july 22, 1982 (Day Four)
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ahunter3= July 22, 1982 (Day Four) =
I slip off by myself after breakfast and find my way back to that little piano I’d seen. I sit down with my morning coffee in my left hand and play some gentle running chords, arpeggios and such, with my right. It has a nice sound for its size. Maybe I’ll come back here later and play for real. At the moment I’m feeling a little bit fragile and shy. It would be one thing if people basically left me alone and let me play, or came by to listen and said nice things. It would be something else if someone told me to stop making noise or said something hostile while I was playing.
* * *
In the same room as yesterday evening’s Alcoholics Anonymous, I now get introduced to its younger sibling. Narcotics Anonymous.
“Yeah, it’s the same twelve steps, but there are some things that got added by people coming from a place of drug addiction, like ‘Stick with winners’, where we’ve learned that you can’t get clean and stay clean and still hang out with people who are still getting wasted”, George informs me.
A woman I’d seen but hadn’t been introduced to yet scrapes her chair, pivoting it to face me. “You can’t make amends to all the people you’ve hurt as long as you’re still blaming most of them. Lots of us here, we practically had needles with us in our cribs. Like here’s Sesame Street and today Mr. Muppet is going to teach us how to freebase.”
“Noelle’s right”, Valerie tells me. “But some of us didn’t get into it until later in life. They give you stuff in hospitals for pain, like if you wipe out skiing and your leg is in pieces, or you get kidney stones so bad they have to bust them up with a supersonic hammer.” She glances over at Ellen momentarilly, then back and continues. “So you find out that you like it. And when you get out you can get more. At least for awhile. Then when they won’t refill your scrip anymore, you ask around and your friends have leftovers, or their cousin’s doctor keeps on refilling and we can buy some off of him.”
“And nobody says you’re a junkie, not then”, Ellen remarks. “Junkies shoot up in phone booths and buy drugs in the park after dark. But as long as you got what you’re using from a prescription pad, you’re just doing what the doctor told you to.”
“Well, that’s getting awfully close to blaming other people again”, Gary Stevens corrects her. “But yeah, narcotics isn’t just heroin. People get strung out on dilaudid, demerol, vicodin, morphine, codeine... ”
I nod. “I’m familiar with those from nurse’s training. I’ve even administered some of them.”
Gary smiles. “How often did you end up on the receiving end of your ‘administrations’?”
“Never did. I never stole or used any hospital medication and I’ve actually never even injected myself, although in nursing school we had to inject each other once with plain saline.”
“Aww, c’mon, man”, George protests, “it’s just us here. What got you into this fancy resort?”
Ellen is saying something more derogatory under her breath, from the tone of it; but I can’t catch it.
“You folks want to know what drugs I made use of before coming to this place.” I make it a statement. I tick them off on my fingers. “I smoke pot. I drop acid a few times a year. I’ve smoked hash now and then. I’ve taken mescaline once or twice. Never managed to score any peyote, but I’ve done mushrooms a few times. Going tripping.” I switch to the fingers of the other hand. “Several times people have tried to turn me on to cocaine, but all it ever does is make my nose go numb, so I don’t get what that’s all about. Let’s see... one time I tried something that was supposed to be MDA, I don’t know if it was or not, it turned me into a total zombie, I had to crawl out of that party, couldn’t stand up. Codeine... my mom had some codeine capsules, and twice in junior high I swiped about four of them, but after that they were so low I knew she’d notice, and she never got a refill. I can see why opiates are addictive, it’s probably a good thing I didn’t run into more of it. Umm...oh yeah, once I tried swallowing a whole lot of ground nutmeg because I’d been told it was psychedelic in large quantities, but all it did was make me really irritated at everything. That’s all I can think of.” It actually sounds like a pretty hardcore list to me.
“Bullshit!!”, Jake says, scowling. “I thought you were seriously on the up and up, man, I really did. How you gonna work on yourself when you can’t stop lying to yourself and us even when you know that lie’s not gonna fly. There’s no way you end up in a place like this for smoking some joints and going tripping on weekends!”
“I’m not bullshitting you. I told y’all that I don’t think of myself as having a drug or alcohol problem. I may have other problems getting in my way, and yeah my parents think so, they’d think anyone who drinks more than two beers at a time or drinks every weekend has a drinking problem, and their attitude to pot is straight out of Reefer Madness.”
“Hold out your arms”, April challenges.
I do. Several people peer at the crease of my elbows. Jake and April exchange dubious glances.
“That don’t mean shit”, Jake proclaims. “He’s in nursing school, I’m sure he knows how to sterilize a needle. Or he could be shooting between his toes for all we know.”
“To start out with?”, April replies. She holds out her own arms wordlessly. White spiderwebs trace patterns. Jake and George display their own histories.
“Okay”, Jake concedes, “so maybe cocaine then. Ronald did most of his up his nose.”
“I told you”, I argue, “I’ve tried it, I dunno, maybe five or six times, always some friend or the good buddy of a friend going to introduce me to the best experience of my life, and they’d lay down these tracks and give me the straw, and I’d shnurff the stuff up my nose... and they’d be staring at me like ‘Wow, right? Isn’t that the most fucking fantastic feeling ever?’, and I’d be like, ‘Dude, my nose is numb, this is like going to the dentist and getting novocaine, when does this shit wear off’...?”
Incredulous stares all around.
“I get a better buzz off of coffee. I don’t know why, that’s just how it is.”
* * *
“Hey, Derek”, Emily greets me at mid-corridor. “Do you feel like you’re settling in and getting used to the place?”
“Well, somewhat. And vice versa. Still a lot of wariness on both sides of the equation but not too bad.”
“It does seem like you’ve opened yourself more to the community lately”, she agrees, “and that’s a good start. It might be a good idea for you to begin thinking in terms of your progress. As you know, we have four tiers of achievement, starting with Level Four, which you earn just for getting yourself here and recognizing you need to work on your issues. With each new level that you bring yourself to, you are trusted with more privileges and you play more of a role in assisting other people in their own climb. You reach Level One and you’re a candidate for discharge, and they place you, they help you find jobs.”
“Who makes the progress assessment? Does each patient make their own, or Dr. Barnes, or our individual counselors, or what?”
“The community as a whole discusses it in group. Dr. Barnes has the final say, of course, but it’s all of us together.” She shifts the notebook she was carrying to the other arm and shoots me a small smile and gives my shoulder a gentle squeeze.
“Aah, I see. And let’s say someone wasn’t regarded as making progress but they were satisfied with how they were doing. How does that play out?”
“Well... that would usually be a sign that they’re stuck in a place where they aren’t seeing their own issues as clearly... I mean you have to let them go at their own pace, I guess, but the path to graduating out and rejoining the larger community is up the tiers. They’re not going to put a person who’s at Level Three back into the world and set them up for failure.”
“It was my understanding that a person could leave at any time if they decided this place wasn’t working for them, though...?”
“Well, yeah, I mean if someone was signing out of the program. Then they’re on their own.” She shrugs and looks back at me a bit sorrowfully.
* * *
“Cast Iron Window” is an instrumental piece I composed while I was living in Athens. I had found several places nearby where I could get access to a piano, to make up for the lack of one at my grandparents’ house. Composed a lot of pieces in youth centers and churches and schools.
“Cast Iron Window” is a piledriver of a piece, more the kind of rock you expect to be driven by a bass player, with the left hand oscillating a fast staccato pattern way down in the cellar of the keyboard, while the right hand smashes slow emphatic chords like the power chords on a lead electric guitar.
The piano is situated in a small alcove at one end of a fairly short corridor that people make use of to get out to recreational activities. The sound is good from where I’m sitting, but I think it probably isn’t overwhelming anyone out beyond this hallway.
Deep into the piece, around the point where it finally resolves into a coda section, I become aware of a presence, someone standing behind me watching and listening.
I build the melange of overlapping chords then simultaneously release the damper and lift my fingers while holding down the sostenuto pedal, and let the sound echo in the hall.
“How do you do that?” It’s Noelle, the short-haired patient I met in Narcotics earlier. Valerie with her. “How are you making the piano sound like that? I used to play piano some but you’re getting a different sound out of it somehow, like you got a distortion pedal or something.”
“Yeah”, Valerie adds, “that was actually pretty awesome.”
“Wow, thanks. Well, for one thing, I’m pounding a lot of very low notes, so they resonate all up through the strings up above them, and with the damper pedal down most of the time it really lets overtones build. I’m also using a trick with the middle pedal, on these little spinets they do this thing where the dampers lift completely from the lower harp but just lightly touch on the upper strings — that lets me bang out short sharp notes and chords, they don’t sustain like the low notes, but they still ring more from overtones than if you weren’t using the pedal. It’s different from what a real sostenuto pedal does if you’ve got a grand, but it’s useful for certain effects.”
Noelle looks thoughtful. “You wrote that, I mean it’s your own music, isn’t it?”
“Yeah... I discovered a long time ago I could come sit at the piano and, whatever mood I was in, the piano would give me the right kind of company. Like if I was all lonely and sad, I’d touch the keys soft and get plaintive pretty sounds and they’d be like hugs or something, or like the piano was crying for me, and it would make me feel less alone. Or if I’m angry and frustrated, maybe I’d come pound and bang away on it, like what you just heard, and it makes these big powerful sounds, and that would make me feel better, too. I think music has always been my best therapist.”
“That’s cool. Well, we didn’t mean to stop you. Play some more. I mean, if you feel like it.”
I do. I launch into something else. Later, when I glance around, they’re gone, but it doesn’t feel like being deserted or abandoned. It feels like someone came by and heard, even if they weren’t here listening now, and that was nice.
* * *
Mark’s office is one of the most featureless spaces for any kind of personal counseling that I’ve ever seen. The desk is a metal-legged brown-topped box, designed to look like wood but made entirely of metal and plastic, utterly planar and sharply cornered. Mark has a metal file holder with a handful of manila folders about organizational procedures, and a phone, but no personal items or motivational posters or anything like that; the low bookshelf holds dictionaries and a Physician’s Desk Reference and the DSM-III psychiatric diagnostic handbook and other reference materials, very generic.
And yet.
So far, Mark has always come from behind his desk to sit directly across from me and I presume he does so for all of his patients. I guess he doesn’t want the desk to come between. Maybe he hopes it will foster trust and a sense of equality. I appreciate that.
“The selling point that really pushed me towards coming to Elk Meadow was communications skills and strategies”, I tell him. “That’s where I think I have the biggest deficits. I didn’t fit in with other kids very well after about third grade. When other boys would hassle me about doing what a girl would do or saying something that sounded to them like what girls would say, or, just in general, you know, being like a girl, ... I mean, when they did that to each other, the boy being called out would usually get all angry and blustery and push that away, you know what I mean? ‘Come over here and say that’, or ‘Prove it, fairy pants’, and I was more like ‘Yeah, so? The girls are doing it right’, and so I didn’t push away from doing or saying things that might get me seen that way because I didn’t care. So after a few years I was mostly off by myself. I didn’t notice right away. I still had some friends who were girls, but it wasn’t as easy as when I was a young kid. A lot of the girls would just view me as different, even if they weren’t often hateful about it the way the boys were. But I still had some girl friends, and there were also a couple friends who were boys who didn’t hate me and think I was weird, and who seemed okay. But not many people. I was pretty isolated, enough for my parents to get worried.”
I stretch and cross the other leg on top and continue. “I think there’s a lot of informal stuff that people with more friends learn without even knowing it, like how to read other people’s expectations and pick up on things that don’t get said out loud. I’m trying to learn that, but growing up I didn’t get as much practice, and I spent a lot more time with my head in a book. In a way, I’m like a foreigner who learned the language but who speaks it kind of formal and stilted, and it’s not how native speakers actually talk. I don’t just mean my actual language, though, that’s just part of it, but, like, I’m comfortable in a classroom but awkward at a party or just hanging out.”
Mark nods. I continue, “I need to be able to reach out to people and make sense to them, but I’m always at a disadvantage. I think people think I’m stuck up in some way, or... I’ve had problems with employers too, I’d show up on time and work as hard as I could and a lot of times they’d say I had some kind of attitude problem. Not the... not the ‘giving you back-talk’ kind of attitude problem, I don’t mean starting arguments or refusing to follow the boss’s orders, but something that they don’t like.”
Mark holds his chin in his hand, listening. He nods again. “So... you do accept that it’s likely that you have your own internal blocks, your own resistances to changing this pattern that you might have to cope with in order to make any progress with this?”
“Yeah, I think that’s very possible. I have my patterns, my ways of doing and saying things, which I’m used to, and I’m also afraid of any kind of reaching out to other people and ending up caring a lot about the outcome, and then failing. Or not being able to get to the point that I’m any good at it. I have stuff in my head, ideas that I think need to have an impact on the world, but they aren’t doing any good while they’re stuck here in my head.”
I sigh. “Honestly, if it were just me, fitting in or not fitting in, me having friends or not having friends, it’s enough now, I don’t have to fit in everywhere and I don’t need everyone as a friend, so I don’t need to care about the rest, about everyone else, where I don’t fit in. But now since I want a receptive audience, I need something from people, from practically everyone. I’m asking for their attention. I don’t much care for that situation, so it’s likely that I do close my eyes to stuff.”
“Well, I think it’s a real breakthrough that you’ve come to this realization so quickly. It’s definitely an encouraging sign of your progress here. I’ll talk with the rest of your treatment team about you being interested in pursuing that.”
I don’t contradict Mark on that, and we conclude our session.
I didn’t just come to this realization, though. It’s been flickering around in my head over the last two years of reading pieces I’d written at open-mike events and watching my supposedly provocative and insightful thoughts fall out of the PA system speakers and die quietly on the floor. It’s on my mind whenever I sit on my bed at home in frustration, trying to figure out what to try next.
But if the Elk Meadow personnel want to think they’ve led me to this new self-awareness, it makes sense to let them. It might ameliorate their sense that I’m resisting their help, and with any luck we can move past this adversarial standoff and focus on changes I actually want to look into making.
If they don’t want their patients reacting with distrust, they shouldn’t make the experience feel so much like being in a cage. The oh-so-enlightened egalitarian approach touted in their literature that impressed my mom and my dad looks mostly like window dressing at close range. Yes, the staff and the patients wear street clothes, but everyone still knows who is a patient and who is on staff. They’re the ones with the keys in their pockets, the ones who can open the doors. No, it’s not a gothic horror house like Mountain View in Albuquerque, with its barred prison-like windows and straitjackets and seclusion rooms, but they don’t actually need bars in our windows; those aren’t normal residential screens in our windows, our screens are made of steel mesh of a gauge that you wouldn’t be able to put your foot through, or even easily hurl a chair through. Thanks, Ken Kesey. And although nobody chases me around with a loaded Thorazine needle or a canvas restraint, the intense attention — with clinical expertise assumed on their side and pathology assumed to exist on mine — feels like a threat.
The majority of the staff seem at least to be well-intentioned, in all fairness, but they are all really oblivious to stuff like this.
* * *
I have a book with me at supper, and so after I finish eating I stay in the cafeteria, reading. I do understand what Emily was driving at, that some of us introverted and self-absorbed people would benefit from interacting instead of just whining about how bad we are at interacting. Reading my book makes me unobtrusive but present, and the cafeteria’s the most likely public space.
Over at the next table, Noelle and Valerie have been hanging out since finishing dinner. I’m not exactly with them and not exactly not with them. I’m in their vicinity. April meanders in from the hallway, I assume she’s returning after having eaten earlier She’s got on a shiny blue top that looks sort of Asian, maybe Indian. Jake comes in from the other hallway with a cup of coffee in his hand. Jake sits at my table. April remains standing. She seems to me to be trying on faces, looking off into the distance in a way that makes me think she’s framing whatever it is she wants to say.
After a pause, she slips onto the bench next to Noelle and across from Jake, facing him. “You said some really strong shit about my mom and me. When I was on the hot seat the other day, I mean. That stuff you said about me blaming her and all, and I get that, but I wanna talk about it the way it looks to me.” April pauses and draws her shoulders in a bit. She pulls her fingers through her hair and takes a breath before continuing. “It’s like shell shock, man. I think I have to be able to be angry at my mom to be able to be angry at how-the-fuck things were. I’m trying to say there’s a difference between ‘I blame mom so it’s her fault’, ...and..., ‘I come to recognize I kind of got messed up, from how things were between my mom and me’. Whatever I was trying to say that all you guys heard as ‘April blames her mom for everything’... I was just trying to say this is where I come from, this me-and-my-mom situation, see? I’m not saying it was all her fault, hey fuck fault, and fuck blame too, just... this is the mess I was in and this is what it was like for me, and it sucked.”
April gives her dark spiky hair a toss. She had been running her fingers through her hair earlier but this is definitely a toss.
Jake continues looking at her, then nods slowly.
But Valerie speaks first. “I get what you’re saying. It’s like you could be using it as an excuse to stay stuck in that, or you could be dealing with it so you can move on.”
“Yeah, it could be that way,” Jake says. “But you got to stay honest with yourself, you know.”
April leans back against the cafeteria table and it squeaks and rolls back a couple inches. She repositions herself and reaches behind to pull the table back.
Noelle adds, “Mark and Gary and Marie and them, they don’t have much truck with excuses. It may seem like everybody come ganging up on you, but you gotta admit, it sounds like you bring up your mom whenever they try to get you to focus on putting your life in order.”
A nod and a lopsided smile from April. “I’m not saying I never used her as an excuse like that. I probably did. But, I mean like what Derek said the other day about being in the basement when the lights go out. I can pick what I think is true about this, and if later it seems like I got it wrong, I can chuck that out and think again, but it seems to me... like maybe I used to only bring up my mom as an excuse, and the rest of the time I never wanted to think about what it all meant, all those years of thinking I was a waste. But now I gotta think about that. It’s a starting point, and everything else came after that.”
“No, I get that”, Jake acknowledges. He’s got his big hands resting on his knees. “I don’t think we can move past the stuff that’s keeping us back without seeing it clearly, or we won’t notice when we start sliding back into it.”
I’m feeling pleased that April cited me, and gratified to be included. I say, “You’re making an important distinction here, between two ways of looking at the same thing, and I think that’s a special skill, because a lot of time once we see something one way, or get told by other folks that that’s how it is, that’s the only way we can look at it.” I wince, thinking I expressed that rather badly. I like writing better than talking, you can edit what you said and say it better. But I’m doing it decently well anyway, at least some of the time.
Noelle says, “April, look, you don’t seem mad, like you’re thinking we dumped on you in psychodrama and you’re pissed about it. This shit isn’t easy to hear, and you took it in. Now you hand this back to us, and it could go down that Gary and them still say you’re still being defensive... but hey, girl, this takes courage too.”
I wonder if staff knows we talk among ourselves like this, whether they’d think that’s good, because it means the things they’ve pushed us to think about are going to carry over into our ongoing thinking. Seems like they should, but back at Mountain View some of the staff acted like us talking with each other and thinking about our issues and progress was going to mess up our therapy, and that we should just park ourselves in front of the TV set and be vegetables between staff-run sessions. Elk Meadow is more sophisticated. I’m still trying to decide if they’re better in a way that truly counts. I wouldn’t be amazed if they’d planned out exactly how much of our day to lock down into a schedule, to leave us with just enough time to repeat the lessons but not quite enough to veer off very far in our own directions with it.
I slip off by myself after breakfast and find my way back to that little piano I’d seen. I sit down with my morning coffee in my left hand and play some gentle running chords, arpeggios and such, with my right. It has a nice sound for its size. Maybe I’ll come back here later and play for real. At the moment I’m feeling a little bit fragile and shy. It would be one thing if people basically left me alone and let me play, or came by to listen and said nice things. It would be something else if someone told me to stop making noise or said something hostile while I was playing.
* * *
In the same room as yesterday evening’s Alcoholics Anonymous, I now get introduced to its younger sibling. Narcotics Anonymous.
“Yeah, it’s the same twelve steps, but there are some things that got added by people coming from a place of drug addiction, like ‘Stick with winners’, where we’ve learned that you can’t get clean and stay clean and still hang out with people who are still getting wasted”, George informs me.
A woman I’d seen but hadn’t been introduced to yet scrapes her chair, pivoting it to face me. “You can’t make amends to all the people you’ve hurt as long as you’re still blaming most of them. Lots of us here, we practically had needles with us in our cribs. Like here’s Sesame Street and today Mr. Muppet is going to teach us how to freebase.”
“Noelle’s right”, Valerie tells me. “But some of us didn’t get into it until later in life. They give you stuff in hospitals for pain, like if you wipe out skiing and your leg is in pieces, or you get kidney stones so bad they have to bust them up with a supersonic hammer.” She glances over at Ellen momentarilly, then back and continues. “So you find out that you like it. And when you get out you can get more. At least for awhile. Then when they won’t refill your scrip anymore, you ask around and your friends have leftovers, or their cousin’s doctor keeps on refilling and we can buy some off of him.”
“And nobody says you’re a junkie, not then”, Ellen remarks. “Junkies shoot up in phone booths and buy drugs in the park after dark. But as long as you got what you’re using from a prescription pad, you’re just doing what the doctor told you to.”
“Well, that’s getting awfully close to blaming other people again”, Gary Stevens corrects her. “But yeah, narcotics isn’t just heroin. People get strung out on dilaudid, demerol, vicodin, morphine, codeine... ”
I nod. “I’m familiar with those from nurse’s training. I’ve even administered some of them.”
Gary smiles. “How often did you end up on the receiving end of your ‘administrations’?”
“Never did. I never stole or used any hospital medication and I’ve actually never even injected myself, although in nursing school we had to inject each other once with plain saline.”
“Aww, c’mon, man”, George protests, “it’s just us here. What got you into this fancy resort?”
Ellen is saying something more derogatory under her breath, from the tone of it; but I can’t catch it.
“You folks want to know what drugs I made use of before coming to this place.” I make it a statement. I tick them off on my fingers. “I smoke pot. I drop acid a few times a year. I’ve smoked hash now and then. I’ve taken mescaline once or twice. Never managed to score any peyote, but I’ve done mushrooms a few times. Going tripping.” I switch to the fingers of the other hand. “Several times people have tried to turn me on to cocaine, but all it ever does is make my nose go numb, so I don’t get what that’s all about. Let’s see... one time I tried something that was supposed to be MDA, I don’t know if it was or not, it turned me into a total zombie, I had to crawl out of that party, couldn’t stand up. Codeine... my mom had some codeine capsules, and twice in junior high I swiped about four of them, but after that they were so low I knew she’d notice, and she never got a refill. I can see why opiates are addictive, it’s probably a good thing I didn’t run into more of it. Umm...oh yeah, once I tried swallowing a whole lot of ground nutmeg because I’d been told it was psychedelic in large quantities, but all it did was make me really irritated at everything. That’s all I can think of.” It actually sounds like a pretty hardcore list to me.
“Bullshit!!”, Jake says, scowling. “I thought you were seriously on the up and up, man, I really did. How you gonna work on yourself when you can’t stop lying to yourself and us even when you know that lie’s not gonna fly. There’s no way you end up in a place like this for smoking some joints and going tripping on weekends!”
“I’m not bullshitting you. I told y’all that I don’t think of myself as having a drug or alcohol problem. I may have other problems getting in my way, and yeah my parents think so, they’d think anyone who drinks more than two beers at a time or drinks every weekend has a drinking problem, and their attitude to pot is straight out of Reefer Madness.”
“Hold out your arms”, April challenges.
I do. Several people peer at the crease of my elbows. Jake and April exchange dubious glances.
“That don’t mean shit”, Jake proclaims. “He’s in nursing school, I’m sure he knows how to sterilize a needle. Or he could be shooting between his toes for all we know.”
“To start out with?”, April replies. She holds out her own arms wordlessly. White spiderwebs trace patterns. Jake and George display their own histories.
“Okay”, Jake concedes, “so maybe cocaine then. Ronald did most of his up his nose.”
“I told you”, I argue, “I’ve tried it, I dunno, maybe five or six times, always some friend or the good buddy of a friend going to introduce me to the best experience of my life, and they’d lay down these tracks and give me the straw, and I’d shnurff the stuff up my nose... and they’d be staring at me like ‘Wow, right? Isn’t that the most fucking fantastic feeling ever?’, and I’d be like, ‘Dude, my nose is numb, this is like going to the dentist and getting novocaine, when does this shit wear off’...?”
Incredulous stares all around.
“I get a better buzz off of coffee. I don’t know why, that’s just how it is.”
* * *
“Hey, Derek”, Emily greets me at mid-corridor. “Do you feel like you’re settling in and getting used to the place?”
“Well, somewhat. And vice versa. Still a lot of wariness on both sides of the equation but not too bad.”
“It does seem like you’ve opened yourself more to the community lately”, she agrees, “and that’s a good start. It might be a good idea for you to begin thinking in terms of your progress. As you know, we have four tiers of achievement, starting with Level Four, which you earn just for getting yourself here and recognizing you need to work on your issues. With each new level that you bring yourself to, you are trusted with more privileges and you play more of a role in assisting other people in their own climb. You reach Level One and you’re a candidate for discharge, and they place you, they help you find jobs.”
“Who makes the progress assessment? Does each patient make their own, or Dr. Barnes, or our individual counselors, or what?”
“The community as a whole discusses it in group. Dr. Barnes has the final say, of course, but it’s all of us together.” She shifts the notebook she was carrying to the other arm and shoots me a small smile and gives my shoulder a gentle squeeze.
“Aah, I see. And let’s say someone wasn’t regarded as making progress but they were satisfied with how they were doing. How does that play out?”
“Well... that would usually be a sign that they’re stuck in a place where they aren’t seeing their own issues as clearly... I mean you have to let them go at their own pace, I guess, but the path to graduating out and rejoining the larger community is up the tiers. They’re not going to put a person who’s at Level Three back into the world and set them up for failure.”
“It was my understanding that a person could leave at any time if they decided this place wasn’t working for them, though...?”
“Well, yeah, I mean if someone was signing out of the program. Then they’re on their own.” She shrugs and looks back at me a bit sorrowfully.
* * *
“Cast Iron Window” is an instrumental piece I composed while I was living in Athens. I had found several places nearby where I could get access to a piano, to make up for the lack of one at my grandparents’ house. Composed a lot of pieces in youth centers and churches and schools.
“Cast Iron Window” is a piledriver of a piece, more the kind of rock you expect to be driven by a bass player, with the left hand oscillating a fast staccato pattern way down in the cellar of the keyboard, while the right hand smashes slow emphatic chords like the power chords on a lead electric guitar.
The piano is situated in a small alcove at one end of a fairly short corridor that people make use of to get out to recreational activities. The sound is good from where I’m sitting, but I think it probably isn’t overwhelming anyone out beyond this hallway.
Deep into the piece, around the point where it finally resolves into a coda section, I become aware of a presence, someone standing behind me watching and listening.
I build the melange of overlapping chords then simultaneously release the damper and lift my fingers while holding down the sostenuto pedal, and let the sound echo in the hall.
“How do you do that?” It’s Noelle, the short-haired patient I met in Narcotics earlier. Valerie with her. “How are you making the piano sound like that? I used to play piano some but you’re getting a different sound out of it somehow, like you got a distortion pedal or something.”
“Yeah”, Valerie adds, “that was actually pretty awesome.”
“Wow, thanks. Well, for one thing, I’m pounding a lot of very low notes, so they resonate all up through the strings up above them, and with the damper pedal down most of the time it really lets overtones build. I’m also using a trick with the middle pedal, on these little spinets they do this thing where the dampers lift completely from the lower harp but just lightly touch on the upper strings — that lets me bang out short sharp notes and chords, they don’t sustain like the low notes, but they still ring more from overtones than if you weren’t using the pedal. It’s different from what a real sostenuto pedal does if you’ve got a grand, but it’s useful for certain effects.”
Noelle looks thoughtful. “You wrote that, I mean it’s your own music, isn’t it?”
“Yeah... I discovered a long time ago I could come sit at the piano and, whatever mood I was in, the piano would give me the right kind of company. Like if I was all lonely and sad, I’d touch the keys soft and get plaintive pretty sounds and they’d be like hugs or something, or like the piano was crying for me, and it would make me feel less alone. Or if I’m angry and frustrated, maybe I’d come pound and bang away on it, like what you just heard, and it makes these big powerful sounds, and that would make me feel better, too. I think music has always been my best therapist.”
“That’s cool. Well, we didn’t mean to stop you. Play some more. I mean, if you feel like it.”
I do. I launch into something else. Later, when I glance around, they’re gone, but it doesn’t feel like being deserted or abandoned. It feels like someone came by and heard, even if they weren’t here listening now, and that was nice.
* * *
Mark’s office is one of the most featureless spaces for any kind of personal counseling that I’ve ever seen. The desk is a metal-legged brown-topped box, designed to look like wood but made entirely of metal and plastic, utterly planar and sharply cornered. Mark has a metal file holder with a handful of manila folders about organizational procedures, and a phone, but no personal items or motivational posters or anything like that; the low bookshelf holds dictionaries and a Physician’s Desk Reference and the DSM-III psychiatric diagnostic handbook and other reference materials, very generic.
And yet.
So far, Mark has always come from behind his desk to sit directly across from me and I presume he does so for all of his patients. I guess he doesn’t want the desk to come between. Maybe he hopes it will foster trust and a sense of equality. I appreciate that.
“The selling point that really pushed me towards coming to Elk Meadow was communications skills and strategies”, I tell him. “That’s where I think I have the biggest deficits. I didn’t fit in with other kids very well after about third grade. When other boys would hassle me about doing what a girl would do or saying something that sounded to them like what girls would say, or, just in general, you know, being like a girl, ... I mean, when they did that to each other, the boy being called out would usually get all angry and blustery and push that away, you know what I mean? ‘Come over here and say that’, or ‘Prove it, fairy pants’, and I was more like ‘Yeah, so? The girls are doing it right’, and so I didn’t push away from doing or saying things that might get me seen that way because I didn’t care. So after a few years I was mostly off by myself. I didn’t notice right away. I still had some friends who were girls, but it wasn’t as easy as when I was a young kid. A lot of the girls would just view me as different, even if they weren’t often hateful about it the way the boys were. But I still had some girl friends, and there were also a couple friends who were boys who didn’t hate me and think I was weird, and who seemed okay. But not many people. I was pretty isolated, enough for my parents to get worried.”
I stretch and cross the other leg on top and continue. “I think there’s a lot of informal stuff that people with more friends learn without even knowing it, like how to read other people’s expectations and pick up on things that don’t get said out loud. I’m trying to learn that, but growing up I didn’t get as much practice, and I spent a lot more time with my head in a book. In a way, I’m like a foreigner who learned the language but who speaks it kind of formal and stilted, and it’s not how native speakers actually talk. I don’t just mean my actual language, though, that’s just part of it, but, like, I’m comfortable in a classroom but awkward at a party or just hanging out.”
Mark nods. I continue, “I need to be able to reach out to people and make sense to them, but I’m always at a disadvantage. I think people think I’m stuck up in some way, or... I’ve had problems with employers too, I’d show up on time and work as hard as I could and a lot of times they’d say I had some kind of attitude problem. Not the... not the ‘giving you back-talk’ kind of attitude problem, I don’t mean starting arguments or refusing to follow the boss’s orders, but something that they don’t like.”
Mark holds his chin in his hand, listening. He nods again. “So... you do accept that it’s likely that you have your own internal blocks, your own resistances to changing this pattern that you might have to cope with in order to make any progress with this?”
“Yeah, I think that’s very possible. I have my patterns, my ways of doing and saying things, which I’m used to, and I’m also afraid of any kind of reaching out to other people and ending up caring a lot about the outcome, and then failing. Or not being able to get to the point that I’m any good at it. I have stuff in my head, ideas that I think need to have an impact on the world, but they aren’t doing any good while they’re stuck here in my head.”
I sigh. “Honestly, if it were just me, fitting in or not fitting in, me having friends or not having friends, it’s enough now, I don’t have to fit in everywhere and I don’t need everyone as a friend, so I don’t need to care about the rest, about everyone else, where I don’t fit in. But now since I want a receptive audience, I need something from people, from practically everyone. I’m asking for their attention. I don’t much care for that situation, so it’s likely that I do close my eyes to stuff.”
“Well, I think it’s a real breakthrough that you’ve come to this realization so quickly. It’s definitely an encouraging sign of your progress here. I’ll talk with the rest of your treatment team about you being interested in pursuing that.”
I don’t contradict Mark on that, and we conclude our session.
I didn’t just come to this realization, though. It’s been flickering around in my head over the last two years of reading pieces I’d written at open-mike events and watching my supposedly provocative and insightful thoughts fall out of the PA system speakers and die quietly on the floor. It’s on my mind whenever I sit on my bed at home in frustration, trying to figure out what to try next.
But if the Elk Meadow personnel want to think they’ve led me to this new self-awareness, it makes sense to let them. It might ameliorate their sense that I’m resisting their help, and with any luck we can move past this adversarial standoff and focus on changes I actually want to look into making.
If they don’t want their patients reacting with distrust, they shouldn’t make the experience feel so much like being in a cage. The oh-so-enlightened egalitarian approach touted in their literature that impressed my mom and my dad looks mostly like window dressing at close range. Yes, the staff and the patients wear street clothes, but everyone still knows who is a patient and who is on staff. They’re the ones with the keys in their pockets, the ones who can open the doors. No, it’s not a gothic horror house like Mountain View in Albuquerque, with its barred prison-like windows and straitjackets and seclusion rooms, but they don’t actually need bars in our windows; those aren’t normal residential screens in our windows, our screens are made of steel mesh of a gauge that you wouldn’t be able to put your foot through, or even easily hurl a chair through. Thanks, Ken Kesey. And although nobody chases me around with a loaded Thorazine needle or a canvas restraint, the intense attention — with clinical expertise assumed on their side and pathology assumed to exist on mine — feels like a threat.
The majority of the staff seem at least to be well-intentioned, in all fairness, but they are all really oblivious to stuff like this.
* * *
I have a book with me at supper, and so after I finish eating I stay in the cafeteria, reading. I do understand what Emily was driving at, that some of us introverted and self-absorbed people would benefit from interacting instead of just whining about how bad we are at interacting. Reading my book makes me unobtrusive but present, and the cafeteria’s the most likely public space.
Over at the next table, Noelle and Valerie have been hanging out since finishing dinner. I’m not exactly with them and not exactly not with them. I’m in their vicinity. April meanders in from the hallway, I assume she’s returning after having eaten earlier She’s got on a shiny blue top that looks sort of Asian, maybe Indian. Jake comes in from the other hallway with a cup of coffee in his hand. Jake sits at my table. April remains standing. She seems to me to be trying on faces, looking off into the distance in a way that makes me think she’s framing whatever it is she wants to say.
After a pause, she slips onto the bench next to Noelle and across from Jake, facing him. “You said some really strong shit about my mom and me. When I was on the hot seat the other day, I mean. That stuff you said about me blaming her and all, and I get that, but I wanna talk about it the way it looks to me.” April pauses and draws her shoulders in a bit. She pulls her fingers through her hair and takes a breath before continuing. “It’s like shell shock, man. I think I have to be able to be angry at my mom to be able to be angry at how-the-fuck things were. I’m trying to say there’s a difference between ‘I blame mom so it’s her fault’, ...and..., ‘I come to recognize I kind of got messed up, from how things were between my mom and me’. Whatever I was trying to say that all you guys heard as ‘April blames her mom for everything’... I was just trying to say this is where I come from, this me-and-my-mom situation, see? I’m not saying it was all her fault, hey fuck fault, and fuck blame too, just... this is the mess I was in and this is what it was like for me, and it sucked.”
April gives her dark spiky hair a toss. She had been running her fingers through her hair earlier but this is definitely a toss.
Jake continues looking at her, then nods slowly.
But Valerie speaks first. “I get what you’re saying. It’s like you could be using it as an excuse to stay stuck in that, or you could be dealing with it so you can move on.”
“Yeah, it could be that way,” Jake says. “But you got to stay honest with yourself, you know.”
April leans back against the cafeteria table and it squeaks and rolls back a couple inches. She repositions herself and reaches behind to pull the table back.
Noelle adds, “Mark and Gary and Marie and them, they don’t have much truck with excuses. It may seem like everybody come ganging up on you, but you gotta admit, it sounds like you bring up your mom whenever they try to get you to focus on putting your life in order.”
A nod and a lopsided smile from April. “I’m not saying I never used her as an excuse like that. I probably did. But, I mean like what Derek said the other day about being in the basement when the lights go out. I can pick what I think is true about this, and if later it seems like I got it wrong, I can chuck that out and think again, but it seems to me... like maybe I used to only bring up my mom as an excuse, and the rest of the time I never wanted to think about what it all meant, all those years of thinking I was a waste. But now I gotta think about that. It’s a starting point, and everything else came after that.”
“No, I get that”, Jake acknowledges. He’s got his big hands resting on his knees. “I don’t think we can move past the stuff that’s keeping us back without seeing it clearly, or we won’t notice when we start sliding back into it.”
I’m feeling pleased that April cited me, and gratified to be included. I say, “You’re making an important distinction here, between two ways of looking at the same thing, and I think that’s a special skill, because a lot of time once we see something one way, or get told by other folks that that’s how it is, that’s the only way we can look at it.” I wince, thinking I expressed that rather badly. I like writing better than talking, you can edit what you said and say it better. But I’m doing it decently well anyway, at least some of the time.
Noelle says, “April, look, you don’t seem mad, like you’re thinking we dumped on you in psychodrama and you’re pissed about it. This shit isn’t easy to hear, and you took it in. Now you hand this back to us, and it could go down that Gary and them still say you’re still being defensive... but hey, girl, this takes courage too.”
I wonder if staff knows we talk among ourselves like this, whether they’d think that’s good, because it means the things they’ve pushed us to think about are going to carry over into our ongoing thinking. Seems like they should, but back at Mountain View some of the staff acted like us talking with each other and thinking about our issues and progress was going to mess up our therapy, and that we should just park ourselves in front of the TV set and be vegetables between staff-run sessions. Elk Meadow is more sophisticated. I’m still trying to decide if they’re better in a way that truly counts. I wouldn’t be amazed if they’d planned out exactly how much of our day to lock down into a schedule, to leave us with just enough time to repeat the lessons but not quite enough to veer off very far in our own directions with it.
