The Marriage Plot - Jeffrey Eugenides [132]
Leonard was a “self-admit,” meaning that he could leave anytime he wanted. He’d signed a consent form, however, agreeing to give the hospital twenty-four-hour notice before doing so. He consented to be given medications, to abide by the rules of the unit, to uphold standards of cleanliness and hygiene. He signed whatever they put in front of him. Once a week, he was allowed to shave. A nurse’s aid brought him a disposable razor, standing by while he used it, and then took it back. They kept him on a strict schedule, getting him up at six a.m. for breakfast and ushering him through a series of daily activities, therapy, group therapy, crafts class, more group therapy, gym, before visiting hours in the afternoon. Lights were out at nine p.m.
Every day, Dr. Shieu stopped by to talk. Shieu was a small woman with papery skin and an alert demeanor. She seemed interested mainly in one thing: whether Leonard was suicidal or not.
“Good morning, Leonard, how are you feeling today?”
“Exhausted. Depressed.”
“Are you feeling suicidal?”
“Not actively.”
“Is that a joke?”
“No.”
“Any plans?”
“Excuse me?”
“Are you planning to harm yourself? Fantasizing about it? Going over scenarios in your head?”
“No.”
Manic-depressives, it turned out, were at a higher risk for suicide than depressives. Dr. Shieu’s number one priority was to keep her patients alive. Her second priority was to get them well enough to leave the hospital before their insurance benefits ran out in thirty days. Her pursuit of these objectives (which ironically mimicked the tunnel vision of mania itself) led to a strong reliance on drug therapy. She automatically placed schizophrenic patients on Thorazine, a drug people likened to a “chemical lobotomy.” Everyone else received sedatives and mood stabilizers. Leonard spent his morning therapy sessions with the psychiatric resident discussing all the stuff he, Leonard, was on. How was he “tolerating” the valium? Was it making him nauseated? Constipated? Yes. Thorazine could cause tardive dyskinesia (repetitive motions, often involving the mouth and lips), but this was often temporary. The resident prescribed additional medications to counteract Leonard’s side effects and, without asking him how he was feeling, sent him on his way.
The clinical psychologist, Wendy Neuman, was at least interested in Leonard’s emotional history, but he saw her only for group therapy. Gathered in the folding chairs of the meeting room, they made a diverse group with the drug-addicted, a perfect democracy of collapse. There were older white guys with M.I.A. tattoos and black dudes who played chess all day, a middle-aged female accounts clerk who drank as much as an English rugby team, and one small young woman, an aspiring singer, whose mental illness took the form of a desire to have her right leg amputated. To stimulate discussion, they passed a book around, a battered hardback with a split spine. The book was called Out of Darkness, Light and contained personal testimonies of people who had recovered from mental illnesses or had learned to cope with a chronic diagnosis. It was borderline religious while professing not to be. They sat in the unkind fluorescence of the meeting room, each reading a paragraph aloud before handing it to the next person. Some people treated the book as if it were a mysterious object. They mispronounced deity. They didn’t know what cur meant. The book was badly out of date. Some contributors referred to depression as “the blues” or “the black dog.” When the book came to him, Leonard read off his paragraph with a cadence and diction that made it clear he’d come to the hospital straight from College Hill. He was under the impression, those first days, that mental illness admitted of hierarchy, that he was a superior form of manic-depressive. If dealing with a mental illness consisted of two parts, one part medication and the other therapy, and if therapy proceeded faster the smarter you were, then many people in the group were at a disadvantage. They could barely remember what had happened in