corner of my desk. “I am going to be your counselor. I wanted to set up this initial meeting so we could get to know each other a little bit, and maybe get started on some of the clinical documentation we need to do.” I sit down as I say this.

Richard doesn’t say anything in response. Instead, he lifts the top paper from the pile and makes a show of opening it up and finding his intended section. He slips off his hat. It’s a brown herringbone newsboy cap. He places it gently on top of the newspapers. As he turns his neck, I notice two small, round scars under his collar.

I rustle the papers of his blank file and begin again. “Why don’t we start with the family history section? This way you can tell me about your family, and we don’t have to dive right into talking about you personally.”

He turns away from me, folds his paper in his lap and focuses his attention on the men climbing the scaffold across the street.

“Okay, no family history. What about goals for treatment? Would you be willing to talk about what you’d like to achieve while you’re here at Typhlos?”

He raises his eyebrows, releases a breath and adjusts his seat to get a better view of the construction workers.

“Okay, that’s a pretty obvious no. How about telling me a little bit about yourself, informally, and I will gather whatever information I need. How’s that?”

Richard glares disapprovingly. “You want me to sit here and tell you all about me? Like a job interview?”

“If that’s how you want to look at it, yes. A job interview would be great.”

“No.” Blunt. Decisive.

I’m barely making more progress than Gary did. It looks like I’m going to have to work on this guy a bit more than I’d anticipated. I feel exhausted just thinking about it.

I sigh an enormous, frustrated sigh, and I intentionally blow it in Richard’s direction. I hope it stinks of booze and vomit and coffee so he knows how much his resistance is pissing me off.

OCTOBER 28TH, 10:01 P.M.

I’m on the train, watching the people in front of me arguing. It’s packed, and it’s cold outside, but the body heat from the rest of the riders is making me sweat into my scarf. The sways and jolts of the train are lulling me into a trance, and all I can hear is the woman in front of me telling her boyfriend that she has had enough.

I am currently seeing someone. I don’t know why that is the terminology we use—“seeing” someone; usually, I say “seeing someone” in reference to a therapist, but this is how I describe my relationship because I don’t want to say “relationship.” We have been involved for a while.

His name is Lucas. On paper, he is the type of guy you’re supposed to marry. He does something in finance, and he calls it “finance,” which makes me want to punch him. He knows the difference between Cabernet and merlot and wants me to taste the tannins. He has a King Charles spaniel named Maverick, which of course just makes him wildly out of my league. He went to Cornell, and he actively parts his hair. In the morning, he uses a fine-tooth comb and creates a straight line down the left side of his head, and he tucks stray hairs behind the line. I am anal, but he is crazy. He wears shoes that he keeps shoe trees in. He finds it very important that when he gets home from work and he takes off his shoes he immediately puts the shoe trees into the shoes because they are warm from wear and more susceptible to morphing into an undesirable shape. I care less about shoes than he does. He has dirty-blond hair, is tall and wears suits with pocket squares that he has to have folded just so. He’s prettier than I am.

He talks to me about getting married. I find this completely ridiculous. I am not the girl you marry. The only reason I have stayed with him for such a long time is because I am trying to rescue him. This is a well-known pattern in my life, and I have only recently become aware of it and okay with the fact that this is what I do.

He has all the things that girls are looking for: the stability, the money, the good looks, the education. But underneath it all lies a very damaged, very insecure little man, and that is who I am dating.

I do not want this picture of perfection; I do not want this combed, shoe-treed, elitist, country-club gentleman. I want the broken-down little puppy inside of him who is desperately trying to play pretend. I want to find that puppy, I want to rub his belly and give him a good home, and then, when he’s better, I will leave. This is a project. This is a way of making sure that I don’t get hurt, and making sure that someone values me.

I have no way of getting value from within, so I get value from without. As soon as I see the reserves beginning to dry up, I will walk out of his life and move on to the next well of validity. The truth is, this plan isn’t working, and hasn’t been working, but I’m not ready to give up just yet.

OCTOBER 31ST, 10:25 A.M.

Richard is in my group this morning, and I suddenly feel like I am performing more than facilitating a therapy session. He’s sitting next to a relatively new kid named Devon. Devon is my age and surprisingly stylish. Today he’s wearing designer jeans, distressed black leather shoes that extend too far out and look like cartoon cowboy boots, a gray athletic T-shirt and a pretty badass leather motorcycle jacket. Not the kind you pick up at a department store for nine hundred dollars; the kind guys who actually ride motorcycles wear. His long dreads are twisted into a thick ponytail. If I had seen him under different circumstances, I might have said he was hot. Except for the shoes.

Devon is diagnosed with schizophrenia, disorganized type. This isn’t particularly common here; most of the patients with schizophrenia are diagnosed with paranoid type. People outside these walls call it paranoid schizophrenia, but when I’m here I have to say it the right way.

He sits with his legs twisted around each other, at the edge of his seat, constantly wringing his hands together and twisting his arms around one another. At several points during today’s group, he looked like he was about to tip over. After a few groups, Devon began standing up in this position. He would perch on one bent leg with the other leg twisted around it, holding his arms out in front of him and eventually doing something that looked like martial arts. He would shadow box standing like that; he would move his arms in slow, concentrated motions like tai chi. This was both fascinating and distracting.

I’m seeing Devon twitch and perch now, and I’m inwardly terrified of how this is going to affect the other patients—particularly Richard. I’m watching him with one eye while keeping the other eye on the group. Richard is keeping to himself; he’s arranged it so there’s more than one chair between him and any other patient, but he is looking up from his papers over his glasses, and he is noticing Devon. The other patients start to become wary of Devon’s behavior, and some become obnoxious and say they don’t want to be around this weirdo and I should kick him out of the group.

“No one is getting kicked out, Barry. Take it easy.” I lean back on the desk.

“Nah, man, this dude is weird, I don’t want none of his weird getting on me, man. He distractin’ the group! He shouldn’t be in here!” Barry likes to be the peacekeeper while not keeping the peace at all. He frequently causes uproars in the name of justice and the betterment of the group process. I think Barry makes big scenes to distract himself from the voices in his head.

“Barry, since you’ve elected yourself to be the spokesman for this group, why don’t we follow your lead and talk about stigma.” Everyone hates when I do this.

“Aww, Miss Sam, can we not? I’m tired of talkin’ ’bout stigmata.”

“Stigma.”

“Whatever you call it. I’m tired of it.”

“Okay. First of all, what is stigma? What does it mean?”

“Stigma is like prejudice, right? Like when you an asshole to someone because of how they look, or being black or something, right?” This is Lucy. Lucy is seventeen. She wears sexy outfits and too much makeup. She has bipolar disorder. Some days she is so with it, I want to send her to Harvard, and some days she can’t tell you her name.

“That’s right, Lucy. Good job. Stigma is a lot like prejudice. It’s a negative belief that exists about a member of a group that is based solely on group membership. Anyone ever have experience with that?” Sometimes, I’m more of a teacher than anything else. When I get into a good discussion, I start kicking my heels against the front of the desk. We are not supposed to be sitting on the desks; it’s another one of the rules about making sure we keep a proper level of separation between “us” and “them.” The longer I’m here, the less I care about this separation.

Everyone raises their hands to indicate they have been stigmatized in the past. Even Richard has his hand up. Devon is the only one who doesn’t respond. I call him out.

“Devon, you see everyone else has their hands up? This has never happened to you?” I’m trying to involve him, not alienate him, but I fear I’ve made the wrong impression. He looks at me and seems to say something.

“I’m sorry, Devon, I can’t hear you from all the way up here. Can you say that one more time?” He responds again, this time unlocking his chin from his neck and seemingly trying to project.

“I’m sorry, still can’t hear you.”

“He says he stays away from people.” Stephan.

“Thank you, Stephan. Sometimes it’s hard to hear. So, Devon, you stay away from people? Is that to avoid being stigmatized?”

He nods.

“It hurts to be the victim of stigma, doesn’t it?”

He nods.

Everyone else nods.

“What kinds of things do you think other people believe about people with mental illnesses? What kind of stigma have you experienced?”

“People say we’re crazy.” As Stephan says this, I start writing the words on the blackboard behind me.

“Lazy. Uneducated. Stupid.” Barry.

“People say we a burden. Like we don’t do nothin’ to help America.” This is Lucy again.

“Dangerous.” I’m surprised at who this is coming from. Adelle is about a hundred years old. She is as frail as they come, and I wouldn’t imagine she experiences the stigma of being dangerously mentally ill. Then I remember that while off her meds, Adelle once stabbed a man in the chest with a pair of scissors.

“Dirty. Disgusting. People don’t want to stand near us. Even we don’t want to stand near each other.” Darryl says this. Darryl is suffering from a traumatic brain injury that resulted from a self-inflicted gunshot wound to the head. He still struggles with major depression, but he swears he will never attempt suicide again. His wife left him after the incident because she couldn’t bear to look at him with the resulting disfigurement.

“Alright, I’ll say it: they say we’re weirdos.” This is Barry making amends. He looks at Devon. “Sorry, man, you don’t need me calling you a weirdo when everyone else already does.”

Devon nods.

“Thank you for that, Barry; that was very nice of you. What else, guys? What are some other stigmas you’ve experienced due to mental illness?” I see Richard looking at Barry, seemingly approving of his apology.

“People think they could catch it from you. Like if they have sex with you, they could get bipolar.” Lucy.

“Does anyone know if that’s true or not?” Me, I’m trying to teach without making the patients feel like they’re in school. I’m looking at Richard, but his head isn’t in the room.

“Nah, you could get AIDS and shit, but you don’t catch crazy.” Barry.

As I’m writing all the words on the board, I’m beginning to feel guilty because I’ve held every single one of these beliefs. I feel simultaneously sad and defensive.

As the group finishes, I wait for everyone to file into the hallway. I am walking around the room putting the chairs back into a semicircle, picking up the garbage left by the patients. As I walk past the chair that Devon squeezed into the corner, I notice little flakes, like paint chips or confetti, scattered at the base of his seat. I brush them onto the floor and keep walking.

I erase the board, making a mental note of all the words written, wondering how often I’ve felt stigmatized. Wondering how many of these things people think about me. Wondering, not for the first time, if I fit a profile.