For most of my time in the hospital, I had done my very best to isolate myself from the other patients. I had spent as much time as possible at the far end of the long hall where the stereo was. I wanted to be near nothing but my music. When another patient came down the hall toward me, it was as if an enemy were invading my territory. Immediately, without even a word, I would pack up my tapes and leave the area, feeling that some peace had been taken from me.
As I got better, I began to share my stereo space more willingly. Other people ceased to feel like intruders. Something in me was growing that enabled me to reach across the air that separated us, and feel that we were all just people. I even began to be able to lend out some of my most precious possessions—my Walkman, my tapes, pretty pieces of clothing. Something in my brain was reaching outside itself, stretching away from the inner world of Voices and faces and toward the outer world of friends and family.
And gradually, I did begin to recognize other people as friends. As I got better and my status went up I was allowed to go to activities. I was offered a choice: I could go with a staff person, with an escorted group, with a fellow patient or by myself. These days I would wait for ten minutes for another patient to get ready so that we could both walk over together. I wasn't afraid to call other patients my friends.
I was even starting to take a more active role in the unit. I was elected secretary of patient government for 3 South. It wasn't a big deal. All the patient government did was handle things like plans for outings, or tie-dying T-shirts, or raising money for our activities. But to me it meant everything. Not only did it mean that I was taking on more responsibility, but it also meant something I never would have believed possible: People liked me and respected me.
I even switched roles a bit. No more running away for me. When one of my fellow patients confided in me that she planned to run, I tried to talk her out of it. When she did take advantage of an open door and tried to bolt, I ran after her, grabbed her and brought her back.
Slowly, old feelings began to unlock. My mind began to be able to distinguish myriad complex emotions where none had existed before. All the powerful feelings had always been there in my heart; it was as if there had been no spot in my brain to register them. My mind had been a slippery surface that only the most violent of emotions—fear, anger, hatred, fearsome love-—could puncture. Now that rock-hard glacial surface was melting, leaving scrabbly little footholds where feelings could take hold and grow. For years I had swung between powerful poles of emotions. I had hated Dr. Fischer. I had loved her. I feared her. I craved her. Torturing swings between two equally unacceptable poles. Only the work we had done together had kept me from being torn apart in those currents.
Now I was beginning to feel other things. My heart could feel other possibilities, and my mind could see that those other possibilities existed. I might like Dr. Fischer. I might look forward to seeing her. I might be annoyed with her. I might disagree with her. The gunk draining from my brain was unclogging whole areas of me that been petrified in poisonous resin for so long that I had forgotten they had ever existed. Our work together took on whole new possibilities.
But before we could take advantage of these possibilities, something happened. Dr. Fischer announced that she was leaving the hospital.
Leaving the hospital? All I heard was that she was leaving me. I knew she had been a postdoctoral fellow. I knew that it was her training she had been doing at New York Hospital, and that it wasn't a permanent post. But I had never realized that she would leave the hospital before I would. I had never thought of her leaving at all. She was so important to me. I needed her. How could she leave me?
We kept on meeting, kept on talking. She kept on advising me on my recovery.
“Go slow, Lori, go slow,” she said. She worried that I was growing too impatient to be well, too impatient to show progress. “We're moving at a snail's pace,” I complained.
“Then move like a wounded snail,” she said. “You'll only cause yourself problems if you try to move on to the next level before you've gotten used to this level.”
We talked about her departure. We talked about what it meant to me. All the old feelings came flooding back. She was leaving me because I was no good. She had finally gotten sick of me, just as everyone else had gotten sick of me. She was turning her back on me because I was a loser who would never leave the hospital. We talked about my feelings about myself, about her, about being abandoned, about—eventually—being on my own.
For the most part, we managed. She tried to get me to focus on the emerging subtle feelings, rather than the powerful, terrifying ones that used to engulf me. Don't turn those feelings back onto yourself, she said. Feel them. Feel the real feelings underneath. Feel that I would miss her. Feel that I would remember her. Feel that I would feel sad that she was gone.
But the closer and closer we came to her date of departure, the harder it became to hold on to the new feelings, and the more seductive the old ones became. The old feelings and patterns were still stronger than the new. I began avoiding her, refusing to come to sessions. Dodging her when I saw her. When I did manage to come to sessions, I would sit in stony-faced silence. I knew that one day we would say goodbye and that would be it. I didn't want that day to come. I wouldn't let her leave me. I would leave her first.
The thought gave me an idea. I would kill myself in honor of her leaving. I wanted to be special to her. How better to make myself special in her memory. If I killed myself just as she was leaving, she would never be able to forget me.
Proudly I brought my idea to Dr. Doller. She looked at me with a half smile on her face, her head tilted in her quizzical, listening pose.
“Lori,” she said. “No one could ever forget you—just the way you are.”
And for the first time, something in me heard her, and was proud. Maybe there was another way. Maybe I could make Dr. Fischer remember me by living, not by dying. Maybe I could make her remember me by being the best patient she ever had. By taking everything she had taught me and putting it into practice. Maybe I could make her not only remember me, but be proud of me.
Still, I faced the end of June with dread. I couldn't bear to see her go. And when, finally, we sat in her office—the office I had struggled so hard to be able even to enter—I couldn't picture never being able to come here again. She had been such a big part of my life for so long. She had come so close to me, done so much to save me. I didn't want to die for her anymore, but how could I live without her? We agreed that we would exchange letters for as long as I wanted to. Finally I could no longer hold on, and tears spilled out over my cheeks. This was it.
We walked back to the unit in silence. As we approached the door where we would finally part, she turned to me.
“Would you like a goodbye hug or a goodbye handshake?” Before she could offer her hand I grabbed her. I gave her the biggest, most heartwarming hug I could muster. It was nothing at all like all the fantasies that had been brewing in my mind all these years. It was nothing like the kinds of hugs the torturing Voices had urged on me in sessions. It was normal. It was friendly. It was a warm, kindly, enveloping bear hug. And then she was gone.
Who would fill the place in my life that Dr. Diane Fischer had left behind? Even Dr. Doller somehow didn't seem enough. But still, where else would I turn? I was hurting so badly I had to talk with someone. Later on that afternoon I met with Dr. Doller. I cried out my pain and loss, trying to explain to her just how big a hole in my long days Dr. Fischer was leaving behind. But as I spoke I realized that while I had lost a friend, I had not lost my only friend. I looked up at Dr. Doller and saw that she had tears in her eyes too.
Gradually my daily life in the hospital changed. My room had furniture in it again. They had taken it away to reduce my stimulation. Now it was back. I could put my things in my dresser and offer a chair to my guests just like any other patient. The bodyguards were gone. No one was stationed outside my room. No one accompanied me to the bathroom. No
more room-care plans, eating solitary meals on solitary trays in my solitary room. I was getting up, getting dressed and going down to the cafeteria to eat with everyone else.
There was no discussion of my being discharged immediately. I was doing well, but no one wanted to jeopardize it by letting me go too soon. I needed to make sure my medication was at a therapeutic level before I left. I still needed other medication for my other symptoms. After I had been on clozapine for a while, Dr. Doller put me back on lithium and slowly my moods began to stabilize.
Many times I got frustrated by the slow pace. “I want to get out of here now!” I announced to Dr. Doller over and over again. “I'll go live with Steven,” I announced. “I don't care if Mom and Dad are mad. I'll get a job delivering flyers in the city. I'll make it on my own.” But the feeling passed. The clozapine continued its work.
I had no idea how the medication worked. Was it plugging up some hole in my brain that had let all my normal thoughts leak out? Was it going in there like a drill, drilling out some boulder, clearing a path for my real, hidden self to emerge? Was it evaporating the food in my brain that the Voices had lived on? Was it starving the Voices out, leaving nothing but me behind? I didn't know a thing. All I knew was that whatever it was doing, it was helping me feel like a real human being again, a human being who existed in the world with other human beings.
I didn't need to strike out as much anymore. Now, instead of smashing windows, I wrote in my journals a list of the things I found stressful:
pass for a haircut
weekend passes
Dr. Doller on vacation
activities
Dr. Fischer leaving
new therapist?
weight
discharge pending
As much as I hated the slow pace of the discharge, I welcomed it too. As much as I wanted to be discharged, I found the prospect frightening. I knew I was getting better, but I was afraid to test it. I was afraid of being expected to act normal. I was afraid of becoming too stressed out and relapsing.
Still, I stayed with the program. Underneath all the fear I wanted desperately to be better. I wanted desperately to be free. I wanted desperately to begin the life that had been denied to me for so long. There was so much to do before that could happen. For one thing, I needed a therapist. After Dr. Fischer left, people made a number of suggestions. There was a private practitioner in White Plains who might do. There was a doctor Dr. Doller knew. But there was only one person I wanted. When Dr. Doller agreed to be my therapist, I knew I was going to make it.
Next task was to find somewhere to live. Earlier I had rejected a halfway house when my parents and Dr. Doller suggested it. After clozapine it was different. I began to believe that a normal life was possible. And so I agreed to enter a halfway house. In September I had an interview at Search for Change. The last time I had left the hospital I had rejected Search for Change because there was a rumor of a mouse there. This time I wasn't going to let a rodent stop me. This was the place that was going to help me get back into the world again.
Even more than in my last hospitalization, I needed to adjust to doing things on my own. It had been over two years since I last had walked around freely.
Little by little I ventured further and further afield. I walked by myself to the dentist on Mamaroneck Avenue in White Plains. I took another trip into town to get my hair cut. I went with another patient to eat Chinese food. Each trip out caused me anxiety. Just keeping a good hold on myself was an effort. Sometimes I had to take some medication to keep the jittery feelings under control. But each time I went out, I got a little more used to it, and it became a little easier.
I was also coming home regularly, staying with my parents, going shopping with my mom, going out to eat with my dad. I was also getting my things ready for my big move. On one weekend home with my mother, I was going through all my things stored in the attic of our house. Among my old books and papers, my college records and memorabilia, I found my old copy of Helter Skelter, the story of Charles Manson's murderous cult. I threw it straight in the wastebasket. His evil eyes would never torture me again.
In the hospital, keys made the sounds of freedom and control. When I was at my sickest, I heard the sound of keys coming down the hall and knew to stop whatever it was I was doing. If I was ripping up dollar bills, I would stop immediately. If I was fiddling with something to use later to hurt myself, I would hide it.
The best key of all was the 9925 key. It was the universal passkey to all the doors on and off the units, to the nursing station, the pantry, the therapeutic activities building—even the Quiet Room. It was the key that Dr. Rockland and Dr. Doller and Dr. Fischer and all the staffers used to come and go from the unit. Patients never touched that key. That key was power. It was the key that opened the locked doors that stood between me and freedom.
Freedom meant loss. In a strange way I had even become fond of this seemingly terrible place. After all, it had been my home for—altogether—nearly four years. I knew the way my bed felt. I knew when the heat came on, and how the place felt in the morning. I knew the times of day when you woke up. I knew when and where to line up for my medication.
I thought about leaving behind all this security. The rules and procedures that had been so foreign to me so many years ago when I had first entered the hospital were second-nature to me now. I was used to community meetings, used to the system of asking for passes. I knew what food was served in the dining room, and how to get seconds and find secret hiding places for the things I liked best.
I knew I was going to miss the staff. Some of them had followed me through all three of my hospitalizations. I thought about the staff who had stood by me, encouraging me. I thought about J.J. and Margo and Jean, who had been with me through the worst. I thought about Rose, who had been my pal. I thought about Barbara, who had given me poems and notes urging me not to give up. Most of all, I thought about Sorin. How was I going to make it without Sorin there behind me? I had a fleeting moment of fear. It passed. I would make it. I would make them all proud of me. I would show them all what I had learned. I would show them all I could make it.
On my last day I was quiet, withdrawn. All the feelings inside me were so hard to control. Quietly and without much comment, I said goodbye to each one, giving each a little gift to remember me by. And then they gave me a gift too. They handed me the 9925 key.
On November 6, 1989, I opened the door to the outside world all by myself, and left the hospital forever.
Epilogue
Lori Hartsdale, New York, 1994
Today when I walk through the doors of New York Hospital, I do so not as a patient but as a teacher. When I walk through the entrance, I might be wearing a stylish linen jacket, slacks, boots and hoop earrings—not baggy warmup suits.
On weekends I work part-time in a gift shop. This isn't a hospital gift shop selling newspapers, candy, gum and flowers for patients. It's a funky place called What's What, selling everything from stuffed animals to designer handbags to mirrors that laugh when you look at them. I enjoy helping people pick out gifts and making neat corners when wrapping packages. I've even worked full-time as a counselor in a halfway house—the same kind of place I lived myself just a few short years ago.
These days I don't live in a bare room with the furniture removed, or even in a community residence anymore. I remember well the day just over a year ago when I moved into my own apartment. After my friends from the halfway house had lugged up the last box and left me alone in my new home, I sat down on the parquet floors. I just looked around me in dazed happiness. I couldn't quite believe I was here at last.
The apartment I live in today is a beautiful place, filled with furniture I picked out by myself, and with food I like in the refrigerator. All kinds of little things about my new life please me. My desk. My floor lamp from South Africa. My fax machine. The fancy tea kettle I keep ready for company. The shower curtain covered with bright-colored fishes. My limited edition anim
ated cartoon art. It's all mine. If I break a mug, it's my mug. I can keep everything neat and clean just as I want it. I can walk around the house in my underwear if I want. The message on my answering machine is my own.
And of course, there's the door. A regular, ordinary front door that opens and closes with a key I keep in my purse. Anytime I want to leave, I do. Anytime I want to go someplace, I drive myself there. I don't need to ask anyone's permission, I don't need to sign out. At last, my life is my own.
I teach three classes at New York Hospital each month. One is for patients and their families on what it feels like to experience schizophrenia. The other is about clozapine. The third is on how to stay well after discharge.
Who would better know than I? For today, four plus years after I left the hospital for the last time, it is I who am in control of my illness and not the other way around.
It's been a long road here.
I spent three and a half years in a halfway house called Search for Change. I had a lot to change. I had a lot of learning to do. After a total of three and a half years in the hospital, I had learned well how to be a patient. I had to learn to be a functioning person out in the real world. Every day I went back to New York Hospital to the day program, which was designed to help former patients make the transition between the hospital and real life. We showed up there as if to a regular job, signed in, took a lunch break and went home at the end of the day. Attendance was mandatory. We had three personal days off and two weeks’ vacation.
We used one another and our counselors to practice behaving normally. At times these groups were so intense that people stormed out in tears. I sometimes was so confused and threatened that I came across as hostile. Gradually, I began taking account of the feedback people were giving me, and started modifying my behavior.