The Marriage Plot - Jeffrey Eugenides [129]
In September, when Madeleine and Leonard were newly arrived at Pilgrim Lake, the dune grass was a lovely shade of light green. It waved and bent as if the landscape were a painted Japanese screen. Saltwater rivulets trickled through the marshes, and scrub pines clustered together in discreet groves. The world reduced itself, here, to basic constituents—sand, sea, sky—keeping trees and flower species to a minimum.
As the summer people left and the weather turned colder, the purity of the landscape only increased. The dunes turned a shade of gray that matched the sky. The days grew noticeably shorter. It was the perfect environment for depression. It was dark when Leonard got up in the morning and dark when he returned from the lab. His neck was so fat he couldn’t button his shirt collars. The proof that lithium stabilized one’s mood was confirmed every time Leonard saw himself naked in the mirror and didn’t kill himself. He wanted to. He thought he had every right. But he couldn’t work up the requisite self-loathing.
This should have made him feel good, but feeling “good” was also out of reach. Both his highs and his lows were evened out, leaving him feeling as though he lived in two dimensions. He was on an increased daily dose of lithium, 1,800 milligrams, with correspondingly severe complications. When he complained to Dr. Perlmann at his weekly appointment at Mass General, an hour and a half away, the natty, shiny-headed psychiatrist always said the same thing: “Be patient.” Perlmann seemed more interested in Leonard’s life at Pilgrim Lake Lab than in the fact that his signature now looked like that of a ninety-year-old. Perlmann wanted to know what Dr. Malkiel was like. He wanted to hear gossip. If Leonard had stayed in Providence, under the care of Dr. Shieu, he would have already been on a lower dose, but now he was back to square one.
In the library at Pilgrim Lake, Leonard tried to learn more about the drug he was on. Reading at the pace of a second-grader, effectively moving his lips, Leonard learned that lithium salts had been used for mood disorders as far back as the nineteenth century. Then, largely because people couldn’t patent it to make money, the therapy had fallen out of favor. Lithium had been used to treat gout, hypertension, and heart disease. It had been the key ingredient in 7 Up (originally named Bib-Label Lithiated Lemon-Lime Soda) until the 1950s. At the moment, clinical trials were under way to test lithium’s efficacy in treating Huntington’s chorea, Tourette’s syndrome, migraine and cluster headache, Ménière’s disease, and hypokalemic periodic paralysis. The drug companies had it the wrong way around. Instead of starting with an illness and developing a drug to treat it, they developed drugs and then tried to figure out what they were good for.
What Leonard knew about lithium without reading was that it made him torpid and fuzzy-brained. His mouth was always dry, no matter how much he drank, and tasted as if he were sucking on a steel screw. One of the reasons he chewed tobacco was to cover the metallic taste. Due to the tremors in his hands, he had no coordination (he couldn’t play Ping-Pong, anymore, or even catch a ball). And, though all his doctors insisted that the lithium wasn’t at fault, Leonard’s sex drive was much reduced. He wasn’t impotent or unable to perform; he just didn’t have a lot of interest. Probably this had to do with how unattractive and prematurely old the drug made him feel. At the Provincetown pharmacy, Leonard went shopping not only for razor blades but also for Mylanta and Preparation H. He was always coming out of the drugstore clutching a little plastic bag, scared the bag’s transparency would reveal the embarrassing product inside, and so holding it even tighter against his little titties in the Cape Cod wind. Leonard patronized the P-town pharmacy in order to avoid the convenience store at the lab, where he ran the risk of running into someone he knew. To keep Madeleine